GOTTLIEB MEMORIAL HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- GOTTLIEB MEMORIAL HOSPITAL (EIN 36-2379649)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-16
- IRS object ID
- 201201379349301250
- Schema version
- 2010v3.2
- 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 F
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-16T11:02:26-07:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362379649 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gottlieb Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOTT | NameControl |
| Phone | 7084504966 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W North Ave | AddressLine1 |
| City | Melrose Park | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Ellyn Chin | Name |
| Title | VP of Finance | Title |
| Date Signed | 2012-05-16 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 129945342 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.gottliebhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | Gottlieb Memorial Hospital is dedicated to providing superior health-care to improve the overall health of all we serve. Individuals within our communities are provided access to medically necessary care regardless of their ability to pay. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 23 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1330 | TotalNbrEmployees |
| Total Nbr Volunteers | 191 | TotalNbrVolunteers |
| Total Gross UBI | 3035095 | TotalGrossUBI |
| Contributions Grants Prior Year | 4017862 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 134971 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 130917977 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 120971380 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 49350 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4690 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 9183556 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8659161 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 144168745 | TotalRevenuePriorYear |
| Total Revenue Current Year | 129770202 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 70225438 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 70514206 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 64109215 | OtherExpensePriorYear |
| Other Expenses Current Year | 60416550 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 134334653 | TotalExpensesPriorYear |
| Total Expenses Current Year | 130930756 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9834092 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1160554 | RevenuesLessExpensesCY |
| Total Assets BOY | 117982309 | TotalAssetsBOY |
| Total Assets EOY | 119134315 | TotalAssetsEOY |
| Total Liabilities BOY | 81923750 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 60244457 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 36058559 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 58889858 | NetAssetsOrFundBalancesEOY |
| Mission Description | Gottlieb Memorial Hospital is dedicated to providing superior health-care to improve the overall health of all we serve. Individuals within our communities are provided access to medically necessary care regardless of their ability to pay. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 117635296 | Expense |
| Revenue | 120971380 | Revenue |
| Description | Health Services - See Schedule O | Description |
| Total Program Service Expense | 117635296 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| 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 | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | 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 | false | 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 | true | 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 | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 90 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1330 | 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 |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 23 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| 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 | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Ellyn Chin | NamePerson |
| Telephone Number | 7084504966 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W North Ave | AddressLine1 |
| City | Melrose Park | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (35 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| William T Divane Jr | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| William F Reichert | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Thomas P Fitzgerald | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Thomas Origitano MD | ||||||||
| Director | 35.00 | X | 0 | 642129 | 38316 | |||
| Robert Sulo MD | ||||||||
| Director | 40.00 | X | 0 | 323089 | 37300 | |||
| Paul K Whelton MD | ||||||||
| Director | 40.00 | X | 0 | 928737 | 415488 | |||
| Patrick J Kelly | ||||||||
| Chairman | 3.00 | X | 0 | 0 | 0 | |||
| Patricia Cassidy | ||||||||
| President | 40.00 | 0 | 463419 | 142689 | X | |||
| Nancy W Knowles | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael R Quinlan | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael R Leyden | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael J Garanzini SJ | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Maurita Adler | ||||||||
| C.I.O. | 40.00 | 145585 | 0 | 36126 | X | |||
| Mark H Schwartz | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Kenneth Fishbain | ||||||||
| COO | 40.00 | 417653 | 0 | 58718 | X | |||
| Jordan M Hadelman | ||||||||
| Vice Chairman | 2.00 | X | 0 | 0 | 0 | |||
| John L Keeley Jr | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| John C Lahey | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| John Astreides | ||||||||
| Director of I.S. | 40.00 | 137178 | 0 | 25366 | X | |||
| James C Dowdle | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Jackie Taylor Holsten | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Jack A Weinberg | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Henry S Lang | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Henly Del Carpio | ||||||||
| RN Weekender II | 40.00 | 135804 | 0 | 44017 | X | |||
| Eric A Reeves | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Ellyn Chin | ||||||||
| VP of Finance | 40.00 | 278484 | 0 | 40305 | X | |||
| Ellen Gaynor MD | ||||||||
| Director | 32.00 | X | 0 | 0 | 0 | |||
| Elizabeth C Mclain | ||||||||
| RN Weekender II | 40.00 | 146567 | 0 | 14207 | X | |||
| David J Wilber MD | ||||||||
| Director | 35.00 | X | 0 | 641228 | 27754 | |||
