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        <BusinessNameLine1>West Suburban Medical Center</BusinessNameLine1>
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      <Phone>8478133727</Phone>
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        <AddressLine1>3 Erie Court</AddressLine1>
        <City>Oak Park</City>
        <State>IL</State>
        <ZIPCode>60302</ZIPCode>
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      <Name>John A OrsiniCPA</Name>
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      <FSAudited>true</FSAudited>
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      <DirectContactLegislators>true</DirectContactLegislators>
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        <Description>Unapplied cash</Description>
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      <OtherLiabilities>
        <Description>Rounding</Description>
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      <OtherLiabilities>
        <Description>Malpractice Liability</Description>
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      <OtherLiabilities>
        <Description>Due to/from third party payors</Description>
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        <Explanation>Transfer to/from affiliated organizations $XXX-XX-XXXX</Explanation>
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        <PercentOfTotalExpense>0.01350</PercentOfTotalExpense>
      </CharityCareAtCost>
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        <DirectOffsettingRevenue>19588620</DirectOffsettingRevenue>
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        <PercentOfTotalExpense>0.05950</PercentOfTotalExpense>
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        <NetCommunityBenefitExpense>16688557</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07290</PercentOfTotalExpense>
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        <Name>
          <BusinessNameLine1>West Suburban Medical Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>3 Erie Court</AddressLine1>
          <City>Oak Park</City>
          <State>IL</State>
          <ZIPCode>60302</ZIPCode>
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        <IncomeBasedCriteria>Discount for Low-Income Uninsured Patients. Financial Assistance/Charity Care discounts or discounted fee schedules is available for Medically Necessary Hospital Services provided to Uninsured Patients who are unable to pay all or part of the otherwise applicable charge for their care due to financial need, as documented in accordance with this Policy. Patients demonstrating financial need based on household income at or below one hundred percent (100%) of the Federal Poverty Level, combined with a general lack of liquid assets, will receive a one hundred percent (100%) discount on Medically Necessary Hospital Services. Patients generally lacking liquid assets who have household income between one hundred percent (100%) and up to four hundred percent (400%) of the Federal Poverty Level will receive a sliding-scale discount for such hospital care, at levels approved by the RHC Executive Leadership Team.Payment Caps Under Illinois Uninsured Patient Discount Act. To the extent required by the Illinois Uninsured Patient Discount Act, and subject to other eligibility standards and exclusions as set forth by such law including standards based on asset level, Uninsured Patients who are Illinois residents having household income of up to six hundred percent (600%) of the Federal Poverty Level shall not be required to pay to an RHC hospital more than twenty five percent (25%) of such patient's family gross income within a twelve (12) month period.Other Payment Caps. An Uninsured Patient who is eligible for Financial Assistance/Charity Care at an RHC Hospital pursuant to the criteria set forth in Section 5.1 or 5.3 below shall be eligible for a payment cap based on RHC's charitable commitment to catastrophic medical expenses assistance based on medical indigence, as follows:For an eligible Uninsured Patient who demonstrates that s/he has a household income of four hundred percent (400%) or less of the Federal Poverty Level, such patient's payment obligation within any 12-month period is limited to the higher of: (a) ten percent (10%) of the patient's annual gross household income; or (b) ten percent (10%) of the patient's Non-Retirement Household Liquid Assets.For an eligible Uninsured Patient who demonstrates that s/he has a household income over four hundred percent (400%) of the Federal Poverty Level, or less, such patient's payment obligation within any 12-month period is limited to the higher of: (a) fifteen percent (15%) of annual gross household income; or (b) fifteen percent (15%) of the patient's Non-Retirement Household Liquid Assets.Financial Assistance/Charity Care for Insured Patients. Subject to insurance and governmental program restrictions (which may limit the ability to grant a discount on co-pays or deductibles, versus discounts on co-insurance), insured individuals, federal program beneficiaries and other individuals who are not automatically eligible for Financial Assistance/Charity Care hereunder but who demonstrate medical indigence or other financial need, may receive a Financial Assistance/Charity Care discount in similar or different amounts as are available to Uninsured Patients under this policy, as determined appropriate under the circumstances by RHC Patient Financial Services.Discounts for Uninsured, Medically Indigent Patients. Uninsured Patients whose household income is greater than four hundred percent (400%) of the Federal Poverty Level or who do not meet the automatic eligibility criteria set forth in Section 5 below, will nevertheless be eligible to receive a financial assistance/charity care discount based on a determination of medical indigence, by virtue of having medical bills from an RHC hospital in an amount equal to or greater than fifteen percent (15%) of their household income and available assets. Such Financial Assistance/Charity Care discount for uninsured higher income but medically indigent patients shall be one that is reasonable in relation to the individual patient's househousehold financial circumstances and the health status of the patient.</IncomeBasedCriteria>
