2024-05-15T17:23:57-05:00 2023-06-30 420714325 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 606063392 990 2022-07-01 362170143 La Rabida Children's Hospital LARA 7733636700 6501 S Promontory Drive Chicago IL 60649 Anthony M McWhorter Executive Director of Finance 7733636700 2024-05-15 1 Anthony McWhorter 999009999 1 Rebekuh Eley P01247672 3126343400 2024-05-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Rolla Sweis 6501 S Promontory Drive Chicago IL 60649 434155208 0 X www.larabida.org X 1896 IL To provide specialized health care to children with medically complex conditions. 33 32 692 75 0 0 6678828 4278129 59657186 66382475 7045902 25466160 294310 435529 73676226 96562293 8664 80030 0 0 40562951 43870582 0 0 894764 22525300 27117074 63096915 71067686 10579311 25494607 239934866 262812366 14869414 20319477 225065452 242492889 X See Schedule O.La Rabida Children's Hospital (LRCH) provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay. 0 0 41287695 80030 41695312 The primary service provided by La Rabida is inpatient services to children with chronic illnesses and disabilities. In fiscal year 2023 we had 122 admissions and 9,994 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 45 physician residents and 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. 10547841 10651976 The secondary services provided by La Rabida are various clinical outpatient services supportive of the special needs of our patients. These services include 106 treatment room visits, 14,623 physician clinic visits and 15,592 outpatient ancillary visits. The physician clinics are for children with chronic healthcare needs and their siblings. These services also include care coordinators, patient education, case management and numerous wrap around services such as nutrition and behavioral health. Included in the ancillary visits are physical therapy, speech therapy, occupational therapy and infant development specialty visits. 5959042 12221831 In conjunction with the inpatient and outpatient services provided, LRCH also provides several primarily grant funded program extensions. The largest are Children's Advocacy Center for children who have been abused, neglected or have experienced trauma; Child and Family Connections which is a healthcare system point of entry for early intervention services for residents of southeast Chicago; and Integrated Assessment which conducts mental health assessments for children entering custody of the Illinois Department of Children & Family Services. 584197 Behavioral Science and Counseling Services to the children of the Chicagoland Community. 0 0 1229159 Income from Joint Venture 0 0 1813356 57794578 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 1 0 0 0 1 68 0 1 692 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 33 32 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Anthony M McWhorter 7733636700 6501 S Promontory Drive Chicago IL 60649 Fred Berglund Chair 1.00 X X 0 0 0 Terence Donnelly Vice Chair 1.00 X X 0 0 0 Allen Kutchins Secretary & Audit Committee Chair 1.00 X X 0 0 0 Cedric Shaw Trustee 1.00 X 0 0 0 Fred Walz Trustee 1.00 X 0 0 0 Bruce Cohen Trustee 1.00 X 0 0 0 Adam Fox Trustee 1.00 X 0 0 0 Brian Gaspardo Trustee 1.00 X 0 0 0 Patricia Halper Trustee 1.00 X 0 0 0 Mark Hanna Trustee 1.00 X 0 0 0 John Harney Trustee 1.00 X 0 0 0 Allen Kanter Trustee 1.00 X 0 0 0 Randy Markowitz Trustee 1.00 X 0 0 0 Daniel Real Trustee 1.00 X 0 0 0 Richard Rodgers Trustee 1.00 X 0 0 0 Julie Vander Weele Trustee 1.00 X 0 0 0 Keith Weiss Trustee 1.00 X 0 0 0 DAndrea Anderson Trustee 1.00 X 0 0 0 Josh Chapman Trustee 1.00 X 0 0 0 William Cordes Trustee 1.00 X 0 0 0 Kelly Guglielmi MD Trustee 1.00 X 0 0 0 Bruce McCrae Trustee 1.00 X 0 0 0 Valerie King Trustee 1.00 X 0 0 0 Kristin Miller Trustee 1.00 X 0 0 0 Matthew C Phipps Trustee 1.00 X 0 0 0 Andy Roscoe Trustee 1.00 X 0 0 0 Grant Sanders Trustee 1.00 X 0 0 0 Eillen Collins Trustee 1.00 X 0 0 0 Brian Darch Trustee 1.00 X 0 0 0 Johara Farhadieh Trustee 1.00 X 0 0 0 John Ferguson Trustee 1.00 X 0 0 0 Megan Ratia Trustee 1.00 X 0 0 0 Michelle Thetford Trustee 1.00 X 0 0 0 Brenda J Wolf President & CEO 37.50 X 620926 0 27045 Mark D Renfree CFO/VP of Admin/Treas (until 12/22) 40.00 X 389892 0 25918 Dr Sarah Hoehn Chief Medical Officer 40.00 X 274045 0 18406 Michele A Wysoglad VP of Fund Development 40.00 X 244721 0 41001 Theresa Martinez VP Patient Care & CNO 40.00 X 272789 0 9418 Kimberly Chmura General Counsel 40.00 X 260667 0 18498 Brian Fredericks CFO/VP of Admin/Treas (until 5/23) 40.00 X 19615 0 0 Sheelah Cabrera Chief Information Officer/Asst VP 40.00 X 233598 0 14726 Anthony McWhorter Director of Finance 40.00 X 212655 0 18911 Lucy I Mayhugh Director of