Form990
Click to see list of attachments
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 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
CALIFORNIA AVENUE AT 15TH STREET
 
Room/suite
City or town, state or country, and ZIP + 4
CHICAGO, IL60608
D Employer identification number

36-1509000
E Telephone number

G Gross receipts $ 287,497,615
F Name and address of principal officer:
WEIS JR CHARLES
CALIFORNIA AVENUE AT 15TH ST
CHICAGO,IL60608
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SINAI.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1918
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Mount Sinai Hospital's mission is to improve the health of the individuals and communities we serve. The vision is to be a national model for the delivery of urban healthcare.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 48
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 45
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 2,371
6 Total number of volunteers (estimate if necessary) ............. 6 101
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 36,195
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) ......... 15,918,100 12,245,007
9 Program service revenue (Part VIII, line 2g) ......... 268,716,092 271,782,765
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,309,944 791,232
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,191,960 2,678,611
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 289,136,096 287,497,615
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,007,008 1,700,004
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 118,020,317 115,187,579
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 9,603 3,901
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet342,685    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 167,800,360 179,248,320
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 286,837,288 296,139,804
19 Revenue less expenses. Subtract line 18 from line 12....... 2,298,808 -8,642,189
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 167,347,165 163,485,276
21 Total liabilities (Part X, line 26)............. 179,995,878 184,574,471
22 Net assets or fund balances. Subtract line 21 from line 20..... -12,648,713 -21,089,195
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: Mount Sinai Hospital's mission is to improve the health of the individuals and communities we serve. The vision is to be a national model for the delivery of urban healthcare.
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 $ 160,842,392 including grants of $ 1,700,004 ) (Revenue $ 133,787,665 )
PATIENT CARE MOUNT SINAI MEDICAL CENTER IS A 319-LICENSED BED ACUTE CARE AND TEACHING HOSPITAL AFFILIATED WITH THE JEWISH FEDERATION OF METROPOLITAN CHICAGO. THE MEDICAL CENTER IS AN INTEGRAL PART OF THE SINAI HEALTH SYSTEM'S CORE MISSION TO IMPROVE THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. FOUNDED IN 1919 TO PROVIDE HEALTH CARE TO LAWNDALE'S EASTERN EUROPEAN JEWISH IMMIGRANT POPULATION, THE HOSPITAL CONTINUES TO PROVIDE CARE TO DIVERSE COMMUNITIES THROUGHOUT THE CHICAGO AREA.THE MEDICAL CENTER IS LOCATED ON A CAMPUS OF APPROXIMATELY EIGHT ACRES AT THE INTERSECTION OF OGDEN AND CALIFORNIA AVENUES ON CHICAGO'S NEAR WEST SIDE, AND PROVIDES A SIGNIFICANT PORTION OF THE TOTAL MEDICAL SERVICES AVAILABLE TO WEST SIDE RESIDENTS. THESE SERVICES INCLUDE A FULL SPECTRUM OF CARE, INCLUDING MEDICAL, SURGICAL, PEDIATRIC, LEVEL III PERINATAL, INTENSIVE CARE AND PSYCHIATRIC SERVICES. MOUNT SINAI MEDICAL CENTER PROVIDES EXCELLENT EMERGENCY AND MATERNAL CHILD HEALTH CARE. IN 2003, THE STATE OF ILLINOIS OFFICIALLY RECOGNIZED SINAI'S PEDIATRIC SERVICE AS A "CHILDREN'S HOSPITAL WITHIN A HOSPITAL". MEANWHILE, THE HOSPITAL'S EMERGENCY DEPARTMENT IS ONE OF ONLY FOUR LEVEL I TRAUMA CENTERS IN CHICAGO. SINAI'S COMMUNITY SERVICE ORIENTATION IS WELL KNOWN AND WAS RECOGNIZED IN 1992 BY THE AMERICAN HOSPITAL ASSOCIATION'S PRESTIGIOUS FOSTER G. MCGRAW PRIZE.PROGRAM SERVICE ACCOMPLISHMENTS FY2013:CHARITY CARE: MOUNT SINAI HOSPITAL PROVIDED $32,130,605 OF CHARITY CARE AT COST AND REDUCED OR NO FEE TO PATIENTS WHO ARE UNABLE TO PAY FOR SERVICES. SINCE SO MANY OF OUR PATIENTS ARE UNINSURED OR OTHERWISE UNABLE TO AFFORD CARE, CHARITY CARE IS A VITAL PART OF OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.AS PART OF OUR MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITIES, SINAI HAS LAUNCHED SEVERAL INITIATIVES TO STUDY AND ADDRESS SPECIFIC HEALTH ISSUES.THE SINAI URBAN HEALTH INSTITUTE (SUHI) IS A NATIONALLY RECOGNIZED RESEARCH ORGANIZATION FUNDED AND OPERATED THROUGH MOUNT SINAI HOSPITAL MEDICAL CENTER. SUHI HAS PUBLISHED GROUNDBREAKING RESEARCH ON RACIAL DISPARITIES, HIV, SMOKING RATES, ASTHMA, DIABETES, BREAST CANCER, AND OTHER HEALTH THREATS FACING LOW-INCOME MINORITY POPULATIONS. NORTH LAWNDALE HAS THE HIGHEST HIV DEATH RATE