        <AnnualCommunityBenefitExpln>A system wide Community Benefit Report is filed by Resurrection Health Care and its affiliates. The 2010 Community Benefit Report entitled "stronger together" is available on www.reshealth.org.</AnnualCommunityBenefitExpln>
        <PercentOfTotalExpenseExpln>Our total expense from Form 990, Part IX, line 25, column (A) was $228,834,007. The bad debt expense included in this amount was $18,617,409. For purposes of calculating line 7, column (f) West Suburban Medical Center used the total expense which includes bad debt expense.</PercentOfTotalExpenseExpln>
        <BadDebtFootnote>The footnotes to Resurrection Health 's audited financial statements do not specifically address bad debt expense. The costing methodology used in determining the amounts reported in line 2 is based on the ratio of patient costs to charges. The bad debt (at cost) was calculated by applying the organization's cost to charge ratio to the organization's provision for uncollectible accounts receivable.</BadDebtFootnote>
        <DebtCollectionPolicy>Collection policies are the same for all RHC entities which includes West Suburban Medical Center's patients. Patients are notified of West Suburban Medical Center's financial assistance policy at time of registration via posted notifications and on every account statement that is sent. We make this available in a number of languages. On receipt of the information, we will determine eligibility for financial assistance and notify the patient as quickly as possible. The Hospital does not pursue collection of amounts from patients who are being reviewed for financial assistance eligibility or who are determined to qualify for charity care. If at any point in the collection process, documentation is received that indicates the patient is potentially eligible for financial assistance but has not applied for it, the account is referred back for a financial assistance review. In addition, all patients having difficulty paying their bills are directed to financial counselors. The financial counselors will work with our patients to qualify them for charity care or government program such as Medicaid. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off in accordance with our financial assistance policy. If there is any remaining balance, only that balance would be subject to our debt collection policy. If a patient has requested and/or filled out a financial aid application, all debt collection activities stop until eligibility for financial assistance can be determined. Our policy provides that once we have received the necessary documentation we will not refer any accounts for collection until we can determine whether the individual is insured and not eligible for financial assistance.</DebtCollectionPolicy>
        <NumberOfFacilityTypeExpln>West Suburban Medical Center does not have any organizations that are not licensed.</NumberOfFacilityTypeExpln>
        <GeneralExplanation>The State of Illinois, Office of the Attorney General. In Illinois, the Attorney General requires that we report charity care based on the cost-to-charge ratio of the Medicare Cost Report and gives the option of reporting bad debt as cost or charges.Needs Assessment (continued)9. The Heartland Alliance is an independent, non-sectarian, non-profit organization serving more than 200,000 people annually. The 2010 Report on Illinois Poverty contains poverty data from 2008 and therefore do not fully capture the effects of the recession.10. Illinois Department of Public Health (IDPH) publishes The Illinois Project for Local Assessment of Needs (IPLAN), a community health assessment and planning process and online tool that is conducted every five years (2006 is most current data) by local health jurisdictions in Illinois. Internal Sources for Assessing Community Needs1. Resurrection Health Care's Strategic Planning Process, includes comprehensive assessments of service area demographics, identified needs, health care trends, market share, financial outcomes, capital needs, and other factors. 2. RES-INFO is a widely utilized Resurrection Health Care telephone service/contact center that provides nurse advice, physician referrals, health information and health care class registrations to callers. Staffed by clinicians and other professionals, community members access RES-INFO by utilizing a toll-free number and the RHC Website. Summary reports indicate the types of health care providers callers seek, the symptoms they need assistance with, the health information they are seeking, and the health classes and seminars they would like to take. 3. The Resurrection Health Care Website (www.reshealth.org) provides an online health information library as well as information related to the full continuum of available health care services, the Resurrection financial assistance program, educational programs and screenings, an online physician search and online job application system, to name a few of the available topics. A parallel version of the site is also available in Spanish. Regular review of site usage statistics provides useful information about the health concerns of website visitors. 4. Resurrection Health Care clinical educators, health educators and physicians supply significant empirical research on the needs of the community. Resurrection Health Care operates several clinics in and around each hospital. Clinical and professional staffs also obtain patient data through health education, health screenings, health fairs and other clinical encounters.</GeneralExplanation>
