2013-08-14T17:00:04-05:00 2012-09-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2011-10-01 362170866 THE INGALLS MEMORIAL HOSPITAL INGA 7083332300 One Ingalls Drive Harvey IL 60426 ANDREW STEFO 2013-08-13 true John Woodhull P01305268 3128997000 2011 2016-02-24 21:20:13Z KURT E JOHNSON One Ingalls Drive Harvey IL 60426 334348992 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 PROVIDED WERE AS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. 17 16 3230 270 469585 0 1532151 1126202 290100144 302199111 13586044 28585473 3597127 1921309 308815466 333832095 0 149694 0 0 130073795 124039341 0 0 0 157788514 174480747 287862309 298669782 20953157 35162313 404099667 448366287 185429927 192632889 218669740 255733398 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 238884043 149694 301747218 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. 27449000 CHARITY CARE: THE INGALLS MEMORIAL HOSPITAL (IMH) PROVIDES FREE AND DISCOUNTED SERVICES TO THE UNINSURED AND UNDERINSURED. CHARITY CARE SERVICES ARE MADE AVAILABLE TO PATIENTS WHO ARE DETERMINED TO BE MEDICALLY INDIGENT. ELIGIBILITY FOR CHARITY CARE IS DETERMINED BY INCOME. IMH USES THE FEDERAL POVERTY INCOME GUIDELINES THAT ARE PUBLISHED AND UPDATED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES IN DETERMINING WHO SHOULD RECEIVE CHARITY CARE AND WHO SHOULDN'T. DURING THE YEAR CHARITY CARE SERVICES PROVIDED WERE AS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENT. 341743 1191877 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. 266674786 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 true false true true false false false false false false false false false false false false false false false true true true false false true 285 0 true 3230 true true true false false false false false false false false false X 17 16 false false false false true true true true true false false true true true true true true true false false IL X Andrew Stefo 7083332300 ONE INGALLS DRIVE Harvey IL 60426 X EUGENE M FEINGOLD 1.00 X X 0 0 0 KURT E JOHNSON 40.00 X X 1443678 0 66256 RICHARD M KING 1.00 X X 0 0 0 ROBERT G VELO 1.00 X X 0 0 0 DAVID H ORTH MD 1.00 X 0 0 0 DENNIS J IRVIN 1.00 X 0 0 0 HENRY K JOHNSON 1.00 X 0 0 0 KEVIN PURCELL 1.00 X 0 0 0 LYNDELL S BECKHAM 1.00 X 0 0 0 MARK KOZLOFF MD 1.00 X 0 0 0 MICHAEL BUSH 1.00 X 0 0 0 MICHAEL P KAMRADT 1.00 X 0 0 0 NATHANIEL K SUTTON 1.00 X 0 0 0 NEAL E KITCHELL 1.00 X 0 0 0 ROBERT L HARRIS 1.00 X 0 0 0 ROBERT TOPEL 1.00 X 0 0 0 SAMUEL J CUTRARA JR CPA 1.00 X 0 0 0 ANDREW STEFO 40.00 X 634660 0 59151 DIANE JACOBY 40.00 X 555708 0 68209 DOROTHY GRZADZINSKI 1.00 X 439910 0 41711 JOSEPH MOSER 1.00 X 396177 0 42861 KATHLEEN MIKOS RN MSN 40.00 X 456960 0 66098 MICHAEL HICKS 40.00 X 339903 0 60518 SCOTT C STRAUSSER 40.00 X 493325 0 49474 ALETHA ROSS 40.00 X 316873 0 25049 CHRISTINE SALVATOR 40.00 X 193580 0 17765 KISHA N CULBREATH LEAR 40.00 X 186222 0 25828 LAWRENCE KLONOWSKI 40.00 X 187199 0 22086 MICHAEL J DEVORE 40.00 X 253006 0 3512 5897201 0 548518 76 true true false ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 60673 CONTRACT FOOD, PLANT, AND HOUSEKEEPING SERVICES 18646829 AMERISOURCEBERGEN 1001 W TAYLOR ROAD ROMEOVILLE IL 60446 PHARMACEUTICAL VENDOR 11870164 