2014-05-01T15:00:45-05:00 2013-09-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2012-10-01 362170866 THE INGALLS MEMORIAL HOSPITAL INGA 7083332300 One Ingalls Drive Harvey IL 60426 ANDREW STEFO 2014-04-18 true John V Woodhull P01305268 3128997000 2012 2015-11-30 17:44:51Z KURT E JOHNSON One Ingalls Drive Harvey IL 60426 300436899 false X WWW.INGALLS.ORG X 1922 IL 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. 16 15 2952 246 1186877 0 1126202 1170993 302199111 288962537 28585473 7763738 1921309 2000885 333832095 299898153 149694 0 0 0 124039341 122486619 0 0 0 174480747 159409256 298669782 281895875 35162313 18002278 448366287 505309486 192632889 210470089 255733398 294839397 X 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) false false 281579555 287468343 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. 316320 1044060 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. 281895875 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 373 0 true 2952 true true true false false false false false false false false false X 16 15 false false false false true true true true true false false true true true true true true false false false IL X Andrew Stefo 7083332300 ONE INGALLS DRIVE Harvey IL 60426 X EUGENE M FEINGOLD 1.00 3.00 X X 0 0 0 KURT E JOHNSON 40.00 5.00 X X 1618535 0 38291 RICHARD M KING 1.00 2.00 X X 0 0 0 ROBERT G VELO 1.00 3.00 X X 0 0 0 DAVID H ORTH MD 1.00 2.00 X 0 0 0 DENNIS J IRVIN 1.00 1.00 X 0 0 0 HEATHER DAVIS 1.00 1.00 X 0 0 0 HENRY K JOHNSON 1.00 1.00 X 0 0 0 KEVIN PURCELL 1.00 1.00 X 0 0 0 LYNDELL S BECKHAM 1.00 1.00 X 0 0 0 MARK KOZLOFF MD 1.00 2.00 X 0 0 0 MICHAEL P KAMRADT 1.00 1.00 X 0 0 0 NATHANIEL K SUTTON 1.00 1.00 X 0 0 0 NEAL E KITCHELL 1.00 1.00 X 0 0 0 ROBERT L HARRIS 1.00 1.00 X 0 0 0 SAMUEL J CUTRARA JR CPA 1.00 1.00 X 0 0 0 ANDREW K STEFO 40.00 5.00 X 710780 0 49316 DIANE JACOBY 40.00 4.00 X 618790 0 38291 ALETHA ROSS 40.00 0 X 368297 0 37811 JOSEPH M MOSER 1.00 40.00 X 397825 0 10847 KATHLEEN MIKOS RN MSN 40.00 0 X 516660 0 30922 MICHAEL HICKS 40.00 0 X 369363 0 42171 SCOTT C STRAUSSER 40.00 0 X 557228 0 150866 DR ROBERT J DUPUIS 40.00 0 X 261642 0 17722 HEIDI L RUHE 40.00 0 X 175316 0 39510 LAWRENCE KLONOWSKI 40.00 0 X 190162 0 7770 LINDA B CONWAY 40.00 0 X 171611 0 10279 MARY JO CRANDALL 40.00 0 X 185237 0 5770 MICHAEL J DEVORE 40.00 0 X 274733 0 17629 6416179 0 497194 104 false true false 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 182 X 1085256 85737 1170993 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 9046427 9046427 0 0 288962537 1127352 1127352 0 0 1080096 538746 541350 0 541350 541350 6636386 6636386 0 6636386 6636386 0 0 0 EXPENSE REIMBURSEMENT AND MGMT FEE 900099 736743 736743 PARKING INCOME 900099 109930 0 109930 CHILD CARE CENTER 900099 612862 0 612862 0 0 0 0 1459535 299898153 288512403 1186877 9027880 0 0 0 0 5901897 5901897 0 97013340 87607077 9406263 3028336 2749435 278901 9016403 8186018 830385 7526643 6833461 693182 8208123 8208123 143274 1483 141791 180000 180000 0 0 1459578 1459578 45786708 36717896 9068812 0 0 1676018 1503410 172608 9723877 9723877 0 833024 538076 294948 684566 570729 113837 0 0 4544013 3741995 802018 0 16118226 14182427 1935799 8616617 7898985 717632 SUPPLIES/MISC EXPENSES 50147009 49082003 1065006 GIFT SHOP/MEDICAL STAFF OFFICE 352081 0 352081 PUBLIC AID ASSESSMENT 9933451 9933451 LAUNDRY 1002691 1002691 0 0 0 0 281895875 236451034 45444841 0 0 3357061 22686922 46929600 39347558 0 0 5261618 5159392 3666360 4102134 467743046 292742526 173529317 175000520 205232259 245574250 0 0 3793189 3647850 388432 741880 6208451 9048980 448366287 505309486 55919833 51811205 297170 115230349 142315083 0 21482707 16046631 192632889 210470089 X 251575523 290403537 4157875 4435860 255733398 294839397 448366287 505309486 X 18002278 16540669 4563052 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 22535 22535 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 A PORTION OF THE DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION AND METROPOLITAN CHICAGO HEALTHCARE COUNCIL ARE USED FOR LOBBYING ACTIVITIES. 