        <NeedsAssessment>In order to ascertain the health care needs of the community served by Resurrection Health Care, a number of internal and external sources were reviewed. The quantitative data focused on published health status indicators as well as our own direct measures of expressed community needs (via phone calls, website and survey responses), while the qualitative data relied upon the direct experience of RHC staff with clinical and health education responsibilities. External Sources for Assessing Community Needs1.Chicago Department of Public Health - Casting Chicago's Health Care Safety Net: A 12-Year Review of Chicago's Community-Based Primary Care System. The report highlights the changes that occurred in Chicago's community-based health care safety net system between 1990-2002. The report also explores, for the same 12-year period, changes in related indicators: general population characteristics, health status and insurance coverage. 2.We Plan 2005-2010 (in conjunction with The Cook County Department of Public Health) summarizes the process of assessment - a systematic collection and analysis in order to provide a basis for decision making and community strategic planning. We Plan 2005-2010 is a compilation of data and analysis, measurable objectives, available resources, interventions and preliminary implementation steps for three priority health indicators: chronic disease, violence and access to Care. 3.Taking a Closer Look at Illinois Uninsured (2009 edition) published by the Gilead Outreach &amp; Referral Center, documents the most current demographics of uninsured individuals and families in Illinois. The report demonstrates that 1.6 million Illinoisans still lack basic health care coverage. 4.The Community Needs Index (CNI) is a standardized community need assessment tool offered by Thomson Reuters that demonstrates the link between community need and access to care. The CNI is a strong indicator of a community's demand for health care services. Specifically, the CNI score is an average of five different barrier scores that measure various socioeconomic indicators of each community: income, cultural, education, insurance and housing. The CNI tool uses a scale of 1 to 5: a score of 1 indicates the least need while a score of 5 represents the most need. This tool was applied to the Resurrection Health Care service area. 5. Metropolitan Chicago Healthcare Council (MCHC) Needs Assessment is a comprehensive, data driven approach to determine the health status, and understand the behaviors and needs of the residents of Cook, Lake, and DuPage counties. This study can be use to address and understand the needs of individual communities. 6.2009 Report on Chicago Region Poverty: In this ninth annual comprehensive analysis of poverty indicators in Illinois, the report explains that unemployment and poverty are correlated; rising unemployment precipitates an increase in poverty. With the Illinois unemployment rate already over 9 percent, the ripple effect on Illinoisans is severe, according to researchers.7.Healthy People 2020 is an updated initiative by the U.S. Department of Health and Human Services, composed of federal, state and territorial departments, to strategically focus on initiatives which can be measured and which promote healthy living and disease prevention. Their website offers information on many leading indicators that are currently being measured. In addition, all community benefit activities are reported and organized using the Community Benefit Inventory for Social Accountability (CBISA) software which utilizes the Healthy People 2010/2020 categories in its database.8. Metro Chicago Information Center (MCIC) is an organization that details information on community needs assessments for the city of Chicago. The information identifies the demographics and community needs by categorizing the city into six distinct areas or communities.</NeedsAssessment>
        <PatientEducationAssistance>The hospital maintains effective methods of communicating the availability of Financial Assistance/Charity Care discounts to all patients, in multiple appropriate media and in multiple appropriate languages. The mechanisms that the Hospital will use to communicate the availability of Financial Assistance/Charity Care will include, but are not limited to the following:1. Signage. Signs shall be conspicuously posted in the admission, registration and other appropriate areas of the hospital stating that patients may be eligible for Financial Assistance/Charity Care discounts, and describing how to obtain more information, including identification of appropriate hospital representatives by title. Such signs shall be prepared in English, Spanish, and any other language that is the primary language of at least 5% of the patients served by the hospital annually.2. Provision of Financial Assistance Materials to Uninsured Patients. RHC hospitals will provide a summary of its Financial Assistance Programs and a Financial Assistance application to all persons receiving hospital care that it identifies as Uninsured Patients at the time of in-person registration, admission, or such later time at which the patient is first identified as an Uninsured Patient. For patients presenting in the Emergency Department, all RHC hospitals will provide such Financial Assistance materials at such time and in such manner as is consistent with their obligations under EMTALA to assess and stabilize the patient before making inquiry of the patient's