Clinic Operations 40.00 X 200504 0 23612 Jennifer Tavares-Kitchen Exec Dir Inpatient Ops (until 11/22) 40.00 X 205486 0 14054 Maria Garcia Director Human Resources 40.00 X 194932 0 1995 Keir Mitchell Director of Rehab and Development 40.00 X 193670 0 25061 Patricia DiFiglio Director of Corporate Compliance 40.00 X 173834 0 24947 Gai Truong Chief Pharmacy 40.00 X 178997 0 18689 Natasha Bhayani Physician 40.00 X 184668 0 10657 Rodney Morris Director Support Services 40.00 X 170919 0 23104 4031918 0 316042 47 0 1 0 Berglund Construction 8410 S South Chicago Ave Chicago IL 60617 Construction 4491790 University of Chicago 5721 S Maryland Avenue Chicago IL 60637 Physician Staffing Services 2303806 Pediatric Faculty Foundation 225 E Chicago Box 152 Chicago IL 60611 Physician Staffing Services 1746769 Soliant Health PO Box 934411 Atlanta GA 31193 Contract Staffing 760348 Aya Healthcare Inc 5930 Cornerstone Ct W Ste 300 San Diego CA 92121 Contract Staffing 756072 26 812007 3466122 143561 4278129 Inpatient Services 621110 41695312 41695312 Grant Funded Programs 621110 12221831 12221831 Outpatient Services 621400 10651976 10651976 Income from Joint Venture 900099 1229159 1229159 Care Coordination Entity 621110 584197 584197 66382475 6772918 6772918 356040255 337282818 64195 18757437 -64195 18693242 18693242 167983 812007 245902 -77919 -77919 Cafeteria 721000 260730 260730 252718 252718 513448 96562293 66382475 0 25901689 X 80030 80030 3258913 639848 2377461 241604 32847560 28641740 3769487 436333 1285424 1042452 218838 24134 3931946 3188726 669394 73826 2546739 2065352 433570 47817 303400 303400 240464 240464 87538 87538 1301074 1301074 9975114 8543211 1389622 42281 4705869 4418983 273706 13180 1373797 312732 1056642 4423 2476193 2469578 6615 81789 33886 45488 2415 14943 14943 3238415 3238415 1451633 1451633 Maintenance Contracts 692958 692958 Bad Debt Expense 436390 436390 Education 83011 65151 17685 175 Books & Subscriptions 34188 14581 17646 1961 620298 458912 161386 71067686 57794578 12378344 894764 6495829 4073285 2831430 1046274 1420798 2423533 3439602 4331779 466139 459135 1115930 1089084 70662194 37549561 27763285 33112633 188715278 204903956 2841476 4099427 4845099 7273260 239934866 262812366 12102915 11343457 0 5519735 2766499 3456285 14869414 20319477 X 219569588 237323875 5495864 5169014 225065452 242492889 239934866 262812366 X 25494607 -9569727 1502557 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 3602 1 70000 0 1 13935 87537 0 Part II-B, Line 1: Part II-B, line 1 (f): The grants to other organizations for lobbying purposes are made through dues paid to the National Association of Children's Hospitals. Part II - B, line 1 (g): We hire a firm to assist in education legislators on the specific financial situation of La Rabida and the importance of appropriate Medicaid reimbursement. Part II - B, line 1(i): A portion of the dues paid to the Illinois Hospital Association and the American Hospital Association are attributable to lobbying. 1203962 3479 4372 1203069 1201000 997 4367 2402 1203962 1200512 488 2402 2402 1201000 1199409 1103 5602 5602 1200512 1199409 9595 9595 1199409 0.00000 1.00000 0.00000 0 0 49285261 22249274 27035987 232007 204218 27789 20685226 14968079 5717147 459700 127990 331710 33112633 Payables to Third-Party Programs 538576 Self-Insurance 2369641 Operating Lease Liabilities 548068 3456285 X 87075234 -9569727 71673 1502557 -7995497 95070731 1301074 190488 1491562 96562293 69647797 71673 245902 317575 69330222 1301074 436390 1737464 71067686 Part V, Line 4: The Hospital's endowments consist of individual funds which were established to support the special services provided by the Hospital which are not covered by Medicaid and other third-party payors. The principal of the endowments must be maintained in perpetuity. Income earned on the endowments may be spent on the special services designated by the donors. Part X, Line 2: 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 follows the Financial Accounting Standards Board (FASB) - issued guidance for accounting for uncertainty in income taxes. 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 income (UBI). The Hospital had no UBI for the years ended June 30, 2023 and 2022. 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. Forms 990 filed by the Hospital are subject to examination by the Internal Revenue Service up to three years from the extended due date of each return. Part XI, Line 2d - Other Adjustments: Change in Pension Obligation 1,502,557. Part XI, Line 4b - Other Adjustments: Bad Debt Expense 436,390. Fundraising Event Expenses -245,902. Part XII, Line 2d - Other Adjustments: Fundraising Event Expenses 245,902. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 436,390. Golf Outing 238365 193065 45300 24271 43286 70 13202 Gala 741625 618942 122683 15736 78690 2214 68433 979990 812007 167983 40007 121976 2284 81635 245902 -77919 1 1 1 X 1 X 1 1 0 1 1 6941 6941 0.00010 57832714 50016852 7815862 0.11070 57839655 50016852 7822803 0.11080 457809 143838 313971 0.00440 2573139 1752222 820917 0.01160 3030948 1896060 1134888 0.01600 60870603 51912912 8957691 0.12680 1 436390 1 1 1 1 La Rabida Children's Hospital 6501 S Promontory Drive Chicago IL 60649 www.larabida.org IL License: 0003012 X X X La Rabida Children's Hospital 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X See Section C X 1 22 1 See Section C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X http://larabida.org/financial-assistance/ X http://larabida.org/wp-content/uploads/2018/05/FA-Application-IP-1.pdf X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 La Rabida Children's Hospital Part V, Section B, Line 5: As part of the Community Needs Assessment, La Rabida routinely receives information about community needs from a number of sources: industry groups such as the Illinois Health and Hospital Association and the Children's Hospital Association; local collaboratives, such as the Healthy Chicago Hospital Collaborative and the South Side Healthcare Collaborative; managed care organizations, with whom we collaborate on prevention and screening efforts; disease- or condition-specific groups such as the Sickle Cell Disease Association of Illinois and EverThrive; and collaborations, particularly with our two major academic medical center colleagues, University of Chicago Medicine and Lurie Children's Hospital. In addition, we receive briefings from Pediatrics Today Smartbrief and Chicago Department of Public Health, and also attend conferences, webinars, grand rounds and community meetings. For the preparation of the Community Health Needs Assessment, the scope of our service area was researched and it was determined that our primary area included approximately 47% of our patients from 12 zip code areas, an additional 21% of patients come from 20 more zip codes, and the final 32% spans a broad region encompassing Illinois and Indiana. The total tertiary region is comprised of 310 additional zip codes, and demonstrates our role as a regional specialty hospital.Focusing on our primary service area, we then turned to the data collected by epidemiologists at the Chicago Department of Public Health, as published in Measuring Chicago's Health, which tracked a "hardship index", comprised of six indicators, as well as age, race, perceptions and practices via the Healthy Chicago survey. Comparing population changes from 2000 to 2020, and estimated changes through 2020 using census data, we determined that our area has experienced significant outmigration, 16% loss. Better job opportunities and safety were the primary reasons for the outmigration found in local research reported by the Tribune. We looked at changes in the health industry that impacted access to services in our area, as well as health and community assets.Finally, since we provide extensive wraparound services to our patients to address a variety of social determinants of health (food, income, housing, and transportation insecurity, access to other support services), we engage in deep conversation daily with our own patients about what they need. We surveyed our own patients, highlighting the specific issues that were found in the public survey data for our primary service area: access to health care, what was needed to improve health and health services, chronic conditions and primary sources of health information. Over a multiple-week period, three hundred surveys (presented in English and Spanish) were distributed to the primary family member whose child had a pre-scheduled appointment. The data reflected responses from 268 (89%) respondents who live in our primary service area. The leading issues identified in our survey agreed with the census data: concerns about unemployment and safety, as well as healthier food and better access to dental, mental health, and transportation services. La Rabida Children's Hospital Part V, Section B, Line 7d: Line 7a URL: The Community Health Needs Assessment and implementation strategy are available to the public using the following URL:https://larabida.org/wp-content/uploads/2022/11/2022-2024-Community-Health-Needs-Assessment.pdf This site offers the CHNA Report document in a format that: - When accessed, downloaded, viewed, and printed in hard copy, exactly reproduces the image of the report; - Grants access to download, view, and print the document without special computer hardware or software required for that format (other than software that is readily available to members of the public without payment of any fee) and without payment of a fee to the hospital organization or facility or to another entity maintaining the website.LRCH will provide any individual requesting a copy of the written report with the direct website address, or URL, where the document can be accessed. LRCH will also maintain at its facilities a hard copy of the CHNA report that may be viewed by anyone who requests it.Part V, Line 10a: The implementation strategy is saved to the following URL:https://larabida.org/wp-content/uploads/2022/11/2022-2024-Community-Health-Needs-Assessment.pdf La Rabida Children's Hospital Part V, Section B, Line 11: A wide range of priority issues emerged from the CHNA process. A committee of La Rabida senior executive staff reviewed the outcomes of the community health needs assessment and the clinic survey. La Rabida Children's Hospital also reviewed the prior implementation plan and we reviewed the plan of the major medical center that is closest to us, as well as some other community initiatives underway in which we have the option to participate.The significant needs identified in the CHNA which La Rabida elected not to address are: 1) Job and employment opportunities, the third biggest concern in our patient survey, as unemployment rated from ranges from 24% to 11% in our primary service area, compared to a long-term state average of 7%. - La Rabida will not address this issue in its Implementation plan, as job insecurity is not just a south side phenomenon, it is a city, county and state issue which is beyond the resources of La Rabida. However, we contribute where we can: for example, we buy local vegetables in season from Growing Home, an urban farm that employs local people with particularly difficult employment challenges, preparing them to enter the mainstream job market. 2) Having a safe place to walk and play was the second most cited concern in our patient survey. Although parks are fairly well distributed in many of our communities, the survey reports that the perception of their safety varies with age, ethnicity and poverty. - La Rabida will not address this issue in its Implementation plans, as the hospital does not have the internal assets nor resources to produce a significant impact on the resolution of this issue.La Rabida evaluated the unique role La Rabida plays as a small specialty hospital in the constellation of providers in our community and discussed the best ways to build on those assets to the benefit of the community. In general, we wish to bring enhanced services and/or access to services in areas of general behavioral health (#3 below), caregiver well-being (#4 below) and asthma intervention (#5 below). The following are the significant needs identified in the CHNA which La Rabida elected to address: 3) Mental Health services, as severe psychological distress is not correlated with age, gender or ethnicity, but it is highly correlated with poverty, with 10 percent of those living at or below the federal poverty level reporting distress compared to 1 percent of those living at 400% of the federal poverty level or above. - La Rabida plans to address this need by (1) embedding Behavior Health providers in our Outpatient Clinics and (2) training primary care providers to treat ADHD, depression and anxiety, including standard prescribing protocols (3) expand child psychiatry to include secondary support of PCP provision of primary health services as well as continuing treatment of more complex cases. (4) introducing sickle cell integrated pain program (4) plan to expand services to include group therapy sessions (5) partner with the University of Chicago on pediatric mobile unit medical clinic to offer trauma consults to vulnerable populations (6) launch a trauma informed care seminar to train community providers 4) Caregiver Well Being, as the adult measures of our survey reflects an increased prevalence of diseases including cancer, stroke, diabetes and asthma. The caregivers of the children we serve are juggling their own poor health while caring for their medically complex children. - La Rabida will address this need by (1) inserting caregiver well-being checks into standard visit templates and (2) insert inquiry into informal supports available to family (neighbors, church) into standard visit templates 5) Asthma Interventions, respondents of our survey were asked to name the top three health conditions their children were facing. Asthma (grouped with diabetes and cerebral palsy) was the leading condition named 52%, followed by allergies (43%), and sickle cell (16%) - La Rabida will collaborate with the University of