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.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Northwestern Memorial Healthcare Group
Employer identification number
36-4724966
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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)
(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)
(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
Gross receipts from related activities, etc. (see instructions)
..................
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........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
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
.....................................................
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)
(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)
(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
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.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
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
Listed below are THOSE gROUP MEMBERS THAT ARE NEITHER A HOSPITAL NOR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(a)(III) nORTHWESTERN mEMORIAL fOUNDATION, tYPE 7, aN ORGANIZATION THAT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(a)(VI) lAKE fOREST HEALTH & fITNESS iNSTITUTE, TYPE 9, AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIP FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS-SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% 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)
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
Software Version:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Northwestern Memorial Healthcare Group
Employer identification number
36-4724966
Identifier
Return Reference
Explanation
NMHC Departmental Transfers
Form 990, Part III, Question 3
NMHC centralized its cash and investments in the parent operation. Reasons supporting the transfers were a. align the financial reporting for investments with the governance structure. b. maintain individual entities' focus on their core functions. Participant entities earn a constant rate of return removing short-term market volatility in their financial statements. c. simplify investment reporting and tracking. d. Support centralizeation of capital allocation decisions. e. Maximize credit strength. f. This change is in line with recent AICPA guidance for financial reporting of cash and investment pooling
Other Program Services
Form 990, Part III, Line 4d
Revenue in other program services includes non-patient related medical services, Lake Forest Health and Fitness Institute revenue, income associated with services provided to Northwestern Memorial HealthCare which is the parent of this group, and other. Some of the expenses associated with these revenues are included in Form 990 Part III lines 4a - 4c.
BUSINESS RELATIONSHIPS
FORM 990, Part VI, SECTION A, QUEStion 2
Group/NMF Terry Savage and Dennis S. Chookaszian are directors at Northwestern Memorial Foundation. They are also directors of the Chicago Mercantile Exchange. Judy Greffin and Andrea Redmond are directors at Northwestern Memorial Foundation. Judy Greffin is an officer and Andrea Redmond is a board member of allstate corporation. Michael a. Ruchim MD, M. Christine stock md and nancy sassower MD are Directors at Northwestern memorial Foundation. They are also directors at Northwestern Healthcare corporation. Nancy W. sassower MD is also an officer of Northwestern healthcare corporation. GROUP/NMH Donald Thompson and Miles white are Directors at Northwestern memorial Hospital. Mr. Thompson is an officer and a Board member and MR. white is also a director at McDonald's Corporation. Donald Thompson, John A. Canning Jr. and Anne Pramaggiore are Directors at Northwestern memorial Hospital. mr. Thompson and mr. Canning are also directors at Exelon corporation and Ms. Pramaggiore is an officer of commonwealth Edison, a subsidiary of exelon corporation. Anne Pramaggiore, Gregory Q. brown and Frederick H. waddell are directors at Northwestern memorial Hospital. They are also directors of the federal reserve bank of chicago. Anne Pramaggiore and Gregory Q. brown are directors at Northwestern memorial hospital. They are also directors at motorola solutions. John A. Canning Jr. and Timothy P. sullivan are directors at Northwestern memorial hospital. Timothy is the managing director and John A. Canning Jr. is the chairman of Madison dearborn partners. Both John and Timothy are also Directors at sage products. Peter J. McCanna, Douglas M. Young and Carol M. Lind are officers of Northwestern Memorial HealthCare, Northwestern memorial Hospital, Northwestern memorial Foundation, and Northwestern Lake Forest Hospital. Douglas M. Young and Peter J. mcCanna are also officers at Northwestern memorial Physicians group. Peter J. mcCanna is an officer of Northwestern Memorial Insurance Company. Douglas M. Young and Carol M. lind are directors and officers of Northwestern Memorial Insurance Company. GROUP/NMPG Jeffery D. Kopin MD and Daniel M. Derman MD. are Directors of Northwestern memorial Physicians Group. Daniel M. derman MD is also an officer of Northwestern memorial Physicians group. Both of these individuals are also partners in an LLC.
members
Form 990, pART vi, SECTION a, question 6
nORTHWESTERN MEMORIAL hOSPITAL, nORTHWESTERN MEMORIAL FOUNDATION AND nORTHWESTERN lAKE FOREST hOSPITAL EACH HAVE ONE MEMBER, nORTHWESTERN MEMORiAL hEALTHCArE, fein 36-3152959. lAKE FOREST hEALTH AND fITNESS INSTITUTE HAS ONE MEMBER, nORTHWESTERN lAKE FOREST hOSPITAL. nORTHWESTERN MEMORIAL PHYSICIANS GROUP HAS ONE MEMBER nORTHWESTERN MEMORIAL HOSPITAL.
eLECTING MEMBERS OF GOVERNING BODY
fORM 990, pART vI, sECTION a, question 7A
Each member of the group has similar by laws regarding how individual directors of their governing board of directors are determined. In the case of NMH, NMF and NLFH, certain officer positions are automatically also board of director positions. For NMH, these are the president and chief executive officer of Northwestern Memorial HealthCare (NMHC), the chairs of the standing committees of the board of directors of Northwestern Memorial Hospital, the chief of staff of the Northwestern Memorial Hospital medical staff, the dean of Northwestern University's Feinberg School of Medicine (FSM),the president of the corporation; and (b) two individuals who are chairs of FSM clinical departments or who are physicians, members of the faculty of FSM, and who hold a leadership position in FSM, the member, or an Affiliate of the member. For NLFH, these are the president and chief executive officer of NMHC, the president of the NLFH medical staff, and the president of the corporation. For NMF, these are the president of the corporation, the president and chief executive officer of NMHC, the president and chief executive officer of Northwestern Memorial Hospital, the president of the Woman's Board of Northwestern Memorial Hospital, the vice chief of the Northwestern Memorial Hospital medical staff, and the chairs of the board's standing committees. All other directors shall be nominated by the executive committee of their member, NMHC, and submitted to the board of directors of that member in accordance with the corporate bylaws of NMHC. For NMPG, the president of the corporation, shall serve, ex officio, as a member of the board of directors. All other directors shall be identified by the board of directors of the member in accordance with the corporate bylaws of Northwestern Memorial Hospital. For Lake Forest health & Fitness Institute, the president of the corporation shall serve, ex officio, as a member of the board of directors. All other directors shall be identified by the board of directors of the member in accordance with the corporate bylaws of Northwestern Lake Forest Hospital.
governance decisions
Form 990, Part VI, section A, question 7b
Reserved powers exist in the member of each affiliate included in this Group, which ultimately is NMHC. The method of exercising such powers can occur through a number of processes, all of which must be supported by resolutions communicated to the affiliate.
REVIEW FORM 990
FORM 990, PART VI, SECTION A, QUESTION 11
The Form 990 (Form) was GENERATED internally by the finance department with support from various departments within the organization. Various sections of the Form were reviewed by senior management of Northwestern Memorial HealthCare (NMHC), as the parent organization, and various committees. As examples, the Chief Integrity Executive reviewed disclosures for related party transactions, the Tax and Regulatory Review Committee reviewed the community benefit report that describes the exempt purpose achievements, and lobbying expenditures were reviewed by the VP External Affairs and communications. The Executive Compensation Subcommittee of the Board of Directors of NMHC was provided the compensation disclosures. The organization then worked with a national, independent public accounting firm as the paid preparer of the Form 990 filing. The final Form was reviewed by members of the Finance department prior to review by the NMHC Vice President, Finance and Interim Chief Financial Officer. Prior to filing, the completed Form 990 was provided to the Board of Directors through a secure website.
Conflict of Interest
Form 990, Part VI, Section B, Question 12 c
Northwestern Memorial HealthCare (NMHC) maintains both a Conflict of Interest Policy and an Intermediate Sanctions Policy. These policies have been approved by its Board of Directors and apply to all entities, directors, officers, employees and transactions which take place within the NMHC system. The policies were written to assist board members and management with the identification of those transactions that warrant attention and consideration to ensure proper adherence to the tax laws impacting tax-exempt organizations. The conflict of interest policy requires completion of an annual certification which affirms that such person has received, read and understands the conflict of interest policy, has agreed to comply, has disclosed any matters required to be disclosed under the policy, and agrees to report any changes promptly to the Chief Integrity Executive. Once the annual certifications are complete, the Chief Integrity Executive reviews the disclosures for compliance with the policy.
COMPENSATION POLICY
Form 990, Part VI, Section B, Question 15 a and b
AS A MEMBER OF THE NORTHWESTERN MEMORIAL HEALTHCARE ORGANIZATION, NMHC IS INCLUDED IN THE OVERALL Board-led executive compensation review and approval process. THE PROCESS FOR DETERMINING EXECUTIVE COMPENSATION AT NORTHWESTERN MEMORIAL COMPLIES WITH IRS GUIDELINES FOR TAX-EXEMPT ORGANIZATIONS; IS DETERMINED BY A SEPARATE SUBCOMMITTEE OF THE BOARD OF DIRECTORS WHOSE MEMBERS ARE ALL INDEPENDENT AND NON-PAID; AND IS ANNUALLY EVALUATED IN THE CONTEXT OF COMPENSATION DATA GATHERED BY EXTERNAL CONSULTANTS FROM A PEER GROUP COMPRISED OF similarly situated healthcare organizations. IN ADDITION, a significant portion of compensation is at risk and is payable only upon achievement of substantial goals. THE BOARD PLACES A HIGH PRIORITY ON ITS ABILITY TO RECRUIT AND RETAIN A STRONG LEADERSHIP TEAM TO ENSURE WE SERVE OUR MISSION AND ACHIEVE OUR GOALS. THE OFFICERS OF NORTHWESTERN MEMORIAL HEALTHCARE ALSO FULFILL OFFICER AND EXECUTIVE FUNCTIONS FOR NMHC'S SUBSIDIARIES.
Governing Documents Disclosure
Form 990, Part VI, Section C, Question 19
THE CORPORATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE CONSOLIDATED FINANCIAL STATEMENTS OF NORTHWESTERN MEMORIAL HEALTHCARE AND SUBSIDIARIES ARE AVAILABLE on the websites for Northwestern memorial Hospital and Northwestern Lake Forest Hospital. The financial statements are also available FROM THE ILLINOIS ATTORNEY GENERAL'S OFFICE AS PART OF ITS ANNUAL COMMUNITY BENEFITS REPORT and through the ELECTRONIC MUNICIPAL MARKET ACCESS SYSTEM OF THE MUNICIPAL SECURITIES RULEMAKING BOARD.
Group Titles & Compensation Presentation
Form 990, Part VII, section A, line 1A
Northwestern Memorial HealthCare (NMHC), is the direct parent organization for Northwestern Memorial Hospital (NMH), Northwestern Memorial Foundation (NMF), and Northwestern Lake Forest Hospital (NLFH). NMHC is also the indirect parent for Northwestern Memorial Physicians Group (NMPG), and Lake Forest Health and Fitness Institute (HFI). These six corporations have combined through the election under Regulation 1.6033-2 (d) (5) to report the directors, officers, key employees and five highly compensated employees under the Group Return requirements for Form 990 for the fiscal year ended 8/31/2013. No organization in this Group Return compensates its directors for services performed as directors. Where compensation is reported for a director, the compensation is associated with another position held within the six corporations. Certain individuals hold multiple positions throughout these six corporations. In order to simplify the reporting, their names are listed only once per Form 990, Part VII and Schedule J. Each individual listed has his or her organization's initials listed next to their respective name and the box checked for their position at that corporation. Additional director or officer positions held by each individual are noted below. Thomas A Cole is the Chair and Director for NMH. John A Canning JR is the Vice-Chair and Director for NMH. Kent P Dauten is the Chair for NMF. Dean M Harrison is director, President and CEO of NMHC and nmh. and the CEO and a Director of NMF and NLFH. Gary A Noskin MD is a Director of NMH. Robert L Parkinson JR is the Chair of NLFH. Homi P Patel is a Director of NLFH. Maria C Bechily is a director of NLFH. Daniel M Derman MD is the President of NMPG. Dennis M Murphy is the Executive Vice President of NMHC, and an Executive Vice President and the Chief Operating Officer of NMH, as well as Chair of NMPG. Douglas M Young is THE INTERIM cfO AND TREASURER OF nmhc, nmh and nmf, TREASURER OF nlfh and Assistant Treasurer of NMH, NMF, and NLFH. Secretary & Assistant Treasurer of NMPG, and Treasurer of hfi. Stephen C Falk is President of NMF. Thomas a McAfee is the President of NLFH, as well as the chair, a director and the president of hfi. Peter J McCanna is the Executive vice president administrative CFO & Treasurer of NMH as well as the CFO & Treasurer of NMF, the Treasurer of NMPG & NLFH. Carol L Lind is the Senior Vice President Senior Counsel & Secretary of NMH and the Secretary of NMF and NLFH. Francis d fraher is the ASSISTANT TREASURER OF nmh, nmF AND nlfh. Jennifer S Wooten is the Assistant Secretary of NMH. Matthew J Flynn is Senior VP, CFO, & Assistant Secretary of NLFH as well as secretary of HFI. Nancy W Sassower MD is a director of NMF, and is also compensated by NMH for a non-director position. The following are Directors per the listed corporations, they are not compensated as Directors or Officers of any entities; Earl J Barnes, Jeffery D Kopin MD, Peter A Lechman MD, Nancy W Sassower MD, MICHAEL A RUCHIM MD and GARY A NOSKIN MD.
HOURS WORKED RELATED COMPANIES
Form 990, Part VII, section A, QUESTION 1B
JULIA L CREAMER, DANIEL M DERMAN MD, STEPHEN c FALK, DEAN M HARRISON, MICHELLE A JANNEY, CAROL M LIND, DEAN L MANHEIMER, THOMAS J MCAFEE, PETER J MCCANNA, DENNIS M MURPHY, CHARLES M WATTS MD, DOUGLAS M YOUNG, Stephen l ondra, earl j barnes, jennifer s wooten, AND TIMOTHY R ZOPH, ARE ALL EMPLOYEES OF NMHC. THEY GENERALLY WORK MORE THAN 40 HOURS A WEEK AND PERFORM SERVICES FOR VARIOUS NMHC SUBSIDIARIES
Reconciliation of Net Assets
Form 990, Part XI, Line 9
Post Retirement Benefit Changes 69,774,975 Other (27,800) Change in Beneficial interests 1,716,567 Change in interest rate swaps 60,756,670 total 132,276,012
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.