2026-05-14T10:30:12+00:00 2025-06-30 135565207 KPMG LLP 200 EAST RANDOLPH STREET SUITE 5500 CHICAGO IL 606016436 990 2024-07-01 362170866 The Ingalls Memorial Hospital INGA 7083332300 One Ingalls Drive Harvey IL 60426 MICHAEL ANTONIADES PRESIDENT 7737021000 2026-05-14 true ZELJKO POPOVIC P01795951 3126651000 2026-05-14 2024 2025-03-06 01:10:19Z MICHAEL ANTONIADES One Ingalls Drive Harvey IL 60426 421459535 false X UCHICAGOMEDICINE.ORG X 1922 IL INGALLS MEMORIAL HOSPITAL IS A NONPROFIT ACUTE CARE HOSPITAL ORGANIZED FOR THE PURPOSE OF PROVIDING PATIENT CARE, EDUCATION, RESEARCH AND COMMUNITY ASSISTANCE. 15 6 2383 145 363383 0 1017615 3157491 379960211 407553800 4484417 3147565 2415969 6717420 387878212 420576276 100000 82500 0 151387140 160386621 0 412568 219056251 226188529 370543391 386657650 17334821 33918626 435665554 462024153 178329445 167154484 257336109 294869669 X INGALLS MEMORIAL HOSPITAL IS A NONPROFIT ACUTE CARE HOSPITAL ORGANIZED FOR THE PURPOSE OF PROVIDING PATIENT CARE, EDUCATION, RESEARCH, AND ASSISTANCE TO UCHICAGO MEDICINE NETWORK INC. false false 249837794 256013993 INGALLS MEMORIAL (IMH) INCLUDES A 400+ CERTIFIED BED HOSPITAL AND A NETWORK OF COMPREHENSIVE OUTPATIENT CENTERS THAT FEATURE A FULL ARRAY OF HIGH-TECH DIAGNOSTIC AND TREATMENT SERVICES. IMH MAKES SURE THAT OUR RESOURCES ARE DIRECTED TO AREAS THAT RESULT IN THE GREATEST BENEFIT TO OUR PATIENTS AND THE COMMUNITY. 52858956 53808601 THE PHARMACY PROVIDES SERVICES TO BOTH OUR INPATIENTS AND INFUSION CENTER PATIENTS. INCLUDED IN THE SERVICES PROVIDED ARE ANTIBIOTIC DOSING, DOSING BASED ON KIDNEY FUNCTION, BLOOD GLUCOSE MANAGEMENT, AND ANTICOAGULANT DOSING AND MONITORING. THE INPATIENT PHARMACY IS OPEN 24/7. WE PROCESS APPROXIMATELY 49,500 MEDICATION ORDERS AND MAKE 1,800 INTERVENTIONS PER MONTH. 26065716 30578359 IMH PERFORMS AN ARRAY OF SURGICAL SERVICES INCLUDING ELECTIVE, NON-ELECTIVE, COMPLEX AND HIGHLY SPECIALIZED PROCEDURES. SURGEONS ON STAFF AT INGALLS SPECIALIZE IN EVERY AREA OF SURGERY, INCLUDING, BUT NOT LIMITED TO CARDIOTHORACIC SURGERY, ORTHOPEDIC SURGERY, NEUROSURGERY, SPINE SURGERY, GENERAL SURGERY, AND VASCULAR SURGERY. IN FY2025 INGALLS PERFORMED NEARLY 1,200 INPATIENT SURGERIES AND OVER 2,200 AMBULATORY SURGERIES. 26925133 82500 73859132 OTHER PROGRAM SERVICES RELATED TO THE PROVISION OF HEALTHCARE INCLUDE LABORATORY SERVICES, PATIENT FINANCIAL SERVICES, COST OF FACILITIES, MALPRACTICE INSURANCE, AND OTHER SUPPORT SERVICES. 26925133 82500 73859132 355687599 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 222 0 true 2383 true true true false false false false false false false false false true false X 15 6 false false false false true true true true true false false false true true true true true true true true false false IL X PHILLIP KAUFMAN 7083332300 150 HARVESTER DRIVE SUITE 300 BURR RIDGE IL 60527 DENNIS IRVIN VICE CHAIRMAN 1.0 0 X X 0 0 0 KEVIN M PURCELL CHAIRMAN 1.0 2.0 X X 0 0 0 MICHAEL ANTONIADES PRESIDENT, INGALLS 40.0 4.0 X X 1241148 0 155102 SAMUEL J CUTRARA JR SECRETARY/TREASURER 1.0 1.0 X X 0 0 0 DANISH AHMED BOARD MEMBER (EFF. 1/1/25) 1.0 40.0 X 0 123718 17401 ENGIN YILMAZ MD BOARD MEMBER 1.0 40.0 X 0 497132 28226 FRANCIS ALMEDA BOARD MEMBER (THRU 1/1/25) 1.0 0 X 0 0 0 GRETCHEN PACHOLEK BOARD MEMBER/VP PATIENT CARE & CNO, INGALLS 40.0 1.0 X 0 378120 68509 HENRY JOHNSON BOARD MEMBER 1.0 0 X 0 0 0 KAVEH RAHMANI DO BOARD MEMBER 1.0 42.0 X 0 804743 40481 MARK KOZLOFF MD BOARD MEMBER 1.0 42.0 X 0 689281 56519 MARY JO CRANDALL BOARD MEMBER/VP OPERATIONS 40.0 1.0 X 423610 0 43610 NATHANIEL SUTTON BOARD MEMBER 1.0 1.0 X 0 0 0 PAULA JACKSON BOARD MEMBER 1.0 0 X 0 0 0 STEPHEN WEBER MD BOARD MEMBER 1.0 41.0 X 0 1233990 145582 THOMAS JACKIEWICZ BOARD MEMBER/PRESIDENT UCHS 1.0 42.0 X 0 2771431 398244 IVAN SAMSTEIN CHIEF FINANCIAL OFFICER (THRU 12/31/24) 1.0 58.0 X 0 1795872 252606 MICHELLE SALOMON ASSISTANT TREASURER 1.0 45.0 X 0 439364 55816 TOMASZ SAMEK ASSISTANT SECRETARY 1.0 42.0 X 0 274776 41159 JENNIFER ARIADO REGISTERED NURSE 40.0 0 X 232628 0 45258 KIZZY ROUSSEAU HARDAWAY Director Perioperative Services 40.0 0 X 227639 0 45074 NEGIN KIYAVASH DIRECTOR PHARMACY 40.0 0 X 243610 0 19260 PAUL DONOHUE VP PHILANTHROPY AND COMMUNITY 40.0 0 X 307165 0 72555 SUSAN KLACZAK EXECUTIVE DIRECTOR ACNO INGALLS 40.0 0 X 242848 0 21588 EMILY CHASE FORMER INTERIM PRESIDENT (7/10/22 THRU 3/7/23) 0.0 40.0 X 0 925350 169170 2918648 9933777 1676160 275 true true false VAYA WORKFORCE SOLUTIONS 5930 Cornerstone Court West San Diego CA 92121 Contract Labor 14161014 CROTHALL HEALTHCARE INC 1500 Liberty Ridge Drive Suite 210 Wayne PA 19087 Healthcare Support Services 8427899 TRIMEDX 5451 Lakeview Pkwy S Drive Indianapolis IN 46268 Healthcare support services 5980839 EPMG OF IL 350 N Wall St Kankakee IL 60901 Emergency Medicine 5942606 THE UNIVERSITY OF CHICAGO 5801 S Ellis Ave Chicago IL 60637 Medical Services 5674909 89 3157491 3157491 NET PATIENT REVENUE 622110 403342555 403342555 RENTAL INCOME 900099 1792061 1792061 LAB SERVICES 621500 363383 363383 CAPTIVE INSURANCE REVENUE 900099 780000 780000 ICN REVENUE 900099 651174 651174 624627 624627 0 0 407553800 889837 889837 894394 883259 11135 0 11135 11135 2218985 38743 2218985 38743 2257728 2257728 340B PROGRAM 900099 4270419 4270419 BANK REBATES 900099 1652254 1652254 MANAGEMENT FEE 900099 208926 208926 574686 574686 0 0 6706285 420576276 413896702 363383 3158700 X 82500 82500 1690363 907291 783072 0 131787337 123889221 7599122 298994 3192106 2947172 178413 66521 14835634 13950796 837785 47053 8881181 8351863 529318 100250 7820 92430 443257 443257 90170 90170 660893 660893 71923683 65144899 6778784 0 941533 941533 3102432 2027386 1075046 4891876 2710298 2181578 11489475 7068509 4420966 29636 26915 2721 11034 11034 2222787 2222787 17659088 17659088 16669883 14282923 2386960 MEDICAL SUPPLIES 57005415 57005415 MEDICAID PROVIDER TAX 23883366 23883366 IMPLANTS 7114239 7114239 MEALS AND CATERING 4551796 4092459 459337 3397716 2301618 1096098 0 386657650 355687599 30557483 412568 5219 5090 28173 24411 40897276 31117327 0 0 0 0 8217756 9231752 1545352 9864963 348726788 139350999 202544503 209375789 115514776 120036209 0 0 66912499 82368612 435665554 462024153 83158327 34137036 2332723 1855679 28665000 26050213 0 0 57500000 55865968 6673395 49245588 178329445 167154484 X 253426979 294550623 3909130 319046 257336109 294869669 435665554 462024153 X 33918626 7973401 -4358467 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 39900 false true 65270 105170 false Schedule C, Part II-B, Line 1g DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The Vice President of Government Affairs for University of Chicago Medicine has contact with legislators and government officials on behalf of Ingalls Memorial Hospital. Topics include Medicare and Medicaid funding and proposed staffing legislation. Schedule C, Part II-B, Line 1i DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED TO SUPPORT LOBBYING BY THE ASSOCIATION FOCUSED ON ADVOCACY AND REPRESENTATION. 9701922 9701922 182843496 58455621 124387875 126627935 77750463 48877472 29553435 3144915 26408520 209375789 DUE FROM AFFILIATES 82368612 RESTRICTED INVESTMENTS - FDN 0 82368612 Federal Income Taxes Estimated 3rd party payor settlements 34093636 Due to Affiliates 8412892 Asbestos Remediation 4534950 Swap Payable 2159646 Lease Obligations 44464 49245588 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM APPLIES ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS. ASC TOPIC 740 PRESCRIBES A MORE LIKELY THAN NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2025 AND 2024, THE SYSTEM DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. true true X true X true X 600 6514098 6514098 0.01685 121102543 137823532 0 0.0 0 0.0 0 0 127616641 137823532 6514098 0.01685 786346 786346 0.00203 2483671 552524 1931147 0.00499 13437482 7676695 5760787 0.01490 0 0.0 91300 91300 0.00024 0 0 16798799 8229219 8569580 0.02216 0 0 144415440 146052751 15083678 0.03901 4127 4127 0.00001 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 4127 0 4127 0.00001 true 19237193 0 53191739 53585387 -393648 X true true NONE 0 0 0 1 1 INGALLS MEMORIAL HOSPITAL ONE INGALLS DRIVE HARVEY IL 60426 WWW.INGALLS.ORG 0001099 X X X X INGALLS MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 24 true false true true X https://www.uchicagomedicine.org/about-us/community/benefit/health-needs-ingalls-memorial/chna X X true 24 true https://www.uchicagomedicine.org/about-us/community/benefit/health-needs-ingalls-memorial/chna false true X 200.0 600.0 X X X X X true true X X X true X https://tinyurl.com/Ingalls-FAP