SIEMENS MEDICAL SOLUTIONS C/O MELLON BANK DEPT CH 14195 PALATINE IL 600554195 INFORMATION SYSTEM OUTSOURCING 6768466 OWENS AND MINOR BANK OF AMERICA 12199 COLLECTION DR CHICAGO IL 60693 MEDICAL SUPPLIES 6270932 SYNERGY BEHAVIORAL HEALTHCARE 1566 W ALGONQUIN ROAD 149 HOFFMAN ESTATES IL 60192 IN PT AND OUT PT PSYCHIATRIC SERVICES 4443568 215 973990 76448 75764 1126202 NET PATIENT SERVICE REVENUE 900099 293311456 293311456 RENTAL INCOME 900099 1857117 1857117 CLIENT SERVICE REVENUE 900099 1164028 1164028 LAB SERVICES 621500 1099698 630113 469585 MEDIC TRAINING 900099 276899 276899 4489913 4489913 0 0 302199111 1871310 1871310 0 0 1084704 516897 567807 0 567807 567807 26714163 26714163 0 26714163 26714163 0 0 0 EXPENSE REIMBURSEMENT AND MGMT FEE 900099 736203 736203 PARKING INCOME 900099 59713 59713 CHILD CARE CENTER 900099 557586 557586 0 0 0 0 1353502 333832095 302525442 469585 29710866 149694 149694 0 0 0 5214599 5214599 0 98789814 89211307 9578507 2959547 2686981 272566 9403147 8537144 866003 7672234 6965643 706591 7097899 7097899 117509 1216 116293 310548 310548 0 0 874314 874314 51898448 43985535 7912913 0 3258699 2923095 335604 0 0 351050 226754 124296 476910 397604 79306 0 0 3244164 2671569 572595 0 15699223 13813746 1885477 6401411 5868272 533139 SUPPLIES 41995380 41661054 334326 BAD DEBT 26666211 26666211 PUBLIC AID ASSESSMENT 9954627 9954627 LAUNDRY 1303501 1303501 4830853 4436234 394619 0 298669782 266674786 31994996 0 0 665157 3357061 40026323 46929600 4701560 5261618 4463490 3666360 450156672 276627355 163648232 173529317 181193649 205232259 0 0 1499348 3793189 431723 388432 7470185 6208451 404099667 448366287 43300508 55919833 120004961 115230349 22124458 21482707 185429927 192632889 X 214682800 251575523 3986940 4157875 218669740 255733398 404099667 448366287 X 35162313 1901345 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7066 7066 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 METROPOLITAN CHICAGO HEALTHCARE COUNCIL ARE USED FOR LOBBYING ACTIVITIES. 304242 304242 226427805 129791442 96636363 12079118 8766451 3312667 180321865 138069462 42252403 31023642 31023642 173529317 0 TENDER PREMIUM PAYABLE 14214341 OTHER LONG TERM PAYABLES 7268366 21482707 333832095 298669782 35162313 2849303 -947957 1901346 37063659 334859127 2849303 0 2849303 332009824 874314 947957 1822271 333832095 297795468 0 0 297795468 874314 0 874314 298669782 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE SYSTEM HAS ADOPTED ASC SUBTOPIC 740-10, INCOME TAXES, 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 FIFTY PERCENT 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, 2011 AND 2010, THE SYSTEM DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. Other changes in net assets Schedule D, Part XI, Line 8 INTEREST RATE SWAP VALUATION - -229392; NET ASSETS RELEASED FROM RESTRICTION FOR OPERATION - -718565; Other revenues in form 990 not in audited financial statements Schedule D, Part XII, Line 4b INTEREST RATE SWAP VALUATION - 229392; NET ASSETS RELEASED FROM RESTRICTION FOR OPERATION - 718565; true true X true X false true true false true true 6404583 0 6404583 0.02360 53907064 42025594 11881470 0.04370 0 0.00000 0 0 60311647 42025594 18286053 0.06730 54398 0 54398 0.00020 420966 276899 144067 0.00050 0 0.00000 0 0.00000 455252 0 455252 0.00170 0 0 930616 276899 653717 0.00240 0 0 61242263 42302493 18939770 0.06970 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 19666864 11652617 109270215 109154947 115268 X true true 1 1 INGALLS MEMORIAL HOSPITAL

