LA RABIDA CHILDRENS HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LA RABIDA CHILDRENS HOSPITAL (EIN 36-2170143)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201121339349304837
- Schema version
- 2009v1.7
- 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 G
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T17:00:50-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM MCGLADREY INC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE SOUTH WACKER DRIVE SUITE 800 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 606063392 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362170143 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Rabida Children's Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LARA | NameControl |
| Phone | 7736366700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6501 S Promontory Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60649 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Paula K Jaudes MD | Name |
| Title | President & CEO | Title |
| Phone | 7736366700 | Phone |
| Date Signed | 2011-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Zack Fortsch | Name |
| Phone | 3126343400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Paula K Jaudes MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6501 S Promontory Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60649 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 99851765 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.larabida.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1896 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | La Rabida Children's Hospital provides both inpatient and outpatient care to children with chronic illness, disabilities or who have been abused in a comprehensive, interdisciplinary family-centered care model. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 39 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 39 | NbrIndependentVotingMembers |
| Total Nbr Employees | 573 | TotalNbrEmployees |
| Total Nbr Volunteers | 219 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4447032 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3709309 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 45853233 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 46024029 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -6906986 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2455735 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 604717 | OtherRevenuePriorYear |
| Other Revenue Current Year | 359909 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 43997996 | TotalRevenuePriorYear |
| Total Revenue Current Year | 52548982 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 25836898 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 27179394 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 200554 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 50000 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 714087 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 17541926 | OtherExpensePriorYear |
| Other Expenses Current Year | 19300002 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 43583378 | TotalExpensesPriorYear |
| Total Expenses Current Year | 46529396 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 414618 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 6019586 | RevenuesLessExpensesCY |
| Total Assets BOY | 108455483 | TotalAssetsBOY |
| Total Assets EOY | 118589383 | TotalAssetsEOY |
| Total Liabilities BOY | 13055459 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14533703 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 95400024 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 104055680 | NetAssetsOrFundBalancesEOY |
| Mission Description | La Rabida Children's Hospital (LRCH) is dedicated to excellence in caring for children with chronic illness, disabilities, or who have been abused, allowing them to achieve their fullest potential through expertise and innovation within the healthcare and academic communities. La Rabida provides comprehensive, interdisciplinary health services to children across a continuum of care, serving as a model for family - centered care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 22243627 | Expense |
| Revenue | 30726313 | Revenue |
| Description | The primary service provided by La Rabida is inpatient services to children with chronic illnesses and disabilities. In fiscal year 2010 we had 1,046 admissions and 10,142 patient days of care. La Rabida Children's Hospital serves these children regardless of race, creed, sex, national origin, or ability to pay and is the most Medicaid dependent hospital in the State of Illinois, with more than 92% of its patient days of care rendered for Medicaid program beneficiaries. La Rabida Children's Hospital is a local expert and provides a site of training for residents and medical students. We train nearly 40 physician residents and 30 medical students each year from the University of Chicago. La Rabida is also a training site for nursing, rehabilitation therapists, social work, psychology and respiratory therapy students. The hospital works to ensure that all hospital staff, both clinical and non-clinical, receives education on how to make the hospital a safe place for children. This includes quality initiatives for infection control, certification classes in CPR and Pediatric Advanced Life Support (PALS), running mock codes, classroom lectures for nurses, emergency preparedness training, and meetings on education and research. La Rabida also holds in-services as warranted for new products, policies and event-related occurrences. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 12234183 | Expense |
| Revenue | 15297716 | Revenue |
| Description | The secondary services provided by La Rabida are various clinical outpatient services supportive of the special needs of our patients. These services include 6,277 treatment room visits, 14,226 physician clinic visits, and 11,616 outpatient ancillary visits. The physician clinics are for children and their siblings with chronic healthcare needs. Included in the ancillary visits are physical therapy, speech therapy, occupational therapy and infant development specialty visits. La Rabida also provides a child abuse program serving children who have been physically abused, neglected, sexually abused, or otherwise experienced trauma. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4823382 | Expense |
| Revenue | 0 | Revenue |