X https://tinyurl.com/IMH-FAP-APP X https://tinyurl.com/IMH-PLAIN X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THE INGALLS MEMORIAL HOSPITAL. THE CHNA PROCESS ENGAGED SEVERAL INTERNAL AND EXTERNAL GROUPS TO COLLECT AND INTERPRET DATA, THEN USE THAT DATA TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. STAKEHOLDER GROUPS AND THEIR ROLES ARE DEFINED BELOW: COMMUNITY BENEFIT STEERING COMMITTEE THE COMMUNITY BENEFIT STEERING COMMITTEE IS COMPRISED OF STAFF AND FACULTY WHO PROVIDE ADVICE AND OVERSIGHT OF UCHICAGO MEDICINE'S COMMUNITY BENEFIT PROGRAMS, REPORTING, AND CHNA DEVELOPMENT AND EXECUTION. THE COMMITTEE IS RESPONSIBLE FOR PROVIDING INPUT ON THE PLANNING AND IMPLEMENTATION OF POLICIES, PROCESSES, AND PROGRAMS THAT SUPPORT THE COMMUNITY BENEFIT FUNCTION OF THE HOSPITAL SYSTEM. THE COMMITTEE MEETS QUARTERLY AND OVERSEES THE DEVELOPMENT AND IMPLEMENTATION OF THE CHNA PROCESS AND REPORTS, AS WELL AS THE OVERALL COMMUNITY BENEFIT STRATEGY. COMMUNITY ADVISORY COUNCIL (CAC) INGALLS MEMORIAL'S COMMUNITY ADVISORY COUNCIL (CAC), ESTABLISHED IN 2020, IS ANOTHER ENTITY THAT PROVIDED INPUT INTO THE 2024-2025 CHNA PROCESS. INGALLS MEMORIAL'S CAC IS A REPRESENTATIVE GROUP OF VOLUNTEER MEMBERS WHO LIVE AND/OR WORK IN THE INGALLS MEMORIAL PSA. MEMBERS OF THE CAC ACT AS ADVISORS TO INGALLS MEMORIAL ON ISSUES OF INTEREST TO THE BROADER COMMUNITY. THE CAC IS AN ESSENTIAL PARTNER AS INGALLS MEMORIAL WORKS TO ACHIEVE ITS GOALS RELATED TO BROADER COMMUNITY INTERESTS, INCLUDING ACCESS TO CARE AND EFFECTIVE COMMUNITY ENGAGEMENT. IN THIS CHNA, THE CAC PLAYED A KEY ROLE IN PROVIDING INPUT TO SURVEY QUESTIONS, IDENTIFYING COMMUNITY ORGANIZATIONS FOR FOCUS GROUPS, DISSEMINATING SURVEYS, AND ENSURING THAT WE HEARD FROM DIVERSE COMMUNITY VOICES THROUGHOUT THE PROCESS. THE INCLUSION OF PATIENT VOICE IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A CORNERSTONE OF THE PROCESS. PRIMARY DATA FOR THE CHNA WAS COLLECTED THROUGH THE FOLLOWING METHODS: 1) 506 COMMUNITY RESIDENT SURVEYS COMPLETED IN ENGLISH AND SPANISH, IN BOTH ELECTRONIC AND PAPER VERSIONS. 2) 4 COMMUNITY RESIDENT FOCUS GROUPS WITH 12 OR FEWER RESIDENTS IN EACH GROUP. TOPICS INCLUDED YOUTH HEALTH, CHRONIC DISEASE, REPRODUCTIVE, MATERNAL AND CHILD HEALTH, MENTAL HEALTH, AND SUBSTANCE USE. 3) 1 HEALTHCARE AND SOCIAL SERVICE PROVIDER FOCUS GROUP WITH INTERNAL INGALLS MEMORIAL LEADERS AND PROVIDERS. 4) 13 KEY INFORMANT INTERVIEWS WITH INTERNAL INGALLS MEMORIAL LEADERS AND PROVIDERS. THROUGHOUT THE CHNA PROCESS, INGALLS WAS ABLE TO TAKE INTO ACCOUNT VARIOUS DIFFERING COMMUNITY VIEWPOINTS. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - THE INGALLS MEMORIAL HOSPITAL. FOR THE 2024- 2025 CHNA CYCLE, THE UCHICAGO MEDICINE HOSPITALS (UNIVERSITY OF CHICAGO MEDICAL CENTER AND INGALLS MEMORIAL) PARTNERED IN AN EFFORT TO ADDRESS SHARED PRIORITIES FOR THE SYSTEM. BOTH HOSPITALS RECEIVED INPUT FROM COMMUNITY ORGANIZATIONS, AND COMMUNITY MEMBERS. INGALLS MEMORIAL HOSPITAL CONTRACTED WITH METOPIO TO COMPLETE THE 2024-2025 COMMUNITY HEALTH NEEDS ASSESSMENT. METOPIO IS A SOFTWARE AND SERVICES COMPANY WITH A DATA VISUALIZATION PLATFORM. STAFF FROM INGALLS MEMORIAL HOSPITAL AND THE UNIVERSITY OF CHICAGO MEDICAL CENTER WORKED WITH METOPIO TO GUIDE THE STRATEGIC DIRECTION OF THE CHNA AND ENGAGED THE COMMUNITY BENEFIT STEERING COMMITTEE, VARIOUS INTERNAL WORKGROUPS, AND SUBJECT MATTER EXPERTS TO ENSURE BROAD ENGAGEMENT OF DIVERSE PERSPECTIVES ACROSS INGALLS MEMORIAL. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - INGALLS MEMORIAL HOSPITAL. THE RESULTS OF THE CHNA REPORT HAVE BEEN DISCUSSED AT COMMUNITY MEETINGS, WITH REFERENCE TO THE FULL REPORT'S AVAILABILITY ON THE HOSPITAL'S WEBSITE AND PAPER COPIES AVAILABLE IN THE INGALLS MEMORIAL MAIN LOBBY AND THE PROFESSIONAL OFFICE BUILDING FRONT DESKS. THE CHNA HAS ALSO BEEN MADE WIDELY AVAILABLE TO VARIOUS CHICAGOLAND COMMUNITY NEWS OUTLETS, INCLUDING THE CHICAGO SUN-TIMES AND AN ON-AIR PRESENTATION TO WVON-1690 AM "COMMUNITY HEALTH FOCUS HOUR". Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - THE INGALLS MEMORIAL HOSPITAL. THE MOST RECENT INGALLS MEMORIAL CHNA WAS CONDUCTED IN 2024-2025. THE IMPLEMENTATION STRATEGY FOR THIS CHNA FOR FISCAL YEARS 2026-2028 WAS ADOPTED BY THE UCHICAGO MEDICINE BOARD OF DIRECTORS GOVERNMENT AND COMMUNITY RELATIONS COMMITTEE IN MAY 2025. THROUGH A DATA-DRIVEN APPROACH, THE COMMUNITY BENEFIT PRIORITIES IDENTIFIED IN THIS MOST RECENT CHNA WERE AS FOLLOWS: 1. PREVENT AND MANAGE CHRONIC DISEASES: CANCERS, HEART DISEASE, DIABETES 2. PROVIDE ACCESS TO CARE AND SERVICES: MATERNAL HEALTH, BEHAVIORAL HEALTH 3. REDUCE HEALTH INEQUITIES DRIVEN BY SOCIAL DETERMINANTS OF HEALTH: HOUSING, YOUTH ENGAGEMENT, WORKFORCE DEVELOPMENT INGALLS MEMORIAL WILL ADDRESS THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH: (A) EXECUTION OF THE STRATEGIC IMPLEMENTATION PLAN, (B) INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS, AND (C) ADOPTION OF A BUDGET FOR THE FISCAL YEAR FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA. INGALLS MEMORIAL ADDRESSES THESE NEEDS WHICH WERE IDENTIFIED AS TOP PRIORITY BY THE COMMUNITY THROUGH ITS COMMUNITY BENEFIT PROGRAMMING. ADDRESSING INGALLS MEMORIAL COMMUNITY BENEFIT PRIORITIES 1) CARE DELIVERY INITIATIVES: A MYRIAD OF INITIATIVES PROVIDE DIRECT HEALTH AND WELLNESS SERVICES TO COMMUNITY MEMBERS. THESE SERVICES ARE EXECUTED IN MULTIPLE WAYS THAT INCLUDE LEVERAGING INGALLS MEMORIAL RESOURCES AND PARTNERING WITH COMMUNITY HEALTH CENTERS AND COMMUNITY-BASED CLINICAL SERVICES. COMMUNITY HEALTH WORKERS (CHWS) FACILITATE ACCESS TO SERVICES, IMPROVE HEALTH OUTCOMES AND ADDRESS SOCIAL DETERMINANTS OF HEALTH OF PATIENTS WITH ASTHMA AND HEART CONDITIONS. 2) COMMUNITY IMPACT GRANTS: INGALLS MEMORIAL CONTINUES TO OFFER FUNDING OPPORTUNITIES PROVIDED TO COMMUNITY-BASED ORGANIZATIONS THAT IMPLEMENT PROGRAMS ADDRESSING THE COMMUNITY BENEFIT PRIORITIES WITHIN THE PRIMARY SERVICE AREA. 3) COMMUNITY-BASED EDUCATION & OUTREACH: INGALLS MEMORIAL OUTREACH AND ENGAGEMENT COMPONENTS ARE DIRECTLY ALIGNED WITH THE HOSPITALS' PRIORITY AREAS, PROMOTING EDUCATION AND AWARENESS TO COMMUNITY MEMBERS IN THE PRIMARY SERVICE AREA. THESE ACTIVITIES ARE INTENDED TO BETTER INFORM AND EDUCATE THE COMMUNITY REGARDING HEALTH PROMOTION AND DISEASE SELF-MANAGEMENT PRACTICES. 4) PARTNERSHIPS: INGALLS MEMORIAL CONTINUES TO FOCUS ON ESTABLISHING AND CULTIVATING INNOVATIVE PARTNERSHIPS WITH A COMMUNITY HEALTH LENS. THESE PARTNERSHIPS LEVERAGE TECHNOLOGY, CROSS-SECTOR COLLABORATIONS, AND MULTI-DISCIPLINARY APPLICATION LEARNINGS TO IMPROVE HEALTH AND ENGAGE THE COMMUNITY which TRANSLATES INTO SUSTAINABLE IMPROVEMENTS IN THE COMMUNITY'S HEALTH. 5) POLICY & ADVOCACY: THROUGH INCREASING CONNECTIONS BETWEEN CLINICAL EXPERTS AND COMMUNITY MEMBERS, ENGAGING POPULATION HEALTH STRATEGIES, INGALLS MEMORIAL IS ABLE TO ADVOCATE FOR INSTITUTIONAL POLICY CHANGE. RATIONALE FOR UNADDRESSED NEEDS: THE MOST RECENT CHNA INCLUDES FIVE OF THE PRIORITY AREAS FROM THE FY 2023-2025 INGALLS MEMORIAL STRATEGIC IMPLEMENTATION PLAN (SIP): HEART DISEASE, DIABETES, CANCERS, MATERNAL HEALTH, AND WORKFORCE DEVELOPMENT. IN THE FY 2023-2025 SIP, MENTAL HEALTH AND FOOD INSECURITY WERE ALSO SELECTED AS PRIORITY AREAS. ACCESS TO FOOD REMAINS AN OVERARCHING FACTOR THAT AFFECTS ALL HEALTH DOMAINS. ALTHOUGH IT WAS REMOVED AS A PRIORITY, INGALLS MEMORIAL WILL CONTINUE ITS CURRENT EFFORTS TO ADDRESS THIS AREA. FURTHERMORE, SINCE OBESITY IS LINKED TO SOME CHRONIC DISEASES, INGALLS MEMORIAL WILL ADDRESS CHRONIC DISEASES BY INCLUDING STRATEGIES THAT ALSO TACKLE OBESITY. THIS CYCLE, THE MENTAL HEALTH PRIORITY WAS BROADENED TO BEHAVIORAL HEALTH TO INCLUDE BEHAVIORS AND LIFESTYLE FACTORS. THE HOSPITAL WILL CONTINUE TO SUPPORT EXISTING PROGRAMS THAT INVEST RESOURCES TOWARD SUSTAINING POSITIVE OUTCOMES. SAFETY WAS A TOPIC OF DISCUSSION; HOWEVER, AFTER GATHERING FEEDBACK FROM VARIOUS STAKEHOLDERS, IT WAS NOT CHOSEN AS A PRIORITY AREA. CURRENTLY, THE HOSPITAL LACKS SUFFICIENT RESOURCES, SPECIALIZED KNOWLEDGE, AND SKILLS TO ADDRESS THIS ISSUE DIRECTLY. NEVERTHELESS, SAFETY WILL BE INTEGRATED INTO OTHER PRIORITY AREAS, SUCH AS REDUCING VIOLENCE THROUGH TEEN PROGRAMS AND WORKFORCE DEVELOPMENT. ADDITIONALLY, THE HOSPITAL WILL SUPPORT AND COLLABORATE WITH COMMUNITY ORGANIZATIONS THAT EFFECTIVELY ADDRESS SAFETY CONCERNS WHENEVER FEASIBLE. THESE THREE DOMAINS AND EIGHT CORRESPONDING PRIORITIES REPRESENT A COORDINATED STRATEGY TO CREATE LONG-TERM HEALTH AND PROSPERITY IN THE COMMUNITY. INGALLS MEMORIAL HOSPITAL ADDRESSES ITS IDENTIFIED COMMUNITY HEALTH PRIORITIES THROUGH STRATEGIES DEVELOPED DURING THE IMPLEMENTATION STRATEGY PLANNING PROCESS. KEY THEMES GUIDING THESE EFFORTS INCLUDE: * APPLYING A PUBLIC HEALTH APPROACH THAT EMPHASIZES PREVENTION AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) * INCREASING COMMUNITY AWARENESS AND STRENGTHENING THE REPUTATION OF INGALLS MEMORIAL'S SERVICES THROUGH COLLABORATION WITH COMMUNITY PARTNERS * SUPPORTING THE HOSPITAL'S GROWTH AS AN ANCHOR INSTITUTION TO HELP BUILD A COHESIVE HEALTHCARE ECOSYSTEM ACROSS THE SOUTHLAND REGION THESE STRATEGIES GUIDE PROGRAMS, PARTNERSHIPS, AND INITIATIVES DESIGNED TO IMPROVE ACCESS TO CARE, ENHANCE COMMUNITY HEALTH OUTCOMES, AND STRENGTHEN LOCAL HEALTH INFRASTRUCTURE. PLEASE SEE A REPORT OF INGALLS COMMUNITY ACTIVITIES IN PART VI, LINE 5. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - THE INGALLS MEMORIAL HOSPITAL. A PATIENT IS NOT REQUIRED TO PAY MORE THAN 20% OF HIS/HER FAMILY INCOME FOR ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY IMH IN A 12-MONTH PERIOD. THE MEDICAL INDIGENCY DISCOUNT APPLIES TO ANY PATIENT WHOSE PATIENT BALANCE DUE FOR EMERGENCY AND OTHER MEDICALLY NECESSARY SERVICES EXCEEDS 20% OF HIS/HER ADJUSTED GROSS INCOME IN THE YEAR THAT THE PATIENT RECEIVED CARE. 4 INGALLS FAMILY CARE CENTER 6701 WEST 159TH STREET TINLEY PARK IL 60477 URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES INGALLS FAMILY CARE CENTER 19550 GOVERNORS HIGHWAY FLOSSMOOR IL 60422 URGENT AID AND SPECIALIST SERVICES INGALLS FAMILY CARE CENTER 1600 TORRENCE AVENUE CALUMET CITY IL 60409 URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES INGALLS WELLNESS CENTER 2920 WELLNESS CENTER HOMEWOOD IL 60430 COMPLEMENTARY MEDICINE AND COMMUNITY HEALTH PROGRAMS Schedule H, Part I Line 3c AUTOMATIC UNINSURED SELF-PAY DISCOUNT A DISCOUNT OF 40% OF GROSS CHARGES, PROVIDED TO ALL UNINSURED PATIENTS WITHOUT REQUIRING EVIDENCE OF INABILITY TO PAY. THIS DISCOUNT IS DESIGNED TO ENSURE THAT PATIENTS ARE CHARGED AT A RATE GENERALLY COMPARABLE TO THAT APPLIED TO INSURED PATIENTS. 1. THERE IS NO APPLICATION PROCESS FOR THE PATIENT TO RECEIVE THE UNINSURED DISCOUNT. THE DISCOUNT IS APPLIED BASED ON THE ACCOUNT'S SELF-PAY/UNINSURED STATUS. 2. PATIENTS RECEIVING PRE-NEGOTIATED DISCOUNTS FOR HOSPITAL SERVICES WILL NOT BE ELIGIBLE FOR THIS UNINSURED DISCOUNT. 3. IF A PATIENT IS SUBSEQUENTLY APPROVED FOR FINANCIAL ASSISTANCE, THE AUTOMATIC DISCOUNT WILL BE REVERSED SO THAT THE FULL AMOUNT CAN BE RECOGNIZED AS A CHARITY ALLOWANCE. 4. IF A PATIENT SUBSEQUENTLY PROVIDES EVIDENCE OF INSURANCE COVERAGE, THE AUTOMATIC DISCOUNT WILL BE REVERSED AND THE INSURANCE COVERAGE PROVIDED WILL BE BILLED ACCORDINGLY. 5. PATIENTS WHO ARE OTHERWISE INSURED AND CHOOSE NOT TO USE THEIR INSURANCE COVERAGE ARE INELIGIBLE FOR THIS AUTOMATIC DISCOUNT. Schedule H, Part V, Section B, Line 4 THE HOSPITAL IS REPORTING THE TAX YEAR BEGINNING FOR WHICH IT LAST CONDUCTED ITS CHNA. THE CHNA WAS FINALIZED DURING THE TAX YEAR ENDED JUNE 30, 2025. Schedule H, Part III Line 1 INGALLS FOLLOWS GAAP PRINCIPLES AND UNDER THE NEW REPORTING STANDARD ASC 606, BAD DEBT IS NOW IMPLICIT PRICE CONCESSIONS. THE REPORTING OF BAD DEBT ALSO CONFORMS TO THE UPDATED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION NO. 15. Schedule H, Part I Line 5a WHILE INGALLS PROJECTS AN ANTICIPATED AMOUNT OF DISCOUNTED CARE EACH FISCAL YEAR WHEN CREATING ITS ANNUAL BUDGET, NO SPECIFIC LINE ITEM OR LIMIT IS INCLUDED IN THE BUDGET. THE ABSENCE OF A LINE ITEM IN NO WAY LIMITS THE AMOUNT OF DISCOUNTED CARE INGALLS PROVIDES. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH THE UNIVERSITY OF CHICAGO INGALLS MEMORIAL HOSPITAL (INGALLS MEMORIAL) IS A COMMUNITY HOSPITAL THAT WORKS WITH ITS COMMUNITY AND PARTNERS TO IMPROVE HEALTH, PREVENT DISEASES AND ADDRESS THE SOCIAL DETERMINANTS OF HEALTH IN ITS COMMUNITY BENEFIT PRIMARY SERVICE AREA. COMMUNITY IMPACT GRANTS INGALLS MEMORIAL COMMUNITY IMPACT GRANTS PROGRAM PROVIDES NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATIONS FUNDING TO SUPPORT HEALTH PROGRAMMING. PRIORITY CONSIDERATION IS GIVEN TO THOSE GRANTS THAT ARE IN LINE WITH STRATEGIC HEALTH PRIORITIES. FUNDING TO COMMUNITY ORGANIZATIONS HELPS THEM EXPAND THEIR CAPABILITIES. IN FY 2025, INGALLS MEMORIAL AWARDED RENEWABLE COMMUNITY IMPACT GRANTS, WHICH WERE USED TO ADDRESS THE HEALTH PRIORITY AREAS. CHRONIC DISEASES: DIABETES, HEART DISEASE AND CANCER LEADING AN ACTIVE LIFESTYLE AND EATING HEALTHY FOODS ARE IMPORTANT FACTORS IN PREVENTING AND MANAGING CHRONIC (LONG-TERM) DISEASES LIKE HEART DISEASE, DIABETES, AND CANCER. INGALLS MEMORIAL IS DEDICATED TO BRINGING FREE NUTRITION AND FITNESS CLASSES TO COMMUNITY MEMBERS IN THE SOUTH SUBURBS. IN FISCAL YEAR 2025, INGALLS CONTINUED COLLABORATING WITH ARMORED FITNESS & NUTRITION TO OFFER FREE FITNESS CLASSES TO HELP MANAGE AND PREVENT CHRONIC DISEASES. CLASSES LIKE CARDIO DRUMMING AND HIP-HOP CARDIO DANCE WERE OFFERED AT MULTIPLE LOCATIONS THROUGHOUT THE PRIMARY SERVICE AREA. INGALLS MEMORIAL LAUNCHED A MONTHLY WALKING CLUB WITH THE PURPOSE OF BUILDING CONNECTIONS WHILE REDUCING STRESS AND BOOSTING MOOD, REDUCING THE RISKS FOR CHRONIC DISEASES AND IMPROVING HEART HEALTH. IN FISCAL YEAR 2025, DIETETIC INTERNS GAVE COMMUNITY NUTRITION TALKS FOCUSED ON TOPICS THAT ADDRESSED CHRONIC DISEASE MANAGEMENT AND PREVENTION. TO PROMOTE COMMUNITY HEALTH ACTIVITIES AND PROGRAMS, INGALLS MEMORIAL DISTRIBUTES INFORMATION VIA: -EXTERNAL NEWSLETTERS -COMMUNITY PARTNERS -MESSAGE BOARDS -SOCIAL MEDIA PLATFORMS -WVON 1690AM COMMUNITY HEALTH FOCUS HOUR RADIO SHOW ACCESS TO MATERNAL HEALTH - HEALTHY BABY NETWORK THE SOUTH SUBURBS HAS LIMITED ACCESS TO MATERNITY HEALTHCARE. THE HEALTHY BABY NETWORK (HBN) WAS ESTABLISHED TO ADDRESS THE NUMBER OF WOMEN GIVING BIRTH WHO HAVE NOT RECEIVED PRENATAL CARE AND ACCESS TO NEEDED RESOURCES. THE LACK OF PRENATAL CARE RESULTS IN PREMATURE BIRTHS, BABIES WITH LOW BIRTH WEIGHTS, INCREASED MORBIDITY AND MORTALITY AND NUMEROUS OTHER COMPLICATIONS. IN FISCAL YEAR 2025, HBN'S YEARLY DRIVE THRU BABY SHOWER PROVIDED 300 DIAPER BAGS, FILLED WTH ESSENTIAL ITEMS. UCM NETWORK DEVELOPMENT FOUNDATION UCM NETWORK DEVELOPMENT FOUNDATION'S PURPOSE IS TO CONNECT DONORS WITH PHILANTHROPIC INVESTMENT OPPORTUNITIES TO TRANSFORM COMMUNITY MEDICINE IN THE SOUTH SUBURBS. OUTREACH AND SUPPORT - MENTAL HEALTH INGALLS MEMORIAL IS THE PRIMARY INPATIENT PSYCHIATRIC FACILITY FOR UCHICAGO MEDICINE AND HAS ONE OF THE STATE'S HIGHEST BEHAVIORAL HEALTH EMERGENCY VISIT RATES. FOLLOWING AN EXPANSION IN 2024 THAT ADDED 15 INPATIENT BEDS AND NEW STAFF, INGALLS MEMORIAL CONTINUED ITS COMMITMENT TO MENTAL HEALTH ACCESS IN 2025. INGALLS MEMORIAL HOSTED FREE MENTAL HEALTH SCREENINGS AT FLOSSMOOR, TINLEY PARK AND CALUMET CITY. THE HOSPITAL OFFERS FREE, CONFIDENTIAL MENTAL HEALTH ASSESSMENTS 24/7 AND INTENSIVE GROUP PROGRAMS MORNINGS, AFTERNOONS AND EVENINGS, BOTH IN PERSON AND VIRTUALLY. ADDRESSING FOOD INSECURITY INGALLS MEMORIAL OPERATES THREE ONSITE FOOD PANTRIES FOR ITS ONCOLOGY PATIENTS. THE PROGRAM DOES NOT REQUIRE INDIVIDUALS TO SIGN UP FOR EMERGENCY FOOD IF THEY ARE UNCOMFORTABLE. THE NUTRITION STATIONS ARE IN HARVEY, FLOSSMOOR, AND TINLEY PARK. IN ADDITION TO the NUTRITION STATIONS, INGALLS MEMORIAL OPERATES THE FOOD BRIGADE PROGRAM, WHICH DELIVERS GROCERIES DIRECTLY TO THE HOMES OF PATIENTS FACING FOOD INSECURITY AND TRANSPORTATION CHALLENGES. CURRENTLY, THE PROGRAM SUPPORTS FOUR FAMILIES. COMMUNITY ADVISORY COUNCIL (CAC) THE INGALLS MEMORIAL CAC, IS COMPRISED OF 12 MEMBERS AND SEEKS COMMUNITY INPUT ON HEALTH ISSUES THAT ARE IMPORTANT TO ITS PRIMARY SERVICE AREA AND SURROUNDING COMMUNITIES. THE COUNCIL TALKS TO THE COMMUNITY TO HELP GUIDE FUTURE DECISIONS FOR HOSPITAL RESOURCES. INGALLS MEMORIAL IS DEEPLY COMMITTED TO PROVIDING HEALTH CARE SOLUTIONS AND SERVICES FOR PATIENTS AND THE COMMUNITY. WITH A CONTINUED FOCUS ON ITS FIVE CRITICAL PILLARS - PEOPLE, COMMUNITY, HEALTHCARE, RESEARCH AND EDUCATION - INGALLS MEMORIAL STRIVES TO HAVE A LASTING IMPACT ON THE HEALTH AND VITALITY OF CHICAGO'S SOUTH SUBURBS. Schedule H, Part I, Line 7b MEDICAID SHORTFALL DURING FY2025, IMH QUALIFIED FOR SAFETY-NET STATUS IN ILLINOIS. A SAFETY-NET HOSPITAL IS AN ILLINOIS HOSPITAL THAT HAS A MEDICAID INPATIENT UTILIZATION RATE (MIUR) OF AT LEAST 40% AND A CHARITY PERCENTAGE OF AT LEAST 4% OR HAS A MIUR OF AT LEAST 50%. IMH QUALIFIED FOR SAFETY-NET STATUS DUE TO ITS MIUR EXCEEDING 50%. AS SUCH, IMH SAW A DECREASE IN ITS FY2025 MEDICAID SHORTFALL DUE TO ITS ELIGIBILITY INCREASED LEVELS OF MEDICAID FUNDING AS A SAFETY-NET HOSPITAL. Schedule H, Part III, Line 6 THE FOLLOWING AMOUNTS REPRESENT REVENUE AND EXPENSES FROM PROFESSIONAL FEES, LABS, AND OTHER MEDICARE CHARGES NOT INCLUDED IN IMH'S MEDICARE COST REPORT FOR THE YEAR: REVENUE RECEIVED FROM MEDICARE $62,313,462 ALLOWABLE COSTS RELATING TO ABOVE PAYMENTS ($72,044,533) SHORTFALL ($9,731,071) Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN FINANCIAL ASSISTANCE AND MEDICAID AT COST IS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. IMH'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE COSTS RELATED TO THE SPECIFIC SERVICES REPORTED IN SUBSIDIZED HEALTH SERVICES. COSTS AND REIMBURSEMENT FROM MEDICAID, COSTS FOR CHARITY, AND BAD DEBT ACCOUNTS HAVE BEEN EXCLUDED. COSTS FOR SUBSIDIZED SERVICES REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. COSTS FOR ALL OTHER PROGRAMS REFLECT THE ACTUAL COSTS OF PROVIDING THOSE PROGRAMS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE AMOUNT REPORTED AS BAD DEBT EXPENSE IS DETERMINED BY APPLYING THE RATIO OF COST TO CHARGES (RCC) TO THE TOTAL CHARGES WRITTEN OFF TO BAD DEBT AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS. THE RCC WAS DETERMINED UTILIZING WORKSHEET 2 FROM FORM 990, SCHEDULE H INSTRUCTIONS. THE BASIS FOR THIS COSTING METHODOLOGY IS THE HOSPITAL'S OPERATING EXPENSES (EXCLUDING BAD DEBT) ADJUSTED BY OTHER OPERATING REVENUE AND COMMUNITY BENEFIT EXPENSE DIVIDED BY GROSS PATIENT CHARGES. Schedule H, Part III, Line 3 Bad Debt Expense Methodology IMH RUNS PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE WHEN SUFFICIENT INFORMATION CANNOT BE OBTAINED. AS A RESULT, IMH DOES NOT BELIEVE THERE IS ANY BAD DEBT FOR INDIVIDUALS THAT WOULD OTHERWISE QUALIFY FOR ASSISTANCE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote FOOTNOTE TO FINANCIAL STATEMENTS: IN ACCORDANCE WITH ASC TOPIC 606, REVENUE FROM CONTRACTS WITH CUSTOMERS, THE SYSTEM DOES NOT ADJUST THE PROMISED AMOUNT OF CONSIDERATION FROM PATIENTS AND THIRD-PARTY PAYORS FOR THE EFFECTS OF A SIGNIFICANT FINANCING COMPONENT DUE TO THE EXPECTATION THAT THE PERIOD BETWEEN THE TIME THE SERVICE IS PROVIDED TO A PATIENT AND THE TIME THAT THE PATIENT OR A THIRD-PARTY PAYOR PAYS FOR SERVICE WILL BE ONE YEAR OR LESS. REVENUES ARE RECOGNIZED IN THE AMOUNTS TO WHICH IT EXPECTS TO BE ENTITLED, WHICH ARE THE TRANSACTION PRICES ALLOCATED TO THE DISTINCT SERVICES. THE SYSTEM HAS AGREEMENTS WITH GOVERNMENTAL AND OTHER THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE SYSTEM AT AMOUNTS DIFFERENT FROM ESTABLISHED CHARGES. PAYMENT ARRANGEMENTS FOR MAJOR THIRD-PARTY PAYORS MAY BE BASED ON PROSPECTIVELY DETERMINED RATES, REIMBURSED COST, DISCOUNTED CHARGES, PER DIEM PAYMENTS, OR OTHER METHODS. THE TRANSACTION PRICE IS DETERMINED BASED ON GROSS CHARGES FOR SERVICES PROVIDED, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYERS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE PROGRAM, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO UNINSURED PATIENTS. THE ESTIMATES OF EXPLICIT PRICE CONCESSIONS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. THE ESTIMATES OF IMPLICIT PRICE CONCESSIONS ARE BASED ON HISTORICAL COLLECTION EXPERIENCE WITH THESE CLASSES OF PATIENTS USING THE PORTFOLIO APPROACH. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE HOSPITAL BELIEVES THE FULL AMOUNT OF THE SHORTFALL FROM MEDICARE SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE IT SERVES ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY, AND IT CANNOT NEGOTIATE CONTRACTUAL RATES WITH THE MEDICARE PROGRAM. THE HOSPITAL MUST ACCEPT WHAT THE MEDICARE PROGRAM PAYS. THE METHODOLOGY USED IN DETERMINING MEDICARE SHORTFALL REPORTED IN THE COMMUNITY BENEFITS REPORT IS MEDICARE NET PATIENT SERVICE REVENUE LESS MEDICARE CHARGES MULTIPLIED BY THE MEDICARE COST REPORT COST TO CHARGE RATIO. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance INGALLS MEMORIAL HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL FOLLOWS THE FOLLOWING CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. COLLECTING INFORMATION ON PATIENT HEALTH COVERAGE AND FINANCIAL RESOURCES PATIENT OBLIGATIONS: PRIOR TO THE DELIVERY OF ANY HEALTH CARE SERVICES (EXCEPT FOR CASES THAT ARE AN EMERGENCY OR URGENT CARE SERVICE LEVEL), THE PATIENT IS EXPECTED TO PROVIDE TIMELY AND ACCURATE INFORMATION ON THEIR INSURANCE STATUS, DEMOGRAPHIC INFORMATION, CHANGES TO THEIR FAMILY INCOME OR INSURANCE STATUS, AND INFORMATION ON ANY DEDUCTIBLES OR CO-PAYMENTS THAT ARE OWED BASED ON THEIR EXISTING INSURANCE OR FINANCIAL PROGRAM'S PAYMENT OBLIGATIONS. THE DETAILED INFORMATION WILL INCLUDE: A. FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, CITIZENSHIP AND RESIDENCY INFORMATION, AND THE PATIENT'S APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY THEIR BILL; B. FULL NAME OF THE PATIENT'S GUARANTOR, THEIR ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, AND THEIR APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY FOR THE PATIENT'S BILL; AND C. OTHER RESOURCES THAT MAY BE USED TO PAY THEIR BILL, INCLUDING OTHER INSURANCE PROGRAMS, MOTOR VEHICLE OR HOMEOWNERS INSURANCE POLICIES IF THE TREATMENT WAS DUE TO AN ACCIDENT, WORKER'S COMPENSATION PROGRAMS, AND STUDENT INSURANCE POLICIES, AMONG OTHERS. IT IS ULTIMATELY THE PATIENT'S OBLIGATION TO KEEP TRACK OF AND TIMELY PAY THEIR UNPAID HOSPITAL BILL, INCLUDING ANY EXISTING CO-PAYMENTS, CO-INSURANCE, AND DEDUCTIBLES. THE PATIENT IS FURTHER REQUIRED TO INFORM EITHER THEIR CURRENT HEALTH INSURER (IF THEY HAVE ONE) OR THE AGENCY THAT DETERMINED THE PATIENT'S ELIGIBILITY STATUS IN A PUBLIC HEALTH INSURANCE PROGRAM OF ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS. THE HOSPITAL MAY ALSO ASSIST THE PATIENT WITH UPDATING THEIR ELIGIBILITY IN A PUBLIC PROGRAM WHEN THERE ARE ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS, BUT ONLY IF THE HOSPITALS IS MADE AWARE BY THE PATIENT OF FACTS THAT MAY INDICATE A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS. PATIENTS ARE REQUIRED TO NOTIFY THE STATE PUBLIC PROGRAM (OFFICE OF MEDICAID), OF INFORMATION RELATED TO ANY LAWSUIT OR INSURANCE CLAIM THAT WILL COVER THE COST OF THE SERVICES PROVIDED BY THE HOSPITAL. HOSPITAL OBLIGATIONS: INGALLS MEMORIAL HOSPITAL WILL MAKE ALL REASONABLE AND DILIGENT EFFORTS TO COLLECT THE PATIENT INSURANCE STATUS AND OTHER INFORMATION TO VERIFY COVERAGE FOR THE HEALTH CARE SERVICES TO BE PROVIDED BY INGALLS MEMORIAL HOSPITAL. THESE EFFORTS MAY OCCUR WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, DURING PREREGISTRATION, WHILE THE PATIENT IS ADMITTED IN THE HOSPITAL, UPON DISCHARGE, OR DURING THE COLLECTION PROCESS WHICH MAY OCCUR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THIS INFORMATION WILL BE OBTAINED PRIOR TO THE DELIVERY OF ANY NONEMERGENT AND NON-URGENT HEALTH CARE SERVICES (I.E., ELECTIVE PROCEDURES AND SCHEDULED PROCEDURES). INGALLS MEMORIAL HOSPITAL WILL DELAY ANY ATTEMPT TO OBTAIN THIS INFORMATION DURING THE DELIVERY OF ANY EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) LEVEL EMERGENCY LEVEL OR URGENT CARE SERVICES, IF THE PROCESS TO OBTAIN THIS INFORMATION WILL DELAY OR INTERFERE WITH EITHER THE MEDICAL SCREENING EXAMINATION OR THE SERVICES UNDERTAKEN TO STABILIZE AN EMERGENCY MEDICAL CONDITION. THE HOSPITAL'S REASONABLE AND DILIGENT EFFORTS WILL INCLUDE, BUT ARE NOT LIMITED TO, REQUESTING INFORMATION ABOUT THE PATIENT'S INSURANCE STATUS, CHECKING ANY AVAILABLE PUBLIC OR PRIVATE INSURANCE DATABASES, AND FOLLOWING THE BILLING RULES OF A KNOWN THIRD PARTY PAYER. IF THE PATIENT OR GUARANTOR/GUARDIAN IS UNABLE TO PROVIDE THE INFORMATION NEEDED, AND THE PATIENT CONSENTS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO CONTACT RELATIVES, FRIENDS, GUARANTOR/GUARDIAN, AND THE THIRD PARTY FOR ADDITIONAL INFORMATION. INGALLS MEMORIAL HOSPITAL WILL ALSO MAKE REASONABLE AND DILIGENT EFFORTS TO INVESTIGATE WHETHER A THIRD PARTY RESOURCE MAY BE RESPONSIBLE FOR THE SERVICES PROVIDED BY THE HOSPITAL, INCLUDING BUT NOT LIMITED TO: (1) A MOTOR VEHICLE OR HOMEOWNER'S LIABILITY POLICY, (2) GENERAL ACCIDENT OR PERSONAL INJURY PROTECTION POLICIES, (3) WORKER'S COMPENSATION PROGRAMS, (4) STUDENT INSURANCE POLICIES, AMONG OTHERS. IN ACCORDANCE WITH APPLICABLE STATE REGULATIONS OR THE INSURANCE CONTRACT, FOR ANY CLAIM WHERE INGALLS MEMORIAL HOSPITAL'S REASONABLE AND DILIGENT EFFORTS RESULTED IN A PAYMENT FROM A PRIVATE INSURER OR PUBLIC PROGRAM, INGALLS MEMORIAL HOSPITAL WILL REPORT THE RECOVERY AND OFF SET IT AGAINST THE CLAIM PAID BY THE PRIVATE INSURER OR PUBLIC PROGRAM. THE HOSPITAL FURTHER MAINTAINS ALL INFORMATION IN ACCORDANCE WITH APPLICABLE FEDERAL AND STATE PRIVACY, SECURITY AND ID THEFT LAWS. Schedule H, Part V, Section B, Line 16a FAP website - INGALLS MEMORIAL HOSPITAL: Line 16a URL: https://tinyurl.com/Ingalls-FAP; Schedule H, Part V, Section B, Line 16b FAP Application website - INGALLS MEMORIAL HOSPITAL: Line 16b URL: https://tinyurl.com/IMH-FAP-APP; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - INGALLS MEMORIAL HOSPITAL: Line 16c URL: https://tinyurl.com/IMH-PLAIN; Schedule H, Part VI, Line 2 Needs assessment INGALLS MEMORIAL ASSESSES THE HEALTH CARE NEEDS OF THE PRIMARY SERVICE AREA THROUGH THE IMPLEMENTATION OF THE CHNA, STAKEHOLDER ENGAGEMENT, AND GRANT OPPORTUNITIES FOR COMMUNITY-BASED ORGANIZATIONS. INGALLS MEMORIAL CONDUCTED ITS LAST CHNA BETWEEN APRIL 2024 AND FEBRUARY 2025 USING A PROCESS THAT WAS ADAPTED FROM THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK. THIS PLANNING FRAMEWORK FOCUSES ON COMMUNITY ENGAGEMENT, PARTNERSHIP DEVELOPMENT, AND INCLUSION OF THOSE WHO HAVE HISTORICALLY BEEN EXCLUDED FROM DECISION-MAKING PROCESSES. PRIMARY DATA FOR THE CHNA WAS COLLECTED THROUGH FOUR CHANNELS: * COMMUNITY RESIDENT SURVEYS * COMMUNITY RESIDENT FOCUS GROUPS * HEALTHCARE AND SOCIAL SERVICE PROVIDER FOCUS GROUP * KEY INFORMANT INTERVIEWS THE COMMUNITY RESIDENT SURVEY TOOL WAS DEVELOPED BY UCHICAGO MEDICINE STAFF AND THE COMMUNITY ADVISORY COUNCIL BASED ON A DESIGN USED BY OTHER PUBLIC HEALTH AGENCIES. THE FINAL SURVEY TOOL INCLUDED 22 QUESTIONS AND ASKED RESPONDENTS TO IDENTIFY TOP COMMUNITY HEALTH ISSUES. COMMUNITY RESIDENT SURVEYS WERE AVAILABLE ONLINE AND IN PERSON IN BOTH ENGLISH AND SPANISH. COMMUNITY PARTNERS DISTRIBUTED THE SURVEY THROUGH VARIOUS CHANNELS WITH A PARTICULAR EMPHASIS ON SURVEYING TYPICALLY UNDERREPRESENTED POPULATIONS. INGALLS MEMORIAL HELD FOUR RESIDENT FOCUS GROUPS, EACH COVERING A SPECIFIC HEALTH AREA OR POPULATION: * YOUTH HEALTH * CHRONIC DISEASE * REPRODUCTIVE, MATERNAL AND CHILD HEALTH * MENTAL HEALTH AND SUBSTANCE USE EACH FOCUS GROUP LASTED 60 MINUTES WITH UP TO TWELVE COMMUNITY MEMBERS IN EACH ONE. THIRTEEN KEY INFORMANTS WERE IDENTIFIED FOR ONE-ON-ONE INTERVIEWS. PARTICIPANTS WERE HOSPITAL LEADERS WITH EXPERTISE ON COMMUNITY HEALTH PRIORITIES AND WERE SELECTED TO FURTHER EXPLORE AND VALIDATE THEMES THAT EMERGED FROM THE COMMUNITY RESIDENT SURVEYS AND FOCUS GROUPS. KEY INFORMANT INTERVIEWS WERE CONDUCTED OVER THE PHONE AND EACH LASTED 30 MINUTES. SECONDARY POPULATION HEALTH AND DEMOGRAPHIC DATA WAS COLLECTED FROM A VARIETY OF SOURCES, INCLUDING ILLINOIS HEALTH & HOSPITAL ASSOCIATION (IHA) COMPDATA. INGALLS MEMORIAL USED A COMMON SET OF HEALTH INDICATORS TO UNDERSTAND THE PREVALENCE OF MORBIDITY AND MORTALITY IN THE SERVICE AREA. ALL DATA WERE UPLOADED AND ANALYZED USING THE METOPIO DATA PLATFORM. BUILDING ON PAST CHNAS, THE COMMUNITY BENEFIT TEAM WORKED WITH THE COMMUNITY BENEFIT STEERING COMMITTEE, AS WELL AS THE COMMUNITY ADVISORY COUNCIL, TO PRIORITIZE HEALTH ISSUES FOR INGALLS MEMORIAL COMMUNITY BENEFIT PROGRAMMING FOR FISCAL 2026-2028. SELECT INGALLS MEMORIAL STAFF AND COMMUNITY STAKEHOLDERS WERE AMONG THE MAJOR CONSTITUENCIES INVOLVED IN THE COMMUNITY BENEFIT PRIORITY SELECTION PROCESS. THESE CONSTITUENCIES WERE STRATEGICALLY SELECTED FOR THEIR RESPECTIVE UNDERSTANDING OF COMMUNITY PERSPECTIVES, COMMUNITY ENGAGEMENT, AND COMMUNITY HEALTH EDUCATION EFFORTS. FOR MORE INFORMATION ON UCMC'S SELECTED HEALTH PRIORITY AREAS PLEASE SEE PART V, SECTION B, LINE 11. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THE ELIGIBILITY FOR ASSISTANCE BY POSTING SIGNS THROUGHOUT THE PATIENT REGISTRATION AREAS REGARDING PATIENT PAYMENT OPTIONS. IN ADDITION, PATIENTS ARE INFORMED VIA THE HOSPITAL'S WEBSITE, INDIVIDUAL PATIENT STATEMENTS, AND FINANCIAL COUNSELORS. BELOW ARE SOME ADDITIONAL DETAILS REGARDING HOW THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SIGNAGE: SIGNS OR SIMILAR WRITTEN NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM WILL BE VISIBLE AT ALL HOSPITAL POINTS OF SERVICE TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE WILL BE POSTED IN THE EMERGENCY DEPARTMENT AND ADMISSION REGISTRATION AREA. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISION OF FINANCIAL ASSISTANCE PROGRAM WILL USE LANGUAGES THAT ARE APPROPRIATE FOR THE SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. HOSPITAL BILL/INVOICE: PATIENT BILLS OR STATEMENTS INCLUDE A PROMINENT STATEMENT THAT PATIENTS WHO MEET CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR FINANCIAL ASSISTANCE AND INFORMATION REGARDING HOW A PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE FOLLOWING ARE MADE PUBLICLY AVAILABLE VIA THE HOSPITAL'S WEBSITE: https://www.uchicagomedicine.org/patients-visitors/patient-information/billing/financial-assistance-at-ingalls 1. PATIENT BROCHURES 2. FINANCIAL ASSISTANCE POLICY 3. APPLICATION FORMS USED TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. 4. PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICY Schedule H, Part VI, Line 4 Community information INGALLS MEMORIAL PRIMARY SERVICE AREA (PSA) CONSISTS OF A LARGE, MEDICALLY UNDER RESOURCED, LOWER INCOME POPULATION IN SOUTH SUBURBAN COOK COUNTY. THE PSA IS COMPRISED OF THORNTON TOWNSHIP, WHICH CONSISTS OF 13 ZIP CODES AND 20 CITIES/MUNICIPALITIES. THE PSA HAS 242,262 RESIDENTS WHICH IS A 4.9% DECREASE SINCE THE 2010 U.S. CENSUS. THE POPULATION OF THE PSA IS APPROXIMATELY 62.9% BLACK, 18.7% HISPANIC/LATINX, 15.2% NON-HISPANIC WHITE, 0.8% ASIAN, <0.1% PACIFIC ISLANDER/NATIVE HAWAIIAN, < 0.1% NATIVE AMERICANS, AND PEOPLE IDENTIFYING AS TWO OR MORE RACES ACCOUNT FOR 2.3% IN THE PSA. IN THE PSA, 19.3% OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL, COMPARED TO 11.7% IN ILLINOIS. THE UNEMPLOYMENT RATE IS 11.5% IN THE PSA COMPARED TO 5.6% IN COOK COUNTY. APPROXIMATELY 14% OF PSA RESIDENTS EXPERIENCE FOOD INSECURITY, ALSO KNOWN AS UNCERTAIN OR LIMITED ACCESS TO FOOD. INGALLS MEMORIAL IS ONE OF THE FEW HOSPITALS LOCATED IN SOUTH SUBURBAN COOK COUNTY AND YET SOME OF THE HIGHEST CHRONIC DISEASE RATES IN THE SOUTH SUBURBS EXIST IN THE PSA. ON AVERAGE, PEOPLE WHO LIVE IN THE PSA HAVE A MORE ADVANCED STAGE OF CANCER WHEN THEY ARE DIAGNOSED THAN OTHER RESIDENTS IN ILLINOIS AND COOK COUNTY. DIABETES HOSPITALIZATIONS ARE HIGHER THAN COMPARABLE AREAS WITH 16.1% OF PSA RESIDENTS DIAGNOSED WITH DIABETES COMPARED TO 10.8% OF COOK COUNTY RESIDENTS. THE RATE OF OBESTIY, WHICH IS A RISK FACTOR FOR TYPE 2 DIABETES, IS NEARLY 41.4% IN THE PRIMARY SERVICE AREA. 6.6% OF PSA RESIDENTS HAVE CORONARY HEART DISEASE AND 38.9% OF RESIDENTS HAVE HIGH BLOOD PRESSURE, TWO CONDITIONS WHICH ARE HIGHER THAN COOK COUNTY RESIDENTS. IN ADDITION TO THE PREVENTABLE CHRONIC DISEASES, THE PSA HAS ONE OF THE HIGHEST BEHAVIORAL HEALTH ED VISIT RATES IN THE STATE FOR ADULTS. POOR SELF-REPORTED MENTAL HEALTH, SUICIDE ED VISIT RATE AND SUBSTANCE USE ED VISIT RATE ARE ALL HIGHER THAN COOK COUNTY OR ILLINOIS. ACCESS TO SERVICES IN THE PSA CAN BE A CHALLENGE, DUE FEWER HEALTH CARE PROVIDERS AS WELL AS A HIGH RATE OF PEOPLE WHO ARE UNINSURED OR UNDERINSURED. THERE ARE FEWER OBSTETRICIAN/GYNECOLOGIST (OB/GYN) DOCTORS IN THE PSA THAN IN ALL COMPARED AREAS. 33.1% OF RESIDENTS IN THE PSA HAVE MEDICAID COVERAGE COMPARED TO 22.3% IN ALL OF COOK COUNTY. WHILE THERE ARE MANY HEALTH AND SOCIAL CHALLENGES IN THE PSA, INGALLS MEMORIAL IS COMMITTED TO ADVANCING COMMUNITY HEALTH INSIDE AND OUTSIDE OF THE HOSPITAL WALLS. Schedule H, Part VI, Line 6 Affiliated health care system The University of Chicago Medical Center and its affiliates (the System) are an integrated nonprofit healthcare organization, collaborating with the University of Chicago Biological Sciences Division, the University of Chicago Pritzker School of Medicine, and the University of Chicago Physicians Group to provide world-class medical care in an academic setting. Included within the System are one academic medical center, University of Chicago Medical Center, two community hospitals, Ingalls Memorial Hospital and UChicago Medicine Northwest Indiana, Inc., an affiliation agreement with AdventHealth Great Lakes Region, and a community medical group and other subsidiaries that cooperate in providing health care services to their respective primary service areas in the City of Chicago, South Suburban Cook County, Southwest and Western suburbs of Chicago, and Northwest Indiana. Schedule H, Part VI, Line 7 State filing of community benefit report IL true SOUTH SUBURBAN PADS 414 W LINCOLN HWY CHICAGO HEIGHTS IL 60411 363744405 501(C)(3) 25000 COMMUNITY IMPACT GRANT TCA HEALTH INC 1029 E 130TH ST CHICAGO IL 60628 362743287 501(C)(3) 25000 COMMUNITY IMPACT GRANT YOUR CAREER TAPESTRY 6040 ASPEN LN MATTESON IL 60443 842421142 501(C)(3) 25000 COMMUNITY IMPACT GRANT 3 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds UCM NETWORK DEVELOPMENT FOUNDATION'S BOARD OF DIRECTORS APPROVES THE GRANTS MADE TO OTHER ORGANIZATIONS. FUNDS ARE THEN TRANSFERRED TO INGALLS MEMORIAL HOSPITAL FOR DISBURSEMENT. ENTITIES RECEIVING GRANT FUNDS MUST PROVIDE A WRITTEN FINAL REPORT AND BUDGET NARRATIVE TO ENSURE THE FUNDS WERE EXPENDED TO ATTAIN GRANT OBJECTIVES. X X X true true X X X X false true false false false false false true false MICHAEL ANTONIADES PRESIDENT, INGALLS 865199 0 217433 0 158516 0 112323 0 42779 0 1396250 0 0 0 MARY JO CRANDALL BOARD MEMBER/VP OPERATIONS 327650 0 80931 0 15029 0 43610 0 0 0 467220 0 0 0 THOMAS JACKIEWICZ BOARD MEMBER/PRESIDENT UCHS 0 1882610 0 841993 0 46828 0 369135 0 29109 0 3169675 0 0 MARK KOZLOFF MD BOARD MEMBER 0 467944 0 217022 0 4315 0 17250 0 39269 0 745800 0 0 GRETCHEN PACHOLEK BOARD MEMBER/VP PATIENT CARE & CNO, INGALLS 0 294584 0 76078 0 7458 0 46603 0 21906 0 446629 0 0 KAVEH RAHMANI DO BOARD MEMBER 0 509809 0 294451 0 483 0 17250 0 23231 0 845224 0 0 STEPHEN WEBER MD BOARD MEMBER 0 833442 0 273708 0 126840 0 27600 0 117982 0 1379572 0 126840 ENGIN YILMAZ MD BOARD MEMBER 0 329390 0 167742 0 0 0 27600 0 626 0 525358 0 0 EMILY CHASE FORMER INTERIM PRESIDENT (7/10/22 THRU 3/7/23) 0 628773 0 248150 0 48427 0 125014 0 44156 0 1094520 0 0 MICHELLE SALOMON ASSISTANT TREASURER 0 315372 0 108709 0 15283 0 52587 0 3229 0 495180 0 0 TOMASZ SAMEK ASSISTANT SECRETARY 0 244338 0 29925 0 513 0 18403 0 22756 0 315935 0 0 IVAN SAMSTEIN CHIEF FINANCIAL OFFICER (THRU 12/31/24) 0 947364 0 833378 0 15130 0 214114 0 38492 0 2048478 0 0 JENNIFER ARIADO REGISTERED NURSE 232477 0 0 0 151 0 7079 0 38179 0 277886 0 0 0 PAUL DONOHUE VP PHILANTHROPY AND COMMUNITY 225332 0 60914 0 20919 0 31901 0 40654 0 379720 0 13871 0 NEGIN KIYAVASH DIRECTOR PHARMACY 211451 0 30699 0 1460 0 6500 0 12760 0 262870 0 0 0 SUSAN KLACZAK EXECUTIVE DIRECTOR ACNO INGALLS 200501 0 36360 0 5987 0 8445 0 13143 0 264436 0 0 0 KIZZY ROUSSEAU HARDAWAY Director Perioperative Services 210199 0 17219 0 221 0 34500 0 10574 0 272713 0 0 0 Schedule J, Part I, Line 1a First-class or charter travel DURING FY2025, ONE OFFICER HAD COMPANION TRAVEL. THE COMPANION TRAVEL WAS DEEMED TAXABLE COMPENSATION AND WAS INCLUDED IN THE INDIVIDUAL'S W-2 FOR THE TAX YEAR. Schedule J, Part I, Line 1a Tax indemnification and gross-up payments During calendar year 2024, the Ingalls President received a tax indemnification and gross-up payment relocation moving expenses. All tax-related payments are included in taxable compensation and are confirmed as being reasonable when considered with all other forms of compensation. Schedule J, Part I, Line 1a Housing allowance or residence for personal use DURING CALENDER YEAR 2024, ONE OFFICER LISTED ON SCHEDULE J, PART II RECEIVED REIMBURSEMENT FOR REASONABLE HOUSING ACCOMMODATIONS IN THE CHICAGO METROPOLITAN AREA IN CONNECTION WITH WORK REQUIREMENTS AND OBLIGATIONS. The housing allowance was reported as taxable income for the calendar year 2024 and reported on 2024 Form W-2. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH UCMC MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN IN JANUARY 2025 FOR CALENDAR YEAR 2024: MICHAEL ANTONIADES EMILY CHASE MARY JO CRANDALL PAUL DONOHUE THOMAS JACKIEWICZ GRETCHEN PACHOLEK MICHELLE SALOMON IVAN SAMSTEIN STEPHEN WEBER THE FOLLOWING INDIVIDUALS BECAME VESTED IN, AND WERE TAXED ON, AMOUNTS PREVIOUSLY CREDITED UNDER THE PLAN TO THE INDIVIDUAL FOR SERVICES PROVIDED TO THE ORGANIZATION IN PRIOR YEARS (INCLUDED IN THE 2024 W-2'S): PAUL DONOHUE - $13,871 STEPHEN WEBER - $126,840 Schedule J, Part I, Line 7 Non-fixed payments SIX PERSONS LISTED IN PART VII, SECTION A, LINE 1A RECEIVED NON-FIXED NON-RECURRING PAYMENTS DURING CALENDAR YEAR 2024. THESE NON-FIXED PAYMENTS ARE RELATED TO PERFORMANCE BONUSES. Schedule J, Part I, Line 1a DISCRETIONARY SPENDING ACCOUNT DISCRETIONARY SPENDING ACCOUNTS ARE AVAILABLE TO UCMC EMPLOYED EXECUTIVES ONLY, SERVING IMH. THOSE WHO MADE USE OF THE DISCRETIONARY SPENDING ACCOUNT RECEIVED BETWEEN $0 AND $10,000 DURING THE YEAR. THESE BENEFITS ARE ALL CONSIDERED TAXABLE COMPENSATION INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). IMH-EMPLOYED EXECUTIVES ARE INELIGIBLE. Schedule J, Part II TAXABLE INCOME REPORTED IN COLUMN (B) MAY INCLUDE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN MOST CASES, THESE PAYMENTS WERE EARNED OVER MANY YEARS OF EMPLOYMENT AND THE AMOUNTS HAD PREVIOUSLY BEEN SUBJECT TO VESTING RULES. SERP PAYMENT AMOUNTS EARNED IN PRIOR YEARS WERE PREVIOUSLY REPORTED ON THE FORM 990 AS DEFERRED COMPENSATION AND ARE REPORTED IN THIS 2024 FORM 990 ON SCHEDULE J, PART II, COLUMN (F). AN INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD ANNUALLY REVIEWS THESE BENEFITS IN COMPARISON TO MARKET DATA AND HAS CONCLUDED THAT THESE BENEFITS AND ALL OTHER FORMS OF COMPENSATION PROVIDED TO THESE INDIVIDUALS ARE REASONABLE. The independent compensation committee of the board conducts its review and approval of all executive compensation, including these SERP amounts, in a manner that qualifies for the rebuttable presumption of reasonableness under federal tax law. This is a rigorous review process designed for tax-exempt organizations by the Internal Revenue Service, and it means that the board compensation committee does not have any conflicts of interest, and relies on market data compiled by an independent compensation consultant to support all executive pay as market competitive and reasonable. FOR THE INDIVIDUALS LISTED ON SCHEDULE J, PART II THAT ARE IDENTIFIED AS FORMER OFFICERS OR KEY EMPLOYEES, THE COMPENSATION LISTED IS EITHER THE FAIR MARKET VALUE COMPENSATION PAID TO THEM FOR SERVICES THEY PERFORMED AS ACTIVE EMPLOYEES OF IMH OR A RELATED ORGANIZATION (AND WAS NOT PAID TO THEM DUE TO THEIR FORMERLY HAVING BEEN LISTED AS OFFICERS OR KEY EMPLOYEES): EMILY CHASE A ILLINOIS FINANCE AUTHORITY 2017 861091967 000000000 2017-12-29 41180000 REFUNDING 2004 BONDS false false false A 14940000 41180000 349422 40830578 2017 true false true true A false true true true false false 0.0 0.0 0.0 false false 0 false true A false false false true false false 0 false false false 0 false false true A true Schedule K, Part V BOND POLICY WRITTEN TAX-EXEMPT BOND PROCEDURES WERE ADOPTED ON FEBRUARY 12, 2018. Schedule K, Part IV, Line 2c REBATE COMPUTATION INGALLS MEMORIAL HOSPITAL PERFORMED A REBATE COMPUTATION ON FEBRUARY 09, 2023. Form 990, Part III, Line 4a-4c Description of program services (Expenses $ 26,925,133 including grants of $ 82,500)(Revenue $ 73,859,132) OTHER PROGRAM SERVICES RELATED TO THE PROVISION OF HEALTHCARE INCLUDE LABORATORY SERVICES, PATIENT FINANCIAL SERVICES, COST OF FACILITIES, MALPRACTICE INSURANCE, AND OTHER SUPPORT SERVICES. Form 990, Part VI, Line 1a PART VI, LINE 1A THE BOARD OF DIRECTORS SHALL APPOINT ANNUALLY FROM ITS MEMBERSHIP AN EXECUTIVE COMMITTEE OF NOT LESS THAN FIVE (5) NOR MORE THAN NINE (9) MEMBERS, OF WHICH THREE (3) MEMBERS SHALL BE THE CHAIRMAN, THE VICE CHAIRMAN, AND THE SECRETARY/TREASURER OF THE HOSPITAL. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS NOT PROHIBITED BY STATUTE OR SECTION 1 OF THE HOSPITAL'S BYLAWS BETWEEN MEETINGS THEREOF. Form 990, Part VI, Line 6 Classes of members or stockholders PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF THE ORGANIZATION IS UCHICAGO MEDICINE NETWORK, INC. ("UCMN"), A RELATED TAX-EXEMPT ORGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, IT HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body DIRECTORS, OTHER THAN THE DIRECTORS EX OFFICIO, SHALL BE ELECTED ANNUALLY BY UCHICAGO MEDICINE NETWORK, INC., OR AT SUCH OTHER TIMES AS MAY BE DETERMINED BY THE SOLE MEMBER OF THE CORPORATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders UCHICAGO MEDICINE NETWORK, INC. SHALL RETAIN THE RIGHT TO REMOVE ANY DIRECTOR, OTHER THAN DIRECTORS EX OFFICIO, WITH OR WITHOUT CAUSE, AT ANY TIME. UCHICAGO MEDICINE NETWORK, INC. MUST APPROVE ANY MODIFICATION OR AMENDMENT TO ANY MISSION STATEMENT, STATEMENT OF GOALS OR VALUES, THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; THE SALE, LEASE, EXCHANGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; AND THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 is prepared internally by the UCMC tax department using information provided by management and reviewed in detail by an independent accounting firm. At its regularly scheduled meeting, the compensation committee of the UCMC Board of Trustees is provided a draft copy of portions of the Form 990. The final complete version of the Form 