ONE INGALLS DRIVE HARVEY IL 60426

X X X INGALLS MEMORIAL HOSPITAL 1 true true 200 false true X true true 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-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 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, BUT DOES USE THE FPG GUIDLINES TO DETERMINE FREE CARE. INGALLS' ONLY DETERMINATION OF ELIGIBILITY OF CHARITY CARE IS MEASURED BY FAMILY INCOME AGAINST THE FEDERAL INCOME POVERTY GUIDELINES. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 26,666,211 Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 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. 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. Used FPG to determine eligibility for providing discounted care criteria Schedule H, Part V Section B, Line 10 (1) INGALLS MEMORIAL HOSPITAL - THE HOSPITAL PROVIDES A 65% DISCOUNT OFF GROSS CHARGES FOR ALL UNINSURED PATIENTS. ; Needs assessment. Schedule H, Part VI, Line 2 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. 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 $31,013, AND THE MEDIAN INCOME FOR A FAMILY WAS $36,284. ABOUT 26.1% OF FAMILIES AND 31.5% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 45.9% OF THOSE UNDER AGE 18 AND 11% OF THOSE AGE 65 OR OVER. THE INFORMATION ABOVE WAS OBTAINED FROM THE UNITED STATES CENSUS BUREAU. HTTP//FACTFINDER.CENSUS.GOV. 2009 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 ROUND 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. 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 false INGALLS DEVELOPMENT FOUNDATION ONE INGALLS DRIVE HARVEY IL 60426 363189150 501(C)(3) 149694 GENERAL OPERATIONS 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 GRANTS ARE PROVIDED TO A RELATED ORGANIZATION, INGALLS DEVELOPMENT FOUNDATION, SO FORMAL MONITORING OF THE GRANT FUNDS IS NOT NEEDED. X X X X false false false false false false false false false MICHAEL J DEVORE 214584 0 32250 0 6172 0 2150 0 1362 0 256518 0 0 0 ALETHA ROSS 222860 0 91377 0 2636 0 7498 0 17551 0 341922 0 0 0 ANDREW STEFO 454992 0 172601 0 7067 0 40950 0 18201 0 693811 0 0 0 LAWRENCE KLONOWSKI 180476 0 0 0 6723 0 7177 0 14909 0 209285 0 0 0 KISHA N CULBREATH LEAR 186017 0 0 0 205 0 7888 0 17940 0 212050 0 0 0 CHRISTINE SALVATOR 192485 0 0 0 1095 0 7888 0 9877 0 211345 0 0 0 DOROTHY GRZADZINSKI 333524 0 102129 0 4257 0 32163 0 9548 0 481621 0 0 0 JOSEPH MOSER 268766 0 124935 0 2476 0 41861 0 1000 0 439038 0 0 0 MICHAEL HICKS 236879 0 100934 0 2090 0 41017 0 19501 0 400421 0 0 0 SCOTT C STRAUSSER 365149 0 123669 0 4507 0 26723 0 22751 0 542799 0 0 0 DIANE JACOBY 405418 0 145949 0 4341 0 48658 0 19551 0 623917 0 0 0 KATHLEEN MIKOS RN MSN 325427 0 123908 0 7625 0 48547 0 17551 0 523058 0 0 0 KURT E JOHNSON 1057720 0 375300 0 10658 0 48705 0 17551 0 1509934 0 0 0 ILLINOIS FINANCE AUTHORITY 861091967 45200BHK7 2007-11-16 48000000 REFUNDING OF 2004 BONDS false false false 0 0 48000000 0 0 0 811990 