ability to pay.3. Brochures. Brochures, information sheets and/or similar forms of written communication regarding the hospital's Financial Assistance/Charity Care policy shall be maintained in appropriate areas of the hospital (e.g., the Emergency Department, organized registration areas, and the Business Office) stating in at least English, Spanish and Polish, that the hospital offers Financial Assistance/Charity Care discounts, and describing how to obtain more information.4. Website. Each RHC's section of the Resurrection Heath Care website must include: a notice in a prominent place that financial assistance is available at the hospital; a description of the financial assistance application process; and a copy of the RHC hospital financial assistance application form.5. Billing Notices. Each RHC hospital shall include a note on or with the Hospital bill and/or statement regarding the hospital's Financial Assistance/Charity Care program, and how the patient may apply for consideration under this program.6. Financial Counselors. Each RHC hospital shall have one or more financial counselors whose contact information is listed or provided with other information concerning the hospital's Financial Assistance/Charity Care discount program, who are available to discuss eligibility and other questions concerning the program, and to provide assistance with applications.7. Notification of Determination. When an RHC hospital has made a determination that a patient's bill is discounted or adjusted in whole or in part based on a determination of financial need, the hospital will notify the patient of such eligibility determination, and that there is no further collection action taken on the discounted portion of the patient's bill.</PatientEducationAssistance>
        <CommunityInformation>To determine our core community, a comprehensive list of factors were considered including inpatient, outpatient and emergency department patient origin, facility location, inpatient market share, net Resurrection Health Care market share, and ongoing community outreach efforts. Oak Park- 60301, 60302, 60304 River Forest- 60305Belmont Cragin- 60639Chicago-Austin- 60644Chicago- Humboldt Park- 60651Elmwood Park- 60707Demographic Information (Based on 2007 data)-The West Suburban Medical Center core community has a total population of 329,939, which is projected to decrease 1.6 % by year 2012. -Within the core community there are a total of 104,510 households. The median home value is 271,896 and the median age is 32.-The core community is racially/ethnically diverse. (32% Hispanic, 42% Black, 23% White, and 1.6% Asian) -The core community has an average household income of $49,124 with a 10.8% unemployment rate. -The population within the core community has varying levels of education with 20.5% holding a bachelor's degree or greater. - Resurrection Health Care hospitals offer either personal or telephonic medical interpretation services. There were 20,965 medical interpretations provided via telephone alone in FY10 across the system, in 77 different languages.Health Status Information -Within the West Suburban Medical Center core community, 26% of the population is uninsured based on 2007 data. Belmont/Cragin have the highest number of uninsured (29,563) within the core community. -A majority of the core community is at high risk for not having received breast cancer and/or cholesterol screening and not engaging in monthly exercise. -In 2003 West Suburban Medical Center core community's leading cause of death was heart disease. The second leading cause of death was cancer.</CommunityInformation>
        <CommunityBuildingActivities>Chicago is a diverse city of unique neighborhoods. West Suburban Medical Center, like all Resurrection Health Care hospitals, has a Neighborhood Community Relations Committee made up of representatives of the hospital, local clergy, business groups, community service agencies and elected officials. These committees work together to identify community health needs and devise strategies and tactics to address those health needs together, with an overall goal of improving the health status of the community.Resurrection Health Care is part of Building a Healthier Chicago (BHC), a collaborative of local and national stakeholders working to strengthen efforts to promote the health of Chicago residents. BHC seeks to create integrated, effective and sustained community-wide partnerships for health promotion. Its goal is to improve the health of Chicago residents by providing information on policies and programs to help promote healthier lifestyle choices for Chicago residents as well as the prevention and treatment of high blood pressure.</CommunityBuildingActivities>
        <OtherInformation>The hospital's Board of Directors is composed of physicians, senior officers and community representatives. The primary focus of the Hospital Boards is on quality and performance improvement, including oversight of physician credentialing decisions. West Suburban Medical Center has an open medical staff and extends privileges to qualified physicians in the community. As a not-for-profit organization, Resurrection Health Care applies surplus funds to improvements in patient care, medical education and research. Hospitals in the system which have negative operating margins, are able to continue to benefit from such investment because they are part of a system. New Services and Technologies and Capital Improvements:-$81.7 million invested in capital improvements planned between 2002 and 2009 including construction of a new Emergency Department and deferred maintenance investments.-?$6 million allocated to West Suburban Medical Center between 2002 and 2009 for providing and upgrading health information technology systems to facilitate the delivery of safer, more efficient patient care.-?For almost 100 years West Suburban has been home to the West Suburban College of Nursing. The College is an upper division specialty nursing college with 250 nursing students. There are currently 650 former students employed in the City of Chicago.Improving the Health of Our Community:-Reach Out program annually helps over 500 uninsured individuals gain access to essential resources such as medical care, housing and employment.-Monthly physician lectures and health screenings on various topics offered to more than100 participants.-Neighborhood Advisory Committee established to obtain community input from area residents regarding the construction of a new Emergency Department.-Community leaders participate on the West Suburban Neighborhood Community Relations Committee to create a community-wide partnership to improve our community's health.</OtherInformation>
        <AffiliatedHealthCareSystem>A single governance structure for the system includes board members from the community, physicians, senior officers and external business and health care executives with an interest in serving Resurrection Health Care's communities.All Resurrection Health Care facilities have robust community relations and patient and family focused care initiatives. While each community is different, similar methods of community engagement are employed at each hospital. The Resurrection Development Foundation is an Illinois not-for-profit corporation organized to solicit, receive and account for charitable contributions that benefit all Resurrection Health Care entities. The mission of the Foundation is to build relationships and develop partnerships across Chicago to enhance Catholic-sponsored health care services to all who need them.</AffiliatedHealthCareSystem>
        <ReportsFiledWithStates>IL</ReportsFiledWithStates>
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        <NamePerson>Tom Capobianco</NamePerson>
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        <NamePerson>Scott A Levin</NamePerson>
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        <NamePerson>Isoken Koko</NamePerson>
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        <ReturnReference>Part III, Additional Information</ReturnReference>
        <Explanation>Resurrection Health Care Corporation's (RHCC) Compensation and Benefits Committee Compensation establishes the compensation methodology used to determine key executive compensation and monitors the compensation for compliance including approving the compensation for all members of the affiliated group including Our Lady of the Resurrection Medical Center. The CEO of West Suburban Medical Center is paid by Resurrection Medical Center and her salary is including in this review. To assure that RHCC and it s affiliates complies with Intermediate Sanctions guidelines on reasonable compensation, the RHCC Compensation and Benefits Committee monitors executive total compensation by approving all components of executive total compensation, positioning RHCC executive total compensation competitively and appropriately, annually reviewing and approving compensation changes for each executive, and reporting its activities regularly to the Resurrection Health Care Board. Avg. Hours Worked For Related Organizations Form 990, Part VII, Section A, Line 1A The following individuals are employees of Resurrection Medical Center and generally work 40 hours per week. Approximately 1 hour of their regular work week is devoted to West Suburban Medical Center. Sandra BruceJoseph F. Toomey Tom CapobiancoJohn OrsiniJames SykesJeannie C. FreyRonald StruxnessStar NovakIvette EstradaThe following individuals are paid by Resurrection Medical Center, the entity that pays all of the systems employees. They generally work 40 hours per week for West Suburban Medical Center:Jay KreuzerPatricia ShehornJoan OrmsbyDeborah DavissonIsoken KokoKenneth BlairMax HarrisScott LevinDaniel Torres</Explanation>
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        <Identifier>Sch J, Part I, Line 7</Identifier>
        <ReturnReference>Part I, Line 7: Non-Fixed payments not listed above</ReturnReference>
        <Explanation>Incentive payments were made to the following physicians:Isoken KokoKenneth BlairScott LevinDaniel TorresPayments made as directed by the written employment agreement. The payments are paid if the physicians perform additional duties (on-call coverage, weekend coverage, etc.); meet certain productivity goals; or achieve other operating goals as defined in the contract.</Explanation>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="09000047" softwareVersion="2009v1.7">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>West Suburban Medical Centers articles of incorporation are on file with the State of Illinois. Resurrection Health Care Corporation and Affiliates audited financial statements are available from the national dissemination agent as required by our bond documents. Conflicts of interest policies are not made available to the public.