2024-02-15T15:25:57-06:00 2023-03-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2022-04-01 362448028 JACKSON PARK HOSPITAL FOUNDATION JACK 7739477500 7531 STONY ISLAND AVENUE CHICAGO IL 60649 WILLIAM DORSEY MD CHAIRMAN/CEO 7739477500 2024-02-14 1 WILLIAM DORSEY MD 999009999 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2024-02-12 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z WILLIAM DORSEY MD 7531 STONY ISLAND AVENUE CHICAGO IL 60649 104523579 0 X WWW.JACKSONPARKHOSPITAL.ORG X 1960 IL TO PROVIDE COMPASSIONATE CARE AND HIGH QUALITY HEALTHCARE SERVICES TO MEET THE NEEDS OF THE PATIENTS AND COMMUNITIES WE SERVE. 9 2 816 2 0 0 8579657 12297254 98627710 91311110 184945 48035 595048 867180 107987360 104523579 0 0 0 0 42284840 42921696 0 0 0 57538932 55473226 99823772 98394922 8163588 6128657 132629667 138360093 45291102 44845925 87338565 93514168 X TO PROVIDE COMPASSIONATE CARE AND HIGH QUALITY HEALTHCARE SERVICES TO MEET THE NEEDS OF THE PATIENTS AND COMMUNITES WE SERVE. 0 0 56951705 0 56435744 INPATIENT MEDICAL CARE TO CHICAGO'S SOUTH SIDE COMMUNITIES REGARDLESS OF THE PATIENT'S ABILITY TO PAY INPATIENT SERVICES INCLUDING MEDICAL SURGICAL, ICU AND HOSPICE. IN 2022 THE HOSPITAL SERVED 2,313 ACUTE CARE ADMISSIONS WHICH AMOUNTED TO 13,118 PATIENT DAYS. 20001564 0 19820357 JACKSON PARK HOSPITAL FOUNDATION PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL MEDICINE SERVICES TO THE GREATER CHICAGOLAND AREA. JACKSON PARK HOSPITAL IS ONE OF THE FEW HOSPITALS IN CHICAGO THAT CONTINUES TO PROVIDE BEHAVIORAL MEDICINE TO ITS COMMUNITY. IN 2022 JACKSON PARK HOSPITAL SERVED 2,875 INPATIENT BEHAVIORAL MEDICINE PATIENTS WHICH AMOUNTED TO 14,470 PATIENT DAYS. JACKSON PARK HOSPITAL PROVIDES MULTIPLE LEVELS OF CARE TO MEET THE NEEDS OF AN ADULT INDIVIDUAL WITH EMOTIONAL AND BEHAVIORAL PROBLEMS. IN ADDITION TO 24 HOUR EMERGENCY PSYCHIATRIC AND INTAKE SERVICES, JACKSON PARK HOSPITAL OFFERS 86-BED INPATIENT PSYCHIATRIC SERVICES, PARTIAL HOSPITAL PROGRAM AND OUTPATIENT SERVICES. THE TREATMENT IS PROVIDED BY MULTIDISCIPLINARY STAFF INCLUDING PSYCHIATRIST, INTERNIST, PSYCHOLOGIST, PSYCHIATRIC NURSE, SOCIAL WORKER, CLINICAL THERAPIST, OCCUPATIONAL THERAPIST, AND NUTRITIONIST. 12468413 0 12355453 JACKSON PARK HOSPITAL PROVIDES BASIC EMERGENCY ROOM SERVICES TO ITS COMMUNITY 24 HOURS A DAY 7 DAYS A WEEK REGARDLESS OF THE PATIENTS' ABILITY TO PAY. IN 2022 THE HOSPITAL SERVED 16,228 EMERGENCY PATIENTS. 2724236 0 2699556 MEDICAL EDUCATION - OUR VISION IS TO PROMOTE COMPETENCE IN HEALTH CARE AND CUSTOMER SERVICE BY PROVIDING EDUCATION, DIRECTION, TRAINING AND LEADERSHIP TO OUR STAFF. JPH EDUCATION DEPARTMENT WORKS WITH SEVERAL MEDICAL AND NURSING COLLEGES AND UNIVERSITIES SERVING AS A CLINICAL SITE FOR MEDICAL STUDENTS, NURSING STUDENTS AND ALLIED HEALTH PROFESSIONALS WHO COMPLETE THEIR CLINICAL AFFILIATION AT JPH AS PART OF THEIR ACADEMIC TRAINING. WE ALSO PARTICIPATE IN COMMUNITY OUTREACH AND HEALTH SCREENING TO PROMOTE WELLNESS IN OUR COMMUNITY. 