IN CHICAGO. IN ADDITION TO THE FULL SPECTRUM OF MEDICAL CARE FOR THE DISEASE, SINAI HAS PIONEERED A PEER EDUCATION PROGRAM INTENDED TO REDUCE THE RATE OF COMPLICATIONS AND MORTALITY HERE.ASTHMA IS A MAJOR HEALTH PROBLEM AMONG LOW-INCOME URBAN POPULATIONS LIKE SINAI'S. RESEARCH CONDUCTED BY SUHI PROMPTED A STATE-FUNDED EFFORT TO REDUCE ASTHMA RATES THROUGH COMMUNITY EDUCATION IN THE EMERGENCY DEPARTMENT. THIS INITIATIVE WAS SO SUCCESSFUL THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH EXPANDED IT INTO THE STATEWIDE CONTROLLING PEDIATRIC ASTHMA THROUGH COLLABORATION AND EDUCATION PROGRAM. MOUNT SINAI HOSPITAL WORKED WITH COMMUNITY LEADERS TO HELP OUR NEIGHBORS TO GAIN HEALTH COVERAGE BY ENROLLING IN THE ILLINOIS KID CARE INSURANCE PLAN. THE PLAN IS INTENDED TO BENEFIT LOW-INCOME CHILDREN AND PREGNANT WOMEN. ALSO, THE SINAI CHILDREN'S HOSPITAL RECENTLY LAUNCHED SINAI FIT, AN EXPANSION OF THE PEDIATRIC WEIGHT MANAGEMENT CLINIC TO ENGAGE YOUTH IN PHYSICAL EXERCISE WHILE ALSO TEACHING PARENTS TO CREATE HEALTHY FAMILY LIFESTYLE CHANGES IN DIET AND EXERCISE.MOUNT SINAI HOSPITAL IS SENSITIVE TO THE HEALTH CARE NEEDS OF DEAF AND HARD-OF-HEARING PEOPLE IN THE COMMUNITY. OUR DEAF ACCESS PROGRAM WHICH WON THE DEAF ILLINOIS AWARD FOR BEST HEALTH SERVICE IN 2007,PROVIDES A FULL COMPLIMENT OF ASL INTERPRETERS, DOCTORS AND SUPPORTING STAFF FLUENT IN SIGN LANGUAGE. IN 2007, MOUNT SINAI HOSPITAL BECAME THE FIRST HOSPITAL IN THE U.S. TO OFFER A VIDEOPHONE BOOTH THAT GIVES SINAI PATIENTS AND THE DEAF COMMUNITY OF CHICAGO A NEW WAY TO COMMUNICATE WITHIN THE HEARING COMMUNITY.
4b (Code:   ) (Expenses $ 38,957,799 including grants of $   ) (Revenue $ 29,313,684 )
PHARMACY and SUPPORTSINAI HEALTH SYSTEM PROVIDES UNDERGRADUATE TRAINING FOR MEDICAL STUDENTS IN SIX MAJOR SPECIALTIES- MEDICINE, SURGERY, OBSTETRIC/GYNECOLOGY, PEDIATRICS, PSYCHIATRY AND PHYSICAL MEDICINE AS WELL AS A NUMBER OF SUB SPECIALTIES. THE HOUSE STAFF PROGRAM PROVIDES TRAINING FOR RESIDENTS AND FELLOWS IN MAJOR CLINICAL AREAS. IN 2008,RELATIONSHIPS WITH ACADEMIC MEDICAL CENTERS WERE EXPANDED THAT ENRICH THE PATIENT CARE RESOURCES AVAILABLE THOUGH AFFILIATIONS WITH NORTHWESTERN MEMORIAL HOSPITAL, THE UNIVERSITY OF CHICAGO MEDICAL CENTER, RUSH UNIVERSITY MEDICAL CENTER, THE UNIVERSITY OF ILLINOIS-CHICAGO AND ROSALIND FRANKLIN UNIVERSITY. RESEARCH PROGRAMS AT MOUNT SINAI HOSPITAL ARE ONGOING IN SEVERAL FIELDS INCLUDING CANCER DETECTION AND TREATMENT, CHILD ABUSE, TRAUMA AND EMERGENCY MEDICINE, PEDIATRIC HIV/AIDS, UROLOGY, RHEUMATOLOGY, HEMATOLOGY AND NEONATOLOGY.
4c (Code:   ) (Expenses $ 30,199,873 including grants of $   ) (Revenue $ 78,638,271 )
PATIENT SERVICE-THRAPHY & DIAGNOSTICSWITH AN AGING POPULATION, REACHING AND PROVIDING HEALTH CARE TO OUR SENIORS ON A TIMELY BASIS HAS BECOME CRITICAL. SINAI HOME HEALTH THROUGH ITS TRAINED NURSES KEEP IN CONTACT WITH SENIORS THROUGH PERIODIC HOME VISITS. SUCH VISITS PROVIDE AN OPPORTUNITY TO DO A GENERAL CHECKUP ON THEIR HEALTH, ENSURE THE PATIENTS ARE TAKING THE PRESCRIBED MEDICATION AND TO DISCUSS THEIR HEALTH CONCERNS. THIS PROGRAM HAS BEEN WELL RECEIVED IN THE COMMUNITY. SINAI IS ALSO DEVELOPING A DEDICATED GERIATRIC SERVICE LINE IN ORDER TO PROVIDE SUPERIOR CONTINUITY OF CARE.FOR ONCOLOGY PATIENTS, THE SINAI HEALTH SYSTEM CANCER CARE CENTER WAS ESTABLISHED IN 2008. WITH THE SUPPORT OF THE COLEMAN FOUNDATION, AN INTEGRATED ONCOLOGY CENTER WAS CREATED THAT LINKS PHYSICIANS' OFFICES, A CHEMOTHERAPY CENTER AND IN INPATIENT UNIT ALL IN ONE AREA. OTHER SERVICES PROVIDED BY MOUNT SINAI HOSPITAL INCLUDE: THE LEVEL I TRAUMA CENTER; LEVEL III NEONATAL CENTER; COMPREHENSIVE SUBSTANCE-ABUSE TREATMENT; CHURCH, SCHOOL AND COMMUNITY- BASED HEALTH EDUCATION AND SCREENING SERVICES' AND A COMPREHENSIVE HOME HEALTH AGENCY. SINAI ALSO PROVIDES A WIDE ARRAY OF DEDICATED PROGRAMS, INCLUDING COMMUNITY MENTAL HEALTH, OCCUPATIONAL HEALTH, DIABETES EDUCATION, OBESITY PREVENTION, BREAST CANCER PREVENTION, SCREENING, AND EDUCATION, AND TEEN PREGNANCY AMONG OTHERS.AN OVERVIEW OF MOUNT SINAI HOSPITAL PERFORMANCE DURING FISCAL YEAR 2013 IS GIVEN BELOW:FY2013PATIENT DAYS: 72,046AVERAGE LENGTH OF STAY: 3.90 DAYSEMERGENCY ROOM VISITS: 53,344OUTPATIENT SURGERIES: 4,369CHARITY CARE (AT COST): $32,130,605ACCREDITATIONS AND CERTIFICATIONS:-THE JOINT COMMISSION GOLD SEAL OF APPROVAL-EMERGENCY DEPARTMENT APPROVED FOR PEDIATRICS CERTIFICATION(EDAP)-AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER-ACCREDITED CHEST PAIN CENTER BY THE SOCIETY OF CHEST PAIN CENTERS-PRIMARY STROKE CENTER
4d Other program services (Describe in Schedule O.)
(Expenses $ 13,179,416 including grants of $   ) (Revenue $ 30,043,145 )
4e Total program service expensesMediumBullet243,179,480
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
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, 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
Yes
 
