2012-08-10T09:33:11-05:00 2011-09-30 Deloitte Tax LLP 111 South Wacker Drive Chicago IL 60606 990 2010-10-01 362167060 NorthShore University HealthSystem NORT 8475702000 1301 Central Street Evanston IL 60201 GARY E WEISS 2012-08-06 true 3124861000 2010 2016-02-24 21:20:13Z Mark R Neaman 1301 Central Street Evanston IL 60201 1949963992 false X northshore.org X 1891 IL The core mission of NorthShore University HealthSystem is to "preserve and improve human life." 25 20 10052 2089 26624943 -272261 11188035 21820514 1136217061 1259561280 35568079 115755104 30629002 41581161 1213602177 1438718059 31956016 45548410 0 0 507921510 574086526 0 0 2497078 628153262 688995935 1168030788 1308630871 45571389 130087188 2673472097 2680646127 1304792510 1313904278 1368679587 1366741849 X See Schedule O false false 1022617587 38855306 1239112703 See Schedule O 44184996 10426841 See Schedule O 38085223 6693104 23783194 See Schedule O 1104887806 true true false true false false false false true true true 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Schweighauser 1.0 X 0 0 0 Susan B Sentell 1.0 X 0 0 0 Mark S Talamonti 29.0 X 599930 365534 50270 J Mikesell Thomas 1.0 X 0 0 0 John R Walter 1.0 X 0 0 0 Sona Wang 1.0 X 0 0 0 Jonathan P Ward 1.0 X 0 0 0 William J White 1.0 X 0 0 0 William Wrigley Jr 1.0 X 0 0 0 Gregory K Jones 1.0 X X 0 0 0 A Steven Crown 1.0 X X 0 0 0 Harry M Jansen Kraemer Jr 1.0 X X 0 0 0 Mark R Neaman 41.0 X X 1807766 0 253407 Jeffrey H Hillebrand 41.0 X 840953 0 186660 Gary E Weiss 41.0 X 527031 0 108444 William D Bloomer 24.0 X 393030 672511 52068 Robert R Edelman 38.0 X 699975 276960 58214 Bernard G Ewigman 40.0 X 403326 0 97190 Gerald P Gallagher 40.0 X 429953 0 102400 Thomas H Hodges 36.0 X 652398 0 36621 Harry L Jones 40.0 X 337738 0 43714 William R Luehrs 40.0 X 464660 0 98818 Demetrius Maraganore 22.0 X 261276 261495 46809 Frederick E Miller 34.0 X 299936 116179 45611 Kristen Murtos 40.0 X 382560 0 100828 Jesse Peterson Hall 40.0 X 465637 0 110806 William J Robb III 40.0 X 575518 0 22168 Leopold G Selker 40.0 X 542404 0 101679 Nancy Semerdjian 40.0 X 366898 0 36377 Richard K Silver 34.0 X 700373 235306 52127 Douglas M Silverstein 40.0 X 522905 0 144766 Thomas W Smith 40.0 X 477570 0 102347 Jeffery S Vender 22.0 X 403852 612614 44678 Thomas A Victor 33.0 X 363260 454117 50831 Brian Washa 40.0 X 322809 0 42604 Kenneth P Anderson 40.0 X 447854 0 44331 John Merz 40.0 X 281104 0 37336 Colleen Mitchell 40.0 X 387372 0 36182 Sean O'Grady 40.0 X 288137 0 44958 Steven Smith 40.0 X 301647 0 42960 David C Holub 32.0 X 141971 42824 23092 Nicholas A Vick 32.0 X 157000 87822 36464 15726240 3704169 2329112 487 true true true Aramark Management Services 2300 Warrenville Road DOWNERS GROVE IL 60515 Facilities/Diet Mgmt 50589939 Pepper Construction Company 643 North Orleans Street CHICAGO IL 60610 Construction Mgmt 42565644 Power Construction Company 2630 North Palmer Drive SCHAUMBURG IL 60173 Construction Mgmt 24490615 University of Chicago Medical Ctr 5841 South Maryland Avenue CHICAGO IL 60637 Medical Education 12952452 McKesson Technologies 5995 Winward Parkway ALPHARETTA GA 30005 Info Tech Services 7647796 282 27505 580606 504077 9257649 457543 10993134 726465 21820514 PATIENT REVENUE 621990 798136547 798136547 MEDICARE AND MEDICAID REVENUE 621990 417823683 417823683 GRANT INCOME 541700 4516249 4516249 FEES AND CONTRACTS FROM GOVT AGENCIES 541700 20024789 20024789 TUITION REVENUE 611600 942078 942078 18117934 18117934 1259561280 30500211 -299437 30799648 0 0 4118236 10546549 -6428313 -6428313 -6428313 584530330 270 493291097 5984610 91239233 -5984340 85254893 85254893 1081713 504077 905482 176231 176231 39019 18493 20526 20526 889834 499702 390132 390132 OFFSITE PHARMACIES 446110 7130215 7130215 CAFETERIA 722210 5091131 5091131 LAB REFERENCE TESTING 541380 18986867 18986867 16214372 13761458 807298 1645616 47422585 1438718059 1255204804 26624943 135067798 45278712 45278712 113576 113576 156122 156122 0 16920914 3994600 12926314 6805070 2826912 3978158 440733520 383341133 55677313 1715074 25516447 19276743 6239704 54384885 49183828 4857689 343368 29725690 25459474 4160490 105726 80797897 69147377 11650520 4648950 94319 4554631 724944 724944 0 0 16594162 16594162 89110417 58480998 30438185 191234 11390937 11370971 19966 30748030 26656388 4027541 64101 2289526 1750593 538933 0 43732910 31340862 12392048 1320019 747416 553385 19218 0 2175054 1328652 842962 3440 8634033 8634033 0 98729395 78287907 20441488 835902 296894 539008 MEDICAL SUPPLIES 220928896 220684800 244096 BAD DEBTS 47693494 47693494 MEDICAID TAX 24827624 24827624 DUES AND SUBSCRIPTIONS 2257314 997656 1224707 34951 SALES TAX 378606 378606 1177825 1172149 5676 1308630871 1104887806 201245987 2497078 3800843 25844974 51061808 16382627 8164470 10868057 166839183 172338299 18050162 18527025 8405724 6308512 1742710548 852316732 840429827 890393816 998580888 927770166 375818862 443144648 82330008 93237674 119990322 75830329 2673472097 2680646127 154807221 157448974 5447827 4892711 394054608 385411480 750482854 766151113 1304792510 1313904278 X 1213731105 1211767856 85601765 83854902 69346717 71119091 1368679587 1366741849 2673472097 2680646127 X 130087188 -132024926 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 77907 77907 false Lobbying Activities Part II-B Line 1i NorthShore University HealthSystem (NorthShore) and its employees are members of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by NorthShore to these organizations are attributable to lobbying activities. 