| Daniel L Flaherty SJ | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Constance Clark | ||||||||
| VP Nursing | 40.00 | 243611 | 0 | 115851 | X | |||
| Charles ReiterIII | ||||||||
| Secretary | 40.00 | 0 | 538439 | 166514 | X | |||
| Carlos Montoya | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Brett Wakefield | ||||||||
| VP of HR/Marketing | 40.00 | 208520 | 0 | 75355 | X | |||
| Alan Goldberg | ||||||||
| VP of Adm Svcs | 40.00 | 246085 | 0 | 99072 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1959487 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3537041 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1337078 | TotalOtherCompensation |
| Number Individuals GT100 K | 59 | 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 |
|---|---|---|---|---|---|
| UBS Global Asset Management | |||||
| 23387 Network Place | Chicago | IL | 606731233 | Bank Fees | 288423 |
| Quest Diagnostics | |||||
| PO Box 12989 | Chicago | IL | 60693 | Lab Service | 290290 |
| Imperial Laundry System Inc | |||||
| 2299 Momentum Place | Chicago | IL | 606895322 | Laundry Service | 298038 |
| George Sollitt Construction Company | |||||
| 790 N Central Ave | Wood Dale | IL | 60191 | Construction Svcs | 3484977 |
| Diversified Clinical Services | |||||
| PO Box 636981 | Cincinnati | OH | 452636981 | Clinical Services | 369099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Fundraising Events | 16850 | FundraisingEvents |
| All Other Contributions | 118121 | AllOtherContributions |
| Total Contributions | 134971 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Care Services | Description |
| Total Revenue Column | 120971380 | TotalRevenueColumn |
| Related Or Exempt Function Income | 120971380 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 120971380 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4690 | TotalRevenueColumn |
| Exclusion | $4,690 | 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 |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 95535 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 16850 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 85372 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10163 | TotalRevenueColumn |
| Exclusion | $10,163 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 97264 | GrossSalesOfInventory |
| Cost Of Goods Sold | 89768 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7496 | TotalRevenueColumn |
| Exclusion | $7,496 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| Reimb. of Occupancy Exp | 541900 | 686370 | 686370 | |
| Outpatient Pharmacy | 621400 | 2103078 | 2103078 | |
| Mgnt. & Prof. Services | 541900 | 4844280 | 245647 | $4,598,633 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1007774 | TotalRevenueColumn |
| Exclusion | $1,007,774 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 8641502 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 129770202 | TotalRevenueColumn |
| Related Or Exempt Function Income | 120971380 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3035095 | UnrelatedBusinessRevenue |
| Exclusion | $5,628,756 | 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 | 1185833 | Total |
| Program Services | 1062094 | ProgramServices |
| Management And General | 123739 | ManagementAndGeneral |
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 | 51899462 | Total |
| Program Services | 46483853 | ProgramServices |
| Management And General | 5415609 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6287980 | Total |
| Program Services | 5623258 | ProgramServices |
| Management And General | 664722 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7324707 | Total |
| Program Services | 6549198 | ProgramServices |
| Management And General | 775509 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3816224 | Total |
| Program Services | 3428470 | ProgramServices |
| Management And General | 387754 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 449443 | Total |
| Management And General | 449443 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -105167 | Total |
| Management And General | -105167 | 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 | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2840159 | Total |
| Program Services | 2835659 | ProgramServices |
| Management And General | 4500 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22219305 | Total |
| Program Services | 22149775 | ProgramServices |
| Management And General | 69530 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2659038 | Total |
| Management And General | 2659038 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51162 | Total |
| Program Services | 48533 | ProgramServices |
| Management And General | 2629 | 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 | 100192 | Total |
| Program Services | 50123 | ProgramServices |
| Management And General | 50069 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7568184 | Total |
| Program Services | 7568184 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1743447 | Total |
| Program Services | 1743447 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Provision for Bad Debts | 7648974 | 7648974 | |
| Printing and Publications | 120065 | 107662 | 12403 |
| Postage and Shipping | 121098 | 87734 | 33364 |
| Other Admin. & General | 12661709 | 10085665 | 2576044 |
| Equipment Rental & Maint. | 2312989 | 2162667 | 150322 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25952 | Total |
| Management And General | 25952 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130930756 | Total |
| Program Services | 117635296 | ProgramServices |
| Management And General | 13295460 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34929833 | BOY |
| EOY | 37685910 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96027 | BOY |
| EOY | 58316 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13965278 | BOY |
| EOY | 12350498 | 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 |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2657012 | BOY |
| EOY | 2759414 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1102381 | BOY |
| EOY | 625540 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 183660176 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 131574078 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54805315 | BOY |
| EOY | 52086098 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75000 | BOY |
| EOY | 75000 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 463777 | BOY |
| EOY | 447260 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9887686 | BOY |