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>Compensation at Resurrection Health Care Corporation (RHCC) and its affiliates is based upon a Board of Directors approved strategy that guides the corporations in establishing total compensation opportunities for the organization's executives. The overall purposes of the RHCC total compensation program are to enable the organization to recruit, motivate, reward, recognize, and retain highly talented executives with the skills required to align performance measures with RHCCs Mission, Vision, and strategic initiatives, and to achieve outstanding results on a continuous basis. To ensure RHC attracts and retains high quality executives with the appropriate skills, the organization uses external labor market data to validate its base salaries and total cash compensation opportunities. The marketplace in which RHCC assesses total compensation is both regional and national in scope and is primarily comprised of comparable healthcare systems and hospitals. To assure that RHCC complies with Intermediate Sanctions guidelines on reasonable compensation, the Board's Compensation and Benefits Committee closely monitors executive total compensation by approving all components of executive total compensation, positioning RHCC executive total compensation competitively and appropriately, annually reviewing and approving compensation changes for each executive, and reporting its activities regularly to the Board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>The compliance department coordinates an annual conflict of interest survey to determine the compliance with the conflict of interest policy and takes the required actions based on the survey results including reporting to the audit and compliance committee.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>A copy of the finalized form will be made available to the West Suburban Medical Center Board of Directors before filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7a</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body</ReturnReference>
        <Explanation>The sole member, Resurrection Health Care Corporation, elects members of the governing body.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</ReturnReference>
        <Explanation>The Corporation has one member, Resurrection Health Care Corporation.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part III, Line 4d</Identifier>
        <ReturnReference>Form 990, Part III, Line 4d : Other Program Services Description</ReturnReference>
        <Explanation>OTHER PROGRAM SERVICES 4: Operated the College of Nursing to educate and train people for future service in health care.</Explanation>
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          <AddressLine1>90 N Main Street</AddressLine1>
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          <State>IL</State>
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        <DirectControllingEntityName>
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          <AddressLine1>1225 West Lake Street</AddressLine1>
          <City>Melrose Park</City>
          <State>IL</State>
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        <EIN>361649520</EIN>
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        <DirectControllingEntityName>
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          <BusinessNameLine1>Our Lady of the Resurrection Medical Ctr</BusinessNameLine1>
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          <AddressLine1>5645 West Addison Street</AddressLine1>
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          <State>IL</State>
          <ZIPCode>60634</ZIPCode>
        </AddressUS>
        <EIN>362644178</EIN>
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          <State>IL</State>
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        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
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          <State>IL</State>
          <ZIPCode>60631</ZIPCode>
        </AddressUS>
        <EIN>362235165</EIN>
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        <DirectControllingEntityName>
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          <State>IL</State>
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        </AddressUS>
        <EIN>412237612</EIN>
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        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
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          <City>Lombard</City>
          <State>IL</State>
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        <EIN>262189763</EIN>
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        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>RESHealth Sleep Care Center of Evanston</BusinessNameLine1>
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          <AddressLine1>665 W North Avenue 500</AddressLine1>
          <City>Lombard</City>
          <State>IL</State>
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        <EIN>261519556</EIN>
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        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
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          <State>IL</State>
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          <State>IL</State>
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        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
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          <Country>BF</Country>
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        <LegalDomicileForeignCountry>BF</LegalDomicileForeignCountry>
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          <State>IL</State>
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      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
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      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
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      <ExchangeOfAssets>false</ExchangeOfAssets>
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      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
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      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
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      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
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  </ReturnData>
</Return>