0 0 48000000 0 0 2004 true false true true false false false false 0.0000 0.0000 0.0000 true false true true MERRILL LYNCH 29.5 false false false false false X 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, 2011, CHARITY CARE SERVICES PROVIDED WAS APPROXIMATELY $26,435,000, 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 establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE ORGANIZATION ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IN DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. 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 SET BY THE DIRECTOR OR MANAGER AND SUBMITTED TO THE VICE PRESIDENT FOR APPROVAL. APPROVED GOALS ARE REVIEWED BY THE EXECUTIVE TEAM. THE PERFORMANCE GOALS ARE COMPARED TO PERFORMANCE AND ASSESSED AS COMPLETED OR NOT COMPLETED BY HUMAN RESOURCES 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. AVERAGE HOURS PER WEEK TO RELATED ORGANIZATION FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) KURT E. JOHNSON, PRESIDENT AND CEO, ANDREW STEFO, VP - FINANCE AND CFO, AND DIANE JACOBY, GENERAL COUNSEL, DEVOTE TIME TO THE FOLLOWING RELATED TAX-EXEMPT ORGANIZATIONS: *THE INGALLS MEMORIAL HOSPITAL (IMH) *INGALLS HEALTH SYSTEM (IHS) *INGALLS DEVELOPMENT FOUNDATION (IDF) *INGALLS HOME CARE (IHC) *IHS EMPLOYEE BENEFIT TRUST (EBT) *INGALLS HEALTH VENTURES (IHV) JOSEPH M. MOSER, VP - DEVELOPMENT FOUNDATION, DEVOTES APPROXIMATELY 40 HOURS A WEEK TO INGALLS DEVELOPMENT FOUNDATION, A RELATED TAX-EXEMPT ORGANIZATION. SCOTT C. STRAUSSER, VP - BUSINESS DEVELOPMENT, DEVOTES APPROXIMATELY 1 HOUR A WEEK TO INGALLS HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION. 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. Other changes in net assets or fund balances Form 990, Part XI, Line 5 NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 2849303; INTEREST RATE SWAP VALUATION - -229392; NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATIONS - -718565; ROUNDING - -1; INGALLS DEVELOPMENT FOUNDATION ONE INGALLS DRIVE HARVEY IL 60426 363189150 SUPPORT IL 501(C)(3) 7 IHS false INGALLS HOME CARE ONE INGALLS DRIVE HARVEY IL 60426 363367939 HEALTHCARE IL 501(C)(3) 9 IMH true INGALLS HEALTH SYSTEM ONE INGALLS DRIVE HARVEY IL 60426 363181170 MANAGEMENT IL 501(C)(3) 11 - Type I NA false INGALLS HEALTH VENTURES ONE INGALLS DRIVE HARVEY IL 60426 363239703 AMBULATORY IL 501(C)(3) 3 IHS false IHS EMPLOYEE BENEFIT TRUST ONE INGALLS DRIVE HARVEY IL 60426 363581617 BENEFITS IL 501(C)(9) N/A NA PRIMARY HEALTHCARE ASSOCIATES SC 71 W 156TH STREET HARVEY IL 60426 364132865 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 IHV N/A 0 0 false 0 false INGALLS PROVIDER GROUP ONE INGALLS DRIVE HARVEY IL 60426 363485578 INSURANCE SERVICE IL NA C CORPORATION 0 6407532 1 MEDCENTRIX INC ONE INGALLS DRIVE HARVEY IL 60426 363374228 BILLING & MGMT IL IHS C CORPORATION 0 INGALLS CASUALTY INSURANCE LTD ONE INGALLS DRIVE HARVEY IL 60426 980485714 LIAB INSURANCE CJ IHS C CORPORATION 0 INGALLS HEALTH COUNCIL ONE INGALLS DRIVE HARVEY IL 60426 273226539 PURCHASING GROUP IL IHS C CORPORATION 0 true false true false false false false false false false false false true true true true true true INGALLS HOME CARE N 88285 FMV INGALLS HOME CARE A 84000 FMV