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
Yes
 
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 attachment
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
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
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...................
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..........................
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV.....................
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...
28c
 
No
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
Yes
 
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
Yes
 
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... Click to see attachment
35b
Yes
 
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
Yes
 
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
458
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
2,371
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
 
 
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
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
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
0
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
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
No
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
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
No
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
 
No
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
 
No
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
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
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
48
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
45
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
 
No
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
Yes
 
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
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL , CA
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:
MediumBulletSAM WILCOCKCALIFORNIA AVENUE AT 15TH STREETCHICAGOIL60608 (773) 257-4420
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) ROSSMARK SHARON........................................................................
VICE CHAIR
 1.00
.......................0.00 		X           0 0 0
(2) MARKIN ROBERT........................................................................
Secretary
 1.00
.......................0.00 		X           0 0 0
(3) LUCCIONI KENNETH........................................................................
Treasurer
 1.00
.......................0.00 		X           0 0 0
(4) UMANS AR........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(5) GOLDSTEIN NEAL........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(6) WISIOL KLAUS........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(7) WHEAT TERRY........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(8) SINGERWILLIAMS........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(9) GILFORD RICHARD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(10) STICKLER K BRUCE........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(11) STEELE ROBERT........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(12) SOLDINGER BEN........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(13) SHERMAN LAWRENCE A........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(14) SHERMAN HAROLD L........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(15) SHAKNO ROBERT J........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(16) SCHWARTZ MAURICE A MD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(17) SALTZMAN BETTYLU K........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
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) KELLER GARY........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(19) MORGAN ABRAHAM C........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(20) MITCHEL MICHAEL M........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(21) MAXWELL BRET R........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(22) MANILOW SUSAN........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(23) DAVIS LESLIE........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(24) BARITZ LENARD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(25) KARMIN ERNEST........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(26) KALISH BERNARD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(27) WENDT SR IMMACULA........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(28) INBINDER ALAN J........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(29) HOFFMAN RICHARD E........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(30) HAVDALA HENRI S MD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(31) TOPEL STEVE........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(32) PIERCE WAYNE........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(33) SOLOW ALAN........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(34) MATERRE GLORIA........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(35) GILBERT HOWARD N........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(36) BROWN CHARLES........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(37) GIACHELLO AIDA L PhD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(38) JONAS JONATHAN........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(39) FRANCIS PAUL........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(40) GRACE ALBERT........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(41) CHERNER PAUL J........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(42) CANTRELL F DANIEL........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(43) ROTHSTEINRUTH........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(44) AHLUWALIA YOGI........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(45) NIEDERPRUEM GARY J........................................................................
CHAIRMAN
 1.00
.......................0.00 		X           0 0 0
(46) FRISCHMARK........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(47) DANAHERJOHN MD........................................................................
Trustee
 1.00
.......................0.00 		X           0 0 0
(48) CHANNING ALAN........................................................................
PRES. & CEO
 40.00
.......................0.00 		X   X       572,588 0 82,246
(49) PACURA LORI JEAN........................................................................
Vice President
 28.00
.......................12.00 		    X       136,223 58,382 18,290
(50) DIVORKENRACHEL........................................................................
EVP Gen Counsel
 0.00
.......................40.00 		    X       0 300,002 41,993
(51) FRAZIER JOEL CRAIG........................................................................
VP Ancilly Serv
 40.00
.......................0.00 		    X       139,385 0 10,233
(52) TEITELBAUM KAREN........................................................................
EXEC VP & COO
 24.00
.......................16.00 		    X       249,772 166,514 58,982
(53) WEIS JR CHARLES........................................................................
CFO & EXEC VP
 32.00
.......................8.00 		    X       345,832 86,457 71,682
(54) JEANNETTE CORONEL........................................................................
NURSE
 40.00
.......................0.00 		        X   167,038 0 13,745
(55) JUSTIN SCHNEIDER........................................................................
DIRECTOR
 40.00
.......................0.00 		        X   133,913 0 7,251
(56) NELMA TAWFIC........................................................................
NURSE
 40.00
.......................0.00 		        X   137,959 0 17,828
(57) EVA CABASE........................................................................
NURSE
 40.00
.......................0.00 		        X   137,733 0 12,202
(58) JAMES MACK........................................................................
CONTROLLER
 40.00
.......................0.00 		        X   130,983 0 24,348
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,151,426 611,355 358,800
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet10
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
 