Chicago Medical Center to improve asthma in the surrounding community by joining and participating in the south side Pediatric Asthma Center. La Rabida's Chief Medical Officer participated on the asthma outreach advisory committee. La Rabida Children's Hospital Part V, line 16c, FAP Plain Language Summary website:https://larabida.org/wp-content/uploads/2023/05/Financial-Assistance-Plain-Language_02-26-23-Update.pdf 5 1 - Child & Family Connections 1525 E 55th Street Suite 300 Chicago IL 60615 Office Building - Provide Child Early Intervention Services 2 - The Chicago Child Trauma Center 1525 E 55th Street Suite 203 Chicago IL 60615 Medical Office Complex - Child Trauma Center 3 - La Rabida Joli Burrell Center 200 Lakewood Boulevard Park Forest IL 60466 Police Station - Children's Advocacy Trauma Center 4 - Chicago Children's Diabetes Center at Si 12701 W 143st Suite 280 Homer Glen IL 60491 Medical Office Complex - Outpatient Center 5 - The Community Hospital Outpatient Center 9660 Wicker Ave St John IN 46373 Medical Office Complex - Outpatient Center Part I, Line 7: A cost to charge ratio, calculated using the IRS worksheet, was used for the Part I, Line 7 table. Part I, Ln 7 Col(f): Bad debt expense of $436,390 was removed from total expenses. Part III, Line 2: Bad debt expense represents as estimate of net patient revenue, which the hospital has projected to have a high probability of non-collection, due to the aging of the receivable or other information gathered during the management of the patient's accounts receivable. Part III, Line 4: The Hospital estimates the allowance for uncollectible accounts based upon management's evaluation of the collectability of its accounts receivable based on factors such as the length of time the receivable is outstanding, payor class, historical experience, trends in health care coverage, and business and economic conditions. Accounts receivable are written off against the allowance for uncollectible accounts when they are deemed uncollectible. Recoveries of receivables previously written off are recorded as a reduction of the provision for uncollectible accounts when received. Patient receivables, where a third-party payor is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual adjustments or discounts provided to third-party payors. The past due status of receivables is determined on a case-by-case basis depending on the payor responsible. Interest is generally not charged on past due accounts. Receivables or payables related to estimated settlements on various payor contracts, primarily Medicaid, are reported as amounts due from or to third-party programs. Significant changes in payor mix, business office operations, economic conditions or trends in federal and state governmental health care coverage could affect the Hospital's collection of accounts receivable, cash flows and results of operations. Part III, Line 9b: La Rabida offers financial assistance to patients who qualify. With the application process, decisions will be communicated by mail or telephone within 10 days of LRCH's receipt of the completed application. Eligibility is determined using the Financial Assistance Application. The application is available on LRCH's website and is also available for pick-up at the hospital's Patient Financial Services Department. Part VI, Line 2: Community Assessment: Goals and ProcessesOur families come from specific environments which can either enhance or challenge their abilities to care for their medically complex children. The goal of our community needs assessment is to understand the context in which our families live, specifically, as informed by Chicago's mission to improve community health (see Measuring Chicago's Health: Findings from the 2014 Healthy Chicago Survey) and the health status data which is gathered and made publicly available online by the Chicago Department of Public Health.We participate in one collaborative: the Chicago Southside HealthCare Collaborative, anchored by the University of Chicago, which shares information and combined efforts to improve community health. We participate in the Medical Home Network, an organization of safety net providers dedicated to improving health and service outcomes for those served by Medicaid. We provide care coordination to one Medicaid Managed Care organization, which actively reviews resources, processes, and outcomes in order to improve services received by those served by Medicaid.Finally, because we work with families to reduce barriers to health and health services, both for children being cared for by La Rabida programs and for 2,500 children being cared for elsewhere across the region, we actively participate in daily conversations