| EOY | 13046279 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117982309 | BOY |
| EOY | 119134315 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63086914 | BOY |
| EOY | 42195592 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18836836 | BOY |
| EOY | 18048865 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81923750 | BOY |
| EOY | 60244457 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35858559 | BOY |
| EOY | 58814858 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200000 | BOY |
| EOY | 75000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36058559 | BOY |
| EOY | 58889858 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117982309 | BOY |
| EOY | 119134315 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1160554 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 23991853 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| 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 | true | GrantsOtherOrganizations |
| Grants Other Organizations | $20,517 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 20517 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4894899 | OtherCostOrOtherBasis |
| Book Value | 4894899 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 120983091 | OtherCostOrOtherBasis |
| Depreciation | 86120669 | Depreciation |
| Book Value | 34862422 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5280884 | OtherCostOrOtherBasis |
| Depreciation | 4930924 | Depreciation |
| Book Value | 349960 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 52070859 | OtherCostOrOtherBasis |
| Depreciation | 40447282 | Depreciation |
| Book Value | 11623577 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 430443 | OtherCostOrOtherBasis |
| Depreciation | 75203 | Depreciation |
| Book Value | 355240 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 52086098 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Premier Limited Partnership | Description |
| Book Value | 142921 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Valuation Allowance Def Tax Asset | -330000 |
| Other Receivables | 2541478 |
| Due From Affiliates | 10169301 |
| Deferred Tax Asset | 564000 |
| Deferred Financing | 101500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 13046279 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Est Settlemnts pay to Third Party Payors | Description |
| Amount | $18,048,865 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 18048865 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XI, Line 8 | Identifier |
| Return Reference | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | ReturnReference |
| Explanation | Pension Liability $22782569 $0 GMH Foundation Donation $1200000 Mr & Mrs Willilam C Brauneis Donation $8300 | Explanation |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America/Caribbea | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 0 | NumberOfEmployees |
| Type Of Activities Conducted | Program Services | TypeOfActivitiesConducted |
| Specific Services Provided | Malpractice Insuranc | SpecificServicesProvided |
| Total Expenditures | 3598744 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 3598744 | SubtotalAmountSpent |
| Total Amount Spent | 3598744 | TotalAmountSpent |
| No Recipient Over5 K | X | NoRecipientOver5K |
| Transfer To Foreign Corp | true | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | false | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Fall Charitable Event | NameOfEvent1 |
| Gross Receipts Event1 | 112385 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 16850 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 95535 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 85372 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 112385 | GrossReceiptsTotal |
| Charitable Contributions Total | 16850 | CharitableContributionsTotal |
| Gross Revenue Total Events | 95535 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 85372 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 85372 | DirectExpenseSummaryEvents |
| Net Income Summary | 10163 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| 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 | 6277576 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6277576 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04790 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17192695 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13192883 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3999812 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03050 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23470271 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13192883 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10277388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07840 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 59834 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -21834 | NetCommunityBenefitExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 426417 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 188018 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 238399 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 143781 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 143781 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 608198 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 247852 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 360346 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24078469 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13440735 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10637734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08130 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,399,767 | BadDebtExpenseAmount |
| Amount Attributable To | 699900 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 51152204 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 58526839 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -7374635 | 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 | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gottlieb Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W North Ave | AddressLine1 |
| City | Melrose Park | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Including oupatient services | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gottlieb Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 600.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| 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 |
| Used Other Method | X | UsedOtherMethod |
| 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 | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Gottlieb Adult Day Care Center | ||||
| 555 W North Ave | Melrose Park | IL | 60160 | Adult Day Care Center |
| Gottlieb Transitional Care | ||||
| 701 W North Ave | Melrose Park | IL | 60160 | Transitional Care Program |
| Gottlieb Home Health & Hospice | ||||
| 905 W North Ave | Melrose Park | IL | 60160 | Home Health and Hospice Program |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - Additional Information | Part I, Line 3b - The "Other" box should be checked with 600%. Our software is unable to check this box.Part V, Line 19dPatients without insurance scheduled to receive or who have already received services will be extended a discount from usual and customary charges. This discount is sixty percent (60%) for hospital charges.Part V, Section CHow many non-hospital facilities did the organization operate during the tax year? The answer should be 3, not 0. Our software is unable to correct this. | |
| Part VI - States Where Community Benefit Report Filed | IL | |
| Part VI - Affilated Health Care System Roles and Promotion | See Schedule O | |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | See Schedule O | |
| Part VI - Community Building Activities | See Schedule O | |
| Part VI - Community Information | Gottlieb Memorial Hospital ("Gottlieb") embraces its commitment and responsibility to provide quality healthcare to the community it serves. Gottlieb was founded as and continues to be a community-based hospital. Gottlieb defines the community it serves by the areas indicated by zip codes below: Core Market Population Franklin Park 60131 20,628 Melrose Park 60160 20,026 Melrose Park 60164 21,956 Stone Park 60165 5,174 River Grove 60171 10,971 Schiller Park 60176 11,345 Elmwood Park 60707 42,274 Southeast Market Bellwood 60104 Forest Park 60130 Maywood 60153 Westchester 60154 Broadview 60155 Oak Park 60301 Oak Park 60302 Oak Park 60304 River Forest 60305 Berwyn 60402 Chicago 60623 Chicago 60638 Chicago 60644 Chicago 60651 Cicero 60804 West Market Addison 60101 Bensenville 60106 Elmhurst 60126 Glendale Heights 60139 Lombard 60148 Hillside 60162 Berkeley 60163 Villa Park 60181 Wood Dale 60191 Northeast Market Des Plaines 60018 Chicago 60618 Chicago 60624 Chicago 60630 Chicago 60631 Chicago 60634 Chicago 60639 Chicago 60641 Chicago 60647 Chicago 60656 Harwood Heights 60706 | |
| Part VI - Patient Education of Eligibility for Assistance | In advising patients, a financial counselor will explain GMH's payment policy and discuss a payment plan for the services. Patients who are not able to comply with the request for payment will then be evaluated for possible Medicaid eligibility. The financial counselor will initiate the Medicaid application or direct the patient to the Public Aid Office whenever it appears the patient would qualify. A copy of the Medicaid denial may be requested prior to extending charity or financial assistance. A patient when requesting charity care must provide the following documentation within 14 days of the request.When patients qualify for charity care or financial assistance, they will receive the applicable discount for that calendar year. This will be indicated on the registration system by the appropriate assigned plan code of each level of discount.The following documentation is required for evaluation for charity care or financial assistance review and approval:1. A copy of most current tax year W-2, 1040, and any other applicable tax forms that were filed.2. Copies of the last three (3) most recent employer paycheck stubs.3. If patient is paid in cash, a letter from the employer stating amount paid weekly.4. Copies of Social Security check is applicable.5. Copy of last three (3) checking and/or saving account statements.If patient does not provide documentation, a credit check will be run on patient. Based on the information provided by the credit organization, a charity determination will be made. | |
| Part VI - Needs Assessment | Gottlieb determines and evaluates the needs of the Community on an ongoing basis. The process includes information from the Medical staff and community leaders. Patient comments are considered along with input from Gottlieb employees, many of which live in the Community. Information is also gathered from various healthcare organizations and societies and consultants are periodically engaged to prepare market studies, including breakdowns by age, gender, and ethnicity. | |
| Part V, Line 19d - Other Billing Determination of Individuals Without Insurance | Patients without insurance scheduled to receive or who have already received services will be extended a discount from usual and customary charges. This discount is sixty percent (60%) for hospital charges. | Number of Hospital Faciltiy - 0 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | Gottlieb's collection policy contains provisions on the collection practices to be followed for patients who are known to qualify for charity care for financial assistance. There are many instances when a patient does not formally complete a charity/financial application, but would qualify for charity or financial assistance if the application were completed. Before an account is turned over to a collection agency, the Patient Accounts staff follows the process of evaluating whether a patient could meet charity or financial assistance by reviewing of the following information: Patient history Patient demographics Employment status Financial information, including credit check Returned mail Citizenship Valid Identification | |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Gottlieb provides quality patient care and promotes health to its surrounding community through a variety of educational and support programs. As such, the Medicare cost report related shortfall would be considered a community benefit.The medical allowable costs of care on Part III, Line 6 were computed using the Medicare cost to charge ratio. | |
| Part III, Line 4 - Bad Debt Expense | Gottlieb's estimate for its Bad Debt expense is based upon management's assessment of historical and expected net collections by payor. | |
| Part I, Line 7g - Costs Associated With Physicans Clinics | The organization did not include any costs attributable to a physician clinic as subsidized health services. | |
| Part I, Line 6a - Related Organization Community Benefit Report | The community benefit report is available upon request. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | 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 |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas Origitano MD | ||||||||||||