No
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
SODEXO INC & AFFILIATESP O BOX 70060CHICAGOIL60673 FOOD 2,526,469
SODEXO INC & AFFILIATES4880 PAYSPHERE CIRCLECHICAGOIL60674 ENGINEERING 3,644,572
SALUD REVENUE SOLUTIONS LLC323 COLUMBIA STE 300LAFAYETTEIN47901 REVENUE MANAGEMENT 4,474,111
ANGELICA CORP920 S CAMPBELL AVECHICAGOIL60612 LAUNDRY 945,057
AMERICAN HERITAGE PROTECTIVE SVCS5100 W 127TH STALSIPIL60803 SECURITY & TRANSPORT 1,617,910
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet38
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 10,669,194
f All other contributions, gifts, grants, and
similar amounts not included above1f 		1,575,813
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 12,245,007
Program Service Revenue Business Code
2a SRH PATIENT SRVC@COST 622110 1,995,149 1,995,149    
b RENTAL INCOME 531390 605,484     605,484
c PATIENT SERVICE REVENUE 622110 267,063,285 267,063,285    
d PARKING GARAGE 812930 764,233     764,233
e CAFETERIA 722212 1,354,614     1,354,614
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 271,782,765
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 633,403     633,403
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 4,400  
b Less: rental expenses    
c Rental income or (loss) 4,400  
d Net rental income or (loss).......MediumBullet 4,400     4,400
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 157,829  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 157,829  
d Net gain or (loss)..........MediumBullet 157,829     157,829
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 PREMIER PURCHASING 423450 961,890   36,195 925,695
b INT INC ON ACCESS LOAN 900099 914,128     914,128
c EDUCATIONAL SERVICES REV 900099 164,612     164,612
d All other revenue .... 633,581     633,581
e Total. Add lines 11a–11d ...... MediumBullet 2,674,211
12 Total revenue. See Instructions......MediumBullet 287,497,615 269,058,434 36,195 6,157,979
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 1,700,004 1,700,004
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 .... 1,829,725   1,829,725  
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 98,121,069 86,154,208 11,966,861  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 580,004 499,944 80,060  
9 Other employee benefits ....... 7,758,398 6,687,477 1,070,921  
10 Payroll taxes ........... 6,898,383 5,946,173 952,210  
11 Fees for services (non-employees):        
a Management ...... 30,193,304 10,344,036 19,849,268  
b Legal ......... 278,447 12,182 266,265  
c Accounting ........... 168,210   168,210  
d Lobbying ........... 331,166   331,166  
e Professional fundraising services. See Part IV, line 17 3,901 3,901
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 10,648,637 3,380,430 7,268,207  
12 Advertising and promotion .... 2,691 2,691    
13 Office expenses ....... 7,081,161 3,946,381 3,134,780  
14 Information technology ...... 2,544,512 1,832,426 712,086  
15 Royalties .. 0      
16 Occupancy ........... 6,624,902 4,637,431 1,987,471  
17 Travel ............ 97,507 81,220 16,287  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 82,021 78,854 3,167  
20 Interest ........... 8,983,696 8,983,696    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 9,271,870 6,490,309 2,781,561  
23 Insurance .............. 4,465,488 4,465,488    
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 LABORARORY SERVICES 1,297,734 1,297,734    
b PROVIDER ASSESSMENT 16,852,819 16,852,819    
c DRUGS & SUPPLIES 30,130,837 30,130,837    
d BAD DEBTS 46,930,700 46,930,700    
e All other expenses 3,262,618 2,724,440 199,394 338,784
25 Total functional expenses. Add lines 1 through 24e 296,139,804 243,179,480 52,617,639 342,685
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 ............. 5,750,858 1 2,509,541
2 Savings and temporary cash investments ......... 5,554,511 2 5,601,896
3 Pledges and grants receivable, net ...........   3 0
4 Accounts receivable, net ............. 34,753,167 4 29,432,283
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  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
  6 0
7 Notes and loans receivable, net ............. 2,978,477 7 2,024,810
8 Inventories for sale or use .............. 3,053,590 8 3,010,750
9 Prepaid expenses and deferred charges .......... 1,768,751 9 8,656,631
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 265,849,390
b Less: accumulated depreciation ..... 10b 183,050,602 78,909,544 10c 82,798,788
11 Investments—publicly traded securities .......... 14,556,070 11 6,841,743
12 Investments—other securities. See Part IV, line 11 .....   12 0
13 Investments—program-related. See Part IV, line 11 ..... 4,506,457 13 4,373,356
14 Intangible assets ...............   14 0
15 Other assets. See Part IV, line 11 ........... 15,515,740 15 18,235,478
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 167,347,165 16 163,485,276
Liabilities 17 Accounts payable and accrued expenses ......... 56,099,237 17 65,404,324
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 69,071,596 20 64,229,212
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
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..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 2,158,906 23 4,146,246
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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.................... 52,666,139 25 50,794,689
26 Total liabilities. Add lines 17 through 25......... 179,995,878 26 184,574,471
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 .............. -16,838,197 27 -21,756,574
28 Temporarily restricted net assets ........... 4,189,484 28 667,379
29 Permanently restricted net assets ...........   29  
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 ........... -12,648,713 33 -21,089,195
34 Total liabilities and net assets/fund balances ........ 167,347,165 34 163,485,276
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
287,497,615
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
296,139,804
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-8,642,189
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-12,648,713
5
Net unrealized gains (losses) on investments ...............
5
175,366
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
26,341
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-21,089,195
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
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
  		Employer identification number

36-1509000
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
  		Employer identification number

36-1509000
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
  		Employer identification number

36-1509000
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: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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-.
(1) JEWISH FEDERATION OF METRO CHICAGO
  		30 SOUTH WELLS ST
CHICAGO,IL60606 		   
(2) BRUCE SIMON
  		601 W MONROE ST
SPRINGFIELD,IL62704 		   
(3) FABIANI AND CO
  		1101 PENNSYLVANIA AVE
WASHINGTON,DC20004 		   
(4) FLETCHERTOPOLOBRIAN & KASPER PC
  		222 N LA SALLE ST STE 300
CHICAGO,IL60601 		   
(5) AMERICAN HOSPOITAL ASSOCIATION
  		PO BOX 92683
CHICAGO,IL60675 		   
(6) ILLINOIS HOSPITAL & HEALTH SYSTEM A
  		1151 EAST WARRENVILLE RD
NAPERVILLE,IL60566 		   
(7) ILLINOIS HOSPITAL ASSOCIATION
  		1151 EAST WARRENVILLE RD
NAPERVILLE,IL60566 		   
(8) MCHC SERVICE CORP
  		222 S RIVERSIDE PLAZA 17F
CHICAGO,IL60606 		   
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? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
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? ........
Yes
 
331,166
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
331,166
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
Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Lobbies on issues primarily related to Medicaid reimbursement, uncompensated care and appropriations. VENDOR EXPENSES % LOBBYING AMOUNTMCHC 256 20% 51IHHSA DUES 17,897 25% 4,474FLETCHER,TOPOL & O'BRIEN 300,000 67% 201,000Fabiani and Associates 125,640 100% 125,640
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID: 12000229
Software Version: 2012v2.0