2724236 0 2699556 92145918 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 0 1 60 0 816 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 2 0 0 0 0 1 0 1 1 1 0 0 0 1 1 1 1 1 0 0 0 IL X RUSMIR ZEC 7739477621 7531 STONY ISLAND CHICAGO IL 60649 X JAMES I CLARK III DIRECTOR 2.00 0.00 X 0 0 0 DR WILLIAM O DORSEY III CHAIRMAN/CEO 40.00 0.00 X X 775628 0 25310 DR HARSHAD MEHTA DIRECTOR/PHYSICIAN 40.00 0.00 X 206056 0 28643 DR LAKSHMI DODDA DIRECTOR/PHYSICIAN 25.00 0.00 X 234965 0 28360 DR HAROON OLOMI DIRECTOR/PHYSICIAN 4.00 36.00 X 5903 209996 24550 DR ZAHIDUR RAHMAN DIRECTOR/PHYSICIAN 4.00 36.00 X 76853 85111 24550 DR SURRENTHIA PARKER DIRECTOR/PHYSICIAN 4.00 0.00 X 46396 0 36649 DR BANGALORE R MURTHY DIRECTOR/PHYSICIAN 25.00 0.00 X 160554 0 41692 DR ARLENE RICHARDSON DIRECTOR/PHYSICIAN 40.00 0.00 X 0 0 0 MERRITT HASBROUCK PRESIDENT 40.00 0.00 X 656069 0 11808 G RANDALL SMITH EXECUTIVE VP 40.00 0.00 X 690294 0 47456 MARGO BROOKS-PUGH VICE PRESIDENT 40.00 0.00 X 115162 0 42878 ALVIN KRUSE SECRETARY 0.25 0.00 X 0 0 0 KENNETH MCGHEE VP FINANCE 40.00 0.00 X 223627 0 14370 THOMAS PANKOW CHIEF INFORMATION OFFICER 40.00 0.00 X 202092 0 4403 M PATRICIA SIMON SENIOR VP QUALITY & COMPLIANCE 40.00 0.00 X 221715 0 40188 NELSON VASQUEZ VP FINANCE (TERM ENDED 11/22) 40.00 0.00 X 409448 0 44793 BARRY MANDELL VP SPECIAL PROJECTS 40.00 0.00 X 187149 0 37180 MAGDALENE ARMSTEAD VP PATIENT CARE 40.00 0.00 X 157725 0 18329 RAYLENE SWINOCK NURSE 40.00 0.00 X 262196 0 9278 SYED ALA MD PHYSICIAN 12.00 28.00 X 57614 170000 47800 MATTHEW MALTERS MD PHYSICIAN 2.00 38.00 X 13166 700712 36649 CYRIL EZEANYAGU NURSE 40.00 0.00 X 238220 0 10727 SAHR NGOMBU NURSE 40.00 0.00 X 235720 0 20349 5176552 1165819 595962 81 0 1 0 WHITE CAP NURSING 2600 SOUTH MICHIGAN AVENUE CHICAGO IL 60616 TEMPORARY NURSE STAFFING 4984149 SIMPLE LABORATORIES 5960 NORTH MILWAUKEE AVENUE CHICAGO IL 60646 LAB SERVICES 2811455 DMS NURSING 2250 E DEVON AVE STE 341 DES PLAINES IL 60018 TEMPORARY NURSE STAFFING 2247898 POWERS & SONS 5040 SOUTH STATE STREET CHICAGO IL 60609 CONSTRUCTION SERVICES 2154500 GREAT LAKES MEDICAL GROUP 1001 GALAXY WAY SUITE 400 CONCORD CA 94520 EMERGENCY ROOM DOCTORS 1617000 64 12247054 50200 12297254 PATIENT SERVICE REVENUE 621110 54857300 54857300 PROVIDER TAX PROCEEDS 621110 36453810 36453810 91311110 48035 48035 243833 0 243833 243833 243833 CAFETERIA 722514 233633 233633 REBATES - OPTUM RX 621110 224762 224762 REFUNDS - HEALTHTRUST 621110 56646 56646 108306 108306 623347 104523579 91311110 0 915215 X 4840795 4840795 32010148 32010148 460125 445325 14800 3061186 3003215 57971 2549442 2467441 82001 557008 557008 236710 236710 21055 21055 118711 118711 22362451 21975466 386985 133714 133714 6213137 5743826 469311 1461508 1365406 96102 1265 1265 625768 601779 23989 2570438 2412099 158339 469073 469073 BAD DEBT 12936787 12936787 HOSPITAL PROVIDER TAX & 7374298 7374298 MISC. EXPENSE 350735 350735 DUES & SUBSCRIPTIONS 36344 36344 4224 4224 98394922 92145918 6249004 0 879089 569244 857312 858147 6165706 10685571 1236520 1268032 638363 649635 87101569 64307096 23351032 22794473 17005268 15307411 5871 913 486163 486163 2673016 82004343 83067488 132629667 138360093 16331844 16661253 5403633 1410954 7238910 11722127 9056835 9047199 7259880 6004392 45291102 44845925 X 87338565 93514168 87338565 93514168 132629667 138360093 X 6128657 259145 -212199 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21055 21055 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO VARIOUS HOSPITAL ASSOCIATIONS ARE RELATED TO LOBBYING. 