Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
NorthShore University HealthSystem
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1301 Central Street
 
Room/suite
City or town, state or country, and ZIP + 4
Evanston, IL60201
D Employer identification number

36-2167060
E Telephone number

G Gross receipts $ 1,949,963,992
F Name and address of principal officer:
Mark R Neaman
1301 Central Street
Evanston,IL60201
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
northshore.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1891
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: The core mission of NorthShore University HealthSystem is to "preserve and improve human life."
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 25
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 20
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 10,052
6 Total number of volunteers (estimate if necessary) .... 6 2,089
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 26,624,943
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -272,261
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 11,188,035 21,820,514
9 Program service revenue (Part VIII, line 2g) ......... 1,136,217,061 1,259,561,280
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 35,568,079 115,755,104
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 30,629,002 41,581,161
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,213,602,177 1,438,718,059
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 31,956,016 45,548,410
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 507,921,510 574,086,526
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet2,497,078    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 628,153,262 688,995,935
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,168,030,788 1,308,630,871
19 Revenue less expenses. Subtract line 18 from line 12...... 45,571,389 130,087,188
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 2,673,472,097 2,680,646,127
21 Total liabilities (Part X, line 26)............ 1,304,792,510 1,313,904,278
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 1,368,679,587 1,366,741,849
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: See Schedule O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,022,617,587 including grants of $ 38,855,306 ) (Revenue $ 1,239,112,703 )
See Schedule O
4b (Code:   ) (Expenses $ 44,184,996 including grants of $   ) (Revenue $ 10,426,841 )
See Schedule O
4c (Code:   ) (Expenses $ 38,085,223 including grants of $ 6,693,104 ) (Revenue $ 23,783,194 )
See Schedule O
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 1,104,887,806
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
654
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
10,052
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
25
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
20
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JEFF BIESCZAT
1301 CENTRAL STREET
EVANSTON,IL60201
(847) 570-5798
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Leon S Benson
Director
 1.0 X           0 0 0
(2) Percy L Berger Sr
Director
 1.0 X           0 0 0
(3) Michael S Caplan
Director and Clinical Chairman
 27.0 X           302,332 213,483 28,876
(4) Toure S Claiborne
Director
 1.0 X           0 0 0
(5) William L Davis
Director
 1.0 X           0 0 0
(6) Mary Dillon
Director
 1.0 X           0 0 0
(7) Connie K Duckworth
Director
 1.0 X           0 0 0
(8) Laurie C Hochberg
Director
 1.0 X           0 0 0
(9) Ike Hong
Director
 1.0 X           0 0 0
(10) Richard L Keyser
Director
 1.0 X           0 0 0
(11) Janardan D Khandekar
Director and Clinical Chairman
 33.0 X           577,065 365,324 45,476
(12) Lester B Knight III
Director
 1.0 X           0 0 0
(13) Theodore Mazzone
Director and Clinical Chairman
 1.0 X           0 0 0
(14) Samuel M Mencoff
Director
 1.0 X           0 0 0
(15) Andrew J Mills
Director
 1.0 X           0 0 0
(16) M Jude Reyes
Director
 1.0 X           0 0 0
(17) Scott C Schweighauser
Director
 1.0 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Susan B Sentell
Director
 1.0 X           0 0 0
(19) Mark S Talamonti
Director and Clinical Chairman
 29.0 X           599,930 365,534 50,270
(20) J Mikesell Thomas
Director
 1.0 X           0 0 0
(21) John R Walter
Director
 1.0 X           0 0 0
(22) Sona Wang
Director
 1.0 X           0 0 0
(23) Jonathan P Ward
Director
 1.0 X           0 0 0
(24) William J White
Director
 1.0 X           0 0 0
(25) William Wrigley Jr
Director
 1.0 X           0 0 0
(26) Gregory K Jones
Board Chairman
 1.0 X   X       0 0 0
(27) A Steven Crown
Board Vice Chairman
 1.0 X   X       0 0 0
(28) Harry M Jansen Kraemer Jr
Board Past Chairman
 1.0 X   X       0 0 0
(29) Mark R Neaman
President and CEO
 41.0 X   X       1,807,766 0 253,407
(30) Jeffrey H Hillebrand
Board Secretary and COO
 41.0     X       840,953 0 186,660
(31) Gary E Weiss
Board Treasurer and CFO
 41.0     X       527,031 0 108,444
(32) William D Bloomer
Clinical Chairman
 24.0       X     393,030 672,511 52,068
(33) Robert R Edelman
Clinical Chairman
 38.0       X     699,975 276,960 58,214
(34) Bernard G Ewigman
Clinical Chairman
 40.0       X     403,326 0 97,190
(35) Gerald P Gallagher
President, Evanston Hospital
 40.0       X     429,953 0 102,400
(36) Thomas H Hodges
Chief Investment Officer
 36.0       X     652,398 0 36,621
(37) Harry L Jones
Chief Compliance Officer
 40.0       X     337,738 0 43,714
(38) William R Luehrs
Chief Human Resources Officer
 40.0       X     464,660 0 98,818
(39) Demetrius Maraganore
Clinical Chairman
 22.0       X     261,276 261,495 46,809
(40) Frederick E Miller
Clinical Chairman
 34.0       X     299,936 116,179 45,611
(41) Kristen Murtos
President, Skokie Hospital
 40.0       X     382,560 0 100,828
(42) Jesse Peterson Hall
President, Highland Park Hosp.
 40.0       X     465,637 0 110,806
(43) William J Robb III
Clinical Chairman
 40.0       X     575,518 0 22,168
(44) Leopold G Selker
President, Research Institute
 40.0       X     542,404 0 101,679
(45) Nancy Semerdjian
Chief Nursing Officer
 40.0       X     366,898 0 36,377
(46) Richard K Silver
Clinical Chairman
 34.0       X     700,373 235,306 52,127
(47) Douglas M Silverstein
President, Glenbrook Hospital
 40.0       X     522,905 0 144,766
(48) Thomas W Smith
Chief Information Officer
 40.0       X     477,570 0 102,347
(49) Jeffery S Vender
Clinical Chairman
 22.0       X     403,852 612,614 44,678
(50) Thomas A Victor
Clinical Chairman
 33.0       X     363,260 454,117 50,831
(51) Brian Washa
Senior Vice President
 40.0       X     322,809 0 42,604
(52) Kenneth P Anderson
Chief Medical Quality Officer
 40.0         X   447,854 0 44,331
(53) John Merz
Senior Vice President
 40.0         X   281,104 0 37,336
(54) Colleen Mitchell
Former President, Foundation
 40.0         X   387,372 0 36,182
(55) Sean O'Grady
Senior Vice President
 40.0         X   288,137 0 44,958
(56) Steven Smith
Chief Technology Officer
 40.0         X   301,647 0 42,960
(57) David C Holub
Former Clinical Chairman
 32.0           X 141,971 42,824 23,092
(58) Nicholas A Vick
Former Clinical Chairman
 32.0           X 157,000 87,822 36,464
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 15,726,240 3,704,169 2,329,112
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet487
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Aramark Management Services
2300 Warrenville Road
DOWNERS GROVE,IL60515 		Facilities/Diet Mgmt 50,589,939
Pepper Construction Company
643 North Orleans Street
CHICAGO,IL60610 		Construction Mgmt 42,565,644
Power Construction Company
2630 North Palmer Drive
SCHAUMBURG,IL60173 		Construction Mgmt 24,490,615
University of Chicago Medical Ctr
5841 South Maryland Avenue
CHICAGO,IL60637 		Medical Education 12,952,452
McKesson Technologies
5995 Winward Parkway
ALPHARETTA,GA30005 		Info Tech Services 7,647,796
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet282
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a 27,505
b Membership dues....1b 580,606
c Fundraising events....1c 504,077
d Related organizations...1d 9,257,649
e Government grants (contributions)1e 457,543
f All other contributions, gifts, grants, and
similar amounts not included above1f 		10,993,134
g Noncash contributions included in lines 1a-1f:$ 726,465
h Total. Add lines 1a-1f.......MediumBullet 21,820,514
Program Service Revenue Business Code
2a PATIENT REVENUE 621,990 798,136,547 798,136,547    
b MEDICARE AND MEDICAID REVENUE 621,990 417,823,683 417,823,683    
c GRANT INCOME 541,700 4,516,249 4,516,249    
d FEES AND CONTRACTS FROM GOVT AGENCIES 541,700 20,024,789 20,024,789    
e TUITION REVENUE 611,600 942,078 942,078    
f All other program service revenue . 18,117,934     18,117,934
g Total. Add lines 2a–2f........MediumBullet 1,259,561,280
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 30,500,211   -299,437 30,799,648
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 4,118,236  
b Less: rental expenses 10,546,549  
c Rental income or (loss) -6,428,313  
d Net rental income or (loss).......MediumBullet -6,428,313     -6,428,313
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 584,530,330 270
b Less: cost or other basis and sales expenses 493,291,097 5,984,610
c Gain or (loss) 91,239,233 -5,984,340
d Net gain or (loss)..........MediumBullet 85,254,893     85,254,893
8a Gross income from fundraising events (not including
$ 504,077
of contributions reported on line 1c). See Part IV, line 18 ...
a 1,081,713
b Less: direct expenses ...b 905,482
c Net income or (loss) from fundraising events..MediumBullet 176,231   176,231
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 39,019
b Less: direct expenses ...b 18,493
c Net income or (loss) from gaming activities...MediumBullet 20,526     20,526
10a Gross sales of inventory, less
returns and allowances .
a 889,834
b Less: cost of goods sold ..b 499,702
c Net income or (loss) from sales of inventory..MediumBullet 390,132     390,132
Miscellaneous Revenue Business Code
11a OFFSITE PHARMACIES 446,110 7,130,215   7,130,215  
b CAFETERIA 722,210 5,091,131     5,091,131
c LAB REFERENCE TESTING 541,380 18,986,867   18,986,867  
d All other revenue .... 16,214,372 13,761,458 807,298 1,645,616
e Total. Add lines 11a–11d ......MediumBullet 47,422,585
12 Total revenue. See Instructions....MediumBullet 1,438,718,059 1,255,204,804 26,624,943 135,067,798
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 45,278,712 45,278,712
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 113,576 113,576
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 156,122 156,122
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 16,920,914 3,994,600 12,926,314  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 6,805,070 2,826,912 3,978,158  
7 Other salaries and wages 440,733,520 383,341,133 55,677,313 1,715,074
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 25,516,447 19,276,743 6,239,704  
9 Other employee benefits ....... 54,384,885 49,183,828 4,857,689 343,368
10 Payroll taxes ........... 29,725,690 25,459,474 4,160,490 105,726
11 Fees for services (non-employees):        
a Management ...... 80,797,897 69,147,377 11,650,520  
b Legal ......... 4,648,950 94,319 4,554,631  
c Accounting ........... 724,944   724,944  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 16,594,162   16,594,162  
g Other .......... 89,110,417 58,480,998 30,438,185 191,234
12 Advertising and promotion .... 11,390,937 11,370,971   19,966
13 Office expenses ....... 30,748,030 26,656,388 4,027,541 64,101
14 Information technology ...... 2,289,526 1,750,593 538,933  
15 Royalties .. 0      
16 Occupancy ........... 43,732,910 31,340,862 12,392,048  
17 Travel ............ 1,320,019 747,416 553,385 19,218
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 2,175,054 1,328,652 842,962 3,440
20 Interest ........... 8,634,033   8,634,033  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 98,729,395 78,287,907 20,441,488  
23 Insurance .............. 835,902 296,894 539,008  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MEDICAL SUPPLIES 220,928,896 220,684,800 244,096  
b BAD DEBTS 47,693,494 47,693,494    
c MEDICAID TAX 24,827,624 24,827,624    
d DUES AND SUBSCRIPTIONS 2,257,314 997,656 1,224,707 34,951
e SALES TAX 378,606 378,606    
f All other expenses 1,177,825 1,172,149 5,676  
25 Total functional expenses. Add lines 1 through 24f 1,308,630,871 1,104,887,806 201,245,987 2,497,078
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 3,800,843 1 25,844,974
2 Savings and temporary cash investments ....... 51,061,808 2 16,382,627
3 Pledges and grants receivable, net ......... 8,164,470 3 10,868,057
4 Accounts receivable, net ......... 166,839,183 4 172,338,299
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 18,050,162 8 18,527,025
9 Prepaid expenses and deferred charges ............ 8,405,724 9 6,308,512
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,742,710,548
b Less: accumulated depreciation. ..... 10b 852,316,732 840,429,827 10c 890,393,816
11 Investments—publicly traded securities .......... 998,580,888 11 927,770,166
12 Investments—other securities. See Part IV, line 11 ...... 375,818,862 12 443,144,648
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 82,330,008 14 93,237,674
15 Other assets. See Part IV, line 11 ........... 119,990,322 15 75,830,329
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,673,472,097 16 2,680,646,127
Liabilities 17 Accounts payable and accrued expenses . 154,807,221 17 157,448,974
18 Grants payable ..........   18  
19 Deferred revenue .......... 5,447,827 19 4,892,711
20 Tax-exempt bond liabilities .......... 394,054,608 20 385,411,480
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 750,482,854 25 766,151,113
26 Total liabilities. Add lines 17 through 25..... 1,304,792,510 26 1,313,904,278
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 1,213,731,105 27 1,211,767,856
28 Temporarily restricted net assets ..... 85,601,765 28 83,854,902
29 Permanently restricted net assets ..... 69,346,717 29 71,119,091
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 1,368,679,587 33 1,366,741,849
34 Total liabilities and net assets/fund balances ..... 2,673,472,097 34 2,680,646,127
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
1,438,718,059
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
1,308,630,871
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
130,087,188
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
1,368,679,587
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-132,024,926
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
1,366,741,849
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(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
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
NorthShore University HealthSystem
  		Employer identification number

36-2167060
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
NorthShore University HealthSystem
  		Employer identification number

36-2167060
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
NorthShore University HealthSystem
  		Employer identification number

36-2167060
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
77,907
j
Total. lines 1c through 1i ...................................
77,907
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Lobbying Activities Part II-B Line 1i NorthShore University HealthSystem (NorthShore) and its employees are members of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by NorthShore to these organizations are attributable to lobbying activities.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 103,298,573 42,760,422 41,297,746
b Contributions ........ 1,772,373 57,871,694 2,467,038
c Investment earnings or losses ... 5,671,678 3,630,113 -331,934
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		6,980,630 963,656 672,428
f Administrative expenses ....      
g End of year balance ...... 103,761,994 103,298,573 42,760,422
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   56,783,859 56,783,859
b Buildings ................   1,091,497,454 497,871,797 593,625,657
c Leasehold improvements ............   40,212,325 17,980,280 22,232,045
d Equipment ................   459,075,536 326,571,727 132,503,809
e Other .................   95,141,374 9,892,928 85,248,446
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 890,393,816
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) HEDGE FUNDS 		325,698,288 C

(B) PRIVATE EQUITY FUNDS 		75,005,294 C

(C) PRIVATE EQUITY FUNDS 		19,906,128 F

(D) REAL ASSET FUND 		21,039,669 F

(E) OTHER INVESTMENTS 		1,495,269 F




Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 443,144,648
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
RESERVE FOR MALPRACTICE LOSSES 278,080,000
DEFERRED COMPENSATION 186,626,547
DUE TO AFFILIATES 223,397,533
DUE TO THIRD PARTIES 60,010,308
CURRENT MATURITY OF LT DEBT 8,555,000
ASSET RETIREMENT OBLIGATION 9,393,597
CURRENT BOND PAYABLE PREMIUM 88,128


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 766,151,113
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 1,438,718,059
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 1,308,630,871
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 130,087,188
4 Net unrealized gains (losses) on investments .......................... 4 -79,596,689
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -1,345,034
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -80,941,723
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 49,145,465
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 1,317,317,451
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -79,596,689
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 36,624,804
e Add lines 2a through 2d ..................... 2e -42,971,885
3 Subtract line 2e from line 1..................... 3 1,360,289,336
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 17,264,779
b Other (Describe in Part XIV): ........... 4b 61,163,944
c Add lines 4a and 4b....................... 4c 78,428,723
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 1,438,718,059
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 1,268,171,986
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 17,954,566
e Add lines 2a through 2d...................... 2e 17,954,566
3 Subtract line 2e from line 1..................... 3 1,250,217,420
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 17,264,779
b Other (Describe in Part XIV): ............ 4b 41,148,672
c Add lines 4a and 4b....................... 4c 58,413,451
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 1,308,630,871
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Endowment Funds Part V Line 4 Endowment fund earnings are available for healthcare services, including capital acquisition and maintenance, operations, free care, research, and education.
FIN 48 (ASC 740) Footnote Part X NorthShore and its related affiliates, except for NorthShore University HealthSystem Medical Group, Inc. (MG), known as NorthShore Exempt Group, have been determined to qualify as a tax-exempt organization under 501(c)(3) of the Internal Revenue Code (IRC). Most of the income received by NorthShore Exempt Group is exempt from taxation under 501(a) of the IRC, as income related to the mission of the organization. Accordingly, there is no material provision for income tax for these entities. Some of the income received by exempt entities is subject to taxation as unrelated business income. NorthShore and its subsidiaries file federal income tax returns and returns for various states in the U.S. ASC 740-10, Income Taxes, requires that realization of an uncertain income tax position is more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it can be recognized in the financial statements. Furthermore, this interpretation prescribes the benefit to be recorded in the financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the periods ended September 30, 2011 or 2010. NorthShore currently has a net operating loss carryforward of $13,319,425, which generated assets of $5,360,964. MG currently has a net operating loss carryforward of $712,280, which generated assets of $284,912. These assets are 100% offset by valuation allowances.
Change in Net Assets Part XI Line 8 Amount represents changes in restricted net assets.
Reconciliation of Revenues Part XII Lines 2d and 4b Line 2d - Amount represents expenses deducted from revenues in Form 990 Part VIII and changes in restricted net assets. Line 4b - Amount represents transfers to related organzations, Foundation administrative expenses, and investment expenses moved to Form 990 Part IX, and changes in restricted net assets.
Reconciliation of Expenses Part XIII Lines 2d and 4b Line 2d - Amount represents expenses deducted from revenues in Form 990 Part VIII. Line 4b - Amount represents transfers to related organzations, Foundation administrative expenses, and investment expenses moved to Form 990 Part IX.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean     Insurance   5,041,729
Central America and the Caribbean     Investments   248,217,089
Central America and the Caribbean     Program Services Medical Conferences 3,645
Central America and the Caribbean     Program Services Medical Services 4,662
East Asia and the Pacific     Program Services Medical Conferences 15,830
East Asia and the Pacific     Program Services Medical Supply/Svcs 2,550
Europe (Including Iceland and Greenland)     Insurance   12,100
Europe (Including Iceland and Greenland)     Program Services Medical Conferences 44,672
Europe (Including Iceland and Greenland)     Program Services Medical Supply/Svcs 986
Middle East and North Africa     Program Services Medical Conferences 1,065
North America     Program Services Medical Conferences 38,307
North America     Program Services Medical Supply/Svcs 253,227
South America     Program Services Medical Conferences 11,948
South America     Program Services Medical Services 1,000
South Asia     Program Services Medical Conferences 5,206
South Asia     Program Services Medical Services 2,000
Sub-Saharan Africa     Program Services Medical Services 3,000
3a Sub-total .....     253,659,016
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     253,659,016
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
East Asia/Pacific   70,166 Check      
Europe/Iceland/Greenland   42,566 Check      
Europe/Iceland/Greenland   25,864 Check      
Europe/Iceland/Greenland   17,526 Check      
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
0
3
Enter total number of other organizations or entities ........................MediumBullet
4
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
Grant and Assistance Procedures Part I Line 2 NorthShore University HealthSystem (NorthShore) provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore also meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

June Gala
(event type) 		(b) Event #2

Craft Expo
(event type) 		(c) Other Events

7
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 613,067 603,152 369,571 1,585,790
2 Less: Charitable
contributions . . . 		280,017 103,201 120,859 504,077
3 Gross income (line 1
minus line 2) . . . 		333,050 499,951 248,712 1,081,713
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . . 45,487 78,313 58,300 182,100
7 Food and beverages . . 87,822 66,587 6,060 160,469
8 Entertainment . . . 15,868     15,868
9 Other direct expenses . 72,115 191,097 283,833 547,045
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 905,482
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 176,231
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .     39,019 39,019
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .     18,493 18,493
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
100.000 %
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow 18,493
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow 20,526
9
Enter the state(s) in which the organization operates gaming activities: IL
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
100.000 %
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
NorthShore University HealthSystem
Address right arrow
1301 Central Street
Evanston,IL60201
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Deborah Waldeck
Gaming manager compensation right arrow $ 0
Description of services provided right arrow
Oversees auxiliary operations including raffle.
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    21,310,776 0 21,310,776 1.710 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    94,927,099 75,641,045 19,286,054 1.540 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     0 0 0 0 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    116,237,875 75,641,045 40,596,830 3.250 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,836,227 0 1,836,227 0.150 %
f Health professions education
(from Worksheet 5) .. 		    44,184,996 10,426,841 33,758,155 2.700 %
g Subsidized health services
(from Worksheet 6) .. 		    54,661,357 34,363,769 20,297,588 1.620 %
h Research (from Worksheet 7)     34,864,194 0 34,864,194 2.790 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    590,418 0 590,418 0.050 %
jTotal Other Benefits ...     136,137,192 44,790,610 91,346,582 7.310 %
kTotal. Add lines 7d and 7j. ..     252,375,067 120,431,655 131,943,412 10.560 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     10,407 0 10,407 0 %
2 Economic development     0 0 0 0 %
3 Community support     7,356 0 7,356 0 %
4 Environmental improvements     2,207 0 2,207 0 %
5 Leadership development and training for community members     223 0 223 0 %
6 Coalition building     3,488 0 3,488 0 %
7 Community health improvement advocacy     29,360 0 29,360 0 %
8 Workforce development     279 0 279 0 %
9 Other            
10 Total     53,320 0 53,320 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
13,330,900
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
349,025,164
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
404,992,415
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-55,967,251
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1HPMOB LP
  		Medical Office Building 29.620 % 0 % 70.380 %
2Ravine Way LLC
  		Orthopaedic Surgery Center 30.000 % 0 % 70.000 %
3NorthShoreUSP LLC
  		General Surgery Centers 49.900 % 0 % 50.100 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?4
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Evanston Hospital
2650 Ridge Avenue
Evanston,IL60201 		X X   X   X X    
2 Glenbrook Hospital
2100 Pfingsten Road
Glenview,IL60026 		X X   X   X X    
3 Highland Park Hospital
777 Park Avenue West
Highland Park,IL60035 		X X   X   X X    
4 Skokie Hospital
9600 Gross Point Road
Skokie,IL60076 		X X   X   X X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Evanston Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Glenbrook Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Highland Park Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Skokie Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?34
Name and address Type of Facility (Describe)
1 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
2 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
3 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
4 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
5 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
6 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
7 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
8 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
9 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
10 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
11 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
12 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
13 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
14 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
15 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
16 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
17 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
18 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
19 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
20 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
21 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
22 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
23 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
24 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
25 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
26 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
27 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
28 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
29 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
30 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
31 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
32 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
33 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
34 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
Percent of Total Expense Part I Line 7 column (f) The amount of bad debt expense that was included in Form 990, Part IX, line 25, column (A) but removed from the figure in Part I, Line 7, column (f) was $47,693,494.
Costing Methodology Part I Line 7 NorthShore University HealthSystem calculated the cost of charity care and means-tested government programs using the cost-to-charge ratio derived from Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges. Amounts in the other benefits section of Line 7 were calculated using costs charged directly to the individual programs from the financial accounting system. An indirect cost allocation factor for hospital shared services was also calculated and included for each program indicated in other benefits.
Community Building Activities Part II NorthShore University HealthSystem (NorthShore) is involved in numerous community building activities which promote the health of the communities it serves. NorthShore encourages its employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities served.
Bad Debt Expense Part III Line 4 Accounts Receivable Financial Statement Footnote - The Corporation evaluates the collectibility of its accounts receivable based on the length of time the receivable is outstanding, payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible. Bad debt expense at cost was calculated using a cost-to-charge methodology. The Ratio of Patient Care cost to charges calculated to report charity care on Part I, Line 7a was multiplied by the bad debt expense to determine the bad debt expense at cost. Discounts and payments on patient accounts are excluded from bad debt expense in order to reflect the expected amount to be paid.
Medicare Shortfall Part III Line 8 NorthShore University HealthSystem (NorthShore) believes that all of the $55,967,251 shortfall should be considered as community benefit. The Internal Revenue Service Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by NorthShore in order to continue treating the elderly in our community. During fiscal year 2011, Medicare accounted for approximately 42% of hospital gross patient revenues. The hospital provides care regardless of this shortfall and thereby relieves the government of the burden of paying the full cost of care for Medicare beneficiaries.
Collection Practices Part III Line 9b NorthShore University HealthSystem (NorthShore) follows the Illinois Fair Patient Billing Act. The collection policy is the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off. Any remaining balance would be collected under the existing debt collection policy.
Number of Other Facilities Part V In addition to the four hospital facilities, NorthShore University HealthSystem (NorthShore) operates 24 outpatient clinics, four outpatient pharmacies, one therapeutic day school, and five ambulatory surgery centers.
Needs Assessment Part VI Line 2 NorthShore University HealthSystem (NorthShore) consistently assesses the needs of its communities and those of the underserved to ensure that its community benefits programs are in alignment with the health needs of the communities it serves. In addition to collecting and analyzing available quantitative and qualitative data on mortality, disease incidence, utilization of and access to health care services, NorthShore established a mechanism in which to actively seek the involvement of our community and public health leaders in an ongoing manner to ensure that our analysis reflects the current public health needs in our area. Community Needs Assessment Methodology - In order to produce a comprehensive health assessment, NorthShore utilized a range of available data sources. Public health statistics on mortality, maternal, infant, and child health, emotional well-being and access to care were obtained from the Illinois Department of Public Health website. The most recent data available is from 2006. As public health data often lags by several years, and is only available at the state, Metropolitan Statistical Area, or county level, NorthShore also identified sources of zip-code level estimates of disease incidence metrics and socioeconomic status. This data assisted in understanding local levels of need and variation across our specific service area. (The zip-code level metrics included data from Thomson/Reuters from 2008, a health care information company, which creates estimates based on Census data, Medicare and third party insurance claims, and a nationally-representative household survey that includes self-reported health status, health care utilization, and self-report diagnoses.) NorthShore also identified zip-code level rates of preventable hospitalizations based on Agency for Healthcare Research and Quality (AHRQ) definitions. Preventable hospitalizations served as an indicator of the quality and depth of the outpatient management of chronic diseases, such as hypertension, high cholesterol, diabetes and obesity. The causes that trigger hospitalization were identified using the Illinois Hospital Associations COMPData database. Based on the compilation of these sources, NorthShore found that mortality and non-obstetric hospitalizations are driven predominantly by heart disease, cancer, stroke, pneumonia, diabetes and psychiatric conditions. Areas of greatest socioeconomic need within NorthShore's service area are concentrated in northern Lake County and the North Chicago neighborhoods. NorthShore also identified differences across the service area in the self-reported health status and diagnosis of disease, and compared overall rates to Healthy Goals 2010 (where applicable). Community Involvement - NorthShore utilizes multiple mechanisms for seeking out the collective voice of the community in understanding the unmet health needs. For example, each NorthShore hospital has a community advisory committee that includes a range of community leaders. These leaders represent local public health agencies, non-profit organizations serving low-income residents, faith based groups, and business and civic leaders. They advise each hospital and NorthShore on services or initiatives from a community perspective and provide strategic recommendations for community benefits programs. NorthShore's key senior administrators as well as its community relations staff maintain strong working relationships with local leaders, public health agencies, township officials and social service agencies not represented in the community advisory committee. In their role as community liaison, the community relations personnel serve as point of contact for NorthShore's involvement with community requests. In addition, community relations personnel coordinate the hospital presidents' role in NorthShore advocacy programs. Senior administrators at NorthShore also participate regularly in outreach to local leaders. NorthShore physicians and staff play an equally important role in identifying health trends and needs through their leadership, board participation and involvement in local, regional and national organizations. Information related to the health assessments and findings are communicated at the department level to NorthShore leadership. NorthShore will continue to track both quantitative and qualitative sources of public health information as it becomes available, as well as feedback from community leaders. Community health needs data is used in our annual strategic planning processes. Stakeholder participation is critical and greatly influences NorthShore's prioritization and execution of its community benefits programs. In addition, collaboration with local leadership allows NorthShore to detect urgent and growing needs that may be underrepresented or absent from aggregate data, in a timely and effective manner. Lastly, collaboration with local leaders has facilitated the development of signature programs, such as Be Well-Lake County and real time solutions to critical health challenges. Strategic Approach for Meeting Community Health Needs - NorthShore implements a three-fold strategy to address the health needs of the communities that it serves as follows: 1) Community benefits programs, signature initiatives and partnerships will address a need identified in the community health needs assessment conducted by NorthShore, 2) Community benefits programs, initiatives and partnerships will address a need identified by the community, 3) Community benefits programs, initiatives and partnerships will be aligned with the guiding principles outlined in Advancing the State of the Art of Community Benefits for Nonprofit Hospitals. The guiding principles are: disproportionate unmet health-related needs; primary prevention; seamless continuum of care; build community capacity; and community collaboration. All of NorthShore's community benefits programs, initiatives and partnerships are documented in a report that provides the date(s), describes the initiative, identifies assessed need(s) met, highlights outcomes and identifies guiding principles met. NorthShore will continue to place priority on providing community benefits and services in the communities located nearest to our hospitals, where we believe we have the greatest capacity and responsibility to serve. NorthShore conducted its most recent assessment in 2010, and therefore, will complete its next assessment in 2013.
Patient Education of Eligibility for Assistance Part VI Line 3 NorthShore informs and educates potentially impacted patients of the Financial Assistance program by posting signage (both English and Spanish) in all the facilities' Emergency Departments and at our Central Registration areas. The NorthShore Patient Handbook is also presented to patients upon admission and it describes the Financial Assistance program that includes Charity Care. NorthShore also has approximately 13 full time financial counselors and 22 customer service agents working in the hospitals and clinics, and they are responsible for coordinating financial assistance and eligibility. Any uninsured patient admitted into the hospital will have their case reviewed by a financial counselor. NorthShore billing statements also indicate the Financial Assistance program and necessary contact information. NorthShore's physician offices and collection agencies are also instructed to coordinate charity care to potentially eligible patients. The NorthShore website is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible will have their case reviewed by a financial counselor or by calling the Customer Service department.
Community Information Part VI Line 4 NorthShore University HealthSystem (NorthShore) has four hospital facilities located in the northern suburbs of Chicago, Illinois. The NorthShore service area has a total population size of approximately 1.6 million*. The average household income is approximately $109,000*. During fiscal year 2011, approximately 5% of NorthShore's patients had no insurance and 7% qualified for Medicaid. Within NorthShore's service area, there are three federally-designated medically underserved areas. NorthShore's service area also includes five other hospitals. *Source: US Census via Thomson Reuters Market Planner Plus
Promotion of Community Health Part VI Line 5 NorthShore University HealthSystem (NorthShore) does extend medical staff privileges to all qualified physicians in the NorthShore community. NorthShore also uses surplus funds to add new buildings and renovate existing facilities to better serve patients and the community. Additional programs conducted by NorthShore to help promote the health of the community include: Residency and Education Programs - NorthShore is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2011, a total of 189 residents and 19 fellows participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (1st Year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Female Pelvic Medicine and Reconstructive Surgery, Magnetic Resonance Imaging, Musculoskeletal Imaging, Emergency Medicine Simulation, Surgical Pathology, and Endocrine Surgery. The affiliate-based residency program areas included: Anesthesiology, Dermatology, Emergency Medicine, Obstetrics and Gynecology, Orthopaedic Surgery, Pediatrics, Psychiatry, Radiology, General Surgery, Neurology, Neurosurgery, Ophthalmology, Otolaryngology, Plastic Surgery, Podiatry, and Urology. The affiliate-based fellowship program areas included: Body Contouring Plastic Surgery, Cardiology, Child Neurology, Child Psychiatry, Electrophysiology, Gastroenterology, Infectious Diseases Research, Maternal-Fetal Medicine, Neonatal-Perinatal Medicine, Palliative Medicine, Surgical Oncology, and Urology. The NorthShore School of Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year 2011, 66 students participated in the program. NorthShore also provided clinical training and internships for 1,694 students in various departments including Social Work, Nursing, Physical Therapy, and Speech Therapy during the 2011 academic year. These internships were conducted through collaborative relationships with several educational institutions including Chamberlain College, College of Lake County, DePaul University, Harper College, Loyola University Chicago, Midwestern University, North Park University, Northern Illinois University, Northwestern University, Oakton Community College, Rosalind Franklin University, Rush University, University of Chicago, University of Illinois, University of Illinois at Chicago, University of Iowa, and University of Minnesota. Community Advisory Committees - The Community Advisory Committees' (CAC) role is to advise hospital administration on services and initiatives from a community perspective. CACs are structured to ensure NorthShore's accountability to the community by working to fulfill our community relations vision that the more NorthShore and the community connect, the stronger and healthier both will become. The CACs are comprised of primarily community members, along with hospital administrative and professional staff. NorthShore strives for diverse membership to include business, faith community, social services, civic organizations, government officials, elected officials, interested citizens, former patients, and healthcare professionals. The role of the CACs is to serve as an advocate for the greater good of the community and its health, and to provide recommendations for annual community benefit planning. The CACs also help identify opportunities for partnerships between the hospitals and community organizations, and they identify gaps in healthcare services within the community. Be Well Lake County - Be Well Lake County is a collaboration between NorthShore, Lake County Health Department and Community Health Center, and supporting community partners. The program's goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. Evanston Hospital Outpatient Clinic - The Outpatient Clinic at Evanston Hospital provides medical care to adults and children who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In fiscal year 2011, the clinic treated 4,659 adult patients at 12,789 visits and 2,711 adolescent patients at 6,869 visits. Dental Center - The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided free and discounted care for 3,081 patients at a cost of $208,814 during fiscal year 2011. Evanston Township High School Health Center - Established as a collaborative partnership with Evanston Township High School, the Evanston Health Department, and NorthShore, the Health Center is a free school-based health clinic for the school's approximately 3,000 students. The Health Center is staffed by NorthShore employees, including a physician, two part-time nurse practitioners, and a social worker. During the 2010-2011 school year, 713 students utilized the Health Center at 2,204 visits at a cost of $545,643. Medication Assistance Program - NorthShore's Medication Assistance Program helps patients with the cost of paying for prescription drugs. The Medication Assistance Program assisted 2,274 patients in filling 30,501 prescriptions at a cost of $797,222 during fiscal year 2011. Home Health and Hospice Services - NorthShore provides intermittent care including skilled nursing, physical therapy, occupational therapy, speech therapy, infusion therapy, and home health aides. Home and Hospice also provides hospice and palliative care services to NorthShore patients and their families. During fiscal year 2011, there were 66,486 patient visits and 5,118 admissions. Perinatal Depression Program - The Perinatal Depression Program identifies women who are suffering from perinatal depression and offer referrals for women who many need additional support. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. The hotline provides multilingual interpretation services to assist those with limited or no English-speaking ability. All services are provided free of charge. In fiscal year 2011, NorthShore physicians conducted 6,102 screenings to identify at-risk patients, and the hotline received 696 calls. Free psychological support and referrals were provided for 516 women identified through the screenings as at-risk for perinatal mood disorders. Community Action for Child Health Equity - NorthShore's Community Action for Child Health Equity (CACHE) is one of five national sites for a National Institutes of Health funded study focused on maternal stress and the corresponding effect on birth outcomes and child health, growth, and development. The overall goal of the study is to gain information that will ultimately lead to the elimination of disparities in maternal health and child development. CACHE has pushed the study to offer immediate community benefit by developing a pioneering parallel system that provides outreach efforts to interview subjects in real time when important health interventions are needed. Employee Volunteerism - NorthShore employees participate in various volunteer activities that meet community needs and promote good will. Several NorthShore publications include information about volunteer organizations and employee volunteer opportunities. NorthShore recognizes employee volunteers through the Sharing Spirit Volunteer Award.
Affiliated Health Care System Part VI Line 6 NorthShore University HealthSystem (NorthShore) is a comprehensive, fully integrated, healthcare delivery system that includes four hospitals, as well as numerous outpatient departments and clinics. In additional to the hospital organization, there are the following affiliates that help to meet the needs of the community: NorthShore University HealthSystem Foundation - The NorthShore University HealthSystem Foundation (Foundation) seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of high-quality services and giving opportunities. NorthShore University HealthSystem Research Institute - The NorthShore University HealthSystem Research Institute (Research Institute) was organized to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute now houses nearly 200 externally funded research faculty who currently occupy over 100,000 net square feet of research space and work on nearly 1,000 active research protocols. Total external funding is now over $100 million. Funding from the NIH places the hospitals of NorthShore among the top 10 comprehensive independent research hospitals in the country. In addition, NorthShore has made a substantial commitment to develop a new Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure will enable large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work will build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research. NorthShore University HealthSystem Faculty Practice Associates - The NorthShore University HealthSystem Faculty Practice Associates (FPA) represents more than 700 physicians with over 80 offices in virtually every specialty all on staff at the hospitals of NorthShore. The primary function and activity of FPA is to employ, supervise, and conduct employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The FPA physicians also conduct medical education activities for the NorthShore interns and residents, and FPA also performs medical research on behalf of NorthShore. Radiation Medicine Institute - The Radiation Medicine Institute (RMI) employs, supervises, and conducts employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. RMI also conducts medical education activities for the NorthShore interns and residents, and RMI also performs medical research on behalf of NorthShore.
STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number
36-2167060
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) American Brain Tumor Association8550 W Bryn Mawr Ave
Chicago,IL60631 		23-7286648 501(c)(3) 8,300       General Support
(2) American Cancer Society820 Davis Street
Evanston,IL60201 		36-2167721 501(c)(3) 27,550       Relay for Life Sponsorship
(3) American Heart Association208 South LaSalle Street
Chicago,IL60604 		36-0900700 501(c)(3) 20,000       Heart Walk Sponsorship
(4) American Red Cross of Greater Chicago2200 West Harrison Street
Chicago,IL60612 		53-0196605 501(c)(3) 25,000       Japan Relief Fund
(5) Cancer Wellness Center215 Revere Dr
Northbrook,IL60062 		36-3604463 501(c)(3) 15,000       Community Contribution
(6) City of Evanston2100 Ridge Ave
Evanston,IL60201 		36-6005870 115 6,500       Community Contribution
(7) Council for Jewish Elderly3003 W Touhy Ave
Chicago,IL60645 		36-2727597 501(c)(3)   5,700 FMV Office Space Community Contribution
(8) Connections for the Homeless2010 Dewey Ave
Evanton,IL60201 		36-3346917 501(c)(3) 10,000       Community Contribution
(9) Evanston Chamber of Commerce1840 Oak Ave
Evanston,IL60201 		36-1051450 501(c)(6) 9,155       Community Contribution
(10) Greater Chicago Food Depository4100 West Ann Lurie Place
Chicago,IL60632 		36-2971864 501(c)(3) 10,000       Community Contribution
(11) Glenview Police Department Social Services Fund2500 E Lake Ave
Glenview,IL60026 		36-6005905 115 10,000       Community Contribution
(12) Highland Park Chamber of Commerce508 Central Ave
Highland Park,IL60035 		36-1217360 501(c)(6) 6,600       Community Contribution
(13) Illinois Hospital Research and Edu Fndn24676 Network Place
Chicago,IL60673 		23-7421930 501(c)(3) 46,403       Hospital Mutual Assistance Program
(14) The Josselyn Center NFP405 Central Ave
Northfield,IL60093 		36-2217996 501(c)(3) 8,000       Community Contribution
(15) Lake County Health Department3010 Grand Avenue
Waukegan,IL60085 		36-6006600 115 170,000       Be Well Lake County Program
(16) Lake County Partners for Economic Develop28055 Ashley Circle
Libertyville,IL60048 		36-4206288 501(c)(3) 10,000       Community Economic Development
(17) Lake Forest High School Booster Club1285 N McKinley Rd
Lake Forest,IL60045 		36-3903280 501(c)(3) 7,500       Community Contribution
(18) Niles Township5255 Main St
Skokie,IL60077 		36-2438196 115 10,000       Community Contribution
(19) North Shore Senior Center161 Northfield Road
Northfield,IL60093 		36-2366074 501(c)(3) 6,190       Community Contribution
(20) Northern Illinois Food Bank600 Industrial Dr
St Charles,IL60174 		36-3203648 501(c)(3) 10,000       Community Contribution
(21) Turning Point Behavioral Health Care Center8324 Skokie Blvd
Skokie,IL60077 		36-2327294 501(c)(3) 10,000       Community Contribution
(22) NorthShore Faculty Practice Associates1301 Central Street
Evanston,IL60201 		36-3738206 501(c)(3) 37,636,597       General Support
(23) Atlantic Health SystemPO BOX 48328
Newark,NJ07101 		52-1958352 501(c)(3) 16,800       Research
(24) The Brigham and Women's Hospital Inc75 Francis St
Boston,MA02115 		04-2312909 501(c)(3) 73,870       Research
(25) Cepheid Inc904 Caribbean Dr
Sunnyvale,CA94089 		77-0441625   367,180       Research
(26) Delve LLC11971 Westline Ind DR
St Louis,MO63143 		20-0684635   1,050,000       Research
(27) FACITtrans381 S Cottage Hill Ave
Elmhurst,IL60126 		27-0945200   111,100       Research
(28) George Washington University801 22nd St NW
Washington,DC20052 		53-0196584 501(c)(3) 10,831       Research
(29) Indiana Institute for Medical Research1481 W 10th St
Indianapolis,IN46202 		35-1781809 501(c)(3) 14,196       Research
(30) Kessler Foundation300 Executive Dr
West Orange,NJ07052 		31-1562134 501(c)(3) 35,333       Research
(31) KUMC Research InstitutePO Box 801708
Kansas City,MO64180 		48-1108830 501(c)(3) 27,799       Research
(32) Mayo Clinic200 First St SW
Rochester,MN55905 		41-6011702 501(c)(3) 311,616       Research
(33) THE Medical College Of Wisconsin Inc8701 Watertown Plank Rd
Milwaukee,WI53226 		39-0806261 501(c)(3) 65,807       Research
(34) Monell Chemical Senses Center3500 Market St
Philadelphia,PA19104 		23-2020897 501(c)(3) 182,492       Research
(35) Northwestern University633 Clark St
Evanston,IL60208 		36-2167817 501(c)(3) 2,304,625       Research
(36) Oregon Health and Science University2525 SW First Avenue
Portland,OR97201 		93-1176109 501(c)(3) 82,476       Research
(37) Rehabilitation Institute Of Chicago345 E Superior St
Chicago,IL60611 		36-2256036 501(c)(3) 16,694       Research
(38) Rutgers3 Rutgers Plaza
New Brunswick,NJ08901 		22-6001086 115 29,087       Research
(39) Southwest Foundation for Biomedical ResPO Box 760549
San Antonio,TX78245 		74-1109630 501(c)(3) 30,156       Research
(40) Stanford UniversityPO Box 44436
San Francisco,CA94144 		94-1156365 501(c)(3) 32,118       Research
(41) Temple University1803 N Broad St
Philadelphia,PA19122 		23-1365971 501(c)(3) 16,058       Research
(42) Texas Biomedical Research InstitutePO Box 760549
San Antonio,TX78245 		74-1109630 501(c)(3) 27,087       Research
(43) The Regents of UC1200 Dutton Hall
Davis,CA95616 		94-6036493 115 105,691       Research
(44) True North DistributingPO Box 251
Ponte Vedra Beach,FL32004 		26-3474864   777,986       Research
(45) Trustees Of Boston University25 Buick Street
Boston,MA02215 		36-3648026 501(c)(3) 35,150       Research
(46) University of Chicago5801 S Ellis Ave
Chicago,IL60637 		36-2177139 501(c)(3) 390,799       Research
(47) University Of Chicago-Opinion Res Center55 East Monroe St
Chicago,IL60603 		36-2167808 501(c)(3) 5,554       Research
(48) University of Illinois506 S Wright
Urbana,IL61801 		37-6000511 115 30,429       Research
(49) University of MinnesotaEducation Suite 190
Minneapolis,MN55455 		41-6007513 115 124,763       Research
(50) University of Pittsburgh580 South Aiken Avenue
Pittsburgh,PA15232 		25-0965591 501(c)(3) 71,864       Research
(51) University of Southern California1450 San Pablo St
Los Angeles,CA90033 		95-1642394 501(c)(3) 90,196       Research
(52) University of Washington12455 Collections Drive
Chicago,IL60693 		91-6001537 115 92,329       Research
(53) Virginia Commonwealth UniversityPO Box 843039
Richmond,VA23284 		54-6001758 115 16,792       Research
(54) Westat IncPO Box 1004
Rockville,MD20850 		84-0529566   143,795       Research
(55) ZRT Laboratory LLC8605 SW Creekside Place
Beaverton,OR97008 		93-1252924   47,850       Research
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
47
3
Enter total number of other organizations ................................ . Bullet Image
8
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Scholarships in Medical Field 79 113,576      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Monitoring of Grant Funds Schedule I Part I line 2 NorthShore University HealthSystem (NorthShore) provides cash and non-cash assistance to organizations that help support NorthShore's mission to preserve and improve human life. Requests to support an outside organization must be reviewed and approved by the Community Relations department and NorthShore management to ensure the organization is aligned with NorthShore's mission and charitable purpose. NorthShore also provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports. In addition, NorthShore provides cash support to related organizations. Support to related organizations is monitored through the NorthShore budget and reporting procedures for the consolidated financial statements. Finally, NorthShore provides nursing scholarships to individuals. The scholarship amount depends on the degree sought, and the number of scholarships awarded depends on the available funds for each year. Scholarships are awarded on an annual basis to applicants that meet the eligibility criteria. Applicants must be current employees of NorthShore as a staff nurse or other related clinical position. Applicants must also be currently enrolled in a nursing degree program, and enrollment must be maintained for the year the scholarship is received. In addition, applicants must sign a Statement of Agreement to work for NorthShore as a staff nurse or in a related clinical position for one year following receipt of the scholarship.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
No
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Michael S Caplan (i)
(ii)		 300,172
161,751 		0
35,000 		2,160
16,732 		13,596
7,327 		5,168
2,785 		321,096
223,595 		0
0
(2) Janardan D Khandekar (i)
(ii)		 577,065
147,813 		0
170,000 		0
47,511 		16,657
4,266 		19,546
5,007 		613,268
374,597 		0
0
(3) Mark S Talamonti (i)
(ii)		 599,930
245,347 		0
100,000 		0
20,187 		14,850
6,073 		20,829
8,518 		635,609
380,125 		0
0
(4) Mark R Neaman (i)
(ii)		 863,089
0 		427,500
0 		517,177
0 		238,423
0 		14,984
0 		2,061,173
0 		0
0
(5) Jeffrey H Hillebrand (i)
(ii)		 566,243
0 		252,000
0 		22,710
0 		168,676
0 		17,984
0 		1,027,613
0 		0
0
(6) Gary E Weiss (i)
(ii)		 358,940
0 		158,000
0 		10,091
0 		94,256
0 		14,188
0 		635,475
0 		0
0
(7) William D Bloomer (i)
(ii)		 393,030
260,626 		0
350,000 		0
61,885 		12,581
8,342 		18,727
12,418 		424,338
693,271 		0
0
(8) Robert R Edelman (i)
(ii)		 699,975
37,536 		0
232,200 		0
7,224 		19,858
1,065 		35,393
1,898 		755,226
279,923 		0
0
(9) Bernard G Ewigman (i)
(ii)		 378,326
0 		25,000
0 		0
0 		50,597
0 		46,593
0 		500,516
0 		0
0
(10) Gerald P Gallagher (i)
(ii)		 296,076
0 		131,000
0 		2,877
0 		80,590
0 		21,810
0 		532,353
0 		0
0
(11) Thomas H Hodges (i)
(ii)		 398,209
0 		190,000
0 		64,189
0 		20,923
0 		15,698
0 		689,019
0 		0
0
(12) Harry L Jones (i)
(ii)		 228,748
0 		106,000
0 		2,990
0 		20,923
0 		22,791
0 		381,452
0 		0
0
(13) William R Luehrs (i)
(ii)		 307,690
0 		150,000
0 		6,970
0 		83,323
0 		15,495
0 		563,478
0 		0
0
(14) Demetrius Maraganore (i)
(ii)		 261,276
209,001 		0
50,000 		0
2,494 		11,624
9,299 		14,382
11,504 		287,282
282,298 		0
0
(15) Frederick E Miller (i)
(ii)		 299,936
49,568 		0
25,000 		0
41,611 		17,956
2,967 		21,187
3,501 		339,079
122,647 		0
0
(16) Kristen Murtos (i)
(ii)		 260,797
0 		120,000
0 		1,763
0 		75,923
0 		24,905
0 		483,388
0 		0
0
(17) Jesse Peterson Hall (i)
(ii)		 317,662
0 		144,000
0 		3,975
0 		86,256
0 		24,550
0 		576,443
0 		0
0
(18) William J Robb III (i)
(ii)		 500,769
0 		67,000
0 		7,749
0 		20,923
0 		1,245
0 		597,686
0 		0
0
(19) Leopold G Selker (i)
(ii)		 314,912
0 		132,000
0 		95,492
0 		84,923
0 		16,756
0 		644,083
0 		0
0
(20) Nancy Semerdjian (i)
(ii)		 255,740
0 		105,000
0 		6,158
0 		20,923
0 		15,454
0 		403,275
0 		0
0
(21) Richard K Silver (i)
(ii)		 700,013
118,585 		0
85,000 		360
31,721 		17,892
3,031 		26,684
4,520 		744,949
242,857 		0
0
(22) Douglas M Silverstein (i)
(ii)		 356,931
0 		160,000
0 		5,974
0 		135,034
0 		9,732
0 		667,671
0 		0
0
(23) Thomas W Smith (i)
(ii)		 313,824
0 		154,000
0 		9,746
0 		84,923
0 		17,424
0 		579,917
0 		0
0
(24) Jeffery S Vender (i)
(ii)		 403,852
341,721 		0
250,000 		0
20,893 		11,333
9,590 		12,867
10,888 		428,052
633,092 		0
0
(25) Thomas A Victor (i)
(ii)		 363,260
73,396 		0
325,000 		0
55,721 		17,406
3,517 		24,881
5,027 		405,547
462,661 		0
0
(26) Brian Washa (i)
(ii)		 237,898
0 		84,000
0 		911
0 		20,923
0 		21,681
0 		365,413
0 		0
0
(27) Kenneth P Anderson (i)
(ii)		 353,571
0 		89,300
0 		4,983
0 		20,923
0 		23,408
0 		492,185
0 		0
0
(28) John Merz (i)
(ii)		 204,380
0 		72,500
0 		4,224
0 		20,923
0 		16,413
0 		318,440
0 		0
0
(29) Colleen Mitchell (i)
(ii)		 207,927
0 		100,000
0 		79,445
0 		20,923
0 		15,259
0 		423,554
0 		0
0
(30) Sean O'Grady (i)
(ii)		 211,952
0 		75,300
0 		885
0 		20,923
0 		24,035
0 		333,095
0 		0
0
(31) Steven Smith (i)
(ii)		 229,848
0 		70,500
0 		1,299
0 		20,923
0 		22,037
0 		344,607
0 		0
0
(32) David C Holub (i)
(ii)		 140,831
34,265 		0
0 		1,140
8,559 		12,693
3,088 		5,880
1,431 		160,544
47,343 		0
0
(33) Nicholas A Vick (i)
(ii)		 156,000
41,878 		0
8,672 		1,000
37,272 		16,483
4,425 		12,264
3,292 		185,747
95,539 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Benefits Provided Part I Line 1a First-class airfare was provided to the Chief Executive Officer and Chief Operating Officer for business travel purposes and was not treated as taxable compensation. The first-class airfare was purchased through a prepaid airline mileage account, which provided discounted airline fare rates.
Reimbursement Substantiation Part I Line 2 A prepaid airline mileage account was purchased for the travel of the Chief Executive Officer and Chief Operating Officer. At the time of the purchase, it was not known what specific travel would occur and therefore the travel could not be substantiated at purchase. The business purpose of each trip was substantiated at the time of travel.
Severance Payments Part I Line 4a Colleen Mitchell, Former President, Foundation, received a severance payment from NorthShore University HealthSystem for $63,231.
Supplemental Nonqualified Retirement Plan Part I line 4b The following individuals participated in a supplemental nonqualified retirement plan and accrued the following benefits: Mark R Neaman, President and Chief Executive Officer - $488,695, Jeffrey H Hillebrand, Chief Operating Officer - $32,420, Thomas H Hodges, Chief Investment Officer - $42,200, Leopold G Selker, President, Research Institute - $82,007, Douglas M Silverstein, President, Glenbrook Hospital - $41,778.
Non-Fixed Payments Part I Line 7 NorthShore University HealthSystem provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the Compensation Committee of the Board of Directors.
Compensation from Unrelated Organizations Core Form 990, Part VII, Line 5 The salary and benefits reported on Schedule J totaling $500,516 for Dr. Bernard G Ewigman were paid by the University of Chicago Medical Center for services provided to NorthShore University HealthSystem as the Chairman of the Department of Family Medicine.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number
36-2167060
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A Illinois Finance Authority
  		86-1091967 45200F4D8 07-14-2010 138,786,145 See Part V   X   X   X
B Illinois Finance Authority
  		86-1091967 45200MU93 12-11-2008 75,000,000 See Part V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 4,145,000      
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 138,786,145 75,000,000    
4 Gross proceeds in reserve funds . .        
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 1,017,771 433,044    
8 Credit enhancement from proceeds. 131,875 131,875    
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 74,435,081 74,435,081    
11 Other spent proceeds . . 137,768,374      
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2010 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X     X        
15 Were the bonds issued as part of an advance refunding issue?   X   X        
16 Has the final allocation of proceeds been made? . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X              
b Are there any research agreements that may result in private business use of bond-financed property? . . X              
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.300 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0.200 %      
6 Total of lines 4 and 5 . . .. . . . . . 0.500 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue?   X X          
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X        
6 Did the bond issue qualify for an exception to rebate? . . . X   X          
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Bond Issue Description of Purpose Part I Column (f) Line A To refund bonds issued on July 3, 2001. Proceeds were also used to pay termination costs in connection with certain derivative agreements related to the refunded bonds.
Bond Issue Description of Purpose Part I Column (f) Line B To reimburse NorthShore University HealthSystem for the costs of construction, renovation, and equipment for various projects at Evanston Hospital, Glenbrook Hospital, and Highland Park Hospital.
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) NorthShore Physician Associates Inc See Part V 25,002,494 Capitation Payments, Other   No
(2) NorthShore Insurance International See Part V 5,003,755 Insurance Premiums   No
(3) Ravine Way Surgery Center LLC See Part V 840,000 Earnings Distributions Yes  
(4) NorthShoreUSP Surgery Center II LL See Part V 748,500 Earnings Distributions Yes  
(5) Advisory Board Company Bd Mbr - Mark Neaman 466,300 Membership Dues   No
(6) Vocera Communications Inc Bd Mbr - Jeff Hillebrand 1,881,810 Communications Equipment   No
(7) VHA Inc Bd Mbr - Jeff Hillebrand 2,783,072 Net Purch Rebates/Mbr Charges   No
(8) Medline Industries Officer - Andrew Mills 743,362 Medical Supplies   No
(9) Blue Cross Blue Shield of Illinois Bd Mbr - Sona Wang 414,921,132 Net Patient Revenues   No
(10) April F Victor Family Mbr-Thomas Victor 50,336 Employment   No
(11) Alexis A Washa Family Mbr-Brian Washa 186,543 Employment   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Business Transactions with Interested Persons Part IV Column (b) NorthShore Physician Associates Inc board members were Mark S Talamonti and Thomas A Victor. NorthShore Insurance International board members were Gerald P Gallagher and Harry L Jones. Ravine Way Surgery Center LLC board members were Jeffrey H Hillebrand and Gerald P Gallagher. NorthShore/USP Surgery Center II LLC board members were Jeffrey H Hillebrand and Thomas H Hodges.
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 26 726,465 Sale Proceeds
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Identifier Return Reference Explanation
Mission Statement Part III Line 1 The core mission of NorthShore University HealthSystem is to "preserve and improve human life." This mission will be achieved through the provision of superior clinical care, academic excellence, and innovative research. NorthShore is a not-for-profit organization principally formed to provide quality healthcare services for the communities it serves. The delivery of healthcare services is provided in a wide range of inpatient and ambulatory healthcare settings, community-wide, employing modern technology and expertise. Support for qualified patients who may not be able to pay the entire cost of their care is a part of the organization's commitment. In support of its primary mission of patient care, the organization engages in a wide range of academic activities in medical education and research. This statement recognizes the Board of Directors' responsibility to maintain the organization's viability to meet its long-term commitment to the communities it serves. It further recognizes the responsibility to maintain technologically current assets for this purpose. This includes the cultivation and development of our physicians, graduate medical students, employees, physical plant, equipment and other resources to assure orderly growth of our services.
Statement of Program Services - Patient Care Part III Line 4a Headquartered in Evanston, Illinois, NorthShore University HealthSystem, (NorthShore), is a comprehensive, fully integrated, healthcare delivery system that serves the Chicago region. NorthShore includes four hospitals: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital and Skokie Hospital. NorthShore has approximately 9,000 employees and 2,400 affiliated physicians, including a multispecialty group practice with over 80 office locations under the NorthShore University HealthSystem Faculty Practice Associates. The integrated health system has significant capabilities in a wide spectrum of clinical programs, including cancer, heart, orthopaedics, high-risk maternity and pediatrics. Further, NorthShore Supports teaching and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine. NorthShore is a Magnet recognized organization, the only one in Illinois designated as a system to receive this prestigious honor that demonstrates excellence in nursing and high standards of patient care. NorthShore is a national leader in the implementation of innovative technologies, including electronic medical records (EMR). In 2003, NorthShore was among the first hospital system in the country to successfully launch a system-wide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement. NorthShore has also been named one of the nation's Top 10 Health Systems by Thomson Reuters, a leading provider of information and solutions to improve the cost and quality of healthcare. The Top 10 Health Systems study measures the performance of health systems based on several metrics, including in-hospital mortality, medical complications, patient safety, average length of stay, adherence to clinical standards of care, and patient survey scores. NorthShore's Evanston and Glenbrook hospitals were named to the annual class of top national hospitals by the Leapfrog Group's Top Hospitals List for 2011. NorthShore's hospitals were among 65 selected from a field of nearly 1,200 hospitals nationally; and only two of five hospitals in Illinois to receive this award. This prestigious designation, which is the most competitive national hospital quality award in the country, recognizes hospitals based on the results of the Leapfrog Group's national survey that measures hospitals' performance in crucial areas of patient safety and quality. NorthShore is ranked nationally in ten different specialties in the U.S. News and World Report annual survey of America's top hospitals. The survey looked at about 5,000 hospitals nationwide, ranking them in 16 different specialties, and a total of only 140 hospitals received at least one national ranking. NorthShore was ranked as high-performing in the following specialties: Cancer, Diabetes and Endocrinology, Ear, Nose, and Throat, Gastroenterology, Geriatrics, Gynecology, Nephrology, Neurology and Neurosurgery, Orthopaedics, and Urology. NorthShore recognizes and embraces its responsibility to ensure that it fulfills its charitable obligations in the most cost-effective and sustainable manner. In order to achieve this goal, NorthShore has aligned its community benefits program with the guiding principles outlined in Advancing the State of the Art of Community Benefit for nonprofit hospitals, which provides a set of uniform standards to increase accountability and align governance, management, and operations to return benefit to local communities. The five guiding principles are: 1) Disproportionate Unmet Health-Related Needs, 2) Primary Prevention, 3) Seamless Continuum of Care, 4) Build Community Capacity, and 5) Community Collaboration. NorthShore informs and educates potentially impacted patients of the Financial Assistance program by posting signage (both English and Spanish) in all the facilities' Emergency Departments and at our Central Registration areas. The NorthShore Patient Handbook is also presented to patients upon admission and it describes the Financial Assistance program that includes Charity Care. NorthShore also has approximately 13 full time financial counselors and 22 customer service agents working in the hospitals and clinics, and they are responsible for coordinating financial assistance and eligibility. Any uninsured patient admitted into the hospital will have their case reviewed by a financial counselor. NorthShore billing statements also indicate the Financial Assistance program and necessary contact information. NorthShore's physician offices and collection agencies are also instructed to coordinate charity care to potentially eligible patients. The NorthShore website is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible will have their case reviewed by a financial counselor or by calling the Customer Service department. Evanston Hospital - With a history dating to 1891, Evanston Hospital is a 354-licensed bed hospital and serves as the nucleus of the NorthShore University HealthSystem. Evanston Hospital demonstrates leadership in cancer and cardiac care, providing specialized cancer services at the Kellogg Cancer Care Center and comprehensive heart care at the Cardiovascular Care Center. Physicians work alongside leading researchers to translate the latest technology, treatment and research into improved patient care. As the regional center for high risk obstetrics, the Women's Hospital offers a comfortable birthing environment where high risk mothers and their babies have access to the latest technology and a highly trained staff. Evanston Hospital is the regional referral center for high risk maternal transports for eight suburban Chicago hospitals. The Hospital is also a licensed Level I Trauma Center. During fiscal year 2011, Evanston Hospital total admissions were 19,262, and total patient days were 101,497.
Statement of Program Services - Patient Care - Continued Part III Line 4a Glenbrook Hospital - Opened in 1977, Glenbrook Hospital is a 169-licensed bed hospital providing advanced diagnostic and therapeutic interventions. Glenbrook Hospital's specialties include the Kellogg Cancer Center, Patricia Nolan Center for Breast Health, Simms Family GI Lab, Eye and Vision Center, and Total Joint Replacement Center. Glenbrook Hospital is also a Level II Trauma Center and a Joint Commission certified primary stroke center. Near Glenbrook Hospital, the NorthShore location at the Glenview Park District Park Center offers an Integrative Medicine Program, rehabilitation services, community wellness programs, and a retail herbal and wellness pharmacy. During fiscal year 2011, Glenbrook Hospital total admissions were 9,833, and total patient days were 45,403. Highland Park Hospital - Founded in 1918, NorthShore's Highland Park Hospital has provided high-quality healthcare and a wide range of clinical programs for nearly a century. The 149-licensed bed Hospital is the site of the first open heart surgery in Lake County and is a key partner in bringing important healthcare programs to area residents. Highland Park Hospital's Kellogg Cancer Care Center offers the most comprehensive subspecialty care for oncology patients. Specialized physicians provide care for the following types of cancer: thoracic and lung; hematology; breast; ovarian; head and neck; melanoma and sarcoma; gastrointestinal; prostate; and stomach. Highland Park Hospital is a Joint Commission certified primary stroke center. Highland Park Hospital also has a wound care center that gives patients access to the most comprehensive wound treatment program on the North Shore. The Emergency Department at Highland Park Hospital participates as the region's "pod" hospital for disaster response activities, coordinating Lake County's efforts when confronted with a disaster. Also available are a wide variety of mental health services, including a center for eating disorders, adolescent psychiatric care, and the Doreen E. Chapman Center for substance abuse. NorthShore also has a partnership with the Lake County Health Department and Community Health Center known as Be Well Lake County. The program's goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. During fiscal year 2011, Highland Park Hospital total admissions were 9,736, and total patient days were 43,330. Skokie Hospital - Founded in 1963, Skokie Hospital has provided high-quality healthcare for nearly five decades. The 195-licensed bed acute care hospital is nationally recognized for its expertise in orthopaedics, cardiac care, and cancer care. Key hospital specialties and features also include minimally invasive surgery, total joint replacement, a women's health center, a gastroenterology lab and graduate medical education (residency) programs in internal medicine, general surgery, and anesthesia. In addition, Skokie Hospital's Level II Trauma Center - Emergency Department - is staffed by experienced trauma team members specially trained in pediatric life support. During fiscal year 2011, Skokie Hospital total admissions were 7,526, and total patient days were 38,793. NorthShore University HealthSystem Faculty Practice Assoicates - In order to increase the efficiency and quality of health care NorthShore provides, NorthShore University HealthSystem Faculty Practice Associates (FPA) was organized to serve as an integral part of its health care mission and activities. FPA represents more than 700 physicians with over 80 offices in virtually every specialty all on staff at the hospitals of NorthShore. The primary function and activity of FPA is to employ, supervise, and conduct employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The FPA physicians also conduct medical education activities for the NorthShore interns and residents, and FPA also performs medical research on behalf of NorthShore. NorthShore University HealthSystem Foundation - NorthShore University HealthSystem Foundation (Foundation) is dedicated to assisting the integrated healthcare delivery system to fulfill NorthShore's mission to "preserve and improve human life." The Foundation seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of high-quality services and giving opportunities. Finally, the Foundation also assures that contributions are used wisely and appropriately.
Statement of Program Services - Education Part III Line 4b NorthShore University HealthSystem (NorthShore) is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2011, a total of 189 residents and 19 fellows participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (1st Year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Female Pelvic Medicine and Reconstructive Surgery, Magnetic Resonance Imaging, Musculoskeletal Imaging, Emergency Medicine Simulation, Surgical Pathology, and Endocrine Surgery. The affiliate-based residency program areas included: Anesthesiology, Dermatology, Emergency Medicine, Obstetrics and Gynecology, Orthopaedic Surgery, Pediatrics, Psychiatry, Radiology, General Surgery, Neurology, Neurosurgery, Ophthalmology, Otolaryngology, Plastic Surgery, Podiatry, and Urology. The affiliate-based fellowship program areas included: Body Contouring Plastic Surgery, Cardiology, Child Neurology, Child Psychiatry, Electrophysiology, Gastroenterology, Infectious Diseases Research, Maternal-Fetal Medicine, Neonatal-Perinatal Medicine, Palliative Medicine, Surgical Oncology, and Urology. The NorthShore School of Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year 2011, 66 students participated in the program. NorthShore also provided clinical training and internships for 1,694 students in various departments including Social Work, Nursing, Physical Therapy, and Speech Therapy during the 2011 academic year. These internships were conducted through collaborative relationships with several educational institutions including Chamberlain College, College of Lake County, DePaul University, Harper College, Loyola University Chicago, Midwestern University, North Park University, Northern Illinois University, Northwestern University, Oakton Community College, Rosalind Franklin University, Rush University, University of Chicago, University of Illinois, University of Illinois at Chicago, University of Iowa, and University of Minnesota.
Statement of Program Services - Research Part III Line 4c The NorthShore University HealthSystem Research Institute (Research Institute) was organized in 1996 to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute now houses nearly 200 externally funded research faculty who currently occupy over 100,000 net square feet of research space and work on nearly 1,000 active research protocols. Total external funding is now over $100 million. Funding from the NIH places the hospitals of NorthShore among the top 10 comprehensive independent research hospitals in the country. In addition, NorthShore has made a substantial commitment to develop a new Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure will enable large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work will build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research.
Business Relationships Part VI Section A Line 2 Business relationship - Harry M Jansen Kraemer Jr and Samuel M Mencoff. Business relationship - Andrew J Mills and Nancy Semerdjian. Business relationship - Mark S Talamonti and Thomas A Victor. Business relationship - Gerald P Gallagher and Harry L Jones. Business relationship - Gerald P Gallagher and Jeffrey H Hillebrand. Business relationship - Jeffrey H Hillebrand and Thomas H Hodges.
Governing Body Review of 990 Part VI Section B Line 11b The NorthShore University HealthSystem (NorthShore) Form 990 was reviewed by executive management and an outside accounting firm. The NorthShore Form 990 was then provided to each member of the Board of Directors via email for their review and ability to ask questions of management prior to filing.
Conflict of Interest Policy Monitoring Part VI Section B Line 12c On an annual basis, the Chief Compliance Officer requires all officers, directors, and key employees to complete, sign and return a Conflict of Interest Disclosure Statement. Timely and accurate completion of the Statement is mandatory, and completed Statements must be returned to the Chief Compliance Officer within 15 days. Any disclosures included on the Statements are reviewed and acted upon as necessary by the Chief Compliance Officer and the Corporate Compliance Committee.
Determination of Compensation Part VI Section B Line 15 A detailed compensation review of the top 16 executives, including the Chief Executive Officer, is conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market data for base and variable compensation is assessed annually for local, regional and national hospitals, integrated delivery systems and academic medical centers. A detailed total compensation market review is conducted every two years. The market assessment includes assessing job content in order to make appropriate market data comparisons. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation.
Public Disclosure of Documents Part VI Section C Line 19 The NorthShore University HealthSystem (NorthShore) governing documents, conflict of interest policy and financial statements are available to the public upon request. The NorthShore annual audit report and financial statements are also available to the public through GuideStar and the Illinois Attorney General's Office websites as part of the federal and state tax return filings. The NorthShore quarterly and annual financial statements and annual audit are also made available to the public through the Electronic Municipal Market Access (EMMA) website as part of the tax-exempt bond offerings.
Average Hours Per Week for Related Organizations Part VII Section A Column B Certain individuals listed in Part VII had the following average hours per week devoted to related organizations: Michael S Caplan - 15, Janardan D Khandekar - 9, Mark S Talamonti - 13, Mark R Neaman - 2, Jeffrey H Hillebrand - 1, William D Bloomer - 17, Robert R Edelman - 3, Bernard G Ewigman - 1, Demetrius Maraganore - 19, Frederick E Miller - 7, Richard K Silver - 7, Jeffery S Vender - 19, Thomas A Victor - 8, David C Holub - 8, Nicholas A Vick - 8.
Other Changes in Net Assets Part XI Line 5 Other changes in net assets of $132,024,926 include unrealized losses of $84,005,997 and equity adjustments for the pension and supplemental executive retirement plans of $48,018,929.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) NorthShore Faculty Practice Associates

1301 Central Street

Evanston,IL60201
36-3738206 		Healthcare IL 501(c)(3) 11 Type I NorthShore
 
 
 
(2) Radiation Medicine Institute

1301 Central Street

Evanston,IL60201
36-3815543 		Healthcare IL 501(c)(3) 11 Type I NorthShore
 
 
 
(3) Healthcare Foundation of Highland Park

610 Central Avenue

Highland Park,IL60035
36-3196647 		Fundraising IL 501(c)(3) 11 Type II NA
 
 
 








For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Ravine Way LLC

2401 Ravine Way
Glenview,IL60025
20-1245279 		Healthcare IL NA
  		Related 1,107,754 1,645,508   No 0 Yes   30.000 %
(2) HPMOB Limited Ptr

1301 Central St
Evanston,IL60201
36-3497502 		Healthcare IL NA
  		Related 56,175 610,431   No 0 Yes   29.620 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) NorthShore Physician Associates Inc
1301 Central Street
Evanston,IL60201
36-3648026 		Healthcare IL NorthShore FPA
  		C corp 1 15,740,149 100.000 %
(2) NorthShore Insurance International
Governors Sq Bldg 4
  Grand Cayman  
CJ
98-0419452 		Insurance CJ NA
  		C corp 105,841 19,542,039 100.000 %










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) NorthShore Faculty Practice Associates

 a 12,974,245  
(2) NorthShore Faculty Practice Associates

 b 37,636,597  
(3) NorthShore Faculty Practice Associates

 c 4,672,095  
(4) Radiation Medicine Institute

 c 525,554  
(5) Healthcare Foundation of Highland Park

 c 4,060,000  
(6) HPMOB Limited Partnership

 j 472,327  
(7) NorthShore Faculty Practice Associates

 o 42,365,546  
(8) NorthShore Faculty Practice Associates

 p 5,733,862  
(9) NorthShore Physician Associates Inc

 p 194,691  
(10) NorthShore Faculty Practice Associates

 q 289,194,906  
(11) Radiation Medicine Institute

 q 5,713,364  
(12) NorthShore Physician Associates Inc

 q 117,221,252  
(13) NorthShore Insurance International

 q 5,033,755  
(14) NorthShore Faculty Practice Associates

 r 272,150,875  
(15) Radiation Medicine Institute

 r 5,187,810  
(16) NorthShore Physician Associates Inc

 r 88,114,228  
(17) Ravine Way Surgery Center LLC

 r 840,000  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: