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
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
Advocate Condell Medical Center
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3075 HIGHLAND PARKWAY
Suite 600
Room/suite
City or town, state or country, and ZIP + 4
DOWNERS GROVE, IL60515
D Employer identification number

26-2525968
E Telephone number

G Gross receipts $ 333,847,419
F Name and address of principal officer:
JAMES W DOHENY
3075 HIGHLAND PKWY STE 600
DOWNERS GROVE,IL60515
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ADVOCATEHEALTH.COM
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 MediumBullet9395
K Form of organization:
 
L Year of formation: 2008
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SERVE THE HEALTH NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A WHOLISTIC PHILOSOPHY ROOTED IN OUR FUNDAMENTAL UNDERSTANDING OF HUMAN BEINGS AS CREATED IN THE IMAGE OF GOD.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 2,414
6 Total number of volunteers (estimate if necessary) ............. 6 489
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,411,149
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 118,636 1,513,302
9 Program service revenue (Part VIII, line 2g) ......... 326,199,807 322,570,846
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -1,857,285 1,078,694
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,993,382 1,987,851
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 326,454,540 327,150,693
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 203,613 92,060
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) 134,976,384 132,969,564
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 178,569,304 165,404,213
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 313,749,301 298,465,837
19 Revenue less expenses. Subtract line 18 from line 12....... 12,705,239 28,684,856
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 400,004,420 402,401,536
21 Total liabilities (Part X, line 26)............. 149,422,827 141,333,832
22 Net assets or fund balances. Subtract line 21 from line 20..... 250,581,593 261,067,704
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 Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
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: THE MISSION IS TO SERVE THE HEALTH NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A WHOLISTIC PHILOSOPHY ROOTED IN OUR FUNDAMENTAL UNDERSTANDING OF HUMAN BEINGS AS CREATED IN THE IMAGE OF GOD.
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 257,073,875 including grants of $ 92,060 ) (Revenue $ 310,226,992 )
Providing Inpatient and Outpatient healthcare services to the community regardless of the patients' ability to pay. Included in this program service are the provision of Charity care and Trauma care. As part of its community benefits strategy and its mission, Advocate Condell is committed to promoting initiatives that enhance access to health care for the uninsured and underinsured. An example of this is Advocate Condell's provision of charity care. Advocate Condell offers a very generous charity care program - requiring no payments from the patients most in need, and providing discounts to uninsured patients earning up to six times the federal poverty level and to insured patients earning up to four times the poverty level. A patient's extenuating circumstances are considered when qualifying patients for charity care and in certain cases, Advocate Condell Medical Center uses Advocate or public records to determine a patient's eligibility ("presumptive eligibility"). Although Advocate Condell's Charity Care Policy is very generous, Advocate Condell Medical Center continues to review and refine its policy in an ongoing effort to ensure that financial assistance is available to those who need help when they need it. The medical center maintains highly visible signage and brochures in multiple languages to inform patients of the availability of financial help and financial counselors. Information about Advocate Condell's charity care program and charity applications is provided to all uninsured patients during registration and as an insert in all uninsured patients' bills. In the area of Trauma care - Advocate Condell is dedicated to providing expert emergency care - today and in the future. Advocate Condell's Level I Trauma Center cares for the most seriously injured people in its service area. As is the case with all Illinois Level I Trauma Centers, Advocate Condell's trauma center is staffed by on-site, 24-hour-a-day trauma surgeons; features 24-hour surgical and nonsurgical services, such as radiology and anesthesia; and can accommodate helicopter transports.
4b (Code:   ) (Expenses $ 7,635,922 including grants of $ 0 ) (Revenue $ 4,236,686 )
Health care and fitness services provided by physicians, nurses, clinicians and other associates employed by Advocate Condell. Advocate Condell clinicians provide care to the community for minor injuries and illnesses through its immediate care centers regardless of the patients' ability to pay. Exercise physiologists and physical therapists also provide sports medicine consultations at local high schools and colleges. Physicians, nurses and other clinicians lead prenatal/childbirth and parenting education classes and diabetes education classes as well as support groups for diabetes education, heart disease, breast and other cancers, lactation/breast feeding, bereavement/loss and caregivers. Advocate Condell partners with the Lake County Health Department/Community Health Center to provide imaging services at rates significantly below cost. Fitness and wellness classes and services are provided at the Advocate Condell Centre Clubs, which provides sliding scale membership rates.
4c (Code:   ) (Expenses $ 27,565,285 including grants of $ 0 ) (Revenue $ 6,406,649 )
Description of Advocate Condell Medical Center Serving the community since 1928, Advocate Condell Medical Center is a 273-bed non-profit acute care hospital based in Libertyville, Illinois. As the largest health care provider in Lake County, Advocate Condell provides a full spectrum of medical services - from obstetrics, radiology services and rehabilitation to open heart surgery, neurosurgery and oncology. Advocate Condell Medical Center's Emergency Department provides Level I Trauma care and has the ability to accommodate growing numbers of patients. In 2012, the hospital experienced 1,869 trauma care visits. Advocate Condell also provides a dedicated pediatric emergency department - the first and only in Lake County - consisting of a team of doctors and nurses dedicated to and specially trained in pediatric emergency medicine. In addition, Condell is an accredited Chest Pain Center and offers a continuum of diagnostic and cardiology treatment services-including open heart surgery. More than 650 physicians and 2,100 associates comprise the team of medical experts known for excellence. In addition to services located on its Libertyville campus, Advocate Condell operates three immediate care centers throughout the County and two medically based fitness centers. Advocate Condell is the Resource hospital for Region 10 Emergency Medical Services, which demonstrates the commitment to efficiently and effectively manage emergency services in a disaster. Advocate Condell also provides community outreach through health fairs, wellness programs and other services in support of its MVP (mission, values and philosophy). The mission of Advocate Condell Medical Center is to serve the health needs of individuals, families and communities through a holistic philosophy rooted in the fundamental understanding of human beings as created in the image of God. The values of Advocate Condell Medical Center serve as an internal compass to guide relationships and actions. They include equality, compassion, excellence, partnership, and stewardship. The philosophy of Advocate Condell Medical Center is grounded in the principles of human ecology, faith and community-based health care. These principles arise from an understanding of human beings as whole persons in light of their relationships with God, themselves, their families and the society in which they live. Through our actions we affirm these principles. Population Served Advocate Condell Medical Center provides quality health care to individuals regardless of race, creed, national origin, age or ability to pay. In 2012, Condell served 213,709 patients, including 18,253 inpatient admissions and 195,456 outpatient visits, delivering 2,515 babies. Commitment to the Community Even in the face of low reimbursements, Advocate Condell Medical Center is dedicated to maintaining a strong presence within its community and continues to monitor these expenditures to make certain that the programs and services supported are in direct response to community need. In 2012, Condell reported approximately $35.8 million in charity care and other services. These services are comprised of many community health programs focused on improving access to care, addressing special needs and improving overall community health. In addition to Medicare/Medicaid and Bad Debt losses, Advocate Condell treats many air force military personnel and Veterans Administration patients at a rate below cost. Community Benefits Plan, Goals & Examples of Program Service Accomplishments Advocate Condell Medical Center's community benefits efforts are aligned with Advocate's community benefits plan. The Advocate Health Care plan was developed to establish strategies for improving access to care and positively affecting the health of the communities served by the hospital. Included in the community benefits plan are not only planned goals and objectives focused on addressing needs as identified through a hospital-specific community health needs assessment, but also other community benefits such as charity care, unreimbursed Medicaid and Medicare, that are ongoing community benefits programs. The plan sets the course for strengthening existing partnerships and building new ones with individuals and organizations within Condell's service area in order to leverage and maximize the impact of its programs. Advocate Condell Medical Center has set four goals and multiple objectives to accomplish this strategy. The goals and some corresponding examples of services Condell offers are provided below. Goal 1: Undertake or support initiatives that enhance access to health and wellness services within the diverse communities Advocate serves. Charity Care - Advocate Condell Medical Center offers a very generous charity care program - requiring no payments from the patients most in need, and providing discounts to uninsured patients earning up to six times the federal poverty level and to insured patients earning up to four times the poverty level. A patient's extenuating circumstances are considered when qualifying patients for charity care and in certain cases, Advocate Condell Medical Center uses Advocate or public records to determine a patient's eligibility ("presumptive eligibility"). Advocate Condell supports the services of the Lake County department of Public Health by providing radiology services to patients treated by the health department. Goal 2: Positively affect the health status and quality of life of individuals and populations in communities served by Advocate through programs and practices that reflect Advocate's wholistic philosophy. School-based health programming -- Advocate Condell is working closely with several area school districts on wellness initiatives, including health education programming and sponsorship of fitness activities. Advocate Condell is poised to take this effort to the next level by offering the Coordinated Approach to Child Health in two area school districts. Diabetes Education -- During Advocate Condell's pursuit to establish a certified diabetes education program, most diabetes education classes and one-on-one counseling sessions were offered free of charge to the public. Plans include expanding these services via a Diabetes Prevention and Management program to potentially four locations: Free clinics in Mundelein and Waukegan; a group of faith organizations serving the Antioch area, and at Round Lake High School as part of a school-based health clinic. Falls Prevention -- Falls among seniors (65+) are a significant health risk and a leading cause of Emergency Department admissions to Advocate Condell Medical Center. In 2012, through its Matter of Balance program, the hospital continued to see success in key areas which have been proven to contribute to falls, including lack of exercise and fear of falling. Looking ahead, Advocate Condell plans to expand the program both onsite and offsite through a partnership with the Libertyville Senior Center and providers in our post-acute care network. Sexual Assault Nurse Examiner Program -- Advocate Condell Medical Center's Sexual Assault Nurse Examiner (SANE) program opened in 2011, and remains the only Lake County program with certified sexual assault nurse examiners available 24 hours, 7 days a week. These highly trained practitioners not only provide compassionate care to victims, but also are able to collect forensic evidence, counsel the victim, and testify in court-helping the victim through the entire process. In addition, the SANE program coordinator works closely with local rape advocates, law enforcement and prosecutors to assure victims of sexual assault in Lake County receive the best care possible. In 2012, Advocate Condell's SANE coordinator, Jennifer Slominski, received the Justice Award from Lake County State's Attorney Michael J. Waller for her role in helping the prosecution of sexual assault cases. She also was recognized for her advocacy work in the community. Jennifer and her team have trained more than 350 law-enforcement members about sexual assault, the importance of a SANE nurse and how to use medical evidence to prosecute a case. They also have educated emergency medical responders on how to talk to victims. The Illinois Coalition Against Sexual Assault (ICASA) has called the hospital's center an "exemplary example" of how a hospital and community can work together to respond to sexual assaults. Advocate Illinois Masonic Medical Center, on Chicago's north side, also has a SANE program. Condell Day Center's Adult Day Care Program - Advocate Condell Day Center's Adult Day Care program fills a gap in continuity of care for clients who are unable to live independently. Condell's program combines adult day care with therapeutic and personal care services. Given that the program is located adjacent to other hospital services, clients can receive physical, speech and occupational therapy from a licensed therapist. In addition, bathing assistance, beaut
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet292,275,082
Form 990 (2012)
Form 990 (2012)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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 IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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 for escrow or custodial account liability; 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 temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
 