2482024 2482024 40314330 35819028 4495302 26050397 12819490 13230907 18081087 15668578 2412509 173731 173731 22794473 DUE FROM RELATED PARTY 83067488 83067488 THIRD PARTY PAYOR SETTLEMENTS 377623 PENSION LIABILITY 894895 PROFESSIONAL LIABILITY 4731874 6004392 X PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 1 X 1 X 1 1 1 0 1 1 7901076 929919 6971157 0.08160 43591740 36453810 7137930 0.08350 51492816 37383729 14109087 0.16510 6156346 6156346 10501978 6203954 4298024 0.05030 16658324 12360300 4298024 0.05030 68151140 49744029 18407111 0.21540 1 4313135 1354191 8023301 10014481 -1991180 X 1 1 1 1 JACKSON PARK HOSPITAL FOUNDATION 7531 STONY ISLAND CHICAGO IL 60649 JACKSONPARKHOSPITAL.ORG 0001115 X X X X JACKSON PARK HOSPITAL FOUNDATION 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X SEE PART V, SECTION C X 1 21 1 SEE PART V, SECTION C 0 1 X 200.000000000000 200.000000000000 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 JACKSON PARK HOSPITAL FOUNDATION PART V, SECTION B, LINE 5: IN 2020, JACKSON PARK HOSPITAL WORKED WITH THE ALLIANCE FOR HEALTH EQUITY AND THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), USING COMMUNITY HEALTH STATUS DATA FROM APPROXIMATELY 20 PUBLICLY AVAILABLE SOURCES THAT ARE ACCESSIBLE THROUGH THE CHICAGO HEALTH ATLAS AND SPARKMAP WEBSITES. IPHI REVIEWED LOCAL RESOURCE LISTS AND COMMUNITY PLANS TO COMPILE COMMUNITY ASSETS. IPHI ALSO CONDUCTED EIGHT KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS WHO HAVE BEEN ACTIVE PARTNERS TO JACKSON PARK HOSPITAL. THE ALLIANCE FOR HEALTH EQUITY WAS DEVELOPED SO THAT PARTICIPATING ORGANIZATIONS CAN COLLABORATIVELY ASSESS COMMUNITY HEALTH NEEDS, COLLECTIVELY DEVELOP SHARED IMPLEMENTATION PLANS TO ADDRESS COMMUNITY HEALTH NEEDS, MORE EFFICIENTLY SHARE RESOURCES, AND HAVE A GREATER IMPACT ON THE LARGE POPULATION RESIDING IN COOK COUNTY. CURRENTLY, 36 HOSPITALS, 6 LOCAL HEALTH DEPARTMENTS INCLUDING CHICAGO DEPARTMENT OF PUBLIC HEALTH AND COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, AND NEARLY 100 COMMUNITYBASED ORGANIZATIONS ARE PARTICIPATING IN THE ALLIANCE FOR HEALTH EQUITY. THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) SERVES AS A BACKBONE ORGANIZATION THAT HELPS TO FACILITATE THE ASSESSMENT AND IMPLEMENTATION PROCESSES, CONVENES PARTNERS ACROSS SECTORS, AND PROVIDES TECHNICAL SUPPORT. THE ALLIANCE FOR HEALTH EQUITY IS COMPRISED OF A STEERING COMMITTEE AND WORKGROUPS AND COMMITTEES COLLABORATING ON IMPLEMENTATION STRATEGIES FOR SEVERAL COMMUNITY HEALTH PRIORITIES. JACKSON PARK HOSPITAL SITS ON THE STEERING COMMITTEE FOR THE ALLIANCE FOR HEALTH EQUITY.THE ALLIANCE FOR HEALTH EQUITY'S METHODS OF COMMUNITY ENGAGEMENT FOR THE CHNA AND IMPLEMENTATION STRATEGIES INCLUDE:GATHERING INPUT FROM COMMUNITY RESIDENTS WHO ARE UNDERREPRESENTED IN TRADITIONAL ASSESSMENT AND IMPLEMENTATION PLANNING PROCESSES;PARTNERING WITH COMMUNITY BASED ORGANIZATIONS FOR COLLECTION OF COMMUNITY INPUT THROUGH SURVEYS AND FOCUS GROUPS;ENGAGING COMMUNITY BASED ORGANIZATIONS AND COMMUNITY RESIDENTS AS MEMBERS OF IMPLEMENTATION COMMITTEES AND WORKGROUPS;UTILIZING THE EXPERTISE OF THE MEMBERS OF IMPLEMENTATION COMMITTEES AND WORKGROUPS