about the immediate and long term needs and options available to families in the region, and by collaborating with other agencies or health plans, to expand options available to our families.These sources drive enhancements and refinements to our programming to build on assets families already have, better meet challenges they face, and improve or expand the services we provide. For this report, we will look at the characteristics of the primary geographic areas we serve, and then at the results of a survey of our clinic attendees about the challenges they face. We expect both of these investigations and the information garnered from the relationships described above to inform program enhancements to be made over the next one to three years. Priority is given to ways we can boost our own programs and processes to help our subset of the population, families caring for medically complex children, reach their health goals. Part VI, Line 3: Patient Education of Eligibility for Assistance: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 ensure eligibility. The family is also notified about our financial assistance policy and the necessary forms for qualification are provided if requested. Part VI, Line 4: Community Information:Nearly 47% of La Rabida families (those who have used inpatient and/or outpatient services) come from 12 zip codes - what we are identifying as our primary service area - bounded by West Garfield and then E. 35th street to the north, State Street and then Western Avenue south to 95th street, then reaching further east and south to Racine and 130th or so, all the way east to the Indiana border. An additional 21% of patients come from 20 more zip codes (our secondary service area), reaching extensively into Chicago's south suburbs. The final 32% spans a broad region encompassing Illinois and Indiana. The total tertiary region is comprised of 310 additional zip codes, and demonstrates our role as a regional specialty hospital.Living below the federal poverty level: In our primary service area, the percentage of residents living below the federal poverty level ranges from 42.2% to 13.7%. By contrast the state average for Illinois is about 14%.Per capita income ranges from $11,993 to $37,519. Poverty is particularly localized in the northwest corner of our service area, though pockets of deep poverty occur elsewhere in the region, such as in Burnside, and the entire region is lower than average. By contrast, per capita income in the state is about $54,203. Unemployment: High rates of unemployment also occur throughout the region, ranging from a high of 24% in Auburn Gresham to a low of 11% in Kenwood/Hyde Park. No high school diploma: The percent of persons aged 25 years and older lacking a high school diploma ranges from 10.8% in Kenwood/Hyde Park to 29.4% in Englewood.Dependency: Englewood has a notably high dependency rate (43.4%) and Kenwood/Hyde Park stands out as a particularly low outlier (34.2%) Crowded Housing: This is a proxy for the stress of living in crowded conditions; it measures the percent of occupied house in which there are more than one person per room. Our primary service area ranges from 6% in East Side to 0.8% in Morgan Park. Part VI, Line 5: Promotion of Community Health:La Rabida serves over 400 children and families through hospitalizations and 15,800 through outpatient clinics and urgent care visits annually. Almost half of La Rabida's patients (approximately 25%) are age five and under. La Rabida serves children and their families through age 18 and ensures that ongoing care is provided through referrals to local hospitals and clinics. In addition, La Rabida assists families in negotiating 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 85% of the hospital's income. The following are some of the programs used to meet the needs within our community.Trauma/Abuse Program:LRCH 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 serves one of Chicago's and Chicago's south suburbs' most low-income areas. Adjunct services include forensic interviewing, case management, court services (i.e. accompanying children to court to testify against the perpetrator), liaison with community hospitals and community agencies. LRCH also provides outreach, training and consultation to child service programs in the community. LRCH 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.LRCH also assists DCFS in providing initial health screenings prior to placement for abused and neglected children who come into custody. LRCH assists the Illinois Department of Healthcare and Family Services as an enrollment site for a health insurance program for low income children and families.Medical Home Program:LRCH is a