Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (1)
RML HEALTH PROVIDERS LP |
364113692 | 3 | Yes | Yes | Yes | 20,000 | |||
| Total | 20,000 | ||||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | 11000230 |
| Software Version: | v2011.1.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | RMLHP CORPORATION, AN IRC 501(C)(3) ORGANIZATION, HAS TWO EQUAL MEMBERS, BOTH OF WHOM ARE ALSO IRC 501(C)(3) ORGANIZATIONS: ADVOCATE HEALTH AND HOSPITALS CORPORATION AND LOYOLA UNIVERSITY MEDICAL CENTER. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | EACH MEMBER (ADVOCATE HEALTH AND HOSPITALS CORPORATION AND LOYOLA UNIVERSITY MEDICAL CENTER) ELECTS AND DESIGNATES TWO OF THE FOUR MEMBERS OF RMLHP CORPORATION'S GOVERNING BODY. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | EACH MEMBER (ADVOCATE HEALTH AND HOSPITALS CORPORATION AND LOYOLA UNIVERSITY MEDICAL CENTER) RETAINS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF RMLHP CORPORATION'S BOARD OF DIRECTORS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | UPON COMPLETION OF RMLHP'S FORM 990, IT IS REVIEWED BY MANAGEMENT RESPONSIBLE FOR FILING THE RETURN, A GROUP INCLUDING BUT NOT LIMITED TO THE RMLHP CORPORATION'S PRESIDENT/CEO AND VP FINANCE/CFO. THE RETURN IS THEN PRESENTED BY MANAGEMENT TO RMLHP CORPORATION'S BOARD OF DIRECTORS FOR THEIR REVIEW AT A REGULARLY SCHEDULED BOARD MEETING. AFTER THE BOARD REVIEW, THE RETURN IS THEN FILED WITH THE IRS. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | RMLHP CORPORATION, REQUIRES ALL BOARD MEMBERS AND PERSONS OF LEADERSHIP TO ANNUALLY SIGN A STATEMENT IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THIS STATEMENT THAT SUCH A PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, AND HAS AGREED TO COMPLY WITH THE POLICY. THIS POLICY APPLIES TO ALL BOARD MEMBERS AND SENIOR MANAGEMENT. THE ANNUAL STATEMENTS ARE REVIEWED BY RML HEALTH PROVIDERS, LP'S CHIEF OPERATING OFFICER, WHO IS ALSO THE COMPLIANCE OFFICER. POTENTIAL CONFLICTS OF INTEREST ARE PRESENTED BY THE COMPLIANCE OFFICER TO THE BOARD OF DIRECTORS. AFTER PRESENTATION OF POTENTIAL CONFLICTS, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE TRANSACTION IS DISCUSSED AND VOTED UPON; THE REMAINING BOARD MEMBERS MAKE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. CORRECTIVE OR DISCIPLINARY ACTIONS FOR NON-COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE AT THE DISCRETION OF THE BOARD OF DIRECTORS. |
| PROCESS USED TO ESTABLISH COMPENSATION OF OFFICERS/KEY EMPLOYEES | FORM 990, PART VI, LINE 15 | RMLHP CORPORATION'S OFFICERS ARE PAID BY RML HEALTH PROVIDERS, LIMITED PARTNERSHIP D/B/A RML SPECIALTY HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION. THEREFORE, QUESTIONS 15B AND 15B DO NOT APPLY AND HAVE BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| Average number of hours devoted per week to related organization | Form 990, Part VII, Section A, Column B | PATRICIA CASSIDY - 2 DANIEL POST - 2 DOMINICA TALLARICO - 2 SCOTT POWDER - 2 JAMES R. PRISTER - 40 THOMAS PATER - 40 JAY SIAL - 2 |
| Software ID: | 11000230 |
| Software Version: | v2011.1.0 |