| 576414 | 61902 | 3813 | 20982 | 17334 | 680445 | |||||||
| Robert Sulo MD | ||||||||||||
| 320905 | 2184 | 20982 | 16318 | 360389 | ||||||||
| Paul K Whelton MD | ||||||||||||
| 768520 | 136343 | 23874 | 405700 | 9788 | 1344225 | 19343 | ||||||
| Patricia Cassidy | ||||||||||||
| 380023 | 56300 | 27096 | 132900 | 9789 | 606108 | |||||||
| Maurita Adler | ||||||||||||
| 142684 | 2901 | 28923 | 7203 | 181711 | ||||||||
| Kenneth Fishbain | ||||||||||||
| 271824 | 6433 | 52565 | 6153 | 476371 | 139396 | |||||||
| John Astreides | ||||||||||||
| 134552 | 2626 | 23753 | 1613 | 162544 | ||||||||
| Henly Del Carpio | ||||||||||||
| 135804 | 41082 | 2935 | 179821 | |||||||||
| Ellyn Chin | ||||||||||||
| 273116 | 5368 | 33514 | 6791 | 318789 | ||||||||
| Elizabeth C Mclain | ||||||||||||
| 146567 | 11386 | 2821 | 160774 | |||||||||
| David J Wilber MD | ||||||||||||
| 571605 | 65985 | 3638 | 20982 | 6772 | 668982 | |||||||
| Constance Clark | ||||||||||||
| 159217 | 3723 | 113726 | 2125 | 359462 | 80671 | |||||||
| Charles ReiterIII | ||||||||||||
| 454548 | 83891 | 144091 | 22423 | 704953 | ||||||||
| Brett Wakefield | ||||||||||||
| 134352 | 3272 | 70097 | 5258 | 283875 | 70896 | |||||||
| Alan Goldberg | ||||||||||||
| 159363 | 3826 | 91869 | 7203 | 345157 | 82896 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch J, Part III, Additional Information | Identifier |
| Return Reference | Part III, Additional Information | ReturnReference |
| Explanation | Paul K. Whelton, M.D. paid by related organization Loyola University Medical Center, Tax ID #36-4015560Patricia Cassidy paid by related organization Loyola University Medical Center, Tax ID #36-4015560Part II, Column B(ii)The organization paid an annual attendance bonus. Any full-time and 0.9 employee who has a accumulated 30 or more earned unused sick days was eligible for a yearly attendance bonus. Earned sick days in excess of 30 days were paid in an annual bonus of one day's pay for every two unused sick days.Part II and Form 990, Part VIDavid J. Wilbur,MD, Thomas Origitano,MD, and Robert Sulo,MD are employed full time as physicians, by a related organization, and are not compensated for their positions on the board. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Daniel J Walsh | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Former Director | Relationship |
| Amount Of Transaction | 1905426 | AmountOfTransaction |
| Description Of Transaction | Construction | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part III, Line 4a, Prog Svc Accomplishm | Gottlieb Memorial Hospital (Gottlieb) is a full service community based not-for-profit hospital providing interrelated health programs to the patients it serves. Gottlieb is affiliated with Loyola University Health System ("LUHS"), a nationally recognized leader in providing specialty and primary health care services. As part of LUHS, we are supported by an unprecedented level of academic medical strength, which enhances patient care in Chicago's Near West suburbs. Our patients have access to state of the art treatments and leading edge technology. Through our participation in the pioneering research being conducted at Loyola, Gottlieb is helping to shape the future of medicine. Our mission is Bringing Quality to Life by providing interrelated health programs that will meet the health care needs of the community to enable people to function at their optimal level, to provide coordinated services humanely, effectively, efficiently, and with recognized excellence through collaborative action and the interdependent efforts of our staff. A focused patient-centered care environment confirms our dedication to providing high quality care in a welcoming and comfortable setting by respecting patients' values and expressed needs. | |
| Part III, Line 4a, continued | Yesterday's Youth Club (YYC) is a community social group that meets at Gottlieb Memorial Hospital each month. Members enjoy socializing in a fun and comfortable setting. Throughout the year, members and their guests enjoy day outings, luncheons, parties, health screenings, and informational lectures on related health topics. Members also enjoy dining in the hospital cafeteria on meeting days without surcharge.Members of a Gottlieb ENT team travelled to the Dominican Republic for a medical mission. Another Gottlieb team travelled to the Dominican Republic to perform spinal surgeries. Gottlieb donated considerable supplies for the missions.Gottlieb is dedicated to promoting healthy lifestyles through its weight loss program which unites physical exercise and medical, nutritional and behavioral education. 12-week weight loss programs are available to community members.Gottlieb's wellness initiative, Inspire Health, promotes the health and wellness of all employees. The goal is to create and sustain a robust employee wellness program that raises awareness about overall health, educates participants on how to stay well, and motivates participants to develop and implement personal action plans.ConclusionAs we look forward to the next fiscal year, there are several initiatives on the horizon: *Continue to expand access to clinical and academic programs and research at the Gottlieb campus. This will bring leading-edge treatments and new protocols to patients who previously did not access them. *Open a new center for care in the neighborhood we serve. In FY 2012, a new site in River Forest opened. *Continue to provide volunteer services and assist in providing government-sponsored program services.Gottlieb takes pride in the benefit it provides to its community. Our goal is to provide health care to as many individuals as we can reach, to do so in a way that reflects our mission to care and provide coordinated services humanely, effectively, and with recognized excellence through collaborative action and the interdependent efforts of our professional and volunteer staff. | |