NCQA-recognized Patient-Centered Medical Home (PCMH) that offers children from birth to age 18 with developmental problems and/or medically complex conditions an interdisciplinary model for primary care. The program utilizes a cross-disciplinary pediatric care team to work in partnership with patients and families to ensure all of the medical and non-medical needs of the patient are met. Through the use of shared patient data in the EMR and robust case management, the program focuses on outcomes while reducing costs associated with duplicative and fragmented care. The American Journal of Managed Care recently published results from a study that showed pediatric PCMH patients were 23% less likely to be hospitalized, required 17% fewer ED services and cost 14.5% less than pediatric non-PCMH patients. Through the medical home program, LRCH provides ongoing healthcare and social supports to children with special needs and their families from infancy until adulthood. This program delivers care and service that is family-centered; comprehensive; holistically addressing the child's needs; coordinated; team driven; and culturally sensitive. LRCH's "one stop shopping" medical home is a particularly important model when working with families who not only have a child with special needs, but also are burdened with other economic stressors. This allows for better and easier access to care, as well as maximizing positive outcomes over the long term while lowering the use of high cost services like duplication of diagnostic procedures and treatments, unnecessary emergency room use and inpatient hospitalization.Case Management Program:The 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 case managers (nurses and 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.The program also 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 LRCH providers and external providers such as subspecialists, 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 hospitalization.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.-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 to caregivers, extended family and school personnel to understand how to manage the disease.-The State of Illinois mandates special classes for caregivers before a medically complex child can be released to the home. These weekly classes run in four week intervals, and include: G-tube care, Tracheotomy care, Ventilator care, and CPR/airway obstruction care.-Ordering of home care services (nursing and equipment).-Telephone Management (Diabetes). Toll free call in numbers 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.-Follow up of newborn screening results (sickle cell diseases).-Wound management consultation.-Coordination of inpatient and outpatient rehabilitation program.-Collaboration with community agencies, such as Division of SpecializedCare for children (DSCC).-Coordination of school needs, including: assistance in preparation of 504 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. 1 Donations for hospital patients 1763 79030 FMV Clothing, Childcare Supplies & Equipment & Education Materials & Medical Equipment Scholarships 1 1000 Part I, Line 2: Tangible items are given to patients, i.e., toys, blankets and games. No monitoring is required. X X X 1 0 0 0 0 1 0 1 0 Brenda J Wolf President & CEO 498074 0 116672 0 6180 0 0 0 27045 0 647971 0 0 0 Mark D Renfree CFO/VP of Admin/Treas (until 12/22) 339537 0 48234 0 2121 0 0 0 25918 0 415810 0 0 0 Dr Sarah Hoehn Chief Medical Officer 263594 0 10000 0 451 0 0 0 18406 0 292451 0 0 0 Michele A Wysoglad VP of Fund Development 244031 0 0 0 690 0 6500 0 34501 0 285722 0 0 0 Theresa Martinez VP Patient Care & CNO 242194 0 29988 0 607 0 2743 0 6675 0 282207 0 0 0 Kimberly Chmura General Counsel 260152 0 0 0 515 0 0 0 18498 0 279165 0 0 0 Sheelah Cabrera Chief Information Officer/Asst VP 213034 0 19320 0 1244 0 0 0 14726 0 248324 0 0 0 Anthony McWhorter Director of Finance 192195 0 18480 0 1980 0 4818 0 14093 0 231566 0 0 0 Lucy I Mayhugh Director of Clinic Operations 181749 0 17465 0 1290 0 20114 0 3498 0 224116 0 0 0 Jennifer Tavares-Kitchen Exec Dir Inpatient Ops (until 11/22) 176478 0 12667 0 16341 0 0 0 14054 0 219540 0 0 0 Keir Mitchell Director of Rehab and Development 176507 0 16473 0 690 0 0 0 25061 0 218731 0 0 0 Patricia DiFiglio Director of Corporate Compliance 156084 0 13940 0 3810 0 0 0 24947 0 198781 0 0 0 Gai Truong Chief Pharmacy 164757 0 13940 0 300 0 0 0 18689 0 197686 0 0 0 Maria Garcia Director Human Resources 187875 0 6500 0 557 0 0 0 1995 0 196927 0 0 0 Natasha Bhayani Physician 184398 0 0 0 270 0 0 0 10657 0 195325 0 0 0 Rodney Morris Director Support Services 154745 0 14630 0 1544 0 0 0 23104 0 194023 0 0 0 Part I, Line 4a Severance payments during 2022 include: Jennifer Tavares-Kitchen - $15,200. These payments are reported as taxable compensation on Part II, column (B)(iii). Part I, Line 6 Each fiscal year, the organaization establishes an Earnings Before Interest Taxes Depreciation and Amortization target. This target is a factor in the Senior Leadership team's variable pay calculation. Part I, Line 7 Bonuses are subject to approval by the Executive Committee of the Board. See Part V See Part V 5849968 See Part V 0 See Part V See Part V 208414 See Part V 0 See Part V See Part V 283722 See Part V 0 See Part V See Part V 118216 See Part V 0 Sch L, Part IV, Business Transactions Involving Interested Persons (a) Name of Interested Person: Berglund Construction(b) Relationship Between Interested Person and Organization:Berglund Construction owned more than 35% by Fred Berglund, Chair and Trustee.(c) Amount of Transaction: $5,849,968(d) Description of Transaction: Construction Services(e) Sharing of Organization Revenues? = No(a) Name of Interested Person: Contributor #94 on Schedule B(b) Relationship Between Interested Person and Organization:Substantial Contributor(c) Amount of Transaction: $208,414(d) Description of Transaction: Financial Services(e) Sharing of Organization Revenues? = No(a) Name of Interested Person: Contributor #79 on Schedule B(b) Relationship Between Interested Person and Organization:Substantial Contributor(c) Amount of Transaction: $283,722(d) Description of Transaction: Construction Services(e) Sharing of Organization Revenues? = No(a) Name of Interested Person: Contributor #11 on Schedule B(b) Relationship Between Interested Person and Organization:Substantial Contributor(c) Amount of Transaction: $118,216(d) Description of Transaction: Financial Services(e) Sharing of Organization Revenues? = No X 7 28082 Avg. Selling Price X Holiday Gifts 188 75472 Fair Market Value X Auction Items 99 40007 Fair Market Value 0 0 0 0 Part I, Column (b): Reporting the number of contributions. Part I, Line 33: The organization receives toys, blankets and donations for small children during the December holiday season. Many of these gifts are dropped off anonymously with a request for a gift receipt. We typically distribute the received donations within 45 days, so the impact on the organization's net profitability is zero. Form 990, Part VI, Section A, line 6 Membership in the Corporation shall be non-sectarian and shall consist of one class of members. Active Trustees of the Corporation shall be members of the Corporation. Other members may be appointed and removed by the Board of Trustees from time to time. Form 990, Part VI, Section B, line 11b Form 990 and appurtenant schedules are prepared by an outside accounting firm using information provided by financial management. Form 990 is reviewed by LRCH's finance leaders, Audit Committee, Executive Committee and Board of Trustees 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 Contracts and Professional Services Committee for review and determination of any conflicts and their findings are presented to the Board of Trustees. Potential conflicts are regularly monitored throughout the year. Should a conflict arise, the Committee will determine the necessary action such as recusing the Trustee or Officer from decision-making regarding the transaction. Form 990, Part VI, Section B, line 15 The Compensation Committee of the Board of Trustees, as needed, engages external compensation consultants to advise it on competitive pay rates for the CEO and all other officers of the Hospital. The Compensation Committee is comprised of non-employee independent volunteer members. Discussion is held by the Committee and a recommendation regarding the CEO's and other officers compensation is presented to the Executive Committee of the Board of Trustees for approval. All compensation discussions and work performed is documented contemporaneously in the Board minutes. 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 the Illinois Attorney General's website. Form 990, Part IX, line 11g Purchased Medical Services: Program service expenses 6,677,211. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,677,211. Other Professional Fees: Program service expenses 1,866,000. Management and general expenses 1,389,622. Fundraising expenses 42,281. Total expenses 3,297,903. Form 990, Part XI, line 9: Change in Pension Obligation 1,502,557. La Rabida Children's Foundation 6501 S Promontory Drive Chicago IL 606491935 363240477 Supporting Organization IL 501(C)(3) Line 12d, III-O N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schedule R, Part II: La Rabida Children's Foundation was dissolved on July 15, 2022.