103298573 1772373 5671678 6980630 103761994 42760422 57871694 3630113 963656 103298573 41297746 2467038 -331934 672428 42760422 1.00000 false false 56783859 56783859 1091497454 497871797 593625657 40212325 17980280 22232045 459075536 326571727 132503809 95141374 9892928 85248446 890393816 HEDGE FUNDS 325698288 C PRIVATE EQUITY FUNDS 75005294 C PRIVATE EQUITY FUNDS 19906128 F REAL ASSET FUND 21039669 F OTHER INVESTMENTS 1495269 F 443144648 0 RESERVE FOR MALPRACTICE LOSSES 278080000 DEFERRED COMPENSATION 186626547 DUE TO AFFILIATES 223397533 DUE TO THIRD PARTIES 60010308 CURRENT MATURITY OF LT DEBT 8555000 ASSET RETIREMENT OBLIGATION 9393597 CURRENT BOND PAYABLE PREMIUM 88128 766151113 1438718059 1308630871 130087188 -79596689 -1345034 -80941723 49145465 1317317451 -79596689 36624804 -42971885 1360289336 17264779 61163944 78428723 1438718059 1268171986 17954566 17954566 1250217420 17264779 41148672 58413451 1308630871 Endowment Funds Part V Line 4 Endowment fund earnings are available for healthcare services, including capital acquisition and maintenance, operations, free care, research, and education. FIN 48 (ASC 740) Footnote Part X NorthShore and its related affiliates, except for NorthShore University HealthSystem Medical Group, Inc. (MG), known as NorthShore Exempt Group, have been determined to qualify as a tax-exempt organization under 501(c)(3) of the Internal Revenue Code (IRC). Most of the income received by NorthShore Exempt Group is exempt from taxation under 501(a) of the IRC, as income related to the mission of the organization. Accordingly, there is no material provision for income tax for these entities. Some of the income received by exempt entities is subject to taxation as unrelated business income. NorthShore and its subsidiaries file federal income tax returns and returns for various states in the U.S. ASC 740-10, Income Taxes, requires that realization of an uncertain income tax position is more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it can be recognized in the financial statements. Furthermore, this interpretation prescribes the benefit to be recorded in the financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the periods ended September 30, 2011 or 2010. NorthShore currently has a net operating loss carryforward of $13,319,425, which generated assets of $5,360,964. MG currently has a net operating loss carryforward of $712,280, which generated assets of $284,912. These assets are 100% offset by valuation allowances. Change in Net Assets Part XI Line 8 Amount represents changes in restricted net assets. Reconciliation of Revenues Part XII Lines 2d and 4b Line 2d - Amount represents expenses deducted from revenues in Form 990 Part VIII and changes in restricted net assets. Line 4b - Amount represents transfers to related organzations, Foundation administrative expenses, and investment expenses moved to Form 990 Part IX, and changes in restricted net assets. Reconciliation of Expenses Part XIII Lines 2d and 4b Line 2d - Amount represents expenses deducted from revenues in Form 990 Part VIII. Line 4b - Amount represents transfers to related organzations, Foundation administrative expenses, and investment expenses moved to Form 990 Part IX. true Central America and the Caribbean Insurance 5041729 Central America and the Caribbean Investments 248217089 Central America and the Caribbean Program Services Medical Conferences 3645 Central America and the Caribbean Program Services Medical Services 4662 East Asia and the Pacific Program Services Medical Conferences 15830 East Asia and the Pacific Program Services Medical Supply/Svcs 2550 Europe (Including Iceland and Greenland) Insurance 12100 Europe (Including Iceland and Greenland) Program Services Medical Conferences 44672 Europe (Including Iceland and Greenland) Program Services Medical Supply/Svcs 986 Middle East and North Africa Program Services Medical Conferences 1065 North America Program Services Medical Conferences 38307 North America Program Services Medical Supply/Svcs 253227 South America Program Services Medical Conferences 11948 South America Program Services Medical Services 1000 South Asia Program Services Medical Conferences 5206 South Asia Program Services Medical Services 2000 Sub-Saharan Africa Program Services Medical Services 3000 253659016 253659016 East Asia/Pacific 70166 Check Europe/Iceland/Greenland 42566 Check Europe/Iceland/Greenland 25864 Check Europe/Iceland/Greenland 17526 Check 0 4 true false true true true false Grant and Assistance Procedures Part I Line 2 NorthShore University HealthSystem (NorthShore) provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore also meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports. June Gala 613067 280017 333050 45487 87822 15868 72115 Craft Expo 603152 103201 499951 78313 66587 191097 7 369571 120859 248712 58300 6060 283833 1585790 504077 1081713 182100 160469 15868 547045 905482 176231 39019 18493 true 1.00000 39019 18493 18493 20526 IL true false false false 1.00000 NorthShore University HealthSystem 1301 Central Street Evanston IL 60201 false Deborah Waldeck 0 Oversees auxiliary operations including raffle. X false true true X true X true X 600. true true true false true true 21310776 0 21310776 0.01710 94927099 75641045 19286054 0.01540 0 0 0 0.00000 116237875 75641045 40596830 0.03250 1836227 0 1836227 0.00150 44184996 10426841 33758155 0.02700 54661357 34363769 20297588 0.01620 34864194 0 34864194 0.02790 590418 0 590418 0.00050 136137192 44790610 91346582 0.07310 252375067 120431655 131943412 0.10560 10407 0 10407 0.00000 0 0 0 0.00000 7356 0 7356 0.00000 2207 0 2207 0.00000 223 0 223 0.00000 3488 0 3488 0.00000 29360 0 29360 0.00000 279 0 279 0.00000 53320 0 53320 0.00000 true 13330900 0 349025164 404992415 -55967251 X true true HPMOB LP Medical Office Building 0.29620 0.00000 0.70380 Ravine Way LLC Orthopaedic Surgery Center 0.30000 0.00000 0.70000 NorthShoreUSP LLC General Surgery Centers 0.49900 0.00000 0.50100 4 1 Evanston Hospital