| Description | In conjunction with providing direct clinical care to our patients, the hospital provides various education and outreach activities in support of our patients and their families. These include caregiver training, training for other agencies in g-tube and tracheostomy care, diabetes classes for caregivers and school staff, and transportation vouchers and bus passes for families having difficulty getting to La Rabida for clinic appointments or visiting an inpatient. Case management is provided for all inpatients. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 39301192 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 1 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 573 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 39 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 39 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Renfree | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7736366700 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6501 S Promontory Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606491935 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (50 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 |
|---|---|---|---|---|---|---|---|
| Billie Wright Adams MD | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Robert L Aguilar | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Howard C Alper | |||||||
| Vice Chair | 1.00 | X | 0 | 0 | 0 | ||
| Robert P Arthur | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Fred Berglund | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Dorothy E Bossung | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Richard M Burridge | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Michele B Bush | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| John G Clifford | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Brian B Devane | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Terence Donnelly | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| John M Eberle | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Nuria I Fernandez | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Peggy P Gann | |||||||
| Chair | 1.00 | X | 0 | 0 | 0 | ||
| James J Gillespie | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Timothy G Goodsell | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| John G Gyann | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Drew M Horowitz | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Jeffrey Husserl | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Mark E Jacobs | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Gloria Jacobson | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Joyce C Johnson-Miller | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Jeffrey Jones | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Allen Kanter | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Anthony R Kitchens | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Allen I Kutchins | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Dana R Levenson | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Alexander Sandy Lourie | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Randy Markowitz | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| James D McKinney | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Craig Miller | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Lynne Pantalena | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| David B Patzwald | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Bruce R Pfaff | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Charles T Price | |||||||
| Vice Chair | 1.00 | X | 0 | 0 | 0 | ||
| Daniel S Real | |||||||
| Vice Chair | 1.00 | X | 0 | 0 | 0 | ||
| Emilio Salvi | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Frederick B Thomas | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Fred K Walz | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Dilek Bishku MD | |||||||
| VP Medical Affairs | 40.00 | 188808 | 0 | 26699 | X | ||
| Michael Cleavenger | |||||||
| VP Development | 40.00 | 151666 | 0 | 7784 | X | ||
| Aden Henry | |||||||
| VP Patient Care Serv. | 40.00 | 176804 | 0 | 8921 | X | ||
| Paula K Jaudes MD | |||||||
| President/CEO | 32.00 | 441398 | 0 | 27031 | X | ||
| Mark Renfree | |||||||
| VP Administration/CFO | 40.00 | 220989 | 0 | 11386 | X | ||
| Brenda Wolf | |||||||
| Executive VP/COO | 40.00 | 245229 | 0 | 12570 | X | ||
| Tim Diamond | |||||||
| Information Systems Director | 40.00 | 126361 | 0 | 6465 | X | ||
| Mike Gallery | |||||||
| Pharmacy Director | 40.00 | 127312 | 0 | 6508 | X | ||
| Frances Lefkow | |||||||
| Human Resources Director | 40.00 | 136414 | 0 | 7493 | X | ||
| Paul J Pasinski | |||||||
| Director of Finance | 40.00 | 121221 | 0 | 6151 | X | ||
| Kevin Rath | |||||||
| Associate VP Bus. & Ext. Affairs | 40.00 | 167336 | 0 | 8442 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2103538 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 129450 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Berglund Construction | |||||
| 8410 S Chicago Avenue | Chicago | IL | 60617 | Construction | 3004098 |
| Loebl Schlossman & Hackl | |||||
| 233 N Michigan Suite 3000 | Chicago | IL | 60601 | Architecture | 300630 |
| Ernst & Young | |||||
| 233 S Wacker Drive | Chicago | IL | 60606 | Accounting | 202515 |
| Medical Staffing Network | |||||
| 3139 Paysphere Circle | Chicago | IL | 60674 | Temporary Staffing | 166281 |
| Mayer Brown LLP | |||||
| 230 S Lasalle Street | Chicago | IL | 60604 | Legal | 142238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Fundraising Events | 157339 | FundraisingEvents |
| All Other Contributions | 3551970 | AllOtherContributions |
| Noncash Contributions | 123169 | NoncashContributions |
| Total Contributions | 3709309 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Medicare/Medicaid | 621500 | 40283417 | 40283417 |
| Other Patient Service | 621500 | 3425149 | 3425149 |
| Net Patient Revenue | 621500 | 2315463 | 2315463 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 46024029 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1506594 | TotalRevenueColumn |
| Exclusion | $1,506,594 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 48015752 | Securities |
| Other | 8524 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 47063413 | Securities |
| Other | 11722 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 952339 | Securities |
| Other | -3198 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 949141 | TotalRevenueColumn |
| Exclusion | $949,141 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 444746 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 157339 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 227648 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 217098 | TotalRevenueColumn |
| Exclusion | $217,098 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Cafeteria | Description |
| Business Code | 722210 | BusinessCode |
| Total Revenue Column | 142811 | TotalRevenueColumn |