| Part III, Line 4a, continued | Transitional CareGottlieb Transitional Care services are centered around working with residents to achieve positive outcomes through emphasis on rehabilitation. Gottlieb is dedicated to providing quality, personalized care through team approach. Our interdisciplinary team includes the residents, their families, physicians, nurses, social workers, therapists, registered dietitians and pastoral care. The team's objective is to assist our resident throughout the recovery process so that he/she can return to an independent lifestyle or function in an assisted care setting. A total of 760 residents were provided care in this unit during FY 2011.Cancer ServicesLocated on the Gottlieb Memorial Hospital campus, Marjorie G. Weinberg Cancer Care Center offers cancer patients the convenience of a community hospital and the expertise of a world-class university hospital to help prevent and treat cancer and to improve the quality of life of cancer survivors.Home Care and HospiceGottlieb Home Care provides skilled, intermittent care to patients in their place of residence. Care may include medication management, infusion therapy, complex wound care, health teaching, and rehabilitative services. Our team of professionals, consisting of registered nurses, physical, speech and occupational therapists, guide patients and their families through the steps necessary for them to once again gain control of daily activities. A registered nurse is available on call to patients and their families, 24 hours a day 7 days a week. In FY 2011, we provided 18,994 visits. | |
| Part III, Line 4a, continued | Subsidized Health ServicesAdult Day CareThe Gottlieb Adult Day Care is designed to meet the needs of an aging population. Committed to providing high quality person-centered care for older adults with physical, psychosocial or mental impairments, the Center provides clients with the assistance and supervision they need during the day so that they may continue to live at home. Our Adult Day Care staff realizes that while we care for clients during the day, family members take on that responsibility the remainder of the time. With that in mind, we not only serve our clients, but their caregivers as well by providing respite from the daily care of a loved one. The Adult Day Care provides care to 13 to 18 clients a day.The staff works with clients and caregivers to provide social, recreational and healthy activities in a group setting. The overall goal is to maintain or restore each client's optimal level of functioning. In the process, most clients reap the emotional rewards of interaction with their peers and the friendships that result.Transportation ServiceGottlieb offers transportation services to and from the Gottlieb campus. The cost to the rider is minimal and companions ride free. The service is passenger friendly with amenities such as wheelchair accessibility, door-to-door service as well as convenient hours of operation.The total cost of Subsidized Health Services totaled $144,000 for FY 2011.Bad DebtsGottlieb has a formal, written, debt collection policy and our annual operating budget includes patient charges projected to be classified as bad debt. For FY 2011, Gottlieb expensed $7,649,000 attributable to bad debt. This figure exceeded the budgeted amount.Community Education and OutreachGottlieb offers a wide variety of health screenings, educational programs and supports other not-for-profit organizations with missions to provide quality care.Community members are educated abount the programs that Gottlieb offers via the Loyola Living/Gottlieb and You publication. This free publication is mailed to over 170,000 households, three times per year.Gottlieb maintains and staffs a Health Information Resource Center to give patients, their families, the general public, employees and others easy access to health information.Gottlieb is the official site which provides the day's allergy count for the Midwest region during the pollen-reporting allergy season. Allergy sufferers can obtain the allergy count through the Gottlieb website, www.GottliebHospital.org. The count is also available through the Gottlieb Allergy Hotline (1-866-4-POLLEN [English] and 1-866-ALERGIA [Spanish]) or you can also follow us on Twitter:@GottliebAllergy, in English, and @AlergiaGottlieb, in Spanish.A Medicare Help Desk for seniors is offered at Gottlieb once a month. Seniors receive assistance with questions they may have about Medicare benefits, supplemental insurance and medical bills.Gottlieb has a pastoral care/ministry department to attend to the spiritual needs of its patients, families, physicians and staff members.Each year, the Gottlieb Auxiliary together with the Medical Staff awards scholarships to area high school students who are interested in the health care field and area students already enrolled in a college level, health care program.Gottlieb is a corporate sponsor of Hispanocare, a not-for-profit organization with a mission to provide quality, cost effective health care to Chicago's Latino community in a culturally sensitive manner. Hispanocare coordinates community health fairs where preventive services and screenings are provided free of charge.Gottlieb participates in the Cristo Rey Jesuit High School's Corporate Internship Program. Students from an economically depressed area gain valuable knowledge and work experience and earn compensation that is applied to their tuition. As part of this program, Gottlieb paid Cristo Rey $26,520 in compensation on behalf of these students. | |
| Part III, Line 4a, continued | Preventing Disease through Employee VaccinationDuring the 2011 flu season, Gottlieb required all employees with or without direct patient contact to receive the flu vaccination. By requiring vaccination, Gottlieb leads the way in improving safety for patients, visitors, employees and their families.ResearchA pairing of Excellence describes the relationship between Gottlieb and Loyola. This relationship allows our patients to benefit from the clinical trials and research being conducted by Loyola. Delivering advanced treatment through cost-effective results is key to improving the health of all we serve.Charity CareAs part of Gottlieb's mission to provide necessary medical care, regardless of each patient's ability to pay, we absorb the expense of healthcare services we provide without charge.Patients without insurance or other means of paying for care may receive necessary medical free of charge, or at a discount. This care is provided regardless of whether a patient cooperates in a formal process to evaluate financial need. Gottlieb attempts to identify patients who may qualify for charity care even if they do not cooperate with the formal process by researching a patient's financial history through various sources, some of which are publicly available. Patients qualify for charity care based upon federal poverty guidelines. Patients are also assesssed on their ability to pay based on a review of their income in relation to the size of the claim.Each year, our operating budget includes funds to ensure that we allow for the cost of charity care and the provision of care to patients insured by the state Medicaid program. The financial commitment is significant and is an area within the operating budget that continues to grow.Charity care is provided to patients based upon the Federal Poverty Guidelines. Patients are provided substantial discounts if their income is less than 600% of the Federal Poverty Guidelines (FPG). Patients who earn up to 200% of the FPG will receive care at no cost. Patients who earn up to 300% of the FPG will receive an 80% discount and patients that earn up to 400% of the FPG will receive a 75% discount. Patients that earn up to 600% of FPG will receive a discount based on cost, reviewed annually. Gottlieb also offers financial assistance in the form of uncompensated care to patients who are unable to pay due to varying circumstances, even if the patients do not provide the information needed to evaluate them under the charity care policy.In FY 2011, total expenses of 2.6 million (at cost) were incurred for charity and uncompensated care.Language Assistance ServicesGottlieb, as part of their normal operating budget, includes provisions for free translation services for the patients it serves. During FY 2011, Gottlieb spent $75,000 in order to provide language assistance.Government Sponsored Indigent Health CareGottlieb incurs additional unreimbursed costs of providing services to Medicare and Medicaid patients. Total hospital Medicare and Medicaid patient days in FY 2011 were 29,982 and 4,220, respectively. The programs supporting Medicare and Medicaid patients continue to grow in response to the demand in the surrounding community. In FY 2011, the financial contribution in terms of the excess cost over reimbursement for government sponsored indigent health care was $11,008,000. | |
| Part III, Line 4a, continued | Gottlieb Hospice provides palliative care to terminally ill patients during the last six months of life. An interdisciplinary team consisting of the patient's attending physician, registered nurses, aides, dietitians, medical social workers, chaplains and volunteers work together to support comfort and quality of life. Hospice services are provided primarily in the patient's place of residence and facility-based acute inpatient and respite level are provided as needed. A structured program of bereavement follow up is provided to all families during the year following the patient's death. Gottlieb Hospice also offers a series of grief support groups and memorial service at no charge for the community throughout the year. In FY 2011, terminally ill patients received 2,173 visits from our staff.Geriatric Behavorial Health CareResponding to the growing geriatric need in the Chicagoland area, Gottlieb's Geriatric Behavioral Health Care Unit is a 12-bed, Medicare certified service designed to diagnose and treat the complex problems related to individuals 65 years of age and older. Because the aging process often causes many physical, emotional and cognitive challenges for older adults, these challenges may lead to depression and isolation, anxiety, physical and emotional adjustments, issues with substance abuse and the lack of appropriate nutrition. Our medical and clinical professionals provide a team approach to develop individualized treatment plans based on comprehensive diagnostic procedures to help improve the quality of life of those facing these challenges.Wound Healing & Hyperbaric Medicine CenterOffering hope to patients with chronic wounds that are difficult to heal, the Gottlieb Wound Healing & Hyperbaric Medicine Center leads the way in low days-to-heal rates putting Gottlieb in the top tier of wound-care centers in the country. The Center provides individualized, comprehensive plans for care and advanced therapies, including hyperbaric oxygen therapy. Assessment and ongoing care is monitored by our highly skilled team of wound care specialists, who also provide educational materials and resources related to prevention, nutrition, and hygiene and training for patient and family on caring for wounds at home.Sleep LaboratoryGottlieb's Sleep Laboratory provides a comprehensive approach to diagnosing and treating adult and pediatric sleep problems, including snoring, sleep apnea and narcolepsy. The multidisciplinary team of sleep specialists includes neurologists, pulmonologists, otolaryngologists and oral/maxillofacial surgeons. | |
| Part III, Line 4a, continued | Financial AccountabilityExceptional teamwork is required to accomplish our mission of Bringing Quality to Life--and to maintain the financial strength to support it. We must continue to be stewards of resources and it is through strategic planning and close collaboration that we strive for continual excellence. We are dedicated about maintaining high quality while improving efficiency. The evaluation of current and the exploration new processes will guide quality and patient safety, as well as to ensure careful control over factors that influence financial performance.Community BenefitGottieb is committed to providing high quality, safe care to community residents who turn to us for hope and healing. We are proud of our not-for-profit mission and our ability to provide medically necessary care for individuals within our community regardless of their ability to pay. We strive to treat all patients equitably and with dignity and compassion. We consider a community benefit to represent activities that meet at least one of the following criteria: | |
| Part III, Line 4a, continued | *Responds to the needs of special populations, such as the poor, the disabled, the elderly or minorities; *Makes little or no money, or operates at a loss; *Provides a service or program that would likely be discontinued if finances were the only deciding factor.Consistent with our commitment to charitable purposes and to improving the health of the community we serve, Gottlieb reported $19.4 million in community benefits for FY 2011. This figure is based on statutorily defined State-wide criteria and represents only a part of what Gottlieb contributes to its community.As a not-for-profit, tax exempt hospital, we acknowledge our responsibility as a charitable healthcare organization and we will continue to demonstrate our willingness serve the health needs of the surrounding communities.Patient Care ServicesGottlieb Memorial Hospital is an acute care not-for-profit hospital, with 255 licensed beds. Operating in the western suburbs of Illinois, Gottlieb provides vital health care services 24 hours a day, seven days a week, to patients in various settings, including cardiovascular/thoracic, obstetrics, orthopaedics, medical imaging, gastroenterology, urology, home care and hospice services, transitional care and adult day care services. For FY 2011, Gottlieb had 7,679 adult and pediatric admissions, representing 46,492 patient days, served 1,448 emergent patients, representing 54,056 hours and 51,797 total outpatient visits, which includes outpatient surgeries.Increasing Safety and EffectivenessEmergency PreparednessGottlieb remains in a perpetual state of emergency preparedness. We are members of a hospital cooperative system which provides emergency support to communities outside our traditional service area. Emergencies can arise at any time and we continuously work to mitigate the risks which could unexpectedly disrupt service.A multidisciplinary committee, including members from our executive team, nurse specialist, nurse manager and directors of purchasing and information technology provide continuing education to the entire hospital and its medical staff in case of an emergency. Participation in multi-community drills also tests our emergency preparedness plan and as such, we continually enhance the plan to protect our mission, our patients, the surrounding community and our staff under potentially adverse conditions.Communication TechnologyGottlieb uses Vocera, a hands-fee, wearable, voice controlled communication technology, which allows our clinical staff to stay connected anywhere on campus. The simplicity of staying in touch also allows clinical staff to focus on improving patient satisfaction and patient safety.Emergency ServicesGottlieb operates a Trauma Level II emergency department open to everyone, 24 hours a day, seven days a week, regardless of a patient's ability to pay. During FY 2011, there were 20,559 emergency patient visits. Some of those visits were provided as charity and uncompensated care. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The organization makes its governing documents, conflict of interest policy and financial statements available to the public by mail, upon written request. The filing organization's Financial Statements are available on the Illinois Attorney General web site at: http://www.illinoisattorneygeneral.gov/charities/search/index.jsp. Financial performance summaries are contained in the LUHS Annual Report and made available to the public on the LUHS web site at: http://www.loyolamedicine.org/News/Publications/LUHS_Annual_Report/index.cfm | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | A compensation committee reviewed compensation of the President and Secretary. This survey covers the CEO, COO and CFO positions. Additionally, Gottlieb Memorial Hospital participates in an annual management compensation survey conducted by the Metropolitan Chicago Healthcare Council which surveys VP and management level salaries. Executive compensation survey data was used by the board as part of the annual compensation review process for key executive staff. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | On an annual basis, directors, officers, key employees and various classes of employees are obligated to complete a disclosure statement that includes a list of questions to identify conflicts of interest. Disclosure information is reviewed through the Board Audit and Corporate Compliance Committee. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | 1. The Form 990 is prepared by information provided by Gottlieb staff and led by senior management of Gottlieb.2. A detailed summary of the draft Form 990 is presented to the organization's Board Finance and Planning Committee. In addition to the detailed summary presented, the organization's officers are provided a copy of the organization's draft Form 990 (including all required schedules).3. Once finalized, a copy of the organization's Form 990 (including all required schedules), is made electronically available to each voting member of the organization's governing body, prior to its filing with the IRS. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | See response to Part VI, Section A, question 4. | Form 990, Part VI, Line 7a |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | See response to Part VI, Section A, question 4. | Form 990, Part VI, Line 6 |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Patrick J. Kelly, Thomas Fitzgerald and Patricia Cassidy have identified a business relationship with each other. Patrick J. Kelly and Eric Reeves have identified a business relationship with each other. | Form 990, Part VI, Line 2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Trust Fund for the Plan of Self Insuranc | |||||||||||
| 701 W North Avenue | Melrose Park | IL | 60160 | 366634432 | Supporting Organization | IL | 501(c)(3) | 11 | N/A | false | |
| Gottlieb Memorial Foundation | |||||||||||
| 701 W North Avenue | Melrose Park | IL | 60160 | 743260011 | Supporting Organization | IL | 501(c)(3) | 11 | N/A | false | |
| Loyola University Medical Center | |||||||||||
| 2160 S First Avenue | Maywood | IL | 60153 | 364015560 | Healthcare | IL | 501(c)(3) | 3 | false | Loyola University Health System | |
| Loyola University Health System | |||||||||||
| 2160 S First Avenue | Maywood | IL | 60153 | 363342448 | Healthcare | IL | 501(c)(3) | 11 | false | Loyola University of Chicago | |
| Gottlieb Community Health Services | |||||||||||
| 701 W North Ave | Melrose Park | IL | 60160 | 363332852 | Physician Svcs/Center for Fitness & Wellness | IL | 501(c)(3) | 9 | false | Gottlieb Memorial Hospital | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Primary ActivityPrimaryActivity | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Loyola University of Chgo Insurance Co | |||||||||||||
| 23 Lime Tree Bay Avenue | Grand Cayman | CJ | Ky1-1102 | Malprac Ins | NA | ||||||||
| GottliebWest Towns PHO Inc | |||||||||||||
| Med Contract | 675 W North Avenue POB LL | Melrose Park | IL | 60160 | 364006263 | IL | N/A | 0.50000 | |||||
| Gottlieb Management Services Inc | |||||||||||||
| Rent/Mgnt Svcs | NA | 701 W North Ave | Melrose Park | IL | 60160 | 363330529 | IL | ||||||
| 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 | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| 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 | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | 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 (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Gottlieb Community Health Services | ||
| r | 48342 | cash |
| Gottlieb Community Health Services | ||
| q | 325395 | cash |
| Gottlieb Community Health Services | ||
| o | 1702613 | cash |
| Gottlieb Community Health Services | ||
| a | 89844 | cash |