IN ASSESSMENT DESIGN, DATA INTERPRETATION, AND IDENTIFICATION OF EFFECTIVE IMPLEMENTATION STRATEGIES AND EVALUATION METRICS;WORKING WITH HOSPITAL AND HEALTH DEPARTMENT COMMUNITY ADVISORY GROUPS TO GATHER INPUT INTO THE CHNA AND IMPLEMENTATION STRATEGIES; ANDPARTNERING WITH LOCAL COALITIONS TO SUPPORT AND ALIGN WITH EXISTING COMMUNITYDRIVEN EFFORTS.THE COMMUNITY BASED ORGANIZATIONS ENGAGED IN THE ALLIANCE FOR HEALTH EQUITY REPRESENT A BROAD RANGE OF SECTORS SUCH AS WORKFORCE DEVELOPMENT, HOUSING SERVICES, FOOD SECURITY, COMMUNITY SAFETY, PLANNING, COMMUNITY DEVELOPMENT, IMMIGRANT RIGHTS, PRIMARY AND SECONDARY EDUCATION, FAITH COMMUNITIES, BEHAVIORAL HEALTH SERVICES, ADVOCACY, POLICY, TRANSPORTATION, OLDER ADULT SERVICES, HEALTH CARE SERVICES, HIGHER EDUCATION, AND MANY MORE. ALL COMMUNITY PARTNERS WORK WITH OR REPRESENT COMMUNITIES THAT ARE DISPROPORTIONATELY AFFECTED BY HEALTH INEQUITIES SUCH AS COMMUNITIES OF COLOR, IMMIGRANTS, YOUTH, OLDER ADULTS AND CAREGIVERS, LGBTQ+, INDIVIDUALS EXPERIENCING HOMELESSNESS OR HOUSING INSTABILITY, INDIVIDUALS LIVING WITH MENTAL ILLNESS OR SUBSTANCE USE DISORDERS, INDIVIDUALS WITH DISABILITIES, VETERANS, AND UNEMPLOYED YOUTH AND ADULTS. THIS INFORMATION WAS CONSIDERED DURING THE PROCESS OF ESTABLISHING HEALTH PRIORITIES. JACKSON PARK HOSPITAL FOUNDATION PART V, SECTION B, LINE 11: GOAL 1: REDUCE INEQUITIES IN ACCESS TO HEALTH CARE. THIS IS A COMPLEX AND MULTIFACETED CONCEPT THAT INCLUDES DIMENSIONS OF PROXIMITY; AFFORDABILITY; AVAILABILITY; CONVENIENCE; ACCOMMODATION, RELIABILITY, QUALITY, ACCEPTABILITY, OPENNESS, CULTURAL RESPONSIVENESS, APPROPRIATENESS AND APPROACHABILITY.GOAL 2: INCREASE ACCESS TO PRIMARY CARE PHYSICIANS IN THE COMMUNITIES SERVED BY JACKSON PARK HOSPITAL. BETWEEN 60.3% AND 94.9% OF ADULTS REPORT HAVING A PRIMARY CARE PROVIDER. SURVEY DATA MAY BE LESS RELIABLE IN COMMUNITY AREAS WITH SMALLER POPULATIONS (BURNSIDE, PULLMAN, WASHINGTON PARK, AVALON PARK, AND RIVERDALE).STRATEGY FOR GOAL 1 AND 2: THE HOSPITAL HAS COMPLETED AN APPLICATION WITH THE STATE OF ILLINOIS TRANSFORMATION FUND FOR FUNDING TO REMODEL THE OLD ACCESS/RESIDENCY CLINIC TO BE CONVERTED INTO AN FQHC FACILITY. THE HOSPITAL WILL RECEIVE THE RESULTS OF THIS APPLICATION IN MID-NOVEMBER 2021. HAVING AN FQHC FACILITY ON-SITE WILL INCREASE THE NUMBER OF PATIENTS WITH PRIMARY CARE AND ACCESS TO MATERNAL AND CHILD HEALTH CARE IN OUR PRIMARY SERVICE AREA. IN ADDITION TO THE FQHC, THE HOSPITAL'S FAMILY PRACTICE RESIDENCY PROGRAM WILL EXPAND ITS SERVICES INTO THE FQHC AND THE HOSPITAL HAS RECRUITED AN OBSTETRICIAN WHO WILL JOIN ITS MEDICAL STAFF.GOAL 3: TO REDUCE BEHAVIORAL HEALTH - UTILIZATION OF EMERGENCY CARE MENTAL HEALTH-RELATED ED VISIT RATES FOR ADULTS IN THE HOSPITALS PRIMARY CARE SERVICE AREA. THE COOK COUNTY COMMUNITIES RANGE FROM 21 PER 10,000 TO 661 PER 10,000 MENTAL HEALTH RELATED EMERGENCY ROOM VISITS ILLUSTRATING THAT THE NEED FOR QUALITY COMMUNITY-BASED AND PREVENTATIVE BEHAVIORAL HEALTH TREATMENT IS STAGGERINGLY HIGH IN SOME COMMUNITIES. PEOPLE LIVING IN THE COMMUNITIES IN JACKSON PARK HOSPITAL'S SERVICE AREA ON THE SOUTH SIDE OF CHICAGO EXPERIENCE THE HIGHEST RATES OF EMERGENCY DEPARTMENT VISITS FOR MENTAL HEALTH.STRATEGY FOR GOAL 3: THE HOSPITAL HAS COMPLETED AN APPLICATION WITH THE STATE OF ILLINOIS TRANSFORMATION FUNDS FOR FUNDING TO HIRE A FULL TIME PSYCHIATRIST AND SUPPORT STAFF TO SERVE THE OUTPATIENT NEEDS OF OUR PRIMARY SERVICE AREA. THE HOSPITAL WILL RECEIVE THE RESULTS OF THIS APPLICATION IN MID-NOVEMBER 2021. HAVING AN FQHC FACILITY ON-SITE AND A FULL TIME PSYCHIATRIST WILL INCREASE THE NUMBER OF PATIENTS WITH PRIMARY CARE AND ACCESS TO MATERNAL AND CHILD HEALTH CARE AS WELL AS BEHAVIORAL HEALTH IN OUR PRIMARY SERVICE AREA.GOAL 4: INCREASE ACCESS TO SUBOXONE TREATMENT IN THE COMMUNITY. SUBSTANCE USE DISORDERS AND OPIOID OVERDOSE DEATHS ARE INCREASING ACROSS COOK COUNTY AND PARTICULARLY ON THE SOUTH AND WEST SIDES OF CHICAGO. CHICAGO COMMUNITIES AND THE NATION SAW A DRAMATIC UPTICK IN 2020 AMIDST THE COVID-19 PANDEMIC. IN CHICAGO, OPIOID-RELATED OVERDOSE DEATHS INCREASED BY OVER 50% BETWEEN 2019 AND 2020. THERE ARE STRIKING RACIAL INEQUITIES IN OPIOID OVERDOSES STATEWIDE; BLACK ILLINOISANS ARE 5.5 TIMES MORE LIKELY TO VISIT THE EMERGENCY DEPARTMENT FOR OPIOID OVERDOSE THAN WHITE NON-HISPANIC ILLINOISANS.STRATEGY FOR GOAL 4: IMPLEMENT A PROGRAM TO PROVIDE SUBOXONE TREATMENT IN BOTH INPATIENT AND OUTPATIENT SETTINGS. IN APRIL 2020, THE HOSPITAL BEGAN TO PROVIDE SUBOXONE TREATMENT ON AN INPATIENT BASIS. OUTPATIENT SUBOXONE TREATMENT HAS BEEN LIMITED AGAIN BECAUSE OF THE EFFECTS COVID 19 HAS HAD ON THE CITY OF CHICAGO. BOTH THE INPATIENT AND OUTPATIENT PROGRAM WILL BE RE-BOOTED WITH OUR PHYSICIANS AND MARKETING DEPARTMENT IN THE MONTH OF OCTOBER 2021.GOAL 5: REDUCE THE DIABETES MORTALITY RATES IN JACKSON PARK HOSPITAL'S SERVICE AREA FROM 12.3 PER 100,000 POPULATION TO THE CHICAGO AVERAGE.STRATEGY FOR GOAL 5: REBOOT THE CURRENT OUTPATIENT DIABETES CLINIC THROUGH NEW MARKETING AND EDUCATION EFFORTS BY YEAR END.GOAL 6: REDUCE THE CANCER MORTALITY RATES IN THE JACKSON PARK HOSPITAL'S SERVICE AREA FROM 152.3 PER 100,000 POPULATION TO THE CHICAGO AVERAGE.STRATEGY FOR GOAL 6: THE HOSPITAL PHYSICIAN RECRUITER HAS TWO SEPARATE ONCOLOGISTS THAT HAVE INDICATED THEY WOULD LIKE TO JOIN THE MEDICAL STAFF OF THE HOSPITAL AND CARE FOR PATIENTS IN OUR SERVICE AREA. THESE ONCOLOGISTS SHOULD COMPLETE THE APPLICATION AND SCREENING PROCESS BY YEAR END.GOAL 7: IMPROVE ACCESS TO CARE AND MATERNAL AND CHILD HEALTH CARE IS BROADLY DEFINED AS THE "THE TIMELY USE OF PERSONAL HEALTH SERVICES TO ACHIEVE THE BEST HEALTH OUTCOMES" (INSTITUTE OF MEDICINE, 1993). HEALTHY PEOPLE 2020 DESCRIBES THE THREE STEPS REQUIRED FOR AN INDIVIDUAL TO ACCESS HEALTH CARE SERVICES: GAINING ENTRY INTO THE HEALTH CARE SYSTEM; ACCESSING A LOCATION WHERE NEEDED HEALTH CARE SERVICES ARE PROVIDED; AND FINDING A HEALTH CARE PROVIDER WHOM THE PATIENT TRUSTS AND CAN COMMUNICATE WITH (U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, 2019B).STRATEGY FOR GOAL 7: THE HOSPITAL HAS RECRUITED AN OBSTETRICIAN THAT WILL BEGIN TO PRACTICE IN OUR MEDICAL OFFICE BUILDING BEGINNING OCTOBER, 2021. SHE IS ALSO ASSISTING THE HOSPITAL IN RECRUITING ADDITIONAL OBSTETRICIANS TO OUR MEDICAL STAFF.OTHER HEALTH ISSUES IDENTIFIED IN THE CHNA PROCESS (HOUSING & HOMELESSNESS) WERE NOT CHOSEN AS A PRIORITY FOCUS AREAS FOR DEVELOPMENT OF THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN DUE TO LACK OF RESOURCES AVAILABLE TO ADDRESS THESE NEEDS AND THE INTENTION TO FOCUS ON THE OTHER PRIORITIZED HEALTH NEEDS. PART V, SECTION B, LINE 7A - HOSPITAL FACILITY'S WEBSITE FOR CHNA HTTPS://WWW.JACKSONPARKHOSPITAL.ORG/ASSETS/1/7/CHNA%20FINAL%202021.PDF PART V, SECTION B, LINE 10 - HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY HTTPS://WWW.JACKSONPARKHOSPITAL.ORG/ASSETS/1/7/CHNA%20IMPLEMENTATION%20STRATEGY%202021%2022.PDF PART V, SECTION B, LINE 16A - FAP WEBSITE HTTPS://WWW.JACKSONPARKHOSPITAL.ORG/ASSETS/1/7/FINANCIAL%20ASSISTANCE%20POLICY%202021%20DOCX.PDF PART V, SECTION B, LINE 16B - FAP APPLICATION WEBSITE HTTPS://WWW.JACKSONPARKHOSPITAL.ORG/ASSETS/1/7/FINANCIAL_ASSISTANCE_GUIDELINES_PACKET.PDF PART V, SECTION B, LINE 16C - PLAIN LANGUAGE SUMMARY WEBSITE HTTPS://WWW.JACKSONPARKHOSPITAL.ORG/ASSETS/1/7/FAP%20PLAIN%20LANGUAGE%20SUMMARY.PDF PART I, LINE 7: CHARITY CARE COST IS BASED ON THE TOTAL COST TO CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT FOR SERVICES PROVIDED TO PATIENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 12,936,787. PART III, LINE 2: THE COST OF BAD DEBT EXPENSE IS BASED ON THE COST TO CHARGE DERIVED FROM THE HOSPITAL'S MEDICARE COST REPORT. PART III, LINE 3: MANAGEMENT HAS ESTIMATED THE CALCULATION USING THE RATIO OF THE HOSPITAL'S COST OF PROVIDING PATIENT CARE TO ITS CHARGES. THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AND AS RESULT, THIS HAS BEEN INCLUDED AS COMMUNITY BENEFIT. PART III, LINE 4: SEE THE "UNCOMPENSATED CARE AND COMMUNITY BENEFIT" FOOTNOTE 11 ON PAGE 23 AND 24 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL WAS NOT TREATED AS A COMMUNITY BENEFIT. THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6 WERE CALCULATED USING THE FILED MEDICARE COST REPORT. PART III, LINE 9B: THE HOSPITAL HAS A PRESUMPTIVE ELIGIBILITY POLICY AS REQUIRED BY THE STATE OF ILLINOIS. PART VI, LINE 2: JACKSON PARK HOSPITAL FOUNDATION OUTREACH AND ASSESSMENT OF ITS COMMUNITY HEALTH BY EVALUATING WHICH HEALTH CONDITIONS AND DISEASES ARE PREVALENT AMONG ITS INPATIENT AND OUTPATIENTS. THE HOSPITAL PREPARED ITS COMMUNITY HEALTH NEEDS ASSESSMENT USING A PROFESSIONAL COMPANY EXPERIENCED IN ASSISTING HOSPITALS IN THE PROCESS. TOGETHER WE CONFIRMED THE NEED FOR EDUCATION AND OTHER INVENTIONS FOR DIABETES, ASTHMA, AND BEHAVIORAL MEDICINE. THE HOSPITAL HAS RESPONDED TO THESE NEEDS THROUGH THE DEVELOPMENT OF SEVERAL COMMUNITY PROGRAMS AND SPECIALTY CLINICS. THE HOSPITAL IMPLEMENTED FREE TRANSPORTATION FOR PATIENTS WHO ARE UNABLE TO KEEP APPOINTMENTS WITH THEIR PRIMARY CARE PROVIDER OR CONSULTANT. PART VI, LINE 3: THE HOSPITAL HAS CONTRACTED WITH A THIRD PARTY NAMED FIRST SOURCE TO ASSIST ANY PATIENT THROUGH THE FINANCIAL APPLICATION PROCESS TO QUALIFY FOR MEDICAID, MEDICARE AND THE AFFORDABLE CARE ACT. THIS SAME COMPANY WILL ALSO ASSIST A PATIENT AND OR FAMILY THROUGH THE HOSPITAL'S CHARITY APPLICATION PROCESS. PART VI, LINE 4: JACKSON PARK HOSPITAL'S PRIMARY SERVICE AREA IS 60649, 60621, 60637, 60619 AND 60617. OUR PRIMARY CARE AREA FOR BEHAVIORAL PATIENTS IS MUCH BROADER AND ENCOMPASSES THE CITY OF CHICAGO. THE AVERAGE INCOME IN THE HOSPITALS PRIMARY SERVICE AREA IS APPROXIMATELY 53% OF THE STATE OF ILLINOIS AVERAGE. PART VI, LINE 5: IN ADDITION TO VARIOUS EDUCATION PROGRAMS WITHIN THE HOSPITAL, THE HOSPITAL STARTED REGULAR EDUCATION AND OUTREACH PROGRAMS AT LOCAL GROCERY STORES AND BANKS IN 2019. THE HOSPITAL ALSO BEGAN AN OUTREACH PROGRAM FOR SENIOR PATIENTS. THIS SENIOR PROGRAM WILL MANAGE THE PRIMARY HEALTHCARE NEEDS AND MATCH THE PATIENT WITH THE PHYSICIAN. PART VI, LINE 7, REPORTS FILED WITH STATES IL X X X 0 0 0 0 0 0 0 0 0 DR WILLIAM O DORSEY III CHAIRMAN/CEO 775628 0 0 0 0 0 10346 0 14964 0 800938 0 0 0 MATTHEW MALTERS MD PHYSICIAN 13166 700712 0 0 0 0 0 0 36649 0 49815 700712 0 0 G RANDALL SMITH EXECUTIVE VP 690294 0 0 0 0 0 10346 0 37110 0 737750 0 0 0 MERRITT HASBROUCK PRESIDENT 656069 0 0 0 0 0 10346 0 1462 0 667877 0 0 0 NELSON VASQUEZ VP FINANCE (TERM ENDED 11/22) 404448 0 5000 0 0 0 6750 0 38043 0 454241 0 0 0 SYED ALA MD PHYSICIAN 57614 170000 0 0 0 0 0 0 47800 0 105414 170000 0 0 RAYLENE SWINOCK NURSE 226346 0 35850 0 0 0 0 0 9278 0 271474 0 0 0 DR LAKSHMI DODDA DIRECTOR/PHYSICIAN 234965 0 0 0 0 0 0 0 28360 0 263325 0 0 0 M PATRICIA SIMON SENIOR VP QUALITY & COMPLIANCE 201715 0 20000 0 0 0 9750 0 30438 0 261903 0 0 0 SAHR NGOMBU NURSE 200920 0 34800 0 0 0 6375 0 13974 0 256069 0 0 0 CYRIL EZEANYAGU NURSE 198320 0 39900 0 0 0 1222 0 9505 0 248947 0 0 0 DR HAROON OLOMI DIRECTOR/PHYSICIAN 5903 209996 0 0 0 0 0 0 24550 0 30453 209996 0 0 KENNETH MCGHEE VP FINANCE 223627 0 0 0 0 0 0 0 14370 0 237997 0 0 0 DR HARSHAD MEHTA DIRECTOR/PHYSICIAN 206056 0 0 0 0 0 0 0 28643 0 234699 0 0 0 BARRY MANDELL VP SPECIAL PROJECTS 179649 0 7500 0 0 0 0 0 37180 0 224329 0 0 0 THOMAS PANKOW CHIEF INFORMATION OFFICER 198992 0 3100 0 0 0 3250 0 1153 0 206495 0 0 0 DR BANGALORE R MURTHY DIRECTOR/PHYSICIAN 160554 0 0 0 0 0 0 0 41692 0 202246 0 0 0 DR ZAHIDUR RAHMAN DIRECTOR/PHYSICIAN 76853 85111 0 0 0 0 0 0 24550 0 101403 85111 0 0 MAGDALENE ARMSTEAD VP PATIENT CARE 157725 0 0 0 0 0 0 0 18329 0 176054 0 0 0 MARGO BROOKS-PUGH VICE PRESIDENT 115162 0 0 0 0 0 3790 0 39088 0 158040 0 0 0 BANGALORE MURTHY MD DIRECTOR OF ORGANIZATION/BUSINESS OWNER 796235 TEMPORARY STAFFING 0 BANGALORE MURTHY MD DIRECTOR OF ORGANIZATION/BUSINESS OWNER 71604 MEDICAL EDUCATION BILLING 0 SURRENTHIA PARKER MD DIRECTOR OF ORGANIZATION/BUSINESS OWNER 425436 MEDICAL STAFFING 0 ZAHIDUR RAHMAN MD DIRECTOR OF ORGANIZATION/BUSINESS OWNER 123453 MEDICAL STAFFING 0 LAKSHMI DODDA MD DIRECTOR OF ORGANIZATION/BUSINESS OWNER 110131 MEDICAL STAFFING 0 FORM 990, PART VI, SECTION A, LINE 1A THE BOARD 0F DIRECTORS BY RESOLUTION ADOPTED BY A MAJORITY OF THE WHOLE BOARD MAY DESIGNATE TWO OR MORE DIRECTORS TO CONSTITUTE AN EXECUTIVE COMMITTEE. THE DESIGNATION OF SUCH COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD OF DIRECTORS OR ANY MEMBER THEREOF OF ANY RESPONSIBILITY IMPOSED UPON IT OR HIM BY LAW. THE EXECUTIVE COMMITTEE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, SHALL HAVE AND EXERCISE ALL OF THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE CORPORATION EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY SHALL BE LIMITED BY THE RESOLUTION APPOINTING THE EXECUTIVE COMMITTEE AND EXCEPT ALSO THAT THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN REFERENCE TO AMENDING THE ARTICLES OF INCORPORATION; ADOPTING A PLAN OF MERGER OR ADOPTING A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION OR CORPORATIONS; RECOMMENDING TO THE MEMBERS THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION IF NOT MADE IN THE USUAL AND REGULAR COURSE 0 ITS BUSINESS; RECOMMENDING TO THE MEMBERS A VOLUNTARY DISSOLUTION OF THE CORPORATION OR A REVOCATION THEREOF; AMENDING, ALTERING OR REPEALING THE BY-LAWS OF THE CORPORATION; ELECTING OR REMOVING OFFICERS OF THE CORPORATION OR MEMBERS OF THE EXECUTIVE COMMITTEE; FILLLNG VACANCIES ON THE BOARD OF DIRECTORS AND THE EXECUTIVE COMMITTEE; OR AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD OF DIRECTORS WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 ANY ADULT PERSON INTERESTED IN ADVANCING THE PURPOSES OF THE CORPORATION MAY REQUEST ADMISSION TO MEMBERSHIP, AND HE OR SHE SHALL BE ADMITTED TO MEMBERSHIP UPON AN AFFIRMATIVE VOTE BY THE BOARD OF DIRECTORS AT ANY MEETING OF THE SAID BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS ARE LIMITED TO VOTING ON ANY PROPOSED VOLUNTARY DISSOLUTION OF THE ORGANIZATION, THE ADOPTION OF ANY REQUIRED PLAN OF DISTRIBUTION OF THE ASSETS OF THE CORPORATION UPON DISSOLUTION AND ANY PROPOSED REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS. MEMBERS CANNOT VOTE ON ANY OTHER MATTERS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S SENIOR MANAGEMENT REVIEWS THE 990 BEFORE IT IS SUBMITTED. THIS INCLUDES THE ASSISTANT VP OF FINANCE, VP OF FINANCE, EXECUTIVE VP, PRESIDENT AND CEO. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICER REVIEWS POLICIES ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 JACKSON PARK HOSPITAL FOUNDATION HAS AN AUDIT/COMPENSATION COMMITTEE. THE CHAIRMAN OF THIS COMMITTEE REVIEWS THE COMPENSATION OF SENIOR MANAGEMENT AND KEY EMPLOYEES ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 JACKSON PARK HOSPITAL FOUNDATION MAKES ITS COMMUNITY HEALTH NEEDS ASSESSMENT AVAILABLE ON ITS WEBSITE AND BY APPOINTMENT WITH ITS VICE PRESIDENT OF FINANCE. THE CONFLICT OF INTEREST POLICY, COMMUNITY BENEFIT REPORT, FORM 990 AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY APPOINTMENT WITH ITS VICE PRESIDENT OF FINANCE OR ITS SENIOR VICE PRESIDENT OF QUALITY AND COMPLIANCE. FORM 990, PART VII, SECTION B, LINE 1 IT IS POSSIBLE THAT A PORTION OF THE AMOUNTS REPORTED FOR POWERS & SONS WERE RELATED TO MATERIALS IN ADDITION TO AMOUNTS PAID FOR SERVICES, HOWEVER, THE AMOUNTS ARE NOT DISTINGUISHABLE. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,314,229. MANAGEMENT AND GENERAL EXPENSES 150,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,464,362. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 11,539,068. MANAGEMENT AND GENERAL EXPENSES 236,852. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,775,920. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,122,169. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,122,169. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY -212,199. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE FRIEDELL CLINIC SC 7531 STONY ISLAND CHICAGO IL 60649 363290656 PRIMARY HEALTH CARE IL JACKSON PARK HOSPITAL FOUNDATION C -9509346 217913 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 THE FRIEDELL CLINIC SC D 83067488 GL