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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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 .... 4,189,484 481,171 648,003 2,186,968 2,840,091
b Contributions ........ 328,601 3,903,411 257,937 915,877 1,026,876
c Net investment earnings, gains, and losses         -406,917
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		3,850,706 195,099 424,769 2,454,841 1,273,082
f Administrative expenses ....          
g End of year balance ...... 667,379 4,189,484 481,171 648,003 2,186,968
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)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
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 .................   1,725,650 1,725,650
b Buildings ................   150,750,790 94,189,797 56,560,993
c Leasehold improvements ............   682,066 599,521 82,545
d Equipment ................   84,857,449 57,713,334 27,144,115
e Other .................   27,833,435 30,547,950 -2,714,515
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 82,798,788
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
(1) SELF INS INV 46,996
(2) OTHER ACCOUNTS RECEIVABLE 1,577,517
(3) NET ADVANCES TO AFFILIATES 5,377,059
(4) DUE FROM AFFILIATES 6,148,463
(5) DEF BOND ISSUE COST LESS AMORT 1,135,850
(6) BOARD DESIGNATED INV 3,949,593



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 18,235,478
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
SELF INSURANCE RESERVE 41,034,746
OTHER NON CURRENT LIABILITIES 824,484
DUE TO THIRD PARTIES 1,598,759
CAPITAL LEASE 4,682,726
ASSET RETIREMENT OBLIGATION 2,653,974




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 50,794,689
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
Part X Part X : FIN48 Footnote The Corporation, Mount Sinai, Schwab, Holy Cross, SMG and SCI are tax-exempt organizations under Internal Revenue Code Section 501(c)(3) and each as required files a Form 990 (Return of Organization Exempt from Income Tax) annually. HCHP files Federal and Illinois Forms 1120(UMSM Corporation Income Tax Return) annually.The Corporation adopted FASB issued guidance for uncertainty in income taxes. This guidance prescribes a recognition threshold and measurement attribute for the consolidated financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. Examples of tax positions common to health systems include such matters as the following: the tax-exempt status of each entity, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income(UBIT). UBIT is reported on Form 990T as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any.Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. As of June 30,2013 and 2012, there were no unrecognized tax benefits identified and recorded.Forms 990 and 1120 filed by the Corporation, Mount Sinai, Schwab, HCH,SMG, and SCI are subject to examination by the Internal Revenue Service(IRS) for up to three years from extended due date of each return. Forms 990 and 1120 filed by the Corporation, Mount Sinai, Schwab, HCH,SMG, and SCI are no longer subject to examination for the years ended June 30,2009 and prior since.
Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. The funds are used for general operating purposes. The interest from the fund is utilized for unrestricted purposes.
Schedule D (Form 990) 2012

Additional Data


Software ID: 12000229
Software Version: 2012v2.0




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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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
 
No
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) .. 		    32,170,361   32,170,361 12.910 %
b Medicaid (from Worksheet 3,
column a) .... 		    106,987,135 152,022,964 -45,035,829 21.710 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    139,157,496 152,022,964 -12,865,468 34.620 %
Other Benefits
     1,411,761   1,411,761 0.570 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    13,367,259 7,399,882 5,967,377 2.390 %
g Subsidized health services
(from Worksheet 6) .. 		    192,520,522 162,585,249 29,935,273 12.010 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    1,700,004   1,700,004 0.680 %
j Total. Other Benefits ..     208,999,546 169,985,131 39,014,415 15.650 %
k Total. Add lines 7d and 7j .     348,157,042 322,008,095 26,148,947 50.270 %
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
21,694,700
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
7,159,231
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
48,961,452
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
37,438,402
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
11,523,050
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 %
1
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 MOUNT SINAI HOSPITAL
CALIFORNIA AVE AT 15TH STREET
CHICAGO,IL60608 		X   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)
 