No
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, line 10?
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 VIIClick to see attachment.......
11b
 
No
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 VIIIClick 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 IXClick 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 XClick 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 XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII 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 and XII 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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
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 United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
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 United States? If “Yes,” complete Schedule F, Parts III and IV...
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 I (see instructions)....
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............
18
 
No
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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization 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
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
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, highest 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 employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? 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
 
No
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 direct or indirect 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 M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
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, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, 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...
35b
 
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
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
155
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
2,414
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, securities account, or other financial 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 as charitable contributions?...
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
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
Yes
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
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
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
11
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
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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 15a or 15b, 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
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletJAMES H SKOGSBERGH3075 HIGHLAND PKWY SUITE 600DOWNERS GROVEIL60515 (630) 929-5543
Form 990 (2012)
Form 990 (2012)
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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) James Skogsbergh........................................................................
EXEC VP, COO, DIRECTOR
 1.0
.......................40.0 		X   X       0 3,593,725 698,886
(2) Mark Harris........................................................................
Chairperson, Director
 1.0
.......................0.0 		X           0 0 0
(3) Michele Baker Richardson........................................................................
Vice Chairperson, Director
 1.0
.......................0.0 		X           0 0 0
(4) David Anderson........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(5) Alejandro Aparicio MD........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(6) Lynn Crump-Caine........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(7) John Dossey........................................................................
Director - July '12
 1.0
.......................0.0 		X           0 0 0
(8) Ron Greene........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(9) Ronald Mallicoat Jr........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(10) Laurie Meyer........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(11) Clarence Nixon Jr PhD........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(12) Carolyn Smeltzer........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(13) Gary Stuck MD........................................................................
Director
 1.0
.......................0.0 		X           0 0 0
(14) William P Santulli........................................................................
President & CEO
 1.0
.......................40.0 		    X       0 2,114,342 422,797
(15) Lee B Sacks MD........................................................................
Exec VP, Chief Medical Officer
 1.0
.......................40.0 		    X       0 1,697,139 320,165
(16) James Dan MD........................................................................
Pres Physician & Amb Services
 1.0
.......................40.0 		    X       0 1,612,175 243,190
(17) James Doheny........................................................................
VP, Finance & Corp Controller
 1.0
.......................40.0 		    X       0 422,497 58,003
Form 990 (2012)
Form 990 (2012)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) Kelly Jo Golson........................................................................
SVP, Public Affairs & Mktg
 1.0
.......................40.0 		    X       0 737,569 111,309
(19) Kevin Brady........................................................................
SVP, Human Resources
 1.0
.......................40.0 		    X       0 676,224 238,837
(20) Gail D Hasbrouck........................................................................
SVP, Gen Counsel, Corp Sec
 1.0
.......................40.0 		    X       0 1,036,460 177,664
(21) Dominic J Nakis........................................................................
SVP, CFO
 1.0
.......................40.0 		    X       0 1,574,547 320,057
(22) Scott Powder........................................................................
SVP, Strategic Plan & Growth
 1.0
.......................40.0 		    X       0 631,022 127,603
(23) Bruce D Smith........................................................................
SVP, CIO
 1.0
.......................40.0 		    X       0 1,027,935 192,158
(24) Rev K Bender Schwich........................................................................
SVP, Mission & Spiritual Care
 1.0
.......................40.0 		    X       0 223,292 219,264
(25) Ann Errichetti MD........................................................................
President-Condell Med Ctr-7/12
 40.0
.......................0.0 		      X     960,307 0 31,385
(26) Dominica Tallarico........................................................................
President-Condell Medical Cntr
 40.0
.......................0.0 		      X     185,941 294,490 133,780
(27) Debra Susie-Lattner........................................................................
VP, Medical Management
 40.0
.......................0.0 		        X   276,393 0 29,180
(28) Gwenn Leschke........................................................................
VP, Human Resources
 40.0
.......................0.0 		        X   276,042 0 22,635
(29) David Cemate........................................................................
VP, Operations
 40.0
.......................0.0 		        X   248,161 0 50,169
(30) Mary Hillard........................................................................
VP, Patient Care
 40.0
.......................0.0 		        X   226,172 0 49,955
(31) David Cartwright........................................................................
VP, Finance
 40.0
.......................0.0 		        X   221,043 0 47,743
(32) Jose Elizondo MD........................................................................
Director - Dec '11
 0.0
.......................40.0 		          X 0 231,222 37,874
(33) Ben Grigaliunas........................................................................
SVP, Human Resources- Dec '11
 0.0
.......................0.0 		          X 0 1,094,321 141,404
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,394,059 16,966,960 3,674,058
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet143
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
 
No
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CROTHALL LAUNDRY SERVICE, 45 W HINTZ RDWHEELINGIL600906073 Laundry Services 1,390,584
IMPACT ADVISORS LLC, 931 W 75TH STNAPERVILLEIL60565 CONSULTING SERVICES 1,234,716
MMODAL SERVICES LTD, PO BOX 102467ATLANTAGA30368 TRANSCRIPTION SVCS 550,827
KRAUSE CONSTRUCTION LLC, 3330 EDISON AVEBLUE ISLANDIL60406 CONSTR CONTRACTOR 357,013
CASSIDAY SCHADE LLP, 20 N WACKER DRIVE SUITE 1040CHICAGOIL606062901 LEGAL SERVICES 267,956
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet12
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 931,211
e Government grants (contributions)1e 582,091
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 1,513,302
Program Service Revenue Business Code
2a ROUTINE REVENUE 622110 43,528,951 43,528,951    
b INPATIENT REVENUE 622110 139,210,865 139,210,865    
c OUTPATIENT REVENUE 622110 126,912,241 126,912,241    
d MEMBERSHIP REVENUE 621990 4,025,122 4,025,122    
e MEANINGFUL USE 621990 786,500 786,500    
f All other program service revenue . 8,107,167 6,406,649   1,700,518
g Total. Add lines 2a–2f........MediumBullet 322,570,846
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 715,543     715,543
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 579,027  
b Less: rental expenses    
c Rental income or (loss) 579,027 0
d Net rental income or (loss).......MediumBullet 579,027   2,325 576,702
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 6,112,121 947,756
b Less: cost or other basis and sales expenses 5,641,930 1,054,796
c Gain or (loss) 470,191 -107,040
d Net gain or (loss)..........MediumBullet 363,151     363,151
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a DAY CARE SERVICES 624410 1,275,958   1,275,958  
b MASSAGE SERVICES 812190 40,828   40,828  
c PHYSICIAN SERVICES 621110 88,733   88,733  
d All other revenue .... 3,305   3,305  
e Total. Add lines 11a–11d ...... MediumBullet 1,408,824
12 Total revenue. See Instructions......MediumBullet 327,150,693 320,870,328 1,411,149 3,355,914
Form 990 (2012)
Form 990 (2012)
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).Check if Schedule O contains a response to any question in this Part IX ...............
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 United States. See Part IV, line 21 92,060 92,060
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 1,274,497 1,274,497    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 98,567,823 95,696,742 2,871,081  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,477,187 9,204,244 272,943  
9 Other employee benefits ....... 16,457,502 16,303,700 153,802  
10 Payroll taxes ........... 7,192,555 7,028,197 164,358  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 15,181   15,181  
c Accounting ........... 212,370   212,370  
d Lobbying ........... 70,797   70,797  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 78,305   78,305  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 23,318,186 22,954,417 363,769  
12 Advertising and promotion .... 111,237 96,537 14,700  
13 Office expenses ....... 2,214,371 1,928,597 285,774  
14 Information technology ...... 15,957,532 15,769,113 188,419  
15 Royalties .. 0      
16 Occupancy ........... 1,330,846 1,329,124 1,722  
17 Travel ............ 121,023 85,640 35,383  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 87,035 81,580 5,455  
20 Interest ........... 2,513,622 2,513,622    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 16,359,901 15,363,523 996,378  
23 Insurance .............. 4,162,437 4,162,437    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a SUPPLIES, DRUGS AND FOOD 45,144,106 44,906,594 237,512  
b BAD DEBT 16,115,442 16,115,442    
c CONTRACTUAL SERVICES GENERAL 11,891,001 11,888,961 2,040  
d PUBLIC ASSESSMENT FEE 9,589,284 9,589,284    
e All other expenses 16,111,537 15,890,771 220,766  
25 Total functional expenses. Add lines 1 through 24e 298,465,837 292,275,082 6,190,755 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 147,281 1 162,392
2 Savings and temporary cash investments ......... 55,016,535 2 37,128,157
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 37,748,546 4 31,791,395
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 4,146,306 8 4,845,908
9 Prepaid expenses and deferred charges .......... 6,058,582 9 1,276,775
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 346,335,981
b Less: accumulated depreciation ..... 10b 64,246,287 290,467,274 10c 282,089,694
11 Investments—publicly traded securities .......... 0 11 37,905,320
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 6,419,896 15 7,201,895
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 400,004,420 16 402,401,536
Liabilities 17 Accounts payable and accrued expenses ......... 54,456,494 17 41,507,662
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 31,253,453 23 31,032,903
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 63,712,880 25 68,793,267
26 Total liabilities. Add lines 17 through 25......... 149,422,827 26 141,333,832
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 250,581,593 27 261,067,704
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 250,581,593 33 261,067,704
34 Total liabilities and net assets/fund balances ........ 400,004,420 34 402,401,536
Form 990 (2012)
Form 990 (2012)
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
327,150,693
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
298,465,837
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
28,684,856
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
250,581,593
5
Net unrealized gains (losses) on investments ...............
5
1,801,255
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
20,000,000
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
261,067,704
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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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
 
No
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
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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
2012
Open to Public
Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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
2012
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
Advocate Condell Medical Center
  		Employer identification number

26-2525968
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total 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)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
Advocate Condell Medical Center
  		Employer identification number

26-2525968
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
Advocate Condell Medical Center
  		Employer identification number

26-2525968
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(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) (2012)

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
2012
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 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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 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 function 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
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)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(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? ..........................
Yes
 
70,797
j
Total. Add lines 1c through 1i ...............................
70,797
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? .......
 
No
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible 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; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL LOBBYING INFORMATION SCHEDULE C PART II-B, LINE 1I ADVOCATE CONDELL MEDICAL CENTER IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, THE ILLINOIS HOSPITAL ASSOCIATION, AND THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. THESE ORGANIZATIONS, AS PART OF THEIR MISSIONS, ADVOCATE IN THE GENERAL ASSEMBLY AND IN CONGRESS ON LEGAL AND POLICY ISSUES THAT AFFECT HEALTHCARE INCLUDING QUALITY, AFFORDABILITY, PATIENT ACCESS, AND ACCREDITATION. A PORTION OF THE ANNUAL MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS IS ATTRIBUTIBLE TO LOBBYING ACTIVITIES. ADVOCATE CONDELL MEDICAL CENTER ALSO REIMBURSES VARIOUS ASSOCIATES FOR DUES PAID TO VARIOUS PROFESSIONAL ORGANIZATIONS AND ALSO FOR EDUCATIONAL EXPENSES PROVIDED BY PROFESSIONAL AND MEMBERSHIP ORGANIZATIONS. ADVOCATE CONDELL MEDICAL CENTER ENDEAVORS TO IDENTIFY THE PORTION OF OUR DUES OR FEES PAID TO THESE ORGANIZATIONS WHICH ARE ATTRIBUTIBLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2012

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   49,200,000 49,200,000
b Buildings ................   235,594,879 31,459,251 204,135,628
c Leasehold improvements ............   646,120 226,845 419,275
d Equipment ................   54,211,887 31,954,350 22,257,537
e Other .................   6,683,095 605,841 6,077,254
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 282,089,694
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
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) must 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) must 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) Book value
Federal income taxes 0
THIRD PARTY SETTLEMENTS 35,399,670
PENSION PLAN BENEFITS 32,749,268
REMEDIATION COST ACCRUAL 119,072
EXECUTIVE PENSION LIABILITY 46,990
IBNR PROV. INSURANCE LOSS 478,267




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 68,793,267
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
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 XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2012

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
2012
Open to Public Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) .. 		    12,111,312   12,111,312 4.290 %
b Medicaid (from Worksheet 3,
column a) .... 		    43,639,886 33,074,133 10,565,753 3.740 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    55,751,198 33,074,133 22,677,065 8.030 %
Other Benefits
     516,613   516,613 0.180 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    1,480,622   1,480,622 0.520 %
g Subsidized health services
(from Worksheet 6) .. 		    6,761,702 5,727,502 1,034,200 0.370 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    373,610   373,610 0.130 %
j Total. Other Benefits ..     9,132,547 5,727,502 3,405,045 1.200 %
k Total. Add lines 7d and 7j .     64,883,745 38,801,635 26,082,110 9.230 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
16,115,442
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,404,954
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
92,928,842
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
97,558,207
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,629,365
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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 %
1NONE
  		       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 CONDELL MEDICAL CENTER
801 S MILWAUKEE AVENUE
LIBERTYVILLE,IL60048 		X X         X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
CONDELL MEDICAL CENTER
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)  
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1    
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 CHNA 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 CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7    
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?17
Name and address Type of Facility (describe)
1 Condell Medical Center - Mungo BLDG
804 E Park Ave STE 10610711111
Libertyville,IL60048 		Patient Care - OutPatient
2 Condell Medical Center - Office BLDG
2 East Rollins Rd Sts 101 105 1
Round Lake Beach,IL60073 		Patient Care - OutPatient
3 Condell Medical Center - Office BLDG
6 Phillips Road Suite 1109
Vernon Hills,IL60061 		Patient Care - OutPatient
4 Condell Immediate Care Building
150 Half Day Road Suite 207
Buffalo Grove,IL60089 		Patient Care - OutPatient
5 Condell Immediate Care Building
6440 Grand Ave Suite 105
Gurnee,IL60031 		Patient Care - OutPatient
6 Condell Medical Center - Office BLDG
1170 E Belvidere Rd Various Suite
Grayslake,IL60030 		Patient Care - OutPatient
7 Condell Medical Center - Office BLDG
550-560 Midlothian Road
Mundelein,IL60060 		Patient Care - OutPatient
8 CONDELL MEDICAL CENTER - CENTRE CLUB
1405 HUNT CLUB ROAD
GURNEE,IL60031 		PATIENT CARE - OUTPATIENT
9 Condell Medical Center - Gurnee POB
1445 Hunt Club Suite 100 103 203
Gurnee,IL60031 		Patient Care - OutPatient
10 Condell Medical Center - Gurnee Imaging
1435 N Hunt Club
Gurnee,IL60031 		Patient Care - OutPatient
11 Condell Medical Center - Office BLDG
1425 Hunt Club STE 102103203304
Gurnee,IL60031 		Patient Care - OutPatient
12 Condell Medical Center - Centre Club
200 West Golf Rd
Libertyville,IL60048 		Patient Care - OutPatient
13 Condell Medical CTR - Inter Gen Center
700 S Garfield
Libertyville,IL60048 		Patient Care - OutPatient
14 Condell Medical Center - AMBI Center
890 Garfield
Libertyville,IL60048 		Patient Care - OutPatient
15 Condell Medical Center - Office BLDG
755 Milwaukee Ave Various STE
Libertyville,IL60048 		Patient Care - OutPatient
16 Condell Med Ctr-Radiation Therapy
880 Garfield Ave
Libertyville,IL60048 		Patient Care - OutPatient
17 CONDELL HOME HEALTH SVCS & HOSPICE
115 W CHURCH STREET
LIBERTYVILLE,IL60048 		PATIENT CARE - OUTPATIENT
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
Part VI, Line 1 - Description for Part I, Line 3c   N/A Part VI, Line 1 - Description for Part I, Line 6a A SYSTEM-WIDE COMMUNITY BENEFIT REPORT IS FILED BY: ADVOCATE HEALTH CARE NETWORK 3075 HIGHLAND PARKWAY, DOWNERS GROVE, IL 60515 EIN 36-2167779 PART VI, LINE 1 DESCRIPTION FOR PART I, LINE 7 A COST-TO-CHARGE RATIO, DERIVED FROM SCHEDULE H INSTRUCTIONS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7A. SCHEDULE H INSTRUCTIONS WORKSHEET 3, UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7B. A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINES 7E, 7F, 7G, AND 7I. PART VI, LINE 1 DESCRIPTION FOR PART I, LINE 7E Advocate Condell Medical Center (ACMC) provides Community Health Improvement services to the communities in which it serves. ACMC provides language services to all those in need in order to provide better access to care for all community members. In addition, other programs are carried out with the express purpose of improving community health, access to health services and general health knowledge. These services do not generate patient bills, however, certain programs or services may have nominal fees. These services and programs include cancer support groups. These groups focus on educating the newly diagnosed and providing information on better living for survivors. Colorectal cancer screening are also provided; various programs regarding joint pain and replacement including treatment options and information on pain relief; various women and baby, breastfeeding, multiples, childbirth and parenting and sibling classes; various educational programs and support groups to raise awareness of heart disease. diabetes and stroke risk factors and treatment options and education for living with the disease; there are various programs regarding health eating; CPR training is offered to the community as well as various other wellness and screening programs and health fairs are offered throughout the year. Adult day care is provided to the community as well. PART VI, LINE 1 DESCRIPTION FOR PART I, LINE 7G ACMC provides subsidized health services to the community. These services are provided despite creating a financial loss for ACMC. These services are provided because they meet an identified community need. If ACMC did not provide the clinical service, it is reasonable to conclude that these services would not be available to the community. The services included are both inpatient and outpatient programs for chemical dependency health services, orthopedic and hospice services. PART VI, LINE 1 DESCRIPTION FOR PART I, LINE 7H ACMC CONDUCTS NUMEROUS RESEARCH ACTIVITIES FOR THE ADVANCEMENT OF MEDICAL AND HEALTH CARE SERVICES. HOWEVER, THE UNREIMBURSED COST OF SUCH RESEARCH ACTIVITIES IS NOT READILY DETERMINABLE AND NO AMOUNT IS BEING REPORTED FOR PURPOSES OF THE 2012 FORM 990, SCHEDULE H. PART VI, LINE 1 DESCRIPTION FOR PART I, LINE 7, COLUMN (F) $16,115,442 OF BAD DEBT EXPENSE WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS REMOVED FROM THE DENOMINATOR FOR PURPOSES OF SCHEDULE H, PART I, LINE 7, COLUMN (F). PART VI, LINE 1 DESCRIPTION FOR Part II N/A PART VI, LINE 1 DESCRIPTION FOR Part III, Line 4 THE FOOTNOTES TO ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES' AUDITED FINANCIAL STATEMENTS DO NOT SPECIFICALLY ADDRESS BAD DEBT EXPENSE; RATHER, THE FOOTNOTE DESCRIBES ADVOCATE'S PATIENT ACCOUNTS RECEIVABLE POLICY AND THE PERCENTAGE OF ACCOUNTS RECEIVABLE THAT THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERS (SEE PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS). FOR 2012, FOR ADVOCATE CONDELL, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERED 35.51% OF NET PATIENT ACCOUNTS RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. ACMC EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYER CLASS, HISTORICAL COLLECTION EXPERIENCE, AND TRENDS IN HEALTH CARE INSURANCE PROGRAMS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 IS BASED ON THE RATIO OF PATIENT CARE COST TO CHARGES. THE UNREIMBURSED COST OF BAD DEBT WAS CALCULATED BY APPLYING THE ORGANIZATION'S COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) TO THE ORGANIZATION'S BAD DEBT PROVISION PER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS RECEIVED. ADVOCATE MAKES EVERY EFFORT TO IDENTIFY THOSE PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BY STRICTLY ADHERING TO ITS FINANCIAL ASSISTANCE POLICY. WE BELIEVE THAT ADVOCATE HAS A POPULATION OF PATIENTS WHO ARE UNINSURED OR UNDERINSURED BUT WHO DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) WHICH COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY, WAS BASED UPON SELF PAY PATIENT ACCOUNTS WHICH HAD AMOUNTS WRITTEN OFF TO BAD DEBTS. OUR METHOD WAS TO BEGIN WITH THE SELF-PAY PORTION OF BAD DEBT EXPENSE PROVISION. THE SELF-PAY PORTION EXCLUDES THOSE PATIENTS WHO HAD CHARITY APPLICATIONS PENDING AT THE TIME OF SERVICE. THIS COST WAS THEN REDUCED BY CHARGES IDENTIFIED AS TRUE BAD DEBT EXPENSE, INCLUDING COPAYS FOR PATIENTS WHO QUALIFIED FOR LESS THAN 100% FINANCIAL ASSISTANCE, AND CHARGES FOR PATIENTS WHO APPLIED FOR FINANCIAL ASSISTANCE AND WERE DENIED. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE REMAINING CHARGES, TO DETERMINE THE VALUE (AT COST) OF PATIENT ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT. WE BELIEVE THIS PROCESS IS A REASONABLE BASIS FOR OUR ESTIMATE. AS WE ARE ONLY CONSIDERING SELF-PAY ACCOUNTS WRITTEN OFF TO BAD DEBT FOR THIS ESTIMATE, THIS ESTIMATE DOES NOT INCLUDE THE IMMEDIATE 20% DISCOUNT TO CHARGES WHICH IS APPLIED TO ALL SELF-PAY PATIENTS. IT ALSO DOES NOT INCLUDE ACCOUNT BALANCES OR CO-PAYS OF NON-SELF PAY ACCOUNTS WHICH ARE WRITTEN OFF TO BAD DEBT WHEN THE PATIENT HAS NO OTHER FINANCIAL RESOURCES TO PAY THESE AMOUNTS AND THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE. BAD DEBT AMOUNTS HAVE BEEN EXCLUDED FROM OTHER COMMUNITY BENEFIT AMOUNTS REPORTED THROUGHOUT SCHEDULE H. PART VI, LINE 1 DESCRIPTION FOR Part III, Line 8 THE SHORTFALL OF $4,629,365 ON PART III, LINE 7 IS THE UNREIMBURSED COST OF PROVIDING SERVICES FOR MEDICARE PATIENTS AND SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE PROVIDING THESE SERVICES WITHOUT REIMBURSEMENT LESSENS THE BURDENS OF GOVERNMENT OR OTHER CHARITIES THAT WOULD OTHERWISE BE NEEDED TO SERVE THE COMMUNITY. FOR ACMC'S HOSPITAL OPERATIONS, THE UNREIMBURSED COST OF MEDICARE WAS CALCULATED BY APPLYING THE ORGANIZATIONS COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) AND FOR NON-HOSPITAL OPERATIONS THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES TO THE ORGANIZATIONS MEDICARE, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS AND/OR CONTRIBUTIONS RECEIVED THAT WERE DESIGNATED FOR THE PAYMENT OF MEDICARE PATIENT BILLS. PART VI, LINE 1 DESCRIPTION FOR Part III, Line 9b ACMC MAINTAINS BOTH WRITTEN FINANCIAL ASSISTANCE AND BAD DEBT/COLLECTION POLICIES. THE BAD DEBT/COLLECTION POLICY DOES NOT APPLY TO THOSE PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THEREFORE SUCH PATIENTS ARE NOT SUBJECT TO COLLECTION PRACTICES. PATIENTS ARE NOT SUBJECT TO COLLECTION PRACTICES.
Part VI, Line 1 - Description for Part V, Sec B, Line 12H   OTHER FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDE: DECEASED PATIENTS WITH NO ESTATE; HOMELESS PATIENTS, OR PATIENTS WHO RECEIVE CARE IN A HOMELESS CLINIC; PATIENTS WHO QUALIFY FOR A STATE DEPARTMENT OF HUMAN SERVICES (DHS) ASSISTANCE PROGRAM, BUT HAVE NO MEDICAL COVERAGE (E.G., ILLINOIS AMI/GA, FOOD STAMP, PRESCRIPTION, WOMEN, INFANTS AND CHILDREN (WIC), WHY WAIT AND WISE WOMEN PROGRAMS); COUNTY HEALTH CLINIC PATIENTS, LEGAL ASSISTANCE FOUNDATION OF ILLINOIS REFERRALS; INDIVIDUALS WITH A VALID ADDRESS AT LOW-INCOME/SUBSIDIZED HOUSING; INCARCERATED INDIVIDUALS; INCOMPETENT INDIVIDUALS WITH COMPROMISED DIAGNOSES (E.G., SUBSTANCE ABUSE, PSYCHIATRIC); INDIVIDUALS MEETING DEFINED CREDIT REPORTING (OR OTHER EXTERNAL REPORTING) RESULT THRESHOLDS; PATIENTS WITH PRIOR HISTORY OF INABILITY TO MAKE PAYMENTS; PATIENTS WITH COURT FILED OR APPROVED BANKRUPTCY DETERMINATIONS. Part VI, Line 1 - Description for Part V, Sec B, Line 14g ACMC COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY. MEANS OF COMMUNICATION INCLUDE: 1. THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HOSPITAL SERVICES INCLUDES A STATEMENT THAT FINANCIAL COUNSELING, INCLUDING FINANCIAL ASSISTANCE CONSIDERATION, IS AVAILABLE UPON REQUEST. 2. SIGNAGE IS CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS. 3. BROCHURES ARE PLACED IN HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS, AND INCLUDE GUIDANCE ON HOW A PATIENT MAY APPLY FOR MEDICARE, MEDICAID, ALL KIDS, FAMILY CARE ETC., AND THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. A HOSPITAL CONTACT AND TELEPHONE NUMBER FOR FINANCIAL ASSISTANCE IS INCLUDED. 4. A HANDOUT SUMMARIZING ADVOCATE'S FINANCIAL ASSISTANCE POLICY AND A FINANCIAL ASSISTANCE APPLICATION ARE GIVEN TO ALL UNINSURED PATIENTS WHO RECEIVE MEDICALLY NECESSARY HOSPITAL SERVICES AT THE EARLIEST PRACTICAL TIME OF SERVICE. 5. ADVOCATE'S WEBSITE PROMINENTLY NOTES THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLANATION OF THE APPLICATION PROCESS, A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, AND THE FINANCIAL ASSISTANCE APPLICATION. 6. HOSPITAL BILLS TO ALL UNINSURED PATIENTS INCLUDE A REQUEST THAT THE PATIENT INFORM THE HOSPITAL OF ANY AVAILABLE HEALTH INSURANCE COVERAGE; AND INCLUDE A SUMMARY OF ADVOCATE'S FINANCIAL ASSISTANCE POLICY, A FINANCIAL ASSISTANCE APPLICATION AND A TELEPHONE NUMBER TO REQUEST FINANCIAL ASSISTANCE. Part VI, Line 1 - Description for Part V, Sec B, Line 17 ACMC DOES NOT PERFORM ACTIONS SUCH AS THOSE LISTED IN LINES 17 UNTIL REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE A PATIENT'S FAP ELIGIBILITY. Part VI, Line 1 - Description for Part V, Sec B, Line 18E ADVOCATE MAKES REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY UNDER ITS FAP, INCLUDING SENDS A SERIES OF LETTERS AND ATTEMPTS TO WORK WITH THE PATIENT THROUGH THE FINANCIAL COUNSELING PROCESS AND/OR PHONE CALLS. ALL CORRESPONDENCE ASKS THE PATIENT TO NOTIFY THE HOSPITAL IF HE/SHE IS EXPERIENCING "DIFFICULTY IN PAYING YOUR BILL". ADVOCATE ALSO USES EARLY OUT AND PRECOLLECTION VENDORS TO ASSIST IN OBTAINING PAYMENTS OR COLLECTING FINANCIAL ASSISTANCE ELIGIBILITY INFORMATION. THESE VENDORS HAVE THE FOLLOWING LANGUAGE IN THEIR CONTRACT: "VENDOR WILL COMMUNICATE THE ADVOCATE HEALTH CARE POLICY AND GUIDELINE TO ANY PATIENT EXPRESSING A DIFFICULTY IN PAYING THEIR BILL" AND, "VENDOR WILL MAIL THE ADVOCATE HEALTH CARE FINANCIAL ASSISTANCE APPLICATION TO ANY PATIENTS EXPRESSING A DIFFICULTY IN PAYING THEIR BILL". ADVOCATE'S BAD DEBT AGENCY CONTRACTS HAVE THE FOLLOWING LANGUAGE: "AGENCY SHALL EVALUATE EACH PATIENT WHOSE ACCOUNT IS REFERRED TO AGENCY, WHERE THE PATIENT EXPRESSES DIFFICULTY OR INABILITY TO PAY THEIR BILL, FOR ELIGIBILITY UNDER ADVOCATE'S FINANCIAL ASSISTANCE POLICY." VENDOR AND AGENCY CONTRACTS ARE STANDARD ACROSS ADVOCATE'S SYSTEM. Part VI, Line 1 - Description for Part V, Sec B, Line 20D THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO AN FAP-ELIGIBLE PATIENT FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED ON A SLIDING SCALE PERCENTAGE OF ANNUAL FAMILY INCOME WHICH IS TIED TO THE FPG FAMILY INCOME LIMIT APPLICABLE TO THE PATIENT. FOR A FAMILY WITH INCOME BETWEEN TWO AND THREE TIMES THE FEDERAL POVERTY LEVEL, THE MAXIMUM EXPECTED PAYMENT IS 5% OF ANNUAL FAMILY INCOME. FOR A FAMILY WITH INCOME BETWEEN THREE AND FOUR TIMES THE FEDERAL POVERTY LEVEL, THE MAXIMUM EXPECTED PAYMENT IS 10% OF ANNUAL FAMILY INCOME. FOR AN UNINSURED FAMILY WITH INCOME BETWEEN FOUR AND SIX TIMES THE FEDERAL POVERTY LEVEL, THE MAXIMUM EXPECTED PAYMENT IS 25% OF ANNUAL FAMILY INCOME.
Part VI, Line 2 - Needs assessment   IN JANUARY 2011, ACMC IMPLEMENTED A NEW COMMUNITY HEALTH ACCOUNTABILITY STRUCTURE. THE OVERALL GOAL WAS TO MORE STRATEGICALLY FOCUS THE HOSPITALS COMMUNITY HEALTH PROGRAMMING TO ENSURE KEY COMMUNITY NEEDS ARE BEING ADDRESSED AND THAT THE PROGRAMS, WHETHER DEVELOPED OR SUSTAINED, MEASURABLY IMPROVE COMMUNITY HEALTH. A COMMUNITY HEALTH COMMITTEE WAS ESTABLISHED TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT USING A STANDARDIZED APPROACH. REPRESENTATIVES FROM THE HOSPITALS EXECUTIVE TEAM, PUBLIC AFFAIRS AND MARKETING, MISSION AND SPIRITUAL CARE, AND BUSINESS DEVELOPMENT AND STRATEGY DEPARTMENTS, LED BY THE HOSPITALS COMMUNITY HEALTH LEADER, MET REGULARLY DURING THE FIRST HALF OF THE YEAR. IN ADDITION, A GOVERNING COUNCIL REPRESENTATIVE FROM THE COMMUNITY WAS INVITED TO SERVE AS AN ACTIVE PARTICIPANT ON THE COMMUNITY HEALTH COMMITTEE. ADDITIONAL HOSPITAL CLINICAL TEAM MEMBERS WILL BE ADDED TO THE COMMITTEE FOR THEIR DISEASE-SPECIFIC PROGRAM EXPERTISE, AS WILL OTHER COMMUNITY REPRESENTATIVES WITH SPECIAL KNOWLEDGE OR EXPERTISE IN KEY FOCUS AREAS. THE COMMITTEE WILL CONTINUE TO MEET EACH YEAR AS PART OF THE HOSPITALS ONGOING ASSESSMENT PROCESS. DURING 2011, COMMUNITY HEALTH COMMITTEE MEMBERS ATTENDED THREE CHNA WORKSHOPS DESIGNED TO LAUNCH THE CHNA PROCESS BY EDUCATING THEM ON HOW TO CONDUCT AN ASSESSMENT, INCLUDING CUTTING EDGE THINKING ON ADDRESSING COMMUNITY NEED. USING BOTH PRIMARY AND SECONDARY COMMUNITY HEALTH DATA, THE HOSPITAL COMMITTEE IDENTIFIED ITS SERVICE AREAS KEY HEALTH NEEDS AND THEN EMPLOYED A STANDARDIZED PRIORITY SETTING PROCESS TO DETERMINE KEY HEALTH NEEDS ON WHICH TO FOCUS. DURING THE PROCESS, THE HOSPITALS AND COMMUNITYS KEY CHALLENGES AND ASSETS WERE EXAMINED, AND HOSPITAL REPRESENTATIVES ENGAGED EXTERNAL KEY INFORMANTS IN DISCUSSIONS TO DETERMINE THE POTENTIAL FOR PARTNERING WITH OTHER ORGANIZATIONS AND SHARING RESOURCES TO ADDRESS COMMUNITY NEED. CHNA RESULTS WERE SHARED AND THE SELECTED PRIORITIES WERE ENDORSED BY ACMCS PRESIDENT AND FULL GOVERNING COUNCIL. IN 2012 THE HOSPITAL'S HEALTH LEADERS WORKED TO DEEPEN THEIR ASSESSMENTS AND UNDERSTANDING OF THE ROOT CAUSE OF THEIR COMMUNITIES NEEDS THROUGH DISCUSSION WITH COMMUNITY EXPERTS AND OTHER SELECTED COMMUNITY PARTNERS. EACH YEAR THE HOSPITAL PLAN IS REVIEWED AND APPROVED BY THE HOSPITAL PRESIDENT. THE HOSPITAL PLANS ARE THEN SHARED WITH AND ENDORSED BY THE GOVERNING COUNCIL. AS ONE OF TEN HOSPITALS IN THE ADVOCATE HEALTH CARE SYSTEM, ACMCS PLAN SUMMARY WILL BE SHARED PERIODICALLY WITH THE SYSTEM LEVEL EXECUTIVE MANAGEMENT TEAM AND WITH ADVOCATE HEALTH CARES MISSION AND SPIRITUAL CARE COMMITTEE OF THE BOARD, WHICH HAS SYSTEM LEVEL OVERSIGHT OF COMMUNITY HEALTH PLANNING.
Part VI, Line 3 - Patient education of eligibility for assistance   ACMC ASSISTS PATIENTS WITH ENROLLMENT IN GOVERNMENT-SUPPORTED PROGRAMS FOR WHICH THEY ARE ELIGIBLE AND IN SECURING REIMBURSEMENT FROM AVAILABLE THIRD PARTY RESOURCES. FINANCIAL COUNSELING IS PROVIDED TO HELP PATIENTS IDENTIFY AND OBTAIN PAYMENT FROM THIRD PARTIES, INCLUDING ILLINOIS MEDICAID, ILLINOIS CRIME VICTIMS FUND, ETC., AS WELL AS TO DETERMINE ELIGIBILITY UNDER ACMCS FINANCIAL ASSISTANCE POLICY. ADVOCATE UTILIZES A FINANCIAL SCREENING SOFTWARE PROGRAM TO HELP IDENTIFY PUBLIC ASSISTANCE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE OR ADVOCATE'S FINANCIAL ASSISTANCE AT THE TIME OF REGISTRATION OR AS SOON AS PRACTICABLE THEREAFTER. IN ADDITION, HEALTHADVISOR, ADVOCATE'S EDUCATION REGISTRATION AND PHYSICIAN REFERRAL TELEPHONE CENTER, SERVES AS A COMMUNITY RESOURCE PROVIDING REFERRALS TO GOVERNMENT-FUNDED AND OTHER PROGRAMS VIA TELEPHONE FROM 8 A.M. TO 6 P.M., MONDAY THROUGH FRIDAY. ACMC ASSISTS PATIENTS WITH APPLYING FOR ADVOCATE'S OWN FINANCIAL ASSISTANCE SERVICES, IF PATIENTS ARE NOT ELIGIBLE FOR GOVERNMENT-SUPPORTED PROGRAMS. ACMC COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY. MEANS OF COMMUNICATION INCLUDE: 1. THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HOSPITAL SERVICES INCLUDES A STATEMENT THAT FINANCIAL COUNSELING, INCLUDING FINANCIAL ASSISTANCE CONSIDERATION, IS AVAILABLE UPON REQUEST. 2. SIGNS ARE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS. 3. BROCHURES ARE PLACED IN HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS, AND WILL INCLUDE GUIDANCE ON HOW A PATIENT MAY APPLY FOR MEDICARE, MEDICAID, ALL KIDS, FAMILY CARE ETC., AND THE HOSPITALS FINANCIAL ASSISTANCE PROGRAM. A HOSPITAL CONTACT AND TELEPHONE NUMBER FOR FINANCIAL ASSISTANCE IS INCLUDED. 4. A HANDOUT SUMMARIZING ADVOCATES FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION IS GIVEN TO UNINSURED PATIENTS WHO RECEIVE MEDICALLY NECESSARY HOSPITAL SERVICES AT THE EARLIEST PRACTICAL TIME OF SERVICE. 5. ADVOCATES WEBSITE POSTS NOTICE IN A PROMINENT PLACE THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLANATION OF THE FINANCIAL ASSISTANCE APPLICATION PROCESS, AND ENABLE PRINTING OF THE FINANCIAL ASSISTANCE APPLICATION. 6. HOSPITAL BILLS TO UNINSURED PATIENTS INCLUDE A REQUEST THAT THE PATIENT INFORM THE HOSPITAL OF ANY AVAILABLE HEALTH INSURANCE COVERAGE, AND INCLUDE A SUMMARY OF ADVOCATES FINANCIAL ASSISTANCE POLICY, A FINANCIAL ASSISTANCE APPLICATION, AND A TELEPHONE NUMBER TO REQUEST FINANCIAL ASSISTANCE.
Part VI, Line 4 - Community Information   ADVOCATE HEALTH CARE NETWORKS PRIMARY SERVICE AREA COVERS THE SIX-COUNTY, CHICAGO METROPOLITAN AREA. THESE COUNTIES INCLUDE COOK, DUPAGE, KANE, LAKE, MCHENRY, AND WILL. ACMC PRIMARILY SERVES THE COMMUNITY OF LAKE COUNTY. THE POPULATION IN ADVOCATES SERVICE AREA IS DESCRIBED BY THE FOLLOWING DEMOGRAPHIC CHARACTERISTICS: TOTAL POPULATION, POPULATION BY GROUP, RACE/ETHNIC DISTRIBUTION AND KEY SOCIO-ECONOMIC INDICATORS. THE CHICAGO METROPOLITAN AREA IS EXPECTED TO CONTINUE TO GROW FROM 2012 TO 2016, WITH THE POPULATION REACHING NEARLY 8.48 MILLION PEOPLE BY 2017. WHILE THE OVERALL AREA IS EXPECTED TO GROW 1.5%, SEVERAL OF THE COLLAR COUNTIES WILL EXPERIENCE HIGHER GROWTH INCLUDING KANE COUNTY (7.6%) AND WILL COUNTY (9.1%). THE 65+ AGE GROUP IS EXPECTED TO HAVE THE LARGEST INCREASE IN POPULATION (13.3%) FROM 2012 TO 2017, FOLLOWED BY THE 45-64 AGE GROUP (5.1%). THE 18-44 AGE GROUP IS EXPECTED TO DECLINE 3.4%, WHILE THE POPULATION AGES 0-17 IS EXPECTED TO INCREASE SLIGHTLY (.1%). WHILE THESE ARE THE TRENDS ACROSS THE OVERALL METRO AREA, THE TRENDS VARY IN GREAT DEGREE BY COUNTY. A WIDE RANGE OF DIVERSITY EXISTS AMONG THE COMMUNITIES SERVED BY EACH OF OUR HOSPITALS. ASIANS AND HISPANICS ARE PROJECTED TO CONTINUE TO BE THE TWO FASTEST GROWING RACE/ETHNIC GROUPS FROM 2012 TO 2017 (12.6% AND 10.7% GROWTH EXPECTED, RESPECTIVELY). THE SOCIO-ECONOMIC STATUS OF THE CHICAGO AREA ALSO VARIES BY COUNTY. IN COOK COUNTY, NEARLY 23 PERCENT OF THE HOUSEHOLDS HAVE A HOUSEHOLD INCOME UNDER THE FEDERAL POVERTY LEVEL WITH ANNUAL INCOMES BELOW THE $25,000 THRESHOLD. IN THE COLLAR COUNTIES, TEN TO THIRTEEN PERCENT OF THE HOUSEHOLDS ARE SUBSISTING ON LESS THAN $25,000 A YEAR. OVERALL, THE NUMBER OF PEOPLE ON MEDICAID HAS INCREASED FROM 2011 TO 2012 AND THE NUMBER OF UNINSURED INDIVIDUALS HAS INCREASED FROM 2011 TO 2012 BY 0.3%. IN HOUSEHOLDS THAT ARE STRUGGLING ECONOMICALLY, ACCESS TO HEALTH CARE CAN BE LIMITED EITHER BECAUSE OF A LACK OF SERVICES AVAILABLE WITHIN THE MARKET OR BECAUSE AN INDIVIDUALS FINANCIAL CHALLENGES DETER THAT PERSON FROM SEEKING CARE. LACK OF PREVENTIVE CARE OR CARE FOR CHRONIC ILLNESSES BRINGS MORE ACUTELY ILL PATIENTS TO THE HOSPITAL. ACMC PROVIDES QUALITY MEDICAL HEALTH CARE TO VARIOUS COMMUNITIES IN THE CHICAGOLAND AREA REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. IN 2012, ADVOCATE CONDELL EXPERIENCED 118,253 INPATIENT ADMISSIONS, 4,195,456 OUTPATIENT VISITS.
Part VI, Line 5 - Promotion of community health   In addition to providing quality inpatient and outpatient services at its multiple sites of care, ACMC reaches beyond its walls and into communities through a wide array of activities and programs designed and delivered to benefit the communities it serves. These community benefits include: *Care that is provided free, subsidized or without full reimbursement from Medicare, Medicaid or other government insurance programs. *Services responding to unique community needs, such as trauma services, emergency care, neonatal intensive care, behavioral health services, parish nursing and congregational health ministries, as well as health screenings, immunization programs, school-based health care and other community outreach programs. *Education to train physicians, nurses, radiology technicians, physical therapists, EMTs, clinical pastors and a host of other highly skilled health care professionals. *Volunteer services provided by hospital employees who volunteer in their communities and community members who volunteer at hospitals. *Language-assistance services, such as interpreters and translation services for signage, forms, brochures, patient health education materials and other information in languages other than English. *Donations by Advocate hospitals of meeting and clinic space, used medical supplies and equipment, as well as other assistance to community groups. Through Advocate's own programs and services, as well as its participation in the community, Advocate promotes a shared approach to community benefits. Examples include: *Advocate Health Care is dedicated to providing expert emergency care to the most critically injured people in Chicago - today and in the future. Advocate's five Level I Trauma Centers and two Level II Trauma Centers provide care to nearly 20 percent of Chicagoland's trauma patients. In 2012, Advocate Christ Medical Center in Oak Lawn, Advocate Good Samaritan Hospital in Downers Grove, ACMC in Libertyville, Advocate Illinois Masonic Medical Center on Chicago's North Side and Advocate Lutheran General Hospital in Park Ridge handled a total of 303,625 visits, including 10,461 trauma cases. Advocate's Level II Trauma Centers - Advocate BroMenn Medical Center in Normal and Advocate Good Shepherd Hospital in Barrington - together provided care for 69,947 emergency department visits. *Since 1995, Advocate Health Care's Office for Mission and Spiritual Care has provided clinical chaplains and ethicists who offer support and services to individuals and families facing medical crisis. In addition, through its Congregational Health Partnerships and Parish Nurse Ministry programs, Advocate extends its reach into the community, working with churches, social service organizations, governmental agencies and other community partners to address community needs. Advocate's spiritual leaders also oversee a nationally accredited Clinical Pastoral Education program. Training 100 students each year, this program is one of the largest in the country, providing opportunities for seminary students and local health leaders to grow and develop spiritual care ministry skills. *Senior Advocate, a free membership program for adults ages 65 and older, offers services throughout the year to help keep older adults healthy and active. Flu shots and health lectures, as well as health insurance counseling to help with hospital billing paperwork (available at several Advocate hospitals), are a few of the benefits received by Senior Advocate members. A few examples of Advocate's leadership in serving uninsured and underinsured individuals and families are: *Advocate offers a very generous charity care program - requiring no payments from the patients most in need, and providing discounts to uninsured patients earning up to six times the federal poverty level and to insured patients earning up to four times the poverty level. Advocate considers an individual's extenuating circumstances to qualify patients for charity care and, in certain cases, determines a patient's eligibility using Advocate or public records ("presumptive eligibility"). Advocate is also one of the largest providers of health care services to Medicaid and Medicare patients in Chicago and the surrounding suburbs. *ACMC COLLABORATES WITH EMERGENCY MEDICAL SERVICE PROVIDERS TO SHARE BEST-PRACTICE INFORMATION THROUGHOUT ADVOCATE SITES AS WELL AS OTHER NON-ADVOCATE MEDICAL PROVIDERS. ACMC IS A RESOURCE HOSPITAL FOR ILLINOIS REGION 10, WHICH REQUIRES ACMC TO COORDINATE ONGOING TRAINING IN EMERGENCY RESPONSE TO A MASS CASUALTY SITUATION OR OTHER DISASTER. THESE EDUCATION PROGRAMS AND TRAINING EXERCISES INVOLVE EVERY EMERGENCY PROVIDER IN THE AREA, BOTH INSIDE AND OUTSIDE OF ADVOCATE, AS WELL AS THE LAKE COUNTY HEALTH DEPARTMENT AND OTHER REGIONAL ORGANIZATIONS AS APPROPRIATE. ACMC ALSO OFFERS EDUCATIONAL TRAINING COURSES FOR INDIVIDUALS TO EARN PARAMEDIC CERTIFICATION. *ACMC CLINICIANS PROVIDE CARE TO THE COMMUNITY FOR MINOR INJURIES AND ILLNESSES THROUGH ACMC'S IMMEDIATE CARE CENTERS REGARDLESS OF THE PATIENT'S ABILITY TO PAY. EXERCISE PHYSIOLOGISTS AND PHYSICAL THERAPISTS ALSO PROVIDE SPORTS MEDICINE CONSULTATIONS AT LOCAL HIGH SCHOOLS AND COLLEGES. PHYSICIANS, NURSES AND OTHER CLINICIANS LEAD PRENATAL/CHILDBIRTH AND PARENTING EDUCATION CLASSES AND DIABETES EDUCATION CLASSES AS WELL AS SUPPORT GROUPS FOR DIABETES EDUCATION, HEART DISEASE, BREAST AND OTHER CANCERS, LACTATION/BREAST FEEDING, BEREAVEMENT/LOSS AND CAREGIVERS. ACMC PARTNERS WITH THE LAKE COUNTY DEPARTMENT OF PUBLIC HEALTH TO PROVIDE IMAGING SERVICES AT RATES SIGNIFICANTLY BELOW COST, AS WELL AS HOSTS MONTHLY REDUCED-FEE CHILD IMMUNIZATION CLINICS. Advocate is focusing on community health programs and initiatives that improve the quality of life throughout the Chicago region. Examples include: *ACMC'S DAY CENTER ADULT DAY CARE PROGRAM FILLS A GAP IN CONTINUITY OF CARE FOR CLIENTS WHO ARE UNABLE TO LIVE INDEPENDENTLY. ACMC'S PROGRAM COMBINES ADULT DAY CARE WITH THERAPEUTIC AND PERSONAL CARE SERVICES. GIVEN THAT THE PROGRAM IS LOCATED ADJACENT TO OTHER HOSPITAL SERVICES, CLIENTS CAN RECEIVE PHYSICAL, SPEECH AND OCCUPATIONAL THERAPY FROM A LICENSED THERAPIST. IN ADDITION, BATHING ASSISTANCE, BEAUTICIAN/BARBER AND PODIATRY CARE ARE AVAILABLE AS A SERVICE TO THE CLIENT AND CAREGIVER. COMPREHENSIVE ADULT DAY CARE ALLOWS THE CAREGIVER TO REMAIN EMPLOYED AND/OR RECEIVE MUCH NEEDED RESPITE, THUS ALLOWING CLIENTS WITH FRAILTIES OR DEMENTIA TO REMAIN IN THE COMMUNITY AND AVOID OR DELAY THE ADDITIONAL EXPENSE OF LONG-TERM CARE. ACMC'S PROGRAM ACCEPTS CLIENTS WITH A HIGHER ACUITY THAN OTHER LOCAL PROGRAMS, CARING FOR PATIENTS IN THE LATER PART OF MIDDLE-STAGE ALZHEIMER'S. ACMC ALSO WORKS WITH THE VETERAN'S ADMINISTRATION TO PROVIDE SERVICES FOR THEIR PATIENTS UNDER THE CARE OF AN ON-SITE REGISTERED NURSE. *ACMC'S PACT (PEDIATRIC ALTERNATIVES IN CREATIVE THERAPY) PROGRAM IS A UNIQUE MEDICAL SUPPORT SERVICE IN LAKE COUNTY FOR CHILDREN AND TEENS WITH NEUROMUSCULAR DISORDERS, SUCH AS SPINA BIFIDA, CEREBRAL PALSY, HEAD TRAUMA AND SPINAL CORD INJURIES, AS WELL AS THOSE WITH DEVELOPMENTAL DELAY AND SPEECH-LANGUAGE DISORDERS. PACT ALSO TREATS CHILDREN WITH GENETIC AND CONGENITAL ANOMALIES, STRUCTURAL ABNORMALITIES, SUCH AS CLEFT PALATE, AND HEARING/VISION PROBLEMS, SENSORY INTEGRATION DYSFUNCTION AND THOSE RECEIVING RADIATION OR CHEMOTHERAPY TREATMENTS. PACT'S INTERDISCIPLINARY TEAM OF PROFESSIONALS, INCLUDING PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, AND SPEECH-LANGUAGE PATHOLOGIST, PARTNERS WITH THE FAMILIES, SCHOOLS, PHYSICIANS AND COMMUNITY TO PROVIDE COMPREHENSIVE INTERVENTION, AS WELL AS AN INDIVIDUALIZED TREATMENT PROGRAM FOR EACH CHILD. Advocate maintains and continues to actively expand its partnerships and relationships with a wide variety of organizations, including religious organizations, neighborhood groups and outreach and resource programs. Examples include: *Advocate sponsors 18 Advocate parish nurses serving 24 congregations and 13 network nurses serving 13 congregations who provide health education, wellness promotion, health screenings, advocacy and spiritual support to faith communities in Advocate's city and suburban hospital service areas. *ACMC's Sexual Assault Nurse Examiner (SANE) program opened in 2011, and remains the only Lake County program with certified sexual assault nurse examiners available 24 hours, 7 days a week. These highly trained practitioners not only provide compassionate care to victims, but also are able to collect forensic evidence, counsel the victim, and testify in court helping the victim through the entire process. In addition, the SANE program coordinator works closely with local rape advocates, law enforcement and prosecutors to assure victims of sexual assault in Lake County receive the best care possible. In 2012, ACMC's SANE coordinator, Jennifer Slominski, received the Justice Award from Lake County State's Attorney Michael J. Waller for her role in helping the prosecution o
STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL,
Schedule H (Form 990) 2012
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
2012
Open to Public
Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number
26-2525968
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. Part II can be duplicated if additional space is needed.
(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 CANCER SOCIETY
100 TRI-ST INTL PKWY
LINCOLNSHIRE,IL60069 		13-1788491 501(c)3 12,000       RELAY FOR LIFE PROGRAM
(2) HEALTHREACH INC
1800 GRAND AVENUE
WAUKEGAN,IL60085 		36-3816410 501(c)3 62,500       SUPPORT EXEMPT MISSION




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
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.
Part III can be duplicated 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












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants ADVOCATE CONDELL MEDICAL CENTER SUPPORTS ONLY NONPROFIT ORGANIZATIONS THAT ARE TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THAT ARE CONSISTENT WITH AND COMPLEMENTARY TO THE MISSION AND CHARITABLE, TAX-EXEMPT PURPOSES OF ADVOCATE CONDELL MEDICAL CENTER. CASH CONTRIBUTIONS ARE NOT MADE TO INDIVIDUALS, FOR PROFIT BUSINESSES OR PRIVATE PROVIDERS.
Schedule I (Form 990) 2012


Additional Data


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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
2012
Open to Public Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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 or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
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
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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 Regulations 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)James SkogsberghEXEC VP, COO, DIRECTOR (i)
(ii)		 0
1,166,837 		0
1,597,560 		0
829,328 		0
667,330 		0
31,556 		0
4,292,611 		0
632,803
(2)William P SantulliPresident & CEO (i)
(ii)		 0
728,878 		0
926,710 		0
458,754 		0
387,090 		0
35,707 		0
2,537,139 		0
357,548
(3)Lee B Sacks MDExec VP, Chief Medical Officer (i)
(ii)		 0
574,877 		0
685,044 		0
437,218 		0
295,605 		0
24,560 		0
2,017,304 		0
267,698
(4)James Dan MDPres Physician & Amb Services (i)
(ii)		 0
451,202 		0
498,525 		0
662,448 		0
219,645 		0
23,545 		0
1,855,365 		0
193,028
(5)James DohenyVP, Finance & Corp Controller (i)
(ii)		 0
279,518 		0
108,000 		0
34,979 		0
23,128 		0
34,875 		0
480,500 		0
0
(6)Kelly Jo GolsonSVP, Public Affairs & Mktg (i)
(ii)		 0
322,517 		0
201,372 		0
213,680 		0
106,589 		0
4,720 		0
848,878 		0
56,288
(7)Kevin BradySVP, Human Resources (i)
(ii)		 0
384,526 		0
165,597 		0
126,100 		0
203,335 		0
35,502 		0
915,061 		0
0
(8)Gail D HasbrouckSVP, Gen Counsel, Corp Sec (i)
(ii)		 0
409,858 		0
350,179 		0
276,424 		0
153,345 		0
24,319 		0
1,214,124 		0
127,906
(9)Dominic J NakisSVP, CFO (i)
(ii)		 0
536,374 		0
685,044 		0
353,129 		0
295,605 		0
24,452 		0
1,894,604 		0
267,698
(10)Scott PowderSVP, Strategic Plan & Growth (i)
(ii)		 0
282,344 		0
210,837 		0
137,842 		0
96,117 		0
31,486 		0
758,625 		0
71,716
(11)Bruce D SmithSVP, CIO (i)
(ii)		 0
424,675 		0
365,184 		0
238,075 		0
158,896 		0
33,262 		0
1,220,093 		0
133,402
(12)Rev K Bender SchwichSVP, Mission & Spiritual Care (i)
(ii)		 0
122,690 		0
65,722 		0
34,880 		0
140,301 		0
78,963 		0
442,556 		0
0
(13)Ann Errichetti MDPresident-Condell Med Ctr-7/12 (i)
(ii)		 270,273
0 		437,902
0 		252,132
0 		23,128
0 		8,257
0 		991,692
0 		171,322
0
(14)Dominica TallaricoPresident-Condell Medical Cntr (i)
(ii)		 114,743
191,437 		50,000
67,679 		21,198
35,374 		83,409
14,462 		13,455
22,454 		282,805
331,406 		0
0
(15)Debra Susie-LattnerVP, Medical Management (i)
(ii)		 265,662
0 		5,000
0 		5,731
0 		14,396
0 		14,784
0 		305,573
0 		0
0
(16)Gwenn LeschkeVP, Human Resources (i)
(ii)		 9,035
0 		39,930
0 		227,077
0 		6,546
0 		16,089
0 		298,677
0 		197,136
0
(17)David CemateVP, Operations (i)
(ii)		 205,587
0 		43,232
0 		-659
0 		23,128
0 		27,041
0 		298,330
0 		0
0
(18)Mary HillardVP, Patient Care (i)
(ii)		 191,615
0 		38,009
0 		-3,452
0 		21,469
0 		28,486
0 		276,127
0 		0
0
(19)David CartwrightVP, Finance (i)
(ii)		 182,181
0 		39,930
0 		-1,068
0 		20,812
0 		26,931
0 		268,786
0 		0
0
(20)Jose Elizondo MDDirector - Dec '11 (i)
(ii)		 0
193,914 		0
34,038 		0
3,270 		0
21,748 		0
16,126 		0
269,096 		0
0
(21)Ben GrigaliunasSVP, Human Resources- Dec '11 (i)
(ii)		 0
17,819 		0
457,173 		0
619,329 		0
118,300 		0
23,104 		0
1,235,725 		0
629,173
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Compensation Information PART I, LINE 4A SEVERANCE PAYMENTS BEN GRIGALIUNIS, SENIOR VICE PRESIDENT, HUMAN RESOURCES, TERMINATED HIS EMPLOYMENT WITH AHHC IN 2011 AND RECEIVED SEVERANCE OF $452,151 IN 2012. THIS AMOUNT WAS REPORTED ON A PRIOR FORM 990 AS DEFERRED COMPENSATION AND IS LISTED AS A COMPONENT OF COLUMN (F). GWENN LESCHKE, VICE PRESIDENT, HUMAN RESOURCES, TERMINATED HER EMPLOYMENT WITH CONDELL IN 2011 AND RECEIVED SEVERANCE OF $197,136 IN 2012. THIS AMOUNT WAS REPORTED ON A PRIOR FORM 990 AS DEFERRED COMPENSATION AND IS LISTED AS A COMPONENT OF COLUMN (F). PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN BEN GRIGALIUNAS, SENIOR VICE PRESIDENT-HUMAN RESOURCES, IS VESTED IN A NON-QUALIFIED RETIREMENT PLAN. AS SUCH ANY CONTRIBUTIONS ARE TAXED CURRENTLY. THERE IS NO DEFERRED COMPONENT. GAIL HASBROUCK, SENIOR VICE PRESIDENT-GENERAL COUNSEL AND CORPORATED SECRETARY, IS VESTED IN A NON-QUALIFIED RETIREMENT PLAN. AS SUCH ANY CONTRIBUTIONS ARE TAXED CURRENTLY. THERE IS NO DEFERRED COMPONENT. ADVOCATE PROVIDES A TARGET REPLACEMENT SENIOR EXECUTIVE RETIREMENT PLAN. THE CONTRIBUTIONS TO THIS PLAN ARE VESTED AND TAXABLE AFTER FIVE YEARS OF SERVICE. THE FOLLOWING EMPLOYEES ARE VESTED IN THE PLAN AND THEREFORE THE CONTRIBUTIONS ARE REPORTED AS COMPENSATION ON THE W-2: JAMES SKOGSBERGH, BEN GRIGALIUNAS, BRUCE SMITH, DOMINIC NAKIS, GAIL HASBROUCK, LEE SACKS M.D., SCOTT POWDER, WILLIAM SANTULLI, JAMES DAN M.D., KELLY JO GOLSON, ANN ERRICHETTI AND DOMINICA TALLARICO. THE FOLLOWING EMPLOYEES HAVE NOT YET VESTED AND THEREFORE THE CONTRIBUTIONS ARE REPORTED AS DEFERRED COMPENSATION: KATHIE BENDER SCHWICH. PART I, LINE 7 INCENTIVE PAYMENTS ARE BASED UPON A FORMULA. THE AMOUNTS ARE CALCULATED AFTER CERTAIN PERFORMANCE AND OPERATING GOALS ARE ACHIEVED. THE COMPENSATION COMMITTEE CAN EXERCISE DISCRETION OVER WHETHER INCENTIVE COMPENSATION IS PAID OUT ANNUALLY.
Schedule J (Form 990) 2012

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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
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) EVANGELICAL SERVICES CORPORATION SHARED BOARD MEMBER 160,566,892 EXPENSE ALLOCATION   No
(2) EVANGELICAL SERVICES CORPORATION SHARED BOARD MEMBER 862,780 EXPENSE REIMBURSEMENT   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
Schedule L (Form 990 or 990-EZ) 2012

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
2012
Open to Public
Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
Identifier Return Reference Explanation
DESCRIPTION OF BOARD DELEGATING POWERS TO EXECUTIVE COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATIONS BYLAWS PROVIDE THAT THE EXECUTIVE COMMITTEE HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD. THE EXECUTIVE COMMITTEE HAS THE SAME COMPOSITION AND MEMBERS AS THE EXECUTIVE COMMITTEE OF THE CORPORATE MEMBER. THE CORPORATE MEMBERS EXECUTIVE COMMITTEE HAS NINE MEMBERS, CONSISTING OF THE CHAIRPERSON, THE VICE CHAIRPERSON, THE PRESIDENT, THE CHAIRPERSONS OF THE FINANCE, PLANNING, HEALTH OUTCOMES AND MISSION AND SPIRITUAL CARE COMMITTEES, AND TWO OTHER DIRECTORS. THE PAST CHAIRPERSON OF THE BOARD OF DIRECTORS MAY SERVE AS AN EX-OFFICIO MEMBER OF THE COMMITTEE, WITH VOTE. EACH OF THE EXECUTIVE COMMITTEES MEMBERS IS ON THE BOARD. THE SCOPE OF THE EXECUTIVE COMMITTEES AUTHORITY INCLUDES: BE RESPONSIBLE FOR PLANNING EDUCATIONAL PROGRAMS FOR THE BOARD OF DIRECTORS; CONDUCT AN EVALUATION OF THE MEMBERS OF THE BOARD OF DIRECTORS; HAVE SUCH AUTHORITY AS SHALL BE DELEGATED BY THE BOARD OF DIRECTORS; AND ACT ON BEHALF OF THE BOARD OF DIRECTORS BETWEEN MEETINGS. THE EXECUTIVE COMMITTEE IS ACCOUNTABLE AS A BODY TO THE BOARD OF DIRECTORS.
DESCRIPTION OF BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 AS DR. JAMES DAN, GAIL HASBROUCK, JAMES DOHENY, AND DOMINIC NAKIS ARE EITHER DIRECTORS OR OFFICERS OF WHOLLY OWNED ADVOCATE ENTITIES, THEY ARE DEEMED TO HAVE A BUSINESS RELATIONSHIP PURSUANT TO THE INSTRUCTIONS FOR FORM 990. AS DR. JAMES DAN, GAIL HASBROUCK, JAMES DOHENY, AND SCOTT POWDER ARE EITHER DIRECTORS OR OFFICERS OF WHOLLY OWNED ADVOCATE ENTITIES, THEY ARE DEEMED TO HAVE A BUSINESS RELATIONSHIP PURSUANT TO THE INSTRUCTIONS FOR FORM 990. AS DR. JAMES DAN AND DR. LEE SACKS ARE EITHER DIRECTORS OR OFFICERS OF WHOLLY OWNED ADVOCATE ENTITIES, THEY ARE DEEMED TO HAVE A BUSINESS RELATIONSHIP PURSUANT TO THE INSTRUCTIONS FOR FORM 990. AS DR. JAMES DAN, GAIL HASBROUCK, JAMES DOHENY, SCOTT POWDER, AND WILLIAM SANTULLI ARE EITHER DIRECTORS OR OFFICERS OF WHOLLY OWNED ADVOCATE ENTITIES, THEY ARE DEEMED TO HAVE A BUSINESS RELATIONSHIP PURSUANT TO THE INSTRUCTIONS FOR FORM 990.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 BY-LAWS PROVIDE FOR CORPORATE MEMBERS.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A THE NOT FOR PROFIT CORPORATIONS OF ADVOCATE HEALTH CARE, WITH THE EXCEPTION OF ADVOCATE HEALTH CARE NETWORK, HAVE CORPORATE MEMBERS WHO ELECT DIRECTORS. ADVOCATE HEALTH CARE NETWORK DOES NOT HAVE ANY MEMBERS, THEREFORE, THE AHCN BOARD ELECTS ITS DIRECTORS. THE FOR PROFIT ORGANIZATIONS HAVE A SOLE SHAREHOLDER WHO ELECTS DIRECTORS.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B THE FOLLOWING RESERVE POWERS IDENTIFIED IN THE BYLAWS REQUIRE THE APPROVAL OF THE CORPORATE MEMBER, ADVOCATE HEALTH CARE NETWORK: APPOINT OUTSIDE AUDITORS AND ESTABLISH AND REVISE ALL FINANCIAL CONTROL POLICIES, AND ANY CHANGES TO SUCH POLICIES, BEFORE SUCH POLICIES OR CHANGES BECOME EFFECTIVE; CAUSE THE CORPORATION TO PAY, LOAN OR OTHERWISE TRANSFER PROPERTY AND FUNDS TO OTHER ENTITIES AFFILIATED WITH THE CORPORATE MEMBER; AMEND THE BYLAWS WITHOUT ACTION OR APPROVAL BY THE BOARD OF DIRECTORS (AFTER TEN DAYS NOTICE TO THE CORPORATIONS BOARD OF DIRECTORS OF THE PROPOSED AMENDMENT(S) WITH AN OPPORTUNITY FOR BOARD MEMBERS TO CONSULT WITH THE CORPORATE MEMBER REGARDING THE PROPOSED AMENDMENT; APPROVAL OF THE OVERALL MISSION, PHILOSOPHY AND VALUES STATEMENTS AND ANY AMENDMENTS OR SUPPLEMENTS TO SUCH STATEMENTS; APPROVAL OF THE OVERALL STRATEGIC PLANS; APPROVAL OF ALL OVERALL OPERATING AND CAPITAL BUDGETS BEFORE ANY EXPENDITURE, PURSUANT TO SUCH BUDGETS ARE MADE OR COMMITTED, AND APPROVAL OF ALL EXPENDITURES ABOVE ANY LIMIT THAT MAY BE ESTABLISHED BY THE BOARD OF THE CORPORATE MEMBER; APPROVAL OF THE INCURRENCE OR GUARANTEE OF ANY INDEBTEDNESS FOR BORROWED MONEY WHICH HAS NOT ALREADY BEEN APPROVED AS A PART OF THE BUDGET APPROVAL PROCESS OR WHICH IS ABOVE ANY LIMIT THAT MAY BE ESTABLISHED BY THE BOARD OF THE CORPORATE MEMBER; APPROVAL OF ALL TRANSFERS OF OWNERSHIP OR DONATIONS OF ASSETS ABOVE ANY LIMIT THAT MAY BE ESTABLISHED BY THE BOARD OF THE CORPORATE MEMBER; APPROVAL OF ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION BEFORE THEY BECOME EFFECTIVE; APPROVAL OF ANY MERGER, CONSOLIDATION, OR DISSOLUTION; AND APPROVAL OF THE CREATION OF OR AFFILIATION WITH ANY SUBSIDIARY OR AFFILIATE, BEFORE SUCH ENTITY IS CREATED OR THE ENTRANCE INTO ANY JOINT VENTURE IF THE CONTEMPLATED ACTIVITY WILL INVOLVE THE EXPENDITURE OF FUNDS OR THE ASSUMPTION OF OBLIGATIONS WHICH HAVE NOT ALREADY BEEN APPROVED AS A PART OF THE BUDGET APPROVAL PROCESS OR REQUIRE MEMBER APPROVAL UNDER THE FINANCIAL CONTROL POLICIES.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B ADVOCATES TAX PREPARATION PROCESS INCLUDES ONGOING CONSULTATION WITH ITS OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION, TO ADVISE AND ASSIST WITH PREPARATION OF THE FORM 990. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATIONS FINANCE, TAX, AND LEGAL ASSOCIATES AND OTHER MEMBERS OF THE ORGANIZATIONS TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF THE FORM 990. THE FORM 990 IS REVIEWED BY FINANCE MANAGEMENT, THE TAX MANAGER, THE VP OF FINANCE / CORPORATE CONTROLLER, THE CHIEF FINANCIAL OFFICER, AND ADVOCATES OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL. PRIOR TO PRESENTING THE FORM 990 TO THE BOARD OF DIRECTORS AUDIT COMMITTEE IN NOVEMBER, THE ORGANIZATIONS TEAM, INCLUDING ITS ADVISORS, MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF THE FORM 990. AT THE NOVEMBER AUDIT COMMITTEE MEETING, THE VP OF FINANCE / CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER COORDINATED A REVIEW OF THE FORM 990 WITH COMMITTEE MEMBERS, AS THE AUDIT COMMITTEE IS THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH OVERSIGHT OF AUDIT AND TAX MATTERS. THE VP OF FINANCE / CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER RESPONDED TO THE AUDIT COMMITTEE MEMBERS QUESTIONS AND PROVIDED THE OPPORTUNITY FOR DETAILED DISCUSSION OF THE FORM 990. THE CHANGES IDENTIFIED WERE INCORPORATED, AND THEN A COMPLETE COPY OF THE FINAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ORGANIZATIONS BOARD OF DIRECTORS BEFORE THE FORM 990 WAS FILED.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO VARIOUS PEOPLE, INCLUDING MEMBERS OF ADVOCATE'S BOARD OF DIRECTORS, GOVERNING COUNCILS, OFFICERS, ASSOCIATES, VOLUNTEERS, AND MEDICAL STAFF MEMBERS WITH ADMINISTRATIVE RESPONSIBILITIES. ANNUALLY, THE COMPLIANCE DEPARTMENT SENDS THIS POLICY AND THE ADVOCATE CODE OF BUSINESS CONDUCT TO A RANGE OF INDIVIDUALS WHO MAY BE IN A POSITION TO EXERCISE SUBSTANTIAL INTEREST OVER A PARTICULAR MATTER (DEFINED AS 'INTERESTED PERSONS'). THEY ARE REQUIRED TO READ THE POLICIES AND PROVIDE A DISCLOSURE STATEMENT TO THE COMPLIANCE DEPARTMENT, WHICH IDENTIFIES ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER REVIEWS THE DISCLOSURES AND PROVIDES A REPORT TO THE SYSTEM BUSINESS CONDUCT (COMPLIANCE) COMMITTEE, EXECUTIVE MANAGEMENT TEAM AND THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. THE REPORT IS THEN PROVIDED, IN RELEVANT PART, TO THE SITE CHIEF EXECUTIVE OFFICERS. POTENTIAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE DEPARTMENT ON A CASE BY CASE BASIS. FOLLOW UP PROCEDURES CONDUCTED ARE UNIQUE TO THE GIVEN CIRCUMSTANCE, AND MAY INCLUDE REVIEWING THE POTENTIAL CONFLICT WITH THE INTERESTED PERSON, OR INVESTIGATING THE MATTER IN CONSULTATION WITH THE INTERESTED PERSONS SUPERVISOR AND/OR SITE MANAGEMENT. IN CIRCUMSTANCES WHERE THE INTERESTED PERSON IS NOT A MEMBER OF THE BOARD, OR GOVERNING COUNCIL, OR A COMMITTEE THEREOF, OR A PERSON OF INTEREST, IF IT IS DETERMINED THAT THERE IS AN ACTUAL CONFLICT OF INTEREST, THE SUPERVISOR OF THE INDIVIDUAL IS RESPONSIBLE FOR MAKING AN APPROPRIATE RESPONSE, POTENTIALLY INCLUDING A RESTRICTION OF THE INDIVIDUALS JOB DUTIES WITH RESPECT TO THE MATTER GIVING RISE TO THE CONFLICT.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTIONS 15A & 15B EXECUTIVE COMPENSATION AT THE ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES IS BASED ON A BOARD OF DIRECTORS' APPROVED STRATEGY THAT GUIDES THE CORPORATION IN ESTABLISHING COMPENSATION OPPORTUNITIES FOR EXECUTIVES, MANAGERS, PROFESSIONALS, AND ALL EMPLOYEES. IN THIS STRATEGY, SPECIFIC MARKET COMPARISONS ARE IDENTIFIED AND THE DESIRED LEVEL OF COMPETITIVENESS IN THOSE MARKETS SPECIFIED. IN ADDITION, THE LINKAGE OF EXECUTIVE PAY TO PERFORMANCE IS ARTICULATED AND HOW THIS RELATIONSHIP IS TO BE MAINTAINED IS OUTLINED. TO SUPPORT AND IMPLEMENT THE COMPENSATION STRATEGY, FIVE BASIC ELEMENTS ARE UTILIZED. THESE ELEMENTS ARE: - A SOLID, RELIABLE AND TESTED JOB EVALUATION METHODOLOGY - ACCURATE, QUALITY AND RELEVANT COMPENSATION SURVEY INFORMATION - A CONSISTENT ANNUAL PROCESS FOR UPDATING THE COMPENSATION LEVELS - AN ACTIVE BOARD REVIEW PROCESS THAT ASSURES COMPLIANCE WITH THE COMPENSATION STRATEGY AND ON-GOING REVIEW OF THE PERFORMANCE OF THE ORGANIZATION, AND - ACTIVE, EXTERNAL REVIEW AND AUDITING OF COMPENSATION BY EXTERNAL INDEPENDENT CONSULTANTS.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH THE FOLLOWING SITES: DACBOND.COM (DIGITAL ASSURANCE CERTIFICATION LLC) AND EMMA.MSRB.ORG (ELECTRONIC MUNICIPAL MARKET ACCESS). THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENT OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, QUESTION 9 Distribution to AHHC: $20,000,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


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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
2012
Open to Public Inspection
Name of the organization
Advocate Condell Medical Center
 
Employer identification number

26-2525968
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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" to 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 entity?
Yes No
(1) ADVOCATE HEALTH & HOSPITALS CORPORATION

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-2169147 		HEALTH CARE IL 501(C)(3) 3 AHCN
 
 
No
(2) ADVOCATE CHARITABLE FOUNDATION

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-3297360 		FUNDRAISING IL 501(C)(3) 7 AHCN
 
 
No
(3) ADVOCATE HEALTH CARE NETWORK

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-2167779 		PARENT CORP IL 501(C)(3) 11-III-FI NA
 
 
No
(4) EHS HOME HEALTH CARE SERVICE INC

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-2913108 		HOME CARE IL 501(C)(3) 9 AHHC
 
Yes
 
(5) ADVOCATE NORTH SIDE HEALTH NETWORK

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-3196629 		HEALTH CARE IL 501(C)(3) 3 AHHC
 
Yes
 
(6) MERIDIAN HOSPICE

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-3158667 		HOSPICE CARE IL 501(C)(3) 9 EHSHHCS
 
 
No
(7) HISPANO CARE INC

3075 HIGHLAND PARKWAY STE 600

DOWNERS GROVE,IL60515
36-3606486 		HEALTH CARE IL 501(C)(3) 9 ANHN
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) DREYER MERCY AMB SURGERY CNTR

1221 N HIGHLAND AVE
AURORA,IL60506
36-3890298 		MEDICAL SERVICES IL NA
  		                 












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ADVOCATE HEALTH CENTERS INC

3075 HIGHLAND PARKWAY SUITE 600
DOWNERS GROVE,IL60515
36-4217291 		MEDICAL SERVICES IL NA
  		C CORP          
(2) ADVOCATE HOME CARE PRODUCTS

3075 HIGHLAND PARKWAY SUITE 600
DOWNERS GROVE,IL60515
36-3315416 		HEALTH SERVICES IL NA
  		C CORP          
(3) DREYER CLINIC INC

1877 W DOWNER PLACE
AURORA,IL60515
36-2690329 		MEDICAL SERVICES IL NA
  		C CORP          
(4) ADVOCATE INSURANCE SPC

23 LIME TREE BAY AVE GOV SQ BLDG 4
GRAND CAYMAN    
CJ
98-0422925 		INSURANCE CJ NA
  		C CORP          
(5) EVANGELICAL SERVICES CORPORATION

3075 HIGHLAND PARKWAY SUITE 600
DOWNERS GROVE,IL60515
36-3208101 		MGMT SERVICES IL NA
  		C CORP          
(6) HIGH TECHNOLOGY INC

3075 HIGHLAND PARKWAY SUITE 600
DOWNERS GROVE,IL60515
36-3368224 		MEDICAL SERVICES IL NA
  		C CORP          
(7) PARKSIDE CENTER CONDO ASSOCIATION

1775 WEST DEMPSTER STREET
PARK RIDGE,IL60068
36-3452486 		PROPERTY MGMT IL NA
  		C CORP          
(8) MIDWEST HEART SPECIALISTS LTD

1901 S MEYERS RD SUITE 350
OAKBROOK TERRACE,IL60181
36-2841923 		MEDICAL SERVICES IL NA
  		C CORP          
(9) BROMENN PHYSICIAN MANAGEMENT CORPORATION

 
 
37-1313150 		MEDICAL SERVICES IL NA
  		C CORP          
(10) CENTER FOR ENDOSCOPY LLC

22285 PEPPER ROAD
LAKE BARRINGTON,IL60010
26-2387298 		HEALTH SERVICES IL NA
  		C CORP          
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
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-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) ADVOCATE HEALTH & HOSPITALS CORPORATION

 B 20,000,000 COST
(2) ADVOCATE HEALTH & HOSPITALS CORPORATION

 K 306,694 COST
(3) ADVOCATE HEALTH & HOSPITALS CORPORATION

 M 31,238,076 COST
(4) ADVOCATE HEALTH & HOSPITALS CORPORATION

 P 51,724,660 COST
(5) ADVOCATE HEALTH & HOSPITALS CORPORATION

 R 322,932 COST
(6) ADVOCATE HEALTH & HOSPITALS CORPORATION

 L 1,562,211 COST
(7) ADVOCATE HEALTH & HOSPITALS CORPORATION

 Q 14,615,768 COST
(8) ADVOCATE HEALTH & HOSPITALS CORPORATION

 S 4,249,559 COST
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
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


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