2650 Ridge Avenue Evanston IL 60201

X X X X X 2 Glenbrook Hospital

2100 Pfingsten Road Glenview IL 60026

X X X X X 3 Highland Park Hospital

777 Park Avenue West Highland Park IL 60035

X X X X X 4 Skokie Hospital

9600 Gross Point Road Skokie IL 60076

X X X X X Evanston Hospital 1 Glenbrook Hospital 2 Highland Park Hospital 3 Skokie Hospital 4 34 Graham Medical Office Building

1000 Central Street Evanston IL 60201

Outpatient Clinic Highland Park Ambulatory Care Building

757 Park Avenue West Highland Park IL 60035

Outpatient Clinic Old Orchard Medical Office Building

9977 Woods Drive Skokie IL 60077

Outpatient Clinic Highland Park Medical Office Building

767 Park Avenue West Highland Park IL 60035

Outpatient Pharmacy Glenbrook Medical Office Building (North

2150 Pfingsten Road Glenview IL 60026

Outpatient Clinic Glenbrook Medical Office Building (South

2050 Pfingsten Road Glenview IL 60026

Outpatient Clinic Vernon Hills Specialty Care Center

225 N Milwaukee Avenue Vernon Hills IL 60061

Outpatient Clinic Bannockburn Medical Office Building

2151 Waukegan Road Bannockburn IL 60015

Outpatient Clinic Gurnee Medical Office Building

15 Tower Court Gurnee IL 60031

Outpatient Clinic PM&R Pediatrics Lab Services

9811 Woods Drive Skokie IL 60077

Outpatient Clinic NorthShore Lab Services - Mount Prospect

1329 Wolf Road Mount Prospect IL 60056

Outpatient Clinic Glenview Park Center

2400 Chestnut Avenue Glenview IL 60026

Outpatient Clinic Deerfield Medical Office Building

190 Waukegan Road Deerfield IL 60015

Outpatient Clinic PMR Fitness Center

1501 Busch Parkway Buffalo Grove IL 60089

Outpatient Clinic Neurological Institute

1200 S York Road Elmhurst IL 60126

Outpatient Clinic PM&R Benson Avenue

1729 Benson Avenue Evanston IL 60201

Outpatient Clinic Adolescent Day School

3633 W Lake Avenue Glenview IL 60026

Theraputic Day School Northbrook Court Imaging

1182 Northbrook Court Northbrook IL 60062

Outpatient Clinic Neurological Institute

71 W 156th Street Harvey IL 60426

Outpatient Clinic NorthShore Lab Services - Evanston

2500 Ridge Avenue Evanston IL 60201

Outpatient Clinic Fetal Diagnostic Center

880 W Central Road Arlington Heights IL 60005

Outpatient Clinic Lakeshore Imaging

680 N Lake Shore Drive Chicago IL 60611

Outpatient Clinic Fetal Diagnostic Center

660 N Westmoreland Road Lake Forest IL 60045

Outpatient Clinic Northbrook Pharmacy

1127 Church Street Northbrook IL 60062

Outpatient Pharmacy Fetal Diagnostic Center

755 S Milwaukee Avenue Libertyville IL 60048

Outpatient Clinic Libertyville Pharmacy

1451 W Peterson Road Libertyville IL 60048

Outpatient Pharmacy Lake Forest Pharmacy

825 S Waukegan Avenue Lake Forest IL 60045

Outpatient Pharmacy Fetal Diagnostic Center

5145 N California Avenue Chicago IL 60625

Outpatient Clinic Breast Health and Mammography Program

4999 Old Orchard Center Skokie IL 60077

Outpatient Clinic River North Same Day Surgery

One East Erie Street Chicago IL 60611

Ambulatory Surgery Center Ravine Way Surgery Center

2350 Ravine Way Glenview IL 60025

Ambulatory Surgery Center 25 East Same Day Surgery Center

25 East Washington Street Chicago IL 60602

Ambulatory Surgery Center North Shore Same Day Surgery

3725 West Touhy Avenue Lincolnwood IL 60712

Ambulatory Surgery Center Elmwood Park Same Day Surgery

1614 North Harlem Avenue Elmwood Park IL 60707

Ambulatory Surgery Center Percent of Total Expense Part I Line 7 column (f) The amount of bad debt expense that was included in Form 990, Part IX, line 25, column (A) but removed from the figure in Part I, Line 7, column (f) was $47,693,494. Costing Methodology Part I Line 7 NorthShore University HealthSystem calculated the cost of charity care and means-tested government programs using the cost-to-charge ratio derived from Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges. Amounts in the other benefits section of Line 7 were calculated using costs charged directly to the individual programs from the financial accounting system. An indirect cost allocation factor for hospital shared services was also calculated and included for each program indicated in other benefits. Community Building Activities Part II NorthShore University HealthSystem (NorthShore) is involved in numerous community building activities which promote the health of the communities it serves. NorthShore encourages its employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities served. Bad Debt Expense Part III Line 4 Accounts Receivable Financial Statement Footnote - The Corporation evaluates the collectibility of its accounts receivable based on the length of time the receivable is outstanding, payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible. Bad debt expense at cost was calculated using a cost-to-charge methodology. The Ratio of Patient Care cost to charges calculated to report charity care on Part I, Line 7a was multiplied by the bad debt expense to determine the bad debt expense at cost. Discounts and payments on patient accounts are excluded from bad debt expense in order to reflect the expected amount to be paid. Medicare Shortfall Part III Line 8 NorthShore University HealthSystem (NorthShore) believes that all of the $55,967,251 shortfall should be considered as community benefit. The Internal Revenue Service Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by NorthShore in order to continue treating the elderly in our community. During fiscal year 2011, Medicare accounted for approximately 42% of hospital gross patient revenues. The hospital provides care regardless of this shortfall and thereby relieves the government of the burden of paying the full cost of care for Medicare beneficiaries. Collection Practices Part III Line 9b NorthShore University HealthSystem (NorthShore) follows the Illinois Fair Patient Billing Act. The collection policy is the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off. Any remaining balance would be collected under the existing debt collection policy. Number of Other Facilities Part V In addition to the four hospital facilities, NorthShore University HealthSystem (NorthShore) operates 24 outpatient clinics, four outpatient pharmacies, one therapeutic day school, and five ambulatory surgery centers. Needs Assessment Part VI Line 2 NorthShore University HealthSystem (NorthShore) consistently assesses the needs of its communities and those of the underserved to ensure that its community benefits programs are in alignment with the health needs of the communities it serves. In addition to collecting and analyzing available quantitative and qualitative data on mortality, disease incidence, utilization of and access to health care services, NorthShore established a mechanism in which to actively seek the involvement of our community and public health leaders in an ongoing manner to ensure that our analysis reflects the current public health needs in our area. Community Needs Assessment Methodology - In order to produce a comprehensive health assessment, NorthShore utilized a range of available data sources. Public health statistics on mortality, maternal, infant, and child health, emotional well-being and access to care were obtained from the Illinois Department of Public Health website. The most recent data available is from 2006. As public health data often lags by several years, and is only available at the state, Metropolitan Statistical Area, or county level, NorthShore also identified sources of zip-code level estimates of disease incidence metrics and socioeconomic status. This data assisted in understanding local levels of need and variation across our specific service area. (The zip-code level metrics included data from Thomson/Reuters from 2008, a health care information company, which creates estimates based on Census data, Medicare and third party insurance claims, and a nationally-representative household survey that includes self-reported health status, health care utilization, and self-report diagnoses.) NorthShore also identified zip-code level rates of preventable hospitalizations based on Agency for Healthcare Research and Quality (AHRQ) definitions. Preventable hospitalizations served as an indicator of the quality and depth of the outpatient management of chronic diseases, such as hypertension, high cholesterol, diabetes and obesity. The causes that trigger hospitalization were identified using the Illinois Hospital Associations COMPData database. Based on the compilation of these sources, NorthShore found that mortality and non-obstetric hospitalizations are driven predominantly by heart disease, cancer, stroke, pneumonia, diabetes and psychiatric conditions. Areas of greatest socioeconomic need within NorthShore's service area are concentrated in northern Lake County and the North Chicago neighborhoods. NorthShore also identified differences across the service area in the self-reported health status and diagnosis of disease, and compared overall rates to Healthy Goals 2010 (where applicable). Community Involvement - NorthShore utilizes multiple mechanisms for seeking out the collective voice of the community in understanding the unmet health needs. For example, each NorthShore hospital has a community advisory committee that includes a range of community leaders. These leaders represent local public health agencies, non-profit organizations serving low-income residents, faith based groups, and business and civic leaders. They advise each hospital and NorthShore on services or initiatives from a community perspective and provide strategic recommendations for community benefits programs. NorthShore's key senior administrators as well as its community relations staff maintain strong working relationships with local leaders, public health agencies, township officials and social service agencies not represented in the community advisory committee. In their role as community liaison, the community relations personnel serve as point of contact for NorthShore's involvement with community requests. In addition, community relations personnel coordinate the hospital presidents' role in NorthShore advocacy programs. Senior administrators at NorthShore also participate regularly in outreach to local leaders. NorthShore physicians and staff play an equally important role in identifying health trends and needs through their leadership, board participation and involvement in local, regional and national organizations. Information related to the health assessments and findings are communicated at the department level to NorthShore leadership. NorthShore will continue to track both quantitative and qualitative sources of public health information as it becomes available, as well as feedback from community leaders. Community health needs data is used in our annual strategic planning processes. Stakeholder participation is critical and greatly influences NorthShore's prioritization and execution of its community benefits programs. In addition, collaboration with local leadership allows NorthShore to detect urgent and growing needs that may be underrepresented or absent from aggregate data, in a timely and effective manner. Lastly, collaboration with local leaders has facilitated the development of signature programs, such as Be Well-Lake County and real time solutions to critical health challenges. Strategic Approach for Meeting Community Health Needs - NorthShore implements a three-fold strategy to address the health needs of the communities that it serves as follows: 1) Community benefits programs, signature initiatives and partnerships will address a need identified in the community health needs assessment conducted by NorthShore, 2) Community benefits programs, initiatives and partnerships will address a need identified by the community, 3) Community benefits programs, initiatives and partnerships will be aligned with the guiding principles outlined in Advancing the State of the Art of Community Benefits for Nonprofit Hospitals. The guiding principles are: disproportionate unmet health-related needs; primary prevention; seamless continuum of care; build community capacity; and community collaboration. All of NorthShore's community benefits programs, initiatives and partnerships are documented in a report that provides the date(s), describes the initiative, identifies assessed need(s) met, highlights outcomes and identifies guiding principles met. NorthShore will continue to place priority on providing community benefits and services in the communities located nearest to our hospitals, where we believe we have the greatest capacity and responsibility to serve. NorthShore conducted its most recent assessment in 2010, and therefore, will complete its next assessment in 2013. Patient Education of Eligibility for Assistance Part VI Line 3 NorthShore informs and educates potentially impacted patients of the Financial Assistance program by posting signage (both English and Spanish) in all the facilities' Emergency Departments and at our Central Registration areas. The NorthShore Patient Handbook is also presented to patients upon admission and it describes the Financial Assistance program that includes Charity Care. NorthShore also has approximately 13 full time financial counselors and 22 customer service agents working in the hospitals and clinics, and they are responsible for coordinating financial assistance and eligibility. Any uninsured patient admitted into the hospital will have their case reviewed by a financial counselor. NorthShore billing statements also indicate the Financial Assistance program and necessary contact information. NorthShore's physician offices and collection agencies are also instructed to coordinate charity care to potentially eligible patients. The NorthShore website is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible will have their case reviewed by a financial counselor or by calling the Customer Service department. Community Information Part VI Line 4 NorthShore University HealthSystem (NorthShore) has four hospital facilities located in the northern suburbs of Chicago, Illinois. The NorthShore service area has a total population size of approximately 1.6 million*. The average household income is approximately $109,000*. During fiscal year 2011, approximately 5% of NorthShore's patients had no insurance and 7% qualified for Medicaid. Within NorthShore's service area, there are three federally-designated medically underserved areas. NorthShore's service area also includes five other hospitals. *Source: US Census via Thomson Reuters Market Planner Plus Promotion of Community Health Part VI Line 5 NorthShore University HealthSystem (NorthShore) does extend medical staff privileges to all qualified physicians in the NorthShore community. NorthShore also uses surplus funds to add new buildings and renovate existing facilities to better serve patients and the community. Additional programs conducted by NorthShore to help promote the health of the community include: Residency and Education Programs - NorthShore is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2011, a total of 189 residents and 19 fellows participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (1st Year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Female Pelvic Medicine and Reconstructive Surgery, Magnetic Resonance Imaging, Musculoskeletal Imaging, Emergency Medicine Simulation, Surgical Pathology, and Endocrine Surgery. The affiliate-based residency program areas included: Anesthesiology, Dermatology, Emergency Medicine, Obstetrics and Gynecology, Orthopaedic Surgery, Pediatrics, Psychiatry, Radiology, General Surgery, Neurology, Neurosurgery, Ophthalmology, Otolaryngology, Plastic Surgery, Podiatry, and Urology. The affiliate-based fellowship program areas included: Body Contouring Plastic Surgery, Cardiology, Child Neurology, Child Psychiatry, Electrophysiology, Gastroenterology, Infectious Diseases Research, Maternal-Fetal Medicine, Neonatal-Perinatal Medicine, Palliative Medicine, Surgical Oncology, and Urology. The NorthShore School of Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year 2011, 66 students participated in the program. NorthShore also provided clinical training and internships for 1,694 students in various departments including Social Work, Nursing, Physical Therapy, and Speech Therapy during the 2011 academic year. These internships were conducted through collaborative relationships with several educational institutions including Chamberlain College, College of Lake County, DePaul University, Harper College, Loyola University Chicago, Midwestern University, North Park University, Northern Illinois University, Northwestern University, Oakton Community College, Rosalind Franklin University, Rush University, University of Chicago, University of Illinois, University of Illinois at Chicago, University of Iowa, and University of Minnesota. Community Advisory Committees - The Community Advisory Committees' (CAC) role is to advise hospital administration on services and initiatives from a community perspective. CACs are structured to ensure NorthShore's accountability to the community by working to fulfill our community relations vision that the more NorthShore and the community connect, the stronger and healthier both will become. The CACs are comprised of primarily community members, along with hospital administrative and professional staff. NorthShore strives for diverse membership to include business, faith community, social services, civic organizations, government officials, elected officials, interested citizens, former patients, and healthcare professionals. The role of the CACs is to serve as an advocate for the greater good of the community and its health, and to provide recommendations for annual community benefit planning. The CACs also help identify opportunities for partnerships between the hospitals and community organizations, and they identify gaps in healthcare services within the community. Be Well Lake County - Be Well Lake County is a collaboration between NorthShore, Lake County Health Department and Community Health Center, and supporting community partners. The program's goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. Evanston Hospital Outpatient Clinic - The Outpatient Clinic at Evanston Hospital provides medical care to adults and children who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In fiscal year 2011, the clinic treated 4,659 adult patients at 12,789 visits and 2,711 adolescent patients at 