990 is then distributed to all voting members of the Board of Directors prior to its filing. Form 990, Part VI, Line 12c Conflict of interest policy PURSUANT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, ALL OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES MUST AVOID SITUATIONS IN WHICH THEIR PERSONAL INTERESTS MAY CONFLICT, OR APPEAR TO CONFLICT, WITH THE INTEREST OF INGALLS, AND INGALLS REVIEWS ITS OWN RELATIONSHIPS WITH OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS, AND PAYERS TO DETERMINE IF POTENTIAL CONFLICTS EXISTS. BOARD MEMBERS AND EMPLOYEES SHALL HAVE THE CONTINUING AFFIRMATIVE DUTY TO REPORT TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF INGALLS ANY PERSONAL OWNERSHIP OF INTEREST OR OTHER RELATIONSHIP THAT MIGHT AFFECT THEIR ABILITY TO EXERCISE IMPARTIAL, ETHICAL BUSINESS JUDGMENTS IN THE AREA OF THEIR RESPONSIBILITIES. PER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, BOARD MEMBERS AND EMPLOYEES AT MANAGEMENT LEVEL WILL BE REQUIRED TO COMPLETE A CERTIFICATION AND DISCLOSURE FORM, ON A SCHEDULE DETERMINED BY THE CORPORATE COMPLIANCE OFFICER. COMPLETION OF THIS FORM IS A REQUIREMENT FOR ALL BOARD MEMBERS AND MANAGERIAL EMPLOYEES, AND MAY BE REQUIRED OF NON MANAGEMENT EMPLOYEES AS DETERMINED BY THE PRESIDENT AND CEO AND CORPORATE COMPLIANCE OFFICER. EMPLOYEES ALSO HAVE A DUTY TO REPORT CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST OF WHICH THEY MAY BE AWARE OF INVOLVING OTHER EMPLOYEES. EACH SITUATION REPORTED SHALL BE REVIEWED BY THE PRESIDENT AND CEO, AND INGALL'S CORPORATE COMPLIANCE OFFICER, AND A DETERMINATION SHALL BE MADE AS TO WHETHER A CONFLICT OF INTEREST EXISTS OF MAY ARISE FROM SUCH SITUATION. THE DECISION OF THE PRESIDENT AND CEO AND CORPORATE COMPLIANCE OFFICER REGARDING WHETHER A CONFLICT EXISTS SHALL BE FINAL. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S RESOLUTION OF SUCH CONFLICT. THE ORGANIZATION FURTHER PROMOTES KNOWLEDGE AND UNDERSTANDING OF THE CONFLICT OF INTEREST POLICY IN THE EMPLOYEE HANDBOOK. EACH EMPLOYEE IS REQUIRED TO SIGN AN ACKNOWLEDGEMENT OF THE HANDBOOK UPON EMPLOYMENT. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC) IS RESPONSIBLE FOR DETERMINING AND ADMINISTERING COMPENSATION FOR ALL OFFICERS OF EACH RESPECTIVE ENTITY WITHIN THE UCMC CORPORATE STRUCTURE. ALL COMPENSATION AND BENEFIT APPROVALS ARE MADE (BY UCHICAGO MEDICINE NETWORK, INC. COMPENSATION COMMITTEE, AS EXPLAINED BELOW) AS RECOMMENDATIONS TO THE UCMC COMPENSATION COMMITTEE AND ARE SUBJECT TO FURTHER REVIEW AND APPROVAL BY THE UCMC COMPENSATION COMMITTEE. BELOW IS THE PROCESS USED TO ESTABLISH COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL AND SENIOR EXECUTIVES. THE UCHICAGO MEDICINE NETWORK, INC COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES (THE COMMITTEE) IS RESPONSIBLE FOR THE OVERSIGHT OF THE INGALLS MEMORIAL HOSPITAL EXECUTIVE COMPENSATION DECISION-MAKING PROCESS. ITS REVIEW PROCESS IS DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (UNDER INTERMEDIATE SANCTIONS REGULATIONS) WITH RESPECT TO THE TOTAL COMPENSATION AND BENEFITS PROVIDED. THE COMMITTEE IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, ALL OF WHOM ARE "DISINTERESTED" WITHIN THE MEANING OF THE INTERMEDIATE SANCTIONS REGULATIONS. IT REVIEWS AND APPROVES COMPENSATION AND EMPLOYEE BENEFITS PROVIDED TO THE ORGANIZATION'S PRESIDENT AND KEY EXECUTIVES BY FOLLOWING ITS WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND WRITTEN COMPENSATION REVIEW PROCESS, WHICH INCLUDES SEEKING COUNSEL FROM OUTSIDE PROFESSIONAL ADVISORS AND RELYING IN ADVANCE ON APPROPRIATE COMPARABILITY DATA (FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS) PROVIDED BY AN INDEPENDENT THIRD-PARTY CONSULTANT. THE COMMITTEE REVIEWS AND APPROVES ALL NEW COMPENSATION RANGES, AS WELL AS CURRENT PACKAGES FOR NEWLY HIRED EXECUTIVES, AS NEEDED, BUT AT LEAST ANNUALLY. IT PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. Form 990, Part VI, Line 15b Process to establish compensation of other employees AN INDEPENDENT COMPENSATION CONSULTANT REVIEWS THE REASONABLENESS OF PROPOSED TOTAL DIRECT COMPENSATION FOR EACH EXECUTIVE BY PERFORMING A MARKET COMPARISON FOR EACH EXECUTIVE. THE MARKET COMPARISON INVOLVES COLLECTING SURVEY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILAR HEALTHCARE ORGANIZATIONS. PERFORMANCE GOALS ARE NORMALLY ESTABLISHED BASED ON THE BUDGET/BUSINESS PLAN APPROVED BY THE BOARD FOR THE FISCAL YEAR. THE OUTSIDE CONSULTANT OPINES WHETHER OR NOT PERFORMANCE GOALS HAVE BEEN REACHED BEFORE A FISCAL YEAR END. PAYMENTS ARE PRESENTED TO THE COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL. THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. Form 990, Part VI, Line 19 Required documents available to the public IMH'S BYLAWS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 2f Other Program Service Revenue CAPITATION REVENUE - Total Revenue: 624627, Related or Exempt Function Revenue: 624627, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue All other revenue - Total Revenue: 237184, Related or Exempt Function Revenue: 237184, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Xray equipment and staff lease - Total Revenue: 21063, Related or Exempt Function Revenue: 21063, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Medical Records - Total Revenue: 2152, Related or Exempt Function Revenue: 2152, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; EPIC revenue - Total Revenue: 119093, Related or Exempt Function Revenue: 119093, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Legal Settlement - Total Revenue: 14000, Related or Exempt Function Revenue: 14000, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; ED Revenue - Total Revenue: 51257, Related or Exempt Function Revenue: 51257, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; EMS Revenue - Total Revenue: 129937, Related or Exempt Function Revenue: 129937, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees CONTRACT LABOR - Total Expense: 27507262, Program Service Expense: 22758628, Management and General Expenses: 4748634, Fundraising Expenses: ; MEDICAL AGREEMENTS - Total Expense: 19616533, Program Service Expense: 19616533, Management and General Expenses: , Fundraising Expenses: ; PROGRAM SUPPORT SERVICES - Total Expense: 13048491, Program Service Expense: 13048491, Management and General Expenses: , Fundraising Expenses: ; PROFESSIONAL SERVICES - Total Expense: 3555256, Program Service Expense: 3276799, Management and General Expenses: 278457, Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 3243354, Program Service Expense: 3243354, Management and General Expenses: , Fundraising Expenses: ; PATIENT TRANSPORTATION - Total Expense: 2285852, Program Service Expense: 2285852, Management and General Expenses: , Fundraising Expenses: ; LAUNDRY SERVICES - Total Expense: 1270000, Program Service Expense: 795363, Management and General Expenses: 474637, Fundraising Expenses: ; BILLING FEES - Total Expense: 1054344, Program Service Expense: 85846, Management and General Expenses: 968498, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 289945, Program Service Expense: , Management and General Expenses: 289945, Fundraising Expenses: ; PSA EXPENSE - Total Expense: 22042, Program Service Expense: 6485, Management and General Expenses: 15557, Fundraising Expenses: ; OUTSIDE LAB TESTS - Total Expense: 16395, Program Service Expense: 16395, Management and General Expenses: , Fundraising Expenses: ; RECRUITING FEES - Total Expense: 13893, Program Service Expense: 13893, Management and General Expenses: , Fundraising Expenses: ; PROFESSIONAL SERVICES - ANTONIADES - Total Expense: 6682, Program Service Expense: 3675, Management and General Expenses: 3007, Fundraising Expenses: ; NON-EMPLOYEE SALARY EXPENSE - Total Expense: 2750, Program Service Expense: 2701, Management and General Expenses: 49, Fundraising Expenses: ; RENTAL RECLASS - Total Expense: -9116, Program Service Expense: -9116, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAIR VALUE OF DERIVATIVE INSTRUMENTS - -151886; GAIN/LOSS ON DEBT DEFEASANCE - 5947; TRANSFERS TO/FROM AFFILIATES AND OTHER, NET - -4212528; Total - -4358467; ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 HOSPITAL IL 501(c)(3) 3 ADVENT MIDWEST HEALTH false ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139 363208390 HOSPITAL IL 501(c)(3) 3 ADVENT MIDWEST HEALTH false ADVENTIST HEALTH PARTNERS INC 5101 S WILLOW SPRINGS RD B1013 LA GRANGE IL 60525 364138353 PHYSICIAN PRACTICES IL 501(c)(3) 3 AHS MIDWEST MGMT false ADVENTIST MIDWEST HEALTH 120 N OAK STREET HINSDALE IL 60521 362276984 2 HOSPITALS IL 501(c)(3) 3 NA false AHP SPECIALTY CARE NFP 5101 S WILLOW SPRINGS RD B1013 LA GRANGE IL 60525 811105774 PHYSICIAN PRACTICES IL 501(c)(3) 3 AHS MIDWEST MGMT false AHS MIDWEST MANAGEMENT INC 500 REMINGTON BLVD BOLINGBROOK IL 60440 363354567 PHYSICIAN PRACTICE MANAGEMENT IL 501(c)(3) Type I ADVENT MIDWEST HEALTH false ARCH DEVELOPMENT CORPORATION 5555 S WOODLAWN AVENUE CHICAGO IL 60637 363485244 TECH TRANSFER IL 501(c)(3) Type I UCHICAGO false CHAPIN HALL CENTER FOR CHILDREN 1313 E 60TH STREET CHICAGO IL 60637 362167012 POLICY RESEARCH CENTER IL 501(c)(3) 7 NA false CHICAGO HOME FOR THE INCURABLES 5801 S ELLIS AVENUE CHICAGO IL 60637 362169138 SUPP RESEARCH IL 501(c)(3) Type I UCHICAGO false CHICAGO TUMOR INSTITUTE 5801 S ELLIS AVENUE CHICAGO IL 60637 237136019 SUPP RESEARCH IL 501(c)(3) Type I UCHICAGO false COURT THEATRE FUND 5535 S ELLIS AVENUE CHICAGO IL 60637 363203660 SUPP THE ARTS IL 501(c)(3) Type I UCHICAGO false FERMI FORWARD DISCOVERY GROUP LLC 5801 S ELLIS AVENUE CHICAGO IL 60637 933319101 MANAGEMENT IL 501(c)(3) 7 UCHICAGO false FERMI RESEARCH ALLIANCE LLC PO BOX 500 BATAVIA IL 60510 571239010 MANAGE LAB IL 501(c)(3) 7 NA false HYMEN MILGROM SUPPORTING ORGANIZATION 33 N LASALLE ST SUITE 2131 CHICAGO IL 60602 466789522 SUPP EDUCATION RESEARCH VA 501(c)(3) Type III-O NA false LAKE PARK ASSOCIATES 5801 S ELLIS AVENUE CHICAGO IL 60637 366111317 PROPERTY HOLDING IL 501(c)(2) UCHICAGO false NATIONAL OPINION RESEARCH CENTER 55 E MONROE AVENUE CHICAGO IL 60603 362167808 SO SCI SURVEYS IL 501(c)(3) 7 NA false QUADRANGLE CLUB 5801 S ELLIS AVENUE CHICAGO IL 60637 361655190 SOCIAL CLUB IL 501(c)(7) UCHICAGO false SOUTHEAST CHICAGO COMMISSION 1511 EAST 53RD ST CHICAGO IL 60615 362226282 ECONOMIC DEV IL 501(c)(3) 7 UCHICAGO false THE JOHN CRERAR FOUNDATION 5730 S ELLIS AVENUE CHICAGO IL 60637 363155157 SUPPORT THE LIBRARY IL 501(c)(3) Type III-O NA false THE MARINE BIOLOGICAL LABORATORY 7 MBL STREET WOODS HOLE MA 02543 042104690 RESEARCH AND EDUCATION MA 501(c)(3) 7 UCHICAGO false UCHICAGO MEDICINE NETWORK INC ONE INGALLS DRIVE HARVEY IL 60426 363181170 PROMOTE HEALTHY COMMUNITIES & HEALTHCARE SERVICES IL 501(c)(3) Type I UCMC false UCHICAGO MEDICINE NORTHWEST INDIANA INC 10855 VIRGINIA ST CROWN POINT IN 46307 922355855 HOSPITAL IN 501(c)(3) 3 UCMN false UCHICAGO RESEARCH INTERNATIONAL LTD 5801 S ELLIS AVENUE CHICAGO IL 60637 262741573 RESEARCH IL 501(c)(3) Type I UCHICAGO false UCM HOME CARE ONE INGALLS DRIVE HARVEY IL 60426 363367939 HEALTHCARE IL 501(c)(3) 10 UCMN false UCM MEDICAL GROUP INC 5841 S Maryland Ave CHICAGO IL 60637 474221241 HEALTHCARE IL 501(c)(3) 10 UCMN false UCM MEDICAL GROUP SUB LLC (FKA PRIMARY HEALTHCARE ASSOCIATES SC) 71 W 156TH STREET HARVEY IL 60426 364132865 HEALTHCARE IL 501(c)(3) 10 UCM Med Grp false UCM NETWORK DEVELOPMENT FOUNDATION ONE INGALLS DRIVE HARVEY IL 60426 363189150 SUPPORT IL 501(c)(3) 7 UCMN false UCM NFP COMMUNITY VENTURES ONE INGALLS DRIVE HARVEY IL 60426 363239703 AMBULATORY IL 501(c)(3) Type I UCMN false UCMC TITLE HOLDING CORPORATION 5841 S MARYLAND AVE MC 1086 CHICAGO IL 60637 812126789 TITLE HOLDING IL 501(c)(3) Type I UCMC false UCMC TITLE HOLDING CORPORATION II NFP 5841 S MARYLAND AVE MC 1086 CHICAGO IL 60637 821736040 TITLE HOLDING IL 501(c)(3) Type I UCMC false UNIV OF CHGO BOOTH SCHL OF BUSINESS One Bartholomew Close Barts Square LONDON UK EC1A7BL EDUCATION UK UCHICAGO false UNIV OF CHGO BOOTH SCHL OF BUSINESS 101 PENANG RD SINGAPORE SN 238466 EDUCATION SN UCHICAGO false UNIV OF CHGO FOUNDATION IN HONG KONG LTD RM 100 FAR EAST CTR C/O WM FAN CO HONG KONG HK FUNDRAISING HK UCHICAGO false UNIVERSITY OF CHICAGO 5801 S ELLIS AVENUE CHICAGO IL 60637 362177139 EDUCATION & RESEARCH IL 501(c)(3) 2 NA false UNIVERSITY OF CHICAGO CANCER RESEARCH FOUNDATION 5801 S ELLIS AVENUE CHICAGO IL 60637 366056201 SUPP RESEARCH IL 501(c)(3) Type I UCHICAGO false UNIVERSITY OF CHICAGO CENTER IN PARIS 6 RUE THOMAS MANN PARIS FR 75013 EDUCATION FR UCHICAGO false UNIVERSITY OF CHICAGO CHARTER SCHOOL CORPORATION 5801 S ELLIS AVENUE CHICAGO IL 60637 364225812 EDUCATION IL 501(c)(3) 2 UCHICAGO false UNIVERSITY OF CHICAGO CLOISTERS CLUB 1212 E 59TH STREET CHICAGO IL 60637 SOCIAL CLUB IL UCHICAGO false UNIVERSITY OF CHICAGO MEDICAL CENTER 5841 S MARYLAND AVENUE CHICAGO IL 60637 363488183 HOSPITAL IL 501(c)(3) 3 UCHICAGO false UNIVERSITY OF CHICAGO PROPERTY HOLDING CORPORATION 5801 S ELLIS AVENUE CHICAGO IL 60637 366108743 PROPERTY HOLDING IL 501(c)(2) UCHICAGO false UNIVERSITY OF CHICAGO RETIREE MEDICAL TRUST 5801 S ELLIS AVENUE CHICAGO IL 60637 363999692 MEDICAL TRUST IL 501(c)(3) Type I UCHICAGO 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SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC LIMITED 171 ELGIN AVENUE WILLOW HOUSE CRI PO BOX 10233 GRAND CAYMAN CJ KY11002 981571446 LIAB INSURANCE CJ UCMN C Corporation false INGALLS CASUALTY INSURANCE LTD ONE INGALLS DRIVE HARVEY CJ 980485714 LIAB INSURANCE CJ UCMN C Corporation false INGALLS HEALTH COUNCIL ONE INGALLS DRIVE HARVEY IL 60426 273226539 PURCHASING GROUP IL UCMN C Corporation false INGALLS PROVIDER GROUP ONE INGALLS DRIVE HARVEY IL 60426 363485578 INSURANCE SERVICE IL IMH C Corporation -445818 5808341 1 true KOHINOOR CORE (CAYMAN) FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN CJ KY11104 INVESTMENT CJ UChicago C Corporation false NON-EMPLOYED PHYSICIANS SP A SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC L IMITED 171 ELGIN AVENUE WILLOW HOUSE CRI PO BOX 10233 GRAND CAYMAN CJ KY11002 981571387 LIAB INSURANCE CJ UCMN C Corporation false PENSO FUND PLATFORM SPC - SEG PORT PO BOX 309 UGLAND HOUSE GRAND CAYMAN CJ KY11004 981360251 INVESTMENT CJ UChicago C Corporation false PHOENIX OVERLAY FUND LTD 401 N MICHIGAN AVE C/O INVST OFFIC CHICAGO CJ INVESTMENT CJ UChicago C Corporation false POOLED INCOME FUND (1) 5801 S ELLIS AVENUE CHICAGO IL 60637 POOLED INCO FUND IL UChicago C Corporation false SC CURRICULUM INC 70 WEST MADISON ST CHICAGO IL 60602 SCNC CURRICULUM IL UChicago C Corporation false SP 4 A SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC LIMITED REGATTA OFFICE PARK WEST BAY ROAD PO BOX 10233 GRAND CAYMAN CJ KY11002 LIAB INSURANCE CJ UCMN C Corporation false STANDARD GENERAL OFFSHORE FUND LTD 767 5TH AVE 12TH FLOOR NEW YORK CITY NY 10153 INVESTMENT UChicago C Corporation false TARPON ALL EQUITIES FUND LP MAPLES CORPORATE SERVICES LTD OP UGLAND HOUSE OUTH CHURCH ST GRAND CAYMAN CJ INVESTMENT CJ UChicago C Corporation false TRULEN INSURANCE SPC LIMITED 171 ELGIN AVENUE WILLOW HOUSE CRI PO BOX 10233 GRAND CAYMAN CJ KY11002 LIAB INSURANCE CJ UCMN C Corporation false UCHICAGO (BEIJING) CONSULTING CO LTD UNIT 1-10 CULTURE PL OF REMMIN UNI BEIJING CH CONSULTING CH URI C Corporation false UCHICAGO CENTER IN INDIA PRIVATE LIMITED UNIT 5-10 GRD FL DLF CAPITAL POINT NEW DEHLI IN CONSULTING IN UChicago C Corporation false UCM SERVICES CORPORATION ONE INGALLS DRIVE HARVEY IL 60426 BILLING & MGMT IL UCMN C Corporation false VIEWFORTH EUROPEAN EQUITY FUND LIMITED 190 ELGIN AVENUE GRAND CAYMAN CJ KY19001 INVESTMENT CJ UChicago C Corporation false WHITEOAK AVOLUTION CO-INVESTMENT TRUST LEVEL 1 33 LOFTUS STREET SYDNEY AS NSW2000 INVESTMENT AS UChicago Trust false WHITEOAK IIB TRUST LEVEL 32 200 GEORGE STREET SYDNEY AS NSW,2000 INVESTMENT AS UChicago Trust false false true true false false false false false false false false true true true true true true true true INGALLS PROVIDER GROUP S 624627 FMV Schedule R, Part II Although each of UCMC and Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) and its wholly-owned subsidiary, Adventist Health System/Sunbelt, Inc. (AHSSI), appoint only half of Adventist Midwest Health (AMH's) Board of Directors, and thus neither technically has control over AMH based on the definition of "control" in the Schedule R instructions, the affiliation between UCMC and AMH gives UCMC a significant amount of control over AMH, and therefore AMH and its subsidiaries are being reported on the Schedule R of UCMC. For GAAP reporting, UCMC's consolidated financial statements reflect UCMC's controlling interest in the net assets and operations of AMH. Furthermore, the University of Chicago controls both UCMC (by virtue of being its sole member) and AMH and its subsidiaries (within the meaning of Reg §53.4968-3(b)(2)(iii)). As a result, UCMC and AMH and its subsidiaries are related by reason of both being controlled by the University of Chicago (though the University's control over AMH is within the meaning of Reg §53.4968-3(b)(2)(iii)) rather than the Schedule R instructions).