| Exclusion | $142,811 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 142811 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52548982 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46024029 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,815,644 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1573754 | Total |
| Program Services | 1201762 | ProgramServices |
| Management And General | 220326 | ManagementAndGeneral |
| Fundraising | 151666 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20073385 | Total |
| Program Services | 17039040 | ProgramServices |
| Management And General | 2810274 | ManagementAndGeneral |
| Fundraising | 224071 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1321235 | Total |
| Program Services | 1109837 | ProgramServices |
| Management And General | 184973 | ManagementAndGeneral |
| Fundraising | 26425 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2669026 | Total |
| Program Services | 2241981 | ProgramServices |
| Management And General | 373664 | ManagementAndGeneral |
| Fundraising | 53381 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1541994 | Total |
| Program Services | 1295275 | ProgramServices |
| Management And General | 215879 | ManagementAndGeneral |
| Fundraising | 30840 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 683936 | Total |
| Program Services | 215507 | ProgramServices |
| Management And General | 468429 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 302456 | Total |
| Program Services | 260112 | ProgramServices |
| Management And General | 42344 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191292 | Total |
| Program Services | 164511 | ProgramServices |
| Management And General | 26781 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50000 | Total |
| Fundraising | 50000 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5627452 | Total |
| Program Services | 5212287 | ProgramServices |
| Management And General | 415165 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 495699 | Total |
| Program Services | 416387 | ProgramServices |
| Management And General | 69398 | ManagementAndGeneral |
| Fundraising | 9914 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 359656 | Total |
| Program Services | 302111 | ProgramServices |
| Management And General | 50352 | ManagementAndGeneral |
| Fundraising | 7193 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1931198 | Total |
| Program Services | 1622206 | ProgramServices |
| Management And General | 270368 | ManagementAndGeneral |
| Fundraising | 38624 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1279058 | Total |
| Program Services | 1074409 | ProgramServices |
| Management And General | 179068 | ManagementAndGeneral |
| Fundraising | 25581 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Med./Non-Med. Supplies | 4519612 | 3861667 | 639746 | 18199 |
| Miscellaneous Expense | 1977673 | 1661246 | 276874 | 39553 |
| Repairs & Utilities | 1220297 | 1025049 | 170842 | 24406 |
| Contract Staffing | 366236 | 307638 | 51273 | 7325 |
| Bad Debt Expense | 345437 | 290167 | 48361 | 6909 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46529396 | Total |
| Program Services | 39301192 | ProgramServices |
| Management And General | 6514117 | ManagementAndGeneral |
| Fundraising | 714087 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2615919 | BOY |
| EOY | 6600776 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2102144 | BOY |
| EOY | 3305218 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3012688 | BOY |
| EOY | 1880900 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5742935 | BOY |
| EOY | 3446541 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 295988 | BOY |
| EOY | 358547 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 375738 | BOY |
| EOY | 504507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 48752432 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26722276 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18528863 | BOY |
| EOY | 22030156 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47960486 | BOY |
| EOY | 50948114 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23592895 | BOY |
| EOY | 25650459 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4227827 | BOY |
| EOY | 3864165 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108455483 | BOY |
| EOY | 118589383 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5729698 | BOY |
| EOY | 5157649 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10950 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7314811 | BOY |
| EOY | 9376054 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13055459 | BOY |
| EOY | 14533703 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69687025 | BOY |
| EOY | 79562924 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24616558 | BOY |
| EOY | 23396314 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1096441 | BOY |
| EOY | 1096442 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95400024 | BOY |
| EOY | 104055680 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108455483 | BOY |
| EOY | 118589383 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | 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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $494 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $84,454 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 84948 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34232895 | OtherCostOrOtherBasis |
| Depreciation | 16813129 | Depreciation |
| Book Value | 17419766 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2073212 | OtherCostOrOtherBasis |
| Depreciation | 1797424 | Depreciation |
| Book Value | 275788 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11239931 | OtherCostOrOtherBasis |
| Depreciation | 8004034 | Depreciation |
| Book Value | 3235897 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1206394 | OtherCostOrOtherBasis |
| Depreciation | 107689 | Depreciation |
| Book Value | 1098705 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22030156 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Beneficial Interest in Assets | 11487531 | F |
| Int in Restricted Net Assets | 14162928 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 25650459 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Payables to Third-Party Programs | $1,888,735 |
| Pension Obligation | $6,798,419 |
| Self-Insurance | $688,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9376054 | TotalOfAmounts |
| Total Revenue | 52548982 | TotalRevenue |
| Total Expenses | 46529396 | TotalExpenses |
| Excess Or Deficit For Year | 6019586 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2736435 | NetUnrealizedGLOnInvestments |
| Other | -$100,365 | OtherAmount |
| Total Adjustments | 2636070 | TotalAdjustments |
| Excess Or Deficit Per FS | 8655656 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 55411377 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2736435 | NetUnrealizedGainsInvestments |
| Other Revenues | 227648 | OtherRevenues |
| Revenue Not Rptd F990 | 2964083 | RevenueNotRptdF990 |
| Revenue Subtotal | 52447294 | RevenueSubtotal |
| Other Revenues Not Included | 101688 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 101688 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 52548982 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 46655356 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 227648 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 227648 | ExpensesNotRptdF990 |
| Expenses Subtotal | 46427708 | ExpensesSubtotal |
| Other Expenses Not Included | 101688 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 101688 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 46529396 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The Hospital is a tax-exempt organization under Internal Revenue Code Section 501 (c)(3), and accordingly, no income taxes are provided for in the accompanying financial statements. The Hospital adopted the FASB-issued guidance for accounting for uncertainty in income taxes on July 1, 2009. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others may be subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to not-for-profit hospitals include such matters as the following: the tax exempt status of the entity, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income (UBIT). The Hospital had no UBIT for the years ended June 30, 2010 and 2009. The benefit of a tax position is recognized in the financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Upon the adoption of the FASB-issued guidance at July 1, 2009 and as of June 30, 2010, there were no unrecognized tax benefits identified and recorded as a liability. |
| Part XI, Line 8 - Other Adjustments: | Change in Interest of Foundation : 2057565. Change in Pension Obligation : -2157930. | |
| Part XII, Line 2d - Other Adjustments: | Special Event Expenses: 227648. | |
| Part XII, Line 4b - Other Adjustments: | Investment Fees: 101688. | |
| Part XIII, Line 2d - Other Adjustments: | Special Event Expenses: 227648. | |
| Part XIII, Line 4b - Other Adjustments: | Investment Fees: 101688. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
Name Of Organization NameOfOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PJH & Associates | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | Fundraiser/Awards/Benefit Dinner | Activity |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFunds |
| Gross Receipts | 438048 | GrossReceipts |
| Amount Retained By Contractor | 50000 | AmountRetainedByContractor |
| Net To Organization | 388048 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 438048 | TotalGrossReceipts |
| Total Retained By Contractors | 50000 | TotalRetainedByContractors |
| Total Net To Organization | 388048 | TotalNetToOrganization |
| Licensed States | AL | LicensedStates |
| Licensed States | AK | LicensedStates |
| Licensed States | AZ | LicensedStates |
| Licensed States | AR | LicensedStates |
| Licensed States | CA | LicensedStates |
| Licensed States | CO | LicensedStates |
| Licensed States | CT | LicensedStates |
| Licensed States | DE | LicensedStates |
| Licensed States | FL | LicensedStates |
| Licensed States | GA | LicensedStates |
| Licensed States | HI | LicensedStates |
| Licensed States | ID | LicensedStates |
| Licensed States | IL | LicensedStates |
| Licensed States | IN | LicensedStates |
| Licensed States | IA | LicensedStates |
| Licensed States | KS | LicensedStates |
| Licensed States | KY | LicensedStates |
| Licensed States | LA | LicensedStates |
| Licensed States | ME | LicensedStates |
| Licensed States | MD | LicensedStates |
| Licensed States | MA | LicensedStates |
| Licensed States | MI | LicensedStates |
| Licensed States | MN | LicensedStates |
| Licensed States | MS | LicensedStates |
| Licensed States | MO | LicensedStates |
| Licensed States | MT | LicensedStates |
| Licensed States | NE | LicensedStates |
| Licensed States | NV | LicensedStates |
| Licensed States | NH | LicensedStates |
| Licensed States | NJ | LicensedStates |
| Licensed States | NM | LicensedStates |
| Licensed States | NY | LicensedStates |
| Licensed States | NC | LicensedStates |
| Licensed States | ND | LicensedStates |
| Licensed States | OH | LicensedStates |
| Licensed States | OK | LicensedStates |
| Licensed States | OR | LicensedStates |
| Licensed States | PA | LicensedStates |
| Licensed States | RI | LicensedStates |
| Licensed States | SC | LicensedStates |
| Licensed States | SD | LicensedStates |
| Licensed States | TN | LicensedStates |
| Licensed States | TX | LicensedStates |
| Licensed States | UT | LicensedStates |
| Licensed States | VT | LicensedStates |
| Licensed States | VA | LicensedStates |
| Licensed States | WA | LicensedStates |
| Licensed States | WV | LicensedStates |
| Licensed States | WI | LicensedStates |
| Licensed States | WY | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Dinner | NameOfEvent1 |
| Gross Receipts Event1 | 438048 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 140400 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 297648 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 48667 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 77305 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Golf Outing | NameOfEvent2 |
| Gross Receipts Event2 | 105515 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 6960 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 98555 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 885 | CashPrizesEvent2 |
| Non Cash Prizes Event2 | 7643 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 31619 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 16151 | OtherDirectExpensesEvent2 |
| Gross Receipts Other Events | 58522 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 9979 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 48543 | GrossRevenueOtherEvents |
| Rent Facility Costs Other Events | 18384 | RentFacilityCostsOtherEvents |
| Other Direct Expenses Other Events | 26994 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 602085 | GrossReceiptsTotal |
| Charitable Contributions Total | 157339 | CharitableContributionsTotal |
| Gross Revenue Total Events | 444746 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 885 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 7643 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 98670 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 120450 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 227648 | DirectExpenseSummaryEvents |
| Net Income Summary | 217098 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 179742 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 179742 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37711835 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 40277821 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2565986 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37891577 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 40277821 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2386244 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1260 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 590 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 670 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 701167 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 226531 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 474636 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 702427 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 227121 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 475306 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01020 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38594004 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 40504942 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1910938 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01410 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $307,192 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5596 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4702 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 894 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Rabida Children's Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6501 S Promontory Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60649 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Childrens Hospital | X | ChildrensHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: A cost to charge ratio, calculated using the IRS worksheet, was used for the Part I, Line 7 table. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad debt expense of $345,437 was removed from total expenses. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Bad debt expense at cost is based upon the actual charges that are the responsibility of the patient guarantor multiplied by a calculation ratio of cost to charges using the IRS worksheet. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Medicare costs are based upon the actual charges that are the responsibility of the patient guarantor multiplied by a calculation ratio of cost to charges calculated using the IRS worksheet. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: La Rabida offers financial assistance to families who qualify, using a Financial Assistance Application. Several notices are provided to the family advising them of the availability for assistance should they meet the necessary qualifications. | DebtCollectionPolicy |
| General Explanation | Part VI, Line 2:La Rabida provides specialty physicians and services for children with chronic illnesses. We work with many local institutions and physicians in identifying the needs of these children and their families. We constantly assess our capabilities to meet the social as well as the physical need of these children and work to provide a medical home for the children and their families.Part VI, Line 3:At the time of registration, families are asked to provide any insurance information that may be used in paying for the services being rendered. If insurance is not available, the family is advised of the availability of Public Assistance and the need to complete the necessary paperwork. Preliminary paperwork is completed by the Hospital and provided to the necessary Agency for follow-up by the family. It is the family's responsibility to meet with the Agency to insure eligibility. The family is also notified about our financial assistance policy and the necessary forms for qualification are provided is so requested.Part VI, Line 4:While La Rabida provides services to children throughout the metropolitan Chicago area most of the patients reside in Chicago's South Side communities. The population served by La Rabida is approximately 90% African American; the remainder of the population is almost equally divided between White (4-5%) and Hispanic (4-5%). Less than 1% of the community identify themselves as Asian or other. Females are a majority of the population at 55%, over 60% of the households with children under 18 are female-headed households. Based on census data, approximately 39% of the children in these communities are living in poverty and 32% of all families receive some form of Public Aid. Based on recent census tract data, the average annual salary in the area was $19,000, compared to an average of $32,000 for the rest of the Chicago area. | GeneralExplanation |
| General Explanation | Part VI, Line 6:La Rabida serves over 500 children and families through hospitalizations and 8400 through outpatient clinics annually. Almost half of La Rabida's patients (approximately 44%) are age five and under. La Rabida serves children and their families through age 18 and ensure that ongoing care is provided through referrals to local hospitals and clinics. In addition, La Rabida assists families negotiate the new bureaucracies they will encounter once the child is no longer eligible for Medicaid upon reaching age 18. La Rabida is the most public insurance dependent hospital in the state of Illinois with Medicaid comprising over 80% of the hospital's income. The following are some of the programs used to meet the needs within our community.Trauma/Abuse Program:La Rabida has one of the largest child abuse/trauma programs of any children's hospital in the country and has national recognition for cutting edge community based treatment and training programs. This program services one of Chicago's most low-income areas, as well as 39 of the poorest municipalities in the southern suburbs. Adjunct services include case management, court services (i.e. accompanying children to court to testify against the perpetrator), liaison with community hospitals and community agencies, etc. La Rabida also provides outreach, training and consultation to child service programs in the community. La Rabida currently provides ongoing consultation to the Chicago Department of Public Health Safe State Program, Ada s. McKinley Emergency Foster Care program, the Chicago Police Department Crisis Intervention team and the Vernon Park Church of God, among others. The program has provided training to many agencies, including: the Little City Foundation, Cook County State Attorney's Office, Cook County Public Guardian's Office, various Chicago Public Schools, the University of Chicago Department of Psychiatry and Department of Developmental and Behavioral Pediatrics, Casa Central, and the Illinois Violence Prevention Authority. In addition, the Behavioral Sciences Department gives a number of lectures and community presentations throughout the year to school and professional groups. With assistance from the Illinois Department of Children and Family Services (DCFS), the hospital coordinates interviews of child sexual abuse victims. Participants include the police department, state's attorney's office and DCFS. La Rabida Children's Hospital also assists DCFS in providing initial health screenings prior to placement for abused and neglected children who come into custody. La Rabida assists the Illinois Department of Healthcare and Family Services as an enrollment site for KidCare, a health insurance program for low income children and families.Premier Kids:Unlike the typical hospital that focuses on treating the child as quickly as possible and then sends them back to the community, La Rabida provides ongoing healthcare and social supports to special needs children and their families from infancy until adulthood. Premier Kids offers primary care for infants and children who are at risk due to development problems and/or medically complex conditions. Targeted and comprehensive medical management early can enhance overall health later.The Premier Kids Program is a hospital-based outpatient program, conveniently providing an array of services on site. Meeting the definition of a medical home, the program delivers care and service that is family centered; comprehensive, holistically addressing the child's needs; coordinated; team driven; and culturally sensitive.Children, five years of age and younger, enter the Premier Kids Program after having:-Graduated from a neonatal intensive care unit (NICU) or its follow-up program-An inpatient stay, following delivery-Neonatal drug exposure-Received a diagnosis that may challenge physical, motor, cognitive, and nutritional development plus emotional and social growthEach Premier Kid receives routine check-ups, immunizations and urgent care through a board certified pediatrician who also coordinates the care for the child's unique medical condition. The physician leads an interdisciplinary team of clinicians (nurses, dietician, infant development specialist, social workers and advocate) who work in partnership with each family to identify and then access the services and resources the family requires to optimize the child's health and development. By the time the child ages out of the program at age six, he or she is enrolled into the appropriate educational program. La Rabida's "one-stop shopping" medical home program is a particularly important model when working with families who are not only burdened with having a child with special needs but also have other economic stressors. This not only allows for better and easier access, its comprehensive nature maximizes positive outcomes over the long term and minimizes the use of higher cost services like duplication of diagnostic procedures and treatments, unnecessary emergency room use and inpatient hospitalization.Case Management Program:La Rabida Children's Hospital Case Management Program goal is to provide care coordination, assessment and education across the inpatient and outpatient spectrum of care to children with chronic conditions and developmental delays and disabilities. The Program's team of seventeen Case Managers (12 nurses and 5 social workers) has extensive experience and knowledge uniquely qualifying them to serve La Rabida's patients and families. Most of the social workers are Licensed Clinical Social Workers (LCSW). Nurse expertise includes Nurse Practitioners (who also serve as providers in the outpatient clinics), those trained to case manage specific chronic conditions, failure to thrive and technology dependent children. Together they provide services to over half of the hospital's patient population each year. While Case Management services are available to all patients and families, their most intensive interventions focus on patients that are medically complex and with more than one health condition and/or health care provider. The Case Management Program makes it possible to effectively provide continuous chronic care to large groups of children with various conditions from infancy to adulthood. La Rabida's Case Management program assists the families of children with chronic conditions to navigate the necessary support systems. Each child and family is assessed to determine which community linkages need to be established. Case Management coordinates care between La Rabida providers and external providers such as subspecialists (e.g., neurologists, orthopedists, endocrinologists, hematologists, etc.), Child and Family Connections, Chicago Board of Education and other Education Programs, Ounce of Prevention, Division of Specialized Care for Children (DSCC), Children's Home and Aid Society, Erickson Institute, Department of Child and Family Services, home health care agencies and medical equipment vendors. The Case Management Program has a significant impact on the ability of the family to provide necessary home care and to minimize hospitalizations.The Case Management Program performs a large array of activities. While patients and their families may receive services anywhere from a few months to many years, these activities must occur year round on an ongoing basis to ensure children and their families receive needed services in a timely manner. Following is a list of the most common activities performed by Case Management staff. | GeneralExplanation |
| General Explanation | -Coordination of multiple medical services and providers, including coordination of the management of technology dependent children in the home -Patient and caregiver education. For example, diabetes classes are given for caregivers, extended family and school personnel to understand how to manage the disease. The State of Illinois mandates special classes for caretakers before a medically complex child can be released to the home. These weekly classes run in four week intervals, and include: G-tube care (feeding tube), Tracheotomy Care, Ventilator care, and CPR/airway obstruction care. -Ordering of home care services (nursing and equipment)-Telephone Management (Diabetes). Toll free call in number for patients and their families staffed by diabetes specialists. In addition to providing children and their families with a way to update the Diabetes team on their current glucose readings, it provides patients and their families with 24/7 access to a clinical nurse specialist who gives recommendations on medication, nutrition and exercise adjustments over the telephone. -Feeding evaluations, including children with Failure to Thrive -Follow up of newborn screening results (sickle cell diseases) -Wound management consultation -Coordination of inpatient and outpatient rehabilitation programs -Collaboration with community agencies, such as Division of Specialized Care for Children (DSCC)-Coordination of school needs, including: assistance in preparation of 504 plans (written plan for students with disabilities that spells out the modifications and accommodations that will be needed for these students to have an opportunity perform at the same level as their peers, and might include such things as wheelchair ramps, blood sugar monitoring, an extra set of textbooks, a peanut-free lunch environment, home instruction, or a tape recorder or keyboard for taking notes and Individualized Education Plans (a legally binding document that spells out exactly what special education services the child will receive and why. It includes the child's specific disability placement, services such as a one-on-one aide and therapies, academic and behavioral goals, a behavior plan if needed, percentage of time in regular education, and progress reports from teachers and therapists. Many services take place after discharge from an inpatient stay and in between clinic/doctor visits. Case Managers that work with technology dependent children have an average ongoing caseload of about 40 patients each in addition to their day to day responsibilities for inpatient and for seeing patients in the clinics with the physicians. Each patient in the caseload requires frequent follow up, assessment and updating of written home treatment plans and orders. Updates are done every 60 days for the home nursing agencies and a more formal review is required every six months for DSCC. This requires the Case Manager to be very familiar with the child and family and, in conjunction with the primary care provider, regularly review what is/is not working and what needs to be changed.Car Seat Clinics:La Rabida also provides specialized car seats, along with training and installation, for families who have children with special needs. This includes hosting the quarterly meeting of the Illinois special needs car seat technicians. La Rabida also holds 2-3 monthly "car seat clinics" at which patients and their siblings can have their car seats checked. Both hands on and written educational information is provided at the appointments. The total number of car seat inspections in FY10 was 144. More than 100 seats were distributed and 30 special needs car seats were distributed. 45 inpatients were assessed for car seats, 21 of which had never been home. 25 inpatients who received car seats were monitored for their tolerance of sitting in a car seat. No patients failed the test. Education Programs:As a result of "bounce backs" of children receiving care in the home, a new initiative was developed in 2009 to educate home health nurses in ventilator and tracheostomy care. To date, four day-long courses have been offered to home health nurses, each of which was filled to capacity. The demand for this training is high and is something the hospital plans on expanding using video and web technology. Education is also provided for professionals in the community who work with children with special needs. This includes training for physical and occupational therapists, respiratory therapists, early intervention, speech/language pathologists, school nurses, social workers and psychologists. Some of the forums in which we provide such education includes our annual Perspectives in Care Symposium. The symposium is in its 15th year and is a day long event held in the Spring. More than 125 local health care professionals attend each year. La Rabida also develops conferences on specialized topics, such as ventilator care. The therapists in the rehabilitation department are very engaged in providing educational opportunities for their peers. In FY 2010, they hosted three workshops. La Rabida has one of only three NCAST (Nursing Child Assessment Satellite Training) instructors in the State of Illinois. (NCAST is a program which trains health professionals in the use of interactive assessment scales, both feeding and teaching, whose goal is to identify problems before they develop and when intervention is most effective.)La Rabida provides educational programs for parents and caregivers. These are provided in multiple forms, one of which is to offer "101-type" classroom setting education for families. This allows families to meet each other, learn together, and receive materials, in their own language, to take home and review and use as reference when their child is discharged home. Families who have a child with a chronic disease often must spend a disproportionate amount of time and energy on that child, and can struggle with the nurturing of healthy siblings. La Rabida offers a tutoring program for patients and their siblings to address some of these needs. The program is offered five hours per week and provides tutoring for 35 children throughout the school year. The Diabetes program offers extensive education for parents and children. Teaching is conducted by nurses, nurse practitioners and dieticians. Once a year, a program called "Diabetes 101 for Caregivers" is held. Audience members include child care providers, aunts, uncles, grandparents, and parents needing a refresher. Approximately 30 people attend each year. In addition, an advanced concept program is offered each year. This may cover issues like pancreas transplants, pumps, sensors, and the newest research. In the hospital, diabetic patients and their families attend a series of classes to ensure that they are familiar with all aspects of disease management. This training program takes place over three to four 90 minute sessions. Insulin pump classes are also available, for which La Rabida recently received a national award. The first class is in the home and the second class is in the hospital. The patient calls or faxes blood sugar information three times a week and follows up several weeks later by attending a more advanced class, for a total of three classes. These classes usually last about three hours each.Community Events:La Rabida Children's Hospital participates in community events to disseminate information on chronic disease management to affected individuals. Diabetes management, because it can be complex and overwhelming for families, children and school staff, is a good example. La Rabida holds two regional trainings (one in Chicago, one in Indiana) for personnel of schools where diabetic patients attend. La Rabida also hosted an informational table at the Diabetes Expo and provided information to more than 1,000 families about Type I and Type II diabetes. In the summer, the diabetes nurses host a Back to School Jamboree for children with diabetes to complete their school forms, network with similarly affected children, and celebrate the back to school season with free school supplies. The educational programs offered at La Rabida for families, staff, health care providers and the community are provided at significant cost to the hospital. However, it is our responsibility and desire to create the best possible environment at home and at the hospital for children with chronic disease. | GeneralExplanation |
| General Explanation | Part VI, Line 8:A community benefit report is filed with the Illinois Attorney General. | GeneralExplanation |
| General Explanation | l | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: | PatientEducationAssistance |
| Community Information | Part VI, Line 4: | CommunityInformation |
| Other Information | Part VI, Line 6: | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dilek Bishku MD | |||||||||||||
| 155708 | 0 | 33100 | 0 | 0 | 0 | 15372 | 0 | 11327 | 0 | 215507 | 0 | 0 | 0 |
| Michael Cleavenger | |||||||||||||
| 146666 | 0 | 5000 | 0 | 0 | 0 | 0 | 0 | 7784 | 0 | 159450 | 0 | 0 | 0 |
| Aden Henry | |||||||||||||
| 166404 | 0 | 10400 | 0 | 0 | 0 | 0 | 0 | 8921 | 0 | 185725 | 0 | 0 | 0 |
| Paula K Jaudes MD | |||||||||||||
| 284953 | 0 | 156445 | 0 | 0 | 0 | 19600 | 0 | 7431 | 0 | 468429 | 0 | 0 | 0 |
| Mark Renfree | |||||||||||||
| 204189 | 0 | 16800 | 0 | 0 | 0 | 0 | 0 | 11386 | 0 | 232375 | 0 | 0 | 0 |
| Brenda Wolf | |||||||||||||
| 224829 | 0 | 20400 | 0 | 0 | 0 | 0 | 0 | 12570 | 0 | 257799 | 0 | 0 | 0 |
| Kevin Rath | |||||||||||||
| 147134 | 0 | 20202 | 0 | 0 | 0 | 8442 | 0 | 0 | 0 | 175778 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | The discretionary spending account allows for research related trips, medical books, medical subscriptions, medical classes, organization dues, academic memberships, mailing costs, parking, computer hardware & software, and resident and/or medical student lunches. Physicians Amount Paid Amount Allowed Dilek Bishku 3,888 4,000 Paula K. Jaudes 3,458 4,000 | |
| Part I, Line 5 | Maximum payout is 8% of base pay. Qualifying Trigger - Audited operating profit must be 20% better than budget. If qualifying trigger met, then individual payout is determined by measuring performance against goals. Each individual has 5-6 goals, some of which are hospital-wide,i.e., average daily census, the rest are specific to the individual/position. Each goal is weighted between 5-25% and has varying levels of performance ranging from unsatisfactory (0%) to outstanding (100%). The Compensation Committee reviews and approves the plan and individual performance. | |
| Part III | Paula Jaudes received compensation from the University of Chicago as follows: Base Compensation: $284,953 Bonus & Incentive Compensation: $156,445 Deferred Compensation: $19,600 Nontaxable Benefits: $7,431 Dilek Bishku received compensation from the University of Chicago as follows: Base Compensation: $155,708 Bonus & Incentive Compensation: $33,100 Deferred Compensation: $15,372 Nontaxable Benefits: $11,327 | Supplemental Information |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Alper Services | |||
| Howard Alper, Trustee, is a owner of Alper Services | 170308 | Insurance premiums in which Howard Alper received commissions for brokerage services | 0 |
| Berglund Construction Company | |||
| Fred Berglund, Trustee, is a owner of Berglund Contruction Company | 3135719 | Provides construction services and leases warehouse space to La Rabida | 0 |
| Meghan McKinney | |||
| James McKinney, Trustee, is the father of Meghan McKinney | 39723 | Employee of La Rabida | 0 |
| Mayer Brown LLP | |||
| Frederick Thomas, Trustee, is a partner of Mayer Brown LLP | 123954 | Legal services | 0 |
| Chicago Hospitals Risk Pooling Program | |||
| Mark Renfree, Officer, is trustee of Chicago Hospitals Risk Pooling Program | 846324 | Insurance cooperative | 0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 6 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 123169 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Market Quote | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | Dr. Paula Jaudes, President, and Timothy Goodsell, Trustee, have a business relationship. Brenda Wolf, Officer, her spouse has a business relationship with Allen Kutchins, Trustee. |
| Form 990, Part VI, Section A, line 6 | Members of LRCH consist of Active Trustees and Special Trustees of LRCH. In addition, the Women's Board may select up to ten (10) of its officers and/or directors to be members of LRCH. Other members may be appointed and removed by the Board of Trustees from time to time. |
| Form 990, Part VI, Section B, line 11 | The federal Form 990 and appurtenant schedules are prepared by an outside accounting firm using information provided by financial management. The forms are reviewed by the La Rabida Children's Hospital treasurer. The finalized Form 990 will be posted for the Board of Directors to review before filing. |
| Form 990, Part VI, Section B, line 12c | On a yearly basis, all Trustees and Officers are required to complete a conflict of interest document in accordance with hospital policy. A report of the disclosures is presented to the Conflicts Committee for review and determination of any conflicts and their findings are presented to the Board of Trustees. |
| Form 990, Part VI, Section B, line 15 | The compensation committee of the Board of Trustees engages external compensation consultants to advise it on competitive pay rates for the officers of the Hospital. The compensation committee is composed of non-employee independent members. Discussion is held by the committee and a recommendation is presented to the Executive Committee of the Board of Trustees for approval. |
| Form 990, Part VI, Section C, line 19 | LRCH does not make its governing documents or conflict of interest policy available to the public. Financial Statements are available on Illinois Attorney General's website. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Rabida Children's Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6501 S Promontory Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606491935 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363240477 | EIN |
| Primary Activities | Support Organization | PrimaryActivities |
| Legal Domicile State | IL | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11-Type III-F1 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | La Rabida Children's Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 1300000 | AmountInvolved |