6,869 visits. Dental Center - The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided free and discounted care for 3,081 patients at a cost of $208,814 during fiscal year 2011. Evanston Township High School Health Center - Established as a collaborative partnership with Evanston Township High School, the Evanston Health Department, and NorthShore, the Health Center is a free school-based health clinic for the school's approximately 3,000 students. The Health Center is staffed by NorthShore employees, including a physician, two part-time nurse practitioners, and a social worker. During the 2010-2011 school year, 713 students utilized the Health Center at 2,204 visits at a cost of $545,643. Medication Assistance Program - NorthShore's Medication Assistance Program helps patients with the cost of paying for prescription drugs. The Medication Assistance Program assisted 2,274 patients in filling 30,501 prescriptions at a cost of $797,222 during fiscal year 2011. Home Health and Hospice Services - NorthShore provides intermittent care including skilled nursing, physical therapy, occupational therapy, speech therapy, infusion therapy, and home health aides. Home and Hospice also provides hospice and palliative care services to NorthShore patients and their families. During fiscal year 2011, there were 66,486 patient visits and 5,118 admissions. Perinatal Depression Program - The Perinatal Depression Program identifies women who are suffering from perinatal depression and offer referrals for women who many need additional support. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. The hotline provides multilingual interpretation services to assist those with limited or no English-speaking ability. All services are provided free of charge. In fiscal year 2011, NorthShore physicians conducted 6,102 screenings to identify at-risk patients, and the hotline received 696 calls. Free psychological support and referrals were provided for 516 women identified through the screenings as at-risk for perinatal mood disorders. Community Action for Child Health Equity - NorthShore's Community Action for Child Health Equity (CACHE) is one of five national sites for a National Institutes of Health funded study focused on maternal stress and the corresponding effect on birth outcomes and child health, growth, and development. The overall goal of the study is to gain information that will ultimately lead to the elimination of disparities in maternal health and child development. CACHE has pushed the study to offer immediate community benefit by developing a pioneering parallel system that provides outreach efforts to interview subjects in real time when important health interventions are needed. Employee Volunteerism - NorthShore employees participate in various volunteer activities that meet community needs and promote good will. Several NorthShore publications include information about volunteer organizations and employee volunteer opportunities. NorthShore recognizes employee volunteers through the Sharing Spirit Volunteer Award. Affiliated Health Care System Part VI Line 6 NorthShore University HealthSystem (NorthShore) is a comprehensive, fully integrated, healthcare delivery system that includes four hospitals, as well as numerous outpatient departments and clinics. In additional to the hospital organization, there are the following affiliates that help to meet the needs of the community: NorthShore University HealthSystem Foundation - The NorthShore University HealthSystem Foundation (Foundation) seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of high-quality services and giving opportunities. NorthShore University HealthSystem Research Institute - The NorthShore University HealthSystem Research Institute (Research Institute) was organized to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute now houses nearly 200 externally funded research faculty who currently occupy over 100,000 net square feet of research space and work on nearly 1,000 active research protocols. Total external funding is now over $100 million. Funding from the NIH places the hospitals of NorthShore among the top 10 comprehensive independent research hospitals in the country. In addition, NorthShore has made a substantial commitment to develop a new Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure will enable large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work will build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research. NorthShore University HealthSystem Faculty Practice Associates - The NorthShore University HealthSystem Faculty Practice Associates (FPA) represents more than 700 physicians with over 80 offices in virtually every specialty all on staff at the hospitals of NorthShore. The primary function and activity of FPA is to employ, supervise, and conduct employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The FPA physicians also conduct medical education activities for the NorthShore interns and residents, and FPA also performs medical research on behalf of NorthShore. Radiation Medicine Institute - The Radiation Medicine Institute (RMI) employs, supervises, and conducts employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. RMI also conducts medical education activities for the NorthShore interns and residents, and RMI also performs medical research on behalf of NorthShore. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL true American Brain Tumor Association 8550 W Bryn Mawr Ave Chicago IL 60631 237286648 501(c)(3) 8300 General Support American Cancer Society 820 Davis Street Evanston IL 60201 362167721 501(c)(3) 27550 Relay for Life Sponsorship American Heart Association 208 South LaSalle Street Chicago IL 60604 360900700 501(c)(3) 20000 Heart Walk Sponsorship American Red Cross of Greater Chicago 2200 West Harrison Street Chicago IL 60612 530196605 501(c)(3) 25000 Japan Relief Fund Cancer Wellness Center 215 Revere Dr Northbrook IL 60062 363604463 501(c)(3) 15000 Community Contribution City of Evanston 2100 Ridge Ave Evanston IL 60201 366005870 115 6500 Community Contribution Council for Jewish Elderly 3003 W Touhy Ave Chicago IL 60645 362727597 501(c)(3) 5700 FMV Office Space Community Contribution Connections for the Homeless 2010 Dewey Ave Evanton IL 60201 363346917 501(c)(3) 10000 Community Contribution Evanston Chamber of Commerce 1840 Oak Ave Evanston IL 60201 361051450 501(c)(6) 9155 Community Contribution Greater Chicago Food Depository 4100 West Ann Lurie Place Chicago IL 60632 362971864 501(c)(3) 10000 Community Contribution Glenview Police Department Social Services Fund 2500 E Lake Ave Glenview IL 60026 366005905 115 10000 Community Contribution Highland Park Chamber of Commerce 508 Central Ave Highland Park IL 60035 361217360 501(c)(6) 6600 Community Contribution Illinois Hospital Research and Edu Fndn 24676 Network Place Chicago IL 60673 237421930 501(c)(3) 46403 Hospital Mutual Assistance Program The Josselyn Center NFP 405 Central Ave Northfield IL 60093 362217996 501(c)(3) 8000 Community Contribution Lake County Health Department 3010 Grand Avenue Waukegan IL 60085 366006600 115 170000 Be Well Lake County Program Lake County Partners for Economic Develop 28055 Ashley Circle Libertyville IL 60048 364206288 501(c)(3) 10000 Community Economic Development Lake Forest High School Booster Club 1285 N McKinley Rd Lake Forest IL 60045 363903280 501(c)(3) 7500 Community Contribution Niles Township 5255 Main St Skokie IL 60077 362438196 115 10000 Community Contribution North Shore Senior Center 161 Northfield Road Northfield IL 60093 362366074 501(c)(3) 6190 Community Contribution Northern Illinois Food Bank 600 Industrial Dr St Charles IL 60174 363203648 501(c)(3) 10000 Community Contribution Turning Point Behavioral Health Care Center 8324 Skokie Blvd Skokie IL 60077 362327294 501(c)(3) 10000 Community Contribution NorthShore Faculty Practice Associates 1301 Central Street Evanston IL 60201 363738206 501(c)(3) 37636597 General Support Atlantic Health System PO BOX 48328 Newark NJ 07101 521958352 501(c)(3) 16800 Research The Brigham and Women's Hospital Inc 75 Francis St Boston MA 02115 042312909 501(c)(3) 73870 Research Cepheid Inc 904 Caribbean Dr Sunnyvale CA 94089 770441625 367180 Research Delve LLC 11971 Westline Ind DR St Louis MO 63143 200684635 1050000 Research FACITtrans 381 S Cottage Hill Ave Elmhurst IL 60126 270945200 111100 Research George Washington University 801 22nd St NW Washington DC 20052 530196584 501(c)(3) 10831 Research Indiana Institute for Medical Research 1481 W 10th St Indianapolis IN 46202 351781809 501(c)(3) 14196 Research Kessler Foundation 300 Executive Dr West Orange NJ 07052 311562134 501(c)(3) 35333 Research KUMC Research Institute PO Box 801708 Kansas City MO 64180 481108830 501(c)(3) 27799 Research Mayo Clinic 200 First St SW Rochester MN 55905 416011702 501(c)(3) 311616 Research THE Medical College Of Wisconsin Inc 8701 Watertown Plank Rd Milwaukee WI 53226 390806261 501(c)(3) 65807 Research Monell Chemical Senses Center 3500 Market St Philadelphia PA 19104 232020897 501(c)(3) 182492 Research Northwestern University 633 Clark St Evanston IL 60208 362167817 501(c)(3) 2304625 Research Oregon Health and Science University 2525 SW First Avenue Portland OR 97201 931176109 501(c)(3) 82476 Research Rehabilitation Institute Of Chicago 345 E Superior St Chicago IL 60611 362256036 501(c)(3) 16694 Research Rutgers 3 Rutgers Plaza New Brunswick NJ 08901 226001086 115 29087 Research Southwest Foundation for Biomedical Res PO Box 760549 San Antonio TX 78245 741109630 501(c)(3) 30156 Research Stanford University PO Box 44436 San Francisco CA 94144 941156365 501(c)(3) 32118 Research Temple University 1803 N Broad St Philadelphia PA 19122 231365971 501(c)(3) 16058 Research Texas Biomedical Research Institute PO Box 760549 San Antonio TX 78245 741109630 501(c)(3) 27087 Research The Regents of UC 1200 Dutton Hall Davis CA 95616 946036493 115 105691 Research True North Distributing PO Box 251 Ponte Vedra Beach FL 32004 263474864 777986 Research Trustees Of Boston University 25 Buick Street Boston MA 02215 363648026 501(c)(3) 35150 Research University of Chicago 5801 S Ellis Ave Chicago IL 60637 362177139 501(c)(3) 390799 Research University Of Chicago-Opinion Res Center 55 East Monroe St Chicago IL 60603 362167808 501(c)(3) 5554 Research University of Illinois 506 S Wright Urbana IL 61801 376000511 115 30429 Research University of Minnesota Education Suite 190 Minneapolis MN 55455 416007513 115 124763 Research University of Pittsburgh 580 South Aiken Avenue Pittsburgh PA 15232 250965591 501(c)(3) 71864 Research University of Southern California 1450 San Pablo St Los Angeles CA 90033 951642394 501(c)(3) 90196 Research University of Washington 12455 Collections Drive Chicago IL 60693 916001537 115 92329 Research Virginia Commonwealth University PO Box 843039 Richmond VA 23284 546001758 115 16792 Research Westat Inc PO Box 1004 Rockville MD 20850 840529566 143795 Research ZRT Laboratory LLC 8605 SW Creekside Place Beaverton OR 97008 931252924 47850 Research 47 8 Scholarships in Medical Field 79 113576 Monitoring of Grant Funds Schedule I Part I line 2 NorthShore University HealthSystem (NorthShore) provides cash and non-cash assistance to organizations that help support NorthShore's mission to preserve and improve human life. Requests to support an outside organization must be reviewed and approved by the Community Relations department and NorthShore management to ensure the organization is aligned with NorthShore's mission and charitable purpose. NorthShore also provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports. In addition, NorthShore provides cash support to related organizations. Support to related organizations is monitored through the NorthShore budget and reporting procedures for the consolidated financial statements. Finally, NorthShore provides nursing scholarships to individuals. The scholarship amount depends on the degree sought, and the number of scholarships awarded depends on the available funds for each year. Scholarships are awarded on an annual basis to applicants that meet the eligibility criteria. Applicants must be current employees of NorthShore as a staff nurse or other related clinical position. Applicants must also be currently enrolled in a nursing degree program, and enrollment must be maintained for the year the scholarship is received. In addition, applicants must sign a Statement of Agreement to work for NorthShore as a staff nurse or in a related clinical position for one year following receipt of the scholarship. X true false X X X X true true false false false false false true false Michael S Caplan 300172 161751 0 35000 2160 16732 13596 7327 5168 2785 321096 223595 0 0 Janardan D Khandekar 577065 147813 0 170000 0 47511 16657 4266 19546 5007 613268 374597 0 0 Mark S Talamonti 599930 245347 0 100000 0 20187 14850 6073 20829 8518 635609 380125 0 0 Mark R Neaman 863089 0 427500 0 517177 0 238423 0 14984 0 2061173 0 0 0 Jeffrey H Hillebrand 566243 0 252000 0 22710 0 168676 0 17984 0 1027613 0 0 0 Gary E Weiss 358940 0 158000 0 10091 0 94256 0 14188 0 635475 0 0 0 William D Bloomer 393030 260626 0 350000 0 61885 12581 8342 18727 12418 424338 693271 0 0 Robert R Edelman 699975 37536 0 232200 0 7224 19858 1065 35393 1898 755226 279923 0 0 Bernard G Ewigman 378326 0 25000 0 0 0 50597 0 46593 0 500516 0 0 0 Gerald P Gallagher 296076 0 131000 0 2877 0 80590 0 21810 0 532353 0 0 0 Thomas H Hodges 398209 0 190000 0 64189 0 20923 0 15698 0 689019 0 0 0 Harry L Jones 228748 0 106000 0 2990 0 20923 0 22791 0 381452 0 0 0 William R Luehrs 307690 0 150000 0 6970 0 83323 0 15495 0 563478 0 0 0 Demetrius Maraganore 261276 209001 0 50000 0 2494 11624 9299 14382 11504 287282 282298 0 0 Frederick E Miller 299936 49568 0 25000 0 41611 17956 2967 21187 3501 339079 122647 0 0 Kristen Murtos 260797 0 120000 0 1763 0 75923 0 24905 0 483388 0 0 0 Jesse Peterson Hall 317662 0 144000 0 3975 0 86256 0 24550 0 576443 0 0 0 William J Robb III 500769 0 67000 0 7749 0 20923 0 1245 0 597686 0 0 0 Leopold G Selker 314912 0 132000 0 95492 0 84923 0 16756 0 644083 0 0 0 Nancy Semerdjian 255740 0 105000 0 6158 0 20923 0 15454 0 403275 0 0 0 Richard K Silver 700013 118585 0 85000 360 31721 17892 3031 26684 4520 744949 242857 0 0 Douglas M Silverstein 356931 0 160000 0 5974 0 135034 0 9732 0 667671 0 0 0 Thomas W Smith 313824 0 154000 0 9746 0 84923 0 17424 0 579917 0 0 0 Jeffery S Vender 403852 341721 0 250000 0 20893 11333 9590 12867 10888 428052 633092 0 0 Thomas A Victor 363260 73396 0 325000 0 55721 17406 3517 24881 5027 405547 462661 0 0 Brian Washa 237898 0 84000 0 911 0 20923 0 21681 0 365413 0 0 0 Kenneth P Anderson 353571 0 89300 0 4983 0 20923 0 23408 0 492185 0 0 0 John Merz 204380 0 72500 0 4224 0 20923 0 16413 0 318440 0 0 0 Colleen Mitchell 207927 0 100000 0 79445 0 20923 0 15259 0 423554 0 0 0 Sean O'Grady 211952 0 75300 0 885 0 20923 0 24035 0 333095 0 0 0 Steven Smith 229848 0 70500 0 1299 0 20923 0 22037 0 344607 0 0 0 David C Holub 140831 34265 0 0 1140 8559 12693 3088 5880 1431 160544 47343 0 0 Nicholas A Vick 156000 41878 0 8672 1000 37272 16483 4425 12264 3292 185747 95539 0 0 Benefits Provided Part I Line 1a First-class airfare was provided to the Chief Executive Officer and Chief Operating Officer for business travel purposes and was not treated as taxable compensation. The first-class airfare was purchased through a prepaid airline mileage account, which provided discounted airline fare rates. Reimbursement Substantiation Part I Line 2 A prepaid airline mileage account was purchased for the travel of the Chief Executive Officer and Chief Operating Officer. At the time of the purchase, it was not known what specific travel would occur and therefore the travel could not be substantiated at purchase. The business purpose of each trip was substantiated at the time of travel. Severance Payments Part I Line 4a Colleen Mitchell, Former President, Foundation, received a severance payment from NorthShore University HealthSystem for $63,231. Supplemental Nonqualified Retirement Plan Part I line 4b The following individuals participated in a supplemental nonqualified retirement plan and accrued the following benefits: Mark R Neaman, President and Chief Executive Officer - $488,695, Jeffrey H Hillebrand, Chief Operating Officer - $32,420, Thomas H Hodges, Chief Investment Officer - $42,200, Leopold G Selker, President, Research Institute - $82,007, Douglas M Silverstein, President, Glenbrook Hospital - $41,778. Non-Fixed Payments Part I Line 7 NorthShore University HealthSystem provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the Compensation Committee of the Board of Directors. Compensation from Unrelated Organizations Core Form 990, Part VII, Line 5 The salary and benefits reported on Schedule J totaling $500,516 for Dr. Bernard G Ewigman were paid by the University of Chicago Medical Center for services provided to NorthShore University HealthSystem as the Chairman of the Department of Family Medicine. Illinois Finance Authority 861091967 45200F4D8 2010-07-14 138786145 See Part V false false false Illinois Finance Authority 861091967 45200MU93 2008-12-11 75000000 See Part V false false false 4145000 138786145 1017771 137768374 2010 true false true true 75000000 433044 131875 74435081 2008 false false true true false false true true true 0.00300 0.00200 0.00500 true false false false false false true false true false false false true Bond Issue Description of Purpose Part I Column (f) Line A To refund bonds issued on July 3, 2001. Proceeds were also used to pay termination costs in connection with certain derivative agreements related to the refunded bonds. Bond Issue Description of Purpose Part I Column (f) Line B To reimburse NorthShore University HealthSystem for the costs of construction, renovation, and equipment for various projects at Evanston Hospital, Glenbrook Hospital, and Highland Park Hospital. NorthShore Physician Associates Inc See Part V 25002494 Capitation Payments, Other false NorthShore Insurance International See Part V 5003755 Insurance Premiums false Ravine Way Surgery Center LLC See Part V 840000 Earnings Distributions true NorthShoreUSP Surgery Center II LL See Part V 748500 Earnings Distributions true Advisory Board Company Bd Mbr - Mark Neaman 466300 Membership Dues false Vocera Communications Inc Bd Mbr - Jeff Hillebrand 1881810 Communications Equipment false VHA Inc Bd Mbr - Jeff Hillebrand 2783072 Net Purch Rebates/Mbr Charges false Medline Industries Officer - Andrew Mills 743362 Medical Supplies false Blue Cross Blue Shield of Illinois Bd Mbr - Sona Wang 414921132 Net Patient Revenues false April F Victor Family Mbr-Thomas Victor 50336 Employment false Alexis A Washa Family Mbr-Brian Washa 186543 Employment false Business Transactions with Interested Persons Part IV Column (b) NorthShore Physician Associates Inc board members were Mark S Talamonti and Thomas A Victor. NorthShore Insurance International board members were Gerald P Gallagher and Harry L Jones. Ravine Way Surgery Center LLC board members were Jeffrey H Hillebrand and Gerald P Gallagher. NorthShore/USP Surgery Center II LLC board members were Jeffrey H Hillebrand and Thomas H Hodges. X 26 726465 Sale Proceeds false true false Mission Statement Part III Line 1 The core mission of NorthShore University HealthSystem is to "preserve and improve human life." This mission will be achieved through the provision of superior clinical care, academic excellence, and innovative research. NorthShore is a not-for-profit organization principally formed to provide quality healthcare services for the communities it serves. The delivery of healthcare services is provided in a wide range of inpatient and ambulatory healthcare settings, community-wide, employing modern technology and expertise. Support for qualified patients who may not be able to pay the entire cost of their care is a part of the organization's commitment. In support of its primary mission of patient care, the organization engages in a wide range of academic activities in medical education and research. This statement recognizes the Board of Directors' responsibility to maintain the organization's viability to meet its long-term commitment to the communities it serves. It further recognizes the responsibility to maintain technologically current assets for this purpose. This includes the cultivation and development of our physicians, graduate medical students, employees, physical plant, equipment and other resources to assure orderly growth of our services. Statement of Program Services - Patient Care Part III Line 4a Headquartered in Evanston, Illinois, NorthShore University HealthSystem, (NorthShore), is a comprehensive, fully integrated, healthcare delivery system that serves the Chicago region. NorthShore includes four hospitals: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital and Skokie Hospital. NorthShore has approximately 9,000 employees and 2,400 affiliated physicians, including a multispecialty group practice with over 80 office locations under the NorthShore University HealthSystem Faculty Practice Associates. The integrated health system has significant capabilities in a wide spectrum of clinical programs, including cancer, heart, orthopaedics, high-risk maternity and pediatrics. Further, NorthShore Supports teaching and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine. NorthShore is a Magnet recognized organization, the only one in Illinois designated as a system to receive this prestigious honor that demonstrates excellence in nursing and high standards of patient care. NorthShore is a national leader in the implementation of innovative technologies, including electronic medical records (EMR). In 2003, NorthShore was among the first hospital system in the country to successfully launch a system-wide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement. NorthShore has also been named one of the nation's Top 10 Health Systems by Thomson Reuters, a leading provider of information and solutions to improve the cost and quality of healthcare. The Top 10 Health Systems study measures the performance of health systems based on several metrics, including in-hospital mortality, medical complications, patient safety, average length of stay, adherence to clinical standards of care, and patient survey scores. NorthShore's Evanston and Glenbrook hospitals were named to the annual class of top national hospitals by the Leapfrog Group's Top Hospitals List for 2011. NorthShore's hospitals were among 65 selected from a field of nearly 1,200 hospitals nationally; and only two of five hospitals in Illinois to receive this award. This prestigious designation, which is the most competitive national hospital quality award in the country, recognizes hospitals based on the results of the Leapfrog Group's national survey that measures hospitals' performance in crucial areas of patient safety and quality. NorthShore is ranked nationally in ten different specialties in the U.S. News and World Report annual survey of America's top hospitals. The survey looked at about 5,000 hospitals nationwide, ranking them in 16 different specialties, and a total of only 140 hospitals received at least one national ranking. NorthShore was ranked as high-performing in the following specialties: Cancer, Diabetes and Endocrinology, Ear, Nose, and Throat, Gastroenterology, Geriatrics, Gynecology, Nephrology, Neurology and Neurosurgery, Orthopaedics, and Urology. NorthShore recognizes and embraces its responsibility to ensure that it fulfills its charitable obligations in the most cost-effective and sustainable manner. In order to achieve this goal, NorthShore has aligned its community benefits program with the guiding principles outlined in Advancing the State of the Art of Community Benefit for nonprofit hospitals, which provides a set of uniform standards to increase accountability and align governance, management, and operations to return benefit to local communities. The five guiding principles are: 1) Disproportionate Unmet Health-Related Needs, 2) Primary Prevention, 3) Seamless Continuum of Care, 4) Build Community Capacity, and 5) Community Collaboration. NorthShore informs and educates potentially impacted patients of the Financial Assistance program by posting signage (both English and Spanish) in all the facilities' Emergency Departments and at our Central Registration areas. The NorthShore Patient Handbook is also presented to patients upon admission and it describes the Financial Assistance program that includes Charity Care. NorthShore also has approximately 13 full time financial counselors and 22 customer service agents working in the hospitals and clinics, and they are responsible for coordinating financial assistance and eligibility. Any uninsured patient admitted into the hospital will have their case reviewed by a financial counselor. NorthShore billing statements also indicate the Financial Assistance program and necessary contact information. NorthShore's physician offices and collection agencies are also instructed to coordinate charity care to potentially eligible patients. The NorthShore website is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible will have their case reviewed by a financial counselor or by calling the Customer Service department. Evanston Hospital - With a history dating to 1891, Evanston Hospital is a 354-licensed bed hospital and serves as the nucleus of the NorthShore University HealthSystem. Evanston Hospital demonstrates leadership in cancer and cardiac care, providing specialized cancer services at the Kellogg Cancer Care Center and comprehensive heart care at the Cardiovascular Care Center. Physicians work alongside leading researchers to translate the latest technology, treatment and research into improved patient care. As the regional center for high risk obstetrics, the Women's Hospital offers a comfortable birthing environment where high risk mothers and their babies have access to the latest technology and a highly trained staff. Evanston Hospital is the regional referral center for high risk maternal transports for eight suburban Chicago hospitals. The Hospital is also a licensed Level I Trauma Center. During fiscal year 2011, Evanston Hospital total admissions were 19,262, and total patient days were 101,497. Statement of Program Services - Patient Care - Continued Part III Line 4a Glenbrook Hospital - Opened in 1977, Glenbrook Hospital is a 169-licensed bed hospital providing advanced diagnostic and therapeutic interventions. Glenbrook Hospital's specialties include the Kellogg Cancer Center, Patricia Nolan Center for Breast Health, Simms Family GI Lab, Eye and Vision Center, and Total Joint Replacement Center. Glenbrook Hospital is also a Level II Trauma Center and a Joint Commission certified primary stroke center. Near Glenbrook Hospital, the NorthShore location at the Glenview Park District Park Center offers an Integrative Medicine Program, rehabilitation services, community wellness programs, and a retail herbal and wellness pharmacy. During fiscal year 2011, Glenbrook Hospital total admissions were 9,833, and total patient days were 45,403. Highland Park Hospital - Founded in 1918, NorthShore's Highland Park Hospital has provided high-quality healthcare and a wide range of clinical programs for nearly a century. The 149-licensed bed Hospital is the site of the first open heart surgery in Lake County and is a key partner in bringing important healthcare programs to area residents. Highland Park Hospital's Kellogg Cancer Care Center offers the most comprehensive subspecialty care for oncology patients. Specialized physicians provide care for the following types of cancer: thoracic and lung; hematology; breast; ovarian; head and neck; melanoma and sarcoma; gastrointestinal; prostate; and stomach. Highland Park Hospital is a Joint Commission certified primary stroke center. Highland Park Hospital also has a wound care center that gives patients access to the most comprehensive wound treatment program on the North Shore. The Emergency Department at Highland Park Hospital participates as the region's "pod" hospital for disaster response activities, coordinating Lake County's efforts when confronted with a disaster. Also available are a wide variety of mental health services, including a center for eating disorders, adolescent psychiatric care, and the Doreen E. Chapman Center for substance abuse. NorthShore also has a partnership with the Lake County Health Department and Community Health Center known as Be Well Lake County. The program's goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. During fiscal year 2011, Highland Park Hospital total admissions were 9,736, and total patient days were 43,330. Skokie Hospital - Founded in 1963, Skokie Hospital has provided high-quality healthcare for nearly five decades. The 195-licensed bed acute care hospital is nationally recognized for its expertise in orthopaedics, cardiac care, and cancer care. Key hospital specialties and features also include minimally invasive surgery, total joint replacement, a women's health center, a gastroenterology lab and graduate medical education (residency) programs in internal medicine, general surgery, and anesthesia. In addition, Skokie Hospital's Level II Trauma Center - Emergency Department - is staffed by experienced trauma team members specially trained in pediatric life support. During fiscal year 2011, Skokie Hospital total admissions were 7,526, and total patient days were 38,793. NorthShore University HealthSystem Faculty Practice Assoicates - In order to increase the efficiency and quality of health care NorthShore provides, NorthShore University HealthSystem Faculty Practice Associates (FPA) was organized to serve as an integral part of its health care mission and activities. FPA represents more than 700 physicians with over 80 offices in virtually every specialty all on staff at the hospitals of NorthShore. The primary function and activity of FPA is to employ, supervise, and conduct employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The FPA physicians also conduct medical education activities for the NorthShore interns and residents, and FPA also performs medical research on behalf of NorthShore. NorthShore University HealthSystem Foundation - NorthShore University HealthSystem Foundation (Foundation) is dedicated to assisting the integrated healthcare delivery system to fulfill NorthShore's mission to "preserve and improve human life." The Foundation seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of high-quality services and giving opportunities. Finally, the Foundation also assures that contributions are used wisely and appropriately. Statement of Program Services - Education Part III Line 4b NorthShore University HealthSystem (NorthShore) is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2011, a total of 189 residents and 19 fellows participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (1st Year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Female Pelvic Medicine and Reconstructive Surgery, Magnetic Resonance Imaging, Musculoskeletal Imaging, Emergency Medicine Simulation, Surgical Pathology, and Endocrine Surgery. The affiliate-based residency program areas included: Anesthesiology, Dermatology, Emergency Medicine, Obstetrics and Gynecology, Orthopaedic Surgery, Pediatrics, Psychiatry, Radiology, General Surgery, Neurology, Neurosurgery, Ophthalmology, Otolaryngology, Plastic Surgery, Podiatry, and Urology. The affiliate-based fellowship program areas included: Body Contouring Plastic Surgery, Cardiology, Child Neurology, Child Psychiatry, Electrophysiology, Gastroenterology, Infectious Diseases Research, Maternal-Fetal Medicine, Neonatal-Perinatal Medicine, Palliative Medicine, Surgical Oncology, and Urology. The NorthShore School of Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year 2011, 66 students participated in the program. NorthShore also provided clinical training and internships for 1,694 students in various departments including Social Work, Nursing, Physical Therapy, and Speech Therapy during the 2011 academic year. These internships were conducted through collaborative relationships with several educational institutions including Chamberlain College, College of Lake County, DePaul University, Harper College, Loyola University Chicago, Midwestern University, North Park University, Northern Illinois University, Northwestern University, Oakton Community College, Rosalind Franklin University, Rush University, University of Chicago, University of Illinois, University of Illinois at Chicago, University of Iowa, and University of Minnesota. Statement of Program Services - Research Part III Line 4c The NorthShore University HealthSystem Research Institute (Research Institute) was organized in 1996 to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute now houses nearly 200 externally funded research faculty who currently occupy over 100,000 net square feet of research space and work on nearly 1,000 active research protocols. Total external funding is now over $100 million. Funding from the NIH places the hospitals of NorthShore among the top 10 comprehensive independent research hospitals in the country. In addition, NorthShore has made a substantial commitment to develop a new Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure will enable large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work will build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research. Business Relationships Part VI Section A Line 2 Business relationship - Harry M Jansen Kraemer Jr and Samuel M Mencoff. Business relationship - Andrew J Mills and Nancy Semerdjian. Business relationship - Mark S Talamonti and Thomas A Victor. Business relationship - Gerald P Gallagher and Harry L Jones. Business relationship - Gerald P Gallagher and Jeffrey H Hillebrand. Business relationship - Jeffrey H Hillebrand and Thomas H Hodges. Governing Body Review of 990 Part VI Section B Line 11b The NorthShore University HealthSystem (NorthShore) Form 990 was reviewed by executive management and an outside accounting firm. The NorthShore Form 990 was then provided to each member of the Board of Directors via email for their review and ability to ask questions of management prior to filing. Conflict of Interest Policy Monitoring Part VI Section B Line 12c On an annual basis, the Chief Compliance Officer requires all officers, directors, and key employees to complete, sign and return a Conflict of Interest Disclosure Statement. Timely and accurate completion of the Statement is mandatory, and completed Statements must be returned to the Chief Compliance Officer within 15 days. Any disclosures included on the Statements are reviewed and acted upon as necessary by the Chief Compliance Officer and the Corporate Compliance Committee. Determination of Compensation Part VI Section B Line 15 A detailed compensation review of the top 16 executives, including the Chief Executive Officer, is conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market data for base and variable compensation is assessed annually for local, regional and national hospitals, integrated delivery systems and academic medical centers. A detailed total compensation market review is conducted every two years. The market assessment includes assessing job content in order to make appropriate market data comparisons. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation. Public Disclosure of Documents Part VI Section C Line 19 The NorthShore University HealthSystem (NorthShore) governing documents, conflict of interest policy and financial statements are available to the public upon request. The NorthShore annual audit report and financial statements are also available to the public through GuideStar and the Illinois Attorney General's Office websites as part of the federal and state tax return filings. The NorthShore quarterly and annual financial statements and annual audit are also made available to the public through the Electronic Municipal Market Access (EMMA) website as part of the tax-exempt bond offerings. Average Hours Per Week for Related Organizations Part VII Section A Column B Certain individuals listed in Part VII had the following average hours per week devoted to related organizations: Michael S Caplan - 15, Janardan D Khandekar - 9, Mark S Talamonti - 13, Mark R Neaman - 2, Jeffrey H Hillebrand - 1, William D Bloomer - 17, Robert R Edelman - 3, Bernard G Ewigman - 1, Demetrius Maraganore - 19, Frederick E Miller - 7, Richard K Silver - 7, Jeffery S Vender - 19, Thomas A Victor - 8, David C Holub - 8, Nicholas A Vick - 8. Other Changes in Net Assets Part XI Line 5 Other changes in net assets of $132,024,926 include unrealized losses of $84,005,997 and equity adjustments for the pension and supplemental executive retirement plans of $48,018,929. 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