304243 304243 250532585 135661762 114870823 12211665 9265460 2946205 183883537 147815304 36068233 20811016 20811016 175000520 466804 TENDER PREMIUM PAYABLE (SWAP VALUATION PAYABLE) 8208180 OTHER LONG TERM PAYABLES 7371647 16046631 X FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 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. true true X true X false true true false true true 6097087 0 6097087 0.02160 40057237 30431817 9625420 0.03420 0 0.00000 0 0 46154324 30431817 15722507 0.05580 344206 0 344206 0.00120 406303 208103 198200 0.00070 0 0.00000 0 0.00000 882152 882152 0.00310 0 0 1632661 208103 1424558 0.00500 0 0 47786985 30639920 17147065 0.06080 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 28722319 17017974 110017772 108750038 1267734 X true true 1 1 INGALLS MEMORIAL HOSPITAL

ONE INGALLS DRIVE HARVEY IL 60426

WWW.INGALLS.ORG X X X INGALLS MEMORIAL HOSPITAL 1 true X X X X X X X X X 12 true false true X X X X X X X X X X true false true true 200 false true X X X X true true X X X X X X true false X X X X true X false false 9 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 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 X X X X false false false false false false false false false ALETHA ROSS 241158 0 125000 0 2139 0 9895 0 27916 0 406108 0 0 0 ANDREW K STEFO 463749 0 225000 0 22031 0 10375 0 38941 0 760096 0 0 0 DIANE JACOBY 414724 0 184375 0 19691 0 10375 0 27916 0 657081 0 0 0 DR ROBERT J DUPUIS 184829 0 75000 0 1813 0 10375 0 7347 0 279364 0 0 0 HEIDI L RUHE 132912 0 41796 0 609 0 7348 0 32162 0 214826 0 0 0 JOSEPH M MOSER 262436 0 116850 0 18539 0 10097 0 750 0 408672 0 0 0 KATHLEEN MIKOS RN MSN 332129 0 162500 0 22031 0 10375 0 20547 0 547582 0 0 0 KURT E JOHNSON 1084857 0 493594 0 40084 0 10375 0 27916 0 1656826 0 0 0 LAWRENCE KLONOWSKI 183091 0 0 0 7071 0 7770 0 0 0 197933 0 0 0 LINDA B CONWAY 169854 0 0 0 1757 0 7113 0 3166 0 181890 0 0 0 MARY JO CRANDALL 153734 0 30792 0 711 0 5770 0 0 0 191007 0 0 0 MICHAEL HICKS 228812 0 122188 0 18363 0 9837 0 32334 0 411534 0 0 0 MICHAEL J DEVORE 216964 0 51400 0 6369 0 2150 0 15479 0 292361 0 0 0 SCOTT C STRAUSSER 371912 0 165625 0 19691 0 107375 0 43491 0 708094 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45200BHK7 2007-11-16 48000000 REFUNDING OF 11/10/2004 BOND ISSUANCE false false false B ILLINOIS FINANCE AUTHORITY 861091967 45203HPE6 2013-02-06 61860000 REFUNDING OF 7/19/1994 BOND ISSUANCE; CAPITAL PROJECTS false false false 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 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 A false false false true true true MERRILL LYNCH 29.5 false false false 0 false false false B false true false false false false 0.0 false false false 0.0 false false false A false B false 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. 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; 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 INGALLS SAME DAY SURGERY CENTER LTD 6701 W 159TH STREET TINLEY PARK IL 60477 363368549 SURGERY CENTER IL NA N/A 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 CJ NA C CORPORATION INGALLS HEALTH COUNCIL ONE INGALLS DRIVE HARVEY IL 60426 273226539 PURCHASING GROUP IL NA C CORPORATION true false true false false false false false false false false false true true true true true true true INGALLS HOME CARE A 84000 FMV