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 Yes  
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 13
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 Yes  
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   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
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 Yes  
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   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b   No
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: 200.0000%
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: 600.0000%
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?3
Name and address Type of Facility (describe)
1 SINAI TOUHY PHARMACY LLC
2907 W TOUHY AVENUE
CHICAGO,IL60645 		PHARMACY DRUGS AND PHARMACEUTICALS
2 SINAI COMMUNITY PHARMACY
CALIFORNIA AVE AT 15TH STREET
CHICAGO,IL60608 		PHARMACY DRUGS AND PHARMACEUTICALS
3 HAWTHORNE MRI
4701 W CERMACK
CICERO,IL60804 		MAGNETIC RESONANCE IMAGING & OB ULTRASOUND SERVICES
4
5
6
7
8
9
10
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 V - Explanation of Number of Facility Type No other health care facility, other than those required to be licensed, registered, or similarly recognized as a health care facility under state law.
  Part VI - States Where Community Benefit Report Filed IL
  Part VI - Affilated Health Care System Roles and Promotion Mount Sinai Hospital is part of Sinai Health System. Sinai Health System has organizations such as Sinai Community Institute, Mount Sinai Community Foundation and Sinai Urban Health Institute who partner with neighborhood groups and the community overall to understand health and well-being needs. Sinai Community Institute mostly concentrates on serving women, infants and children; families; and building individual potential. Sinai Community Institute and Sinai Urban Health Institute have created "How Healthy is Your Zip Code" which brings together providers, residents and health educators. Additional details of each entity and services are provided in Supplemental Information
  Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Mount Sinai Hospital, as a part of Sinai Health System, has a board comprised of respected leaders in banking, finance, manufacturing, legal, health care and other industries. Mount Sinai Hospital extends medical staff privileges to all qualified physicians for all departments. Mount Sinai Hospital invests any surplus funds into improving patient care.
  Part VI - Community Building Activities No community building activities (as reported in Part II) are reported. Mount Sinai Hospital reports all community related activities as part of Part I - Charity Care and Certain Other Community Benefits.
  Part VI - Community Information Mount Sinai Hospital as a part of Sinai Health System serves a population base of over one million people located on the west side of Chicago. One outlying facility, Sinai's Touhy Clinic on the north side of Chicago, sees refugees from many nations (for example Sudan, Iraq and Burma) as well as resident Orthodox Jewish and Russian populations. Otherwise, Sinai Health System serves primarily African-American and Latino patients. Over 60% of Sinai's patients are Medicaid recipients and 15% are uninsured. Sinai's interpreter services support 150 different languages including American Sign Language making Sinai one of the strongest medical programs in the nation for Deaf and Hard of Hearing patients. Sinai treats more Medicaid patients than any other hospital in Illinois. Ninety-four percent of Sinai's patients are individuals classified in minority race categories. Sinai treats 107,000 children per year and admits 6,000 inpatients to Sinai Children's Hospital inclusive of pediatric visits for asthma and diabetes. Sinai's neonatal intensive care unit sees approximately 310 neonatal patients per year and obstetrics cares for 2,000 mothers categorized as high risk pregnancies. Mount Sinai Hospital Emergency Department has 53,132 patient visits per year; the equivalent of six patients every hour. Among those patients the proportion of uninsured patients is 26.3% - greater than twice the proportion of uninsured patients for Mount Sinai Hospital in total. Mount Sinai Hospital's service area has an average household income of $49,840.
  Part VI - Patient Education of Eligibility for Assistance Mount Sinai Hospital informs patients of the charity care policy through signage in the hospital, written communication, statements and related corporation Sinai Health System website. Each hospital bill, invoice, or other summary of charges to an uninsured patient shall include with it, or on it, a prominent statement that an Uninsured Patient who meets certain income requirements may qualify for an Uninsured Discount along with information regarding how the patient may apply for financial assistance.
  Part VI - Needs Assessment In addition to the community- and hospital/office-based healthcare surveys, focus groups, and data analyses described in the Community Health Needs Assessment plan for Mount Sinai Hospital (MSH), the Hospital utilizes the following channels to gain greater insight into the health needs of its communities:1)Community- and hospital/office-based health screenings2)Presentation of patients in the Emergency Department and needs noted during the visit3)Partnership activities with community-based organizations and health workers focused on the health and social services needs of the populations servedMount Sinai Hospital begins outreach and assessment of community health by first evaluating which health conditions and diseases are prevalent among its inpatients and outpatients. Determination of prevalence then guides the design of community services also assures there is no bias based on race, gender, or patients' ability to pay. Mount Sinai is related to organizations such as Sinai Community Institute, Mount Sinai Community Foundation and Sinai Urban Health Institute(SUHI) who partner with neighborhood groups and the community overall to understand health and well-being needs. SUHI, in particular, conducts comprehensive door-to-door health needs assessment. Sinai shared the health assessment findings with local residents and community groups, forging interventional partnerships. Together they confirmed the need for education and other interventions for asthma, obesity, diabetes and breast cancer. Mount Sinai also supports Sinai Community Institute and Sinai Urban Health Institute by providing clinicians and health educators to provide community education series "How Healthy is Your Zip Code". These forums arm participants with knowledge about the chronic diseases that can affect them and action plans for avoiding or managing those diseases.
Number of Hospital Faciltiy - 1 Part V, Line 6i - Describe Other Needs Identified In addition to the community-and hospital/office-based health care surveys, focus groups, and data analyses described in the Community Health Needs Assessment plan, the hospital utilizes the following channels to gain greater insight into the health needs of its communities:1) Community-and hospital/office-based health screenings2) Presentation of patients in the Emergency Department and needs noted during the visit3) Partnership activities with community-based organizations and health workers focused on the health and social services needs of the population served.
Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community MSH partnered with community-based organizations to facilitate seven focus groups with 66 community members. Two focus groups were conducted in Humboldt Park, North Lawndale, and South Lawndale each, and a single group was conducted in Chicago Lawn. The purpose of the focus groups was to gain insight on the most pressing health conditions affecting each community, the barriers to overcoming those conditions, and how a community hospital such as MSH might help improve the communitys health. These groups were held in both English and Spanish, as appropriate.Many people contributed to this report. Among these has been the staff of the Sinai Urban Health Institute. These are ALL people trained in public health (most are graduates of schools of public health with MPH or PhD degrees). One of the authors (Dr. Whitman) was the founding member of the Epidemiology Program of the Chicago Department of Public Health. That program grew from 0 to 53 people during his 10-year tenure at the Department. We thus believe that the public health credentials of the authors of this report are substantial and notable.
  Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Mount Sinai's collection process includes both letter and call series built to inform patients' of their outstanding balances and to explain available payment options. If the patient is uninsured a discount is applied to the patient's account in accordance with Illinois Patient Uninsured Act. In addition, resources are made available to patients throughout the collections process. These resources include: a charity program targeted to low income individuals residing in Sinai Health System core service area, and non-interest bearing payment plans that start as low as $25 a month. The debt collection practices only apply to charity patients to the extent of the copayments or patient portion balances and not to amounts that have been approved as charity or financial assistance.
  Part III, Line 8 - Explanation Of Shortfall As Community Benefit Consistent with Medicare guidelines, rules & regulations, non-allowable costs are offset on worksheet A via A-8 adjustments. General Overhead cost centers costs are step down on Worksheet B using various approved statistics such as square footage, gross salaries, pounds, FTE's and etc.
  Part III, Line 4 - Bad Debt Expense Mount Sinai Hospital first determines if a patient qualifies for charity care. If a patient is classified as charity care they would not be included as bad debt. Some patients do not desire to complete the charity care applications and as such can be included in the bad debt amounts. One example of a patient population that does not complete charity care applications is undocumented workers. The corporation estimates bad debt expense based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Management assesses the allowance for uncollectible accounts based upon historical write-off experience.
  Part I, Line 7g - Costs Associated With Physicans Clinics Mount Sinai reported in subsidized health services $28,234,037 as support to Sinai Medical Group which provides specialty care to the community. Mount Sinai also reported $1,051,289 as support to Sinai Community Institute which provides a wide array of community health support.
  Part I, Line 7, Column F - Explanation of Bad Debt Expense The bad debt expense is $46,930,700.
  Part I, Line 7 - Explanation of Costing Methodology Total cost per the Medicare Cost Report worksheet B,PT1 column 27 divided by total inpatient and outpatient gross revenue.
  Part I, Line 6a - Related Organization Community Benefit Report The community benefit report is prepared by parent corporation Sinai Health System.
Schedule H (Form 990) 2012
Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number
36-1509000
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) ACCESS COMMUNITY HEALTH NETWORK
1501 S CALIFORNIA AVE
CHICAGO,IL60608 		36-3317058 501(c)(3) 1,700,004 0     OPERATING






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
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
Grantmaker's Description of How Grants are Used   This is an extension of our mission to help these agencies provide services to the underserved and uninsured individuals within our primary service area.All awarded grants usage are monitored annually. The recipient reports to Sinai Health System the allocations and expenditures of the application and usage of disbursed grant awards. The awarded grants fund the uncompensated services which the recipient's provide.
Schedule I (Form 990) 2012


Additional Data


Software ID: 12000229
Software Version: 2012v2.0


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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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
 
No
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
 
No
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)WEIS JR CHARLESCFO & EXEC VP (i)
(ii)		 288,898
72,224 		22,398
5,599 		34,536
8,634 		42,172
10,543 		15,174
3,793 		403,178
100,793 		 
 
(2)TEITELBAUM KARENEXEC VP & COO (i)
(ii)		 208,079
138,719 		15,875
10,583 		25,818
17,212 		30,786
20,524 		4,603
3,069 		285,161
190,107 		 
 
(3)PACURA LORI JEANVice President (i)
(ii)		 123,699
53,014 		 
  		12,524
5,368 		2,747
1,177 		10,056
4,310 		149,026
63,869 		 
 
(4)NELMA TAWFICNURSE (i)
(ii)		 137,959
  		 
  		 
  		1,966
  		15,862
  		155,787
  		 
 
(5)JEANNETTE CORONELNURSE (i)
(ii)		 167,038
  		 
  		 
  		3,013
  		10,732
  		180,783
  		 
 
(6)JAMES MACKCONTROLLER (i)
(ii)		 130,983
  		 
  		 
  		2,922
  		21,426
  		155,331
  		 
 
(7)DIVORKENRACHELEVP Gen Counsel (i)
(ii)		  
240,312 		 
20,158 		 
39,532 		 
41,269 		 
724 		 
341,995 		 
 
(8)CHANNING ALANPRES. & CEO (i)
(ii)		 524,175
  		 
  		48,413
  		67,583
  		14,663
  		654,834
  		 
 
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
Sch J, Part I, Line 7 Part I, Line 7: Non-Fixed payments not listed above NON FIXED PAYMENTS NOT LISTED.SCHEDULE J,PART I LINE 7 MOUNT SINAI HOSPITAL PAYS OUT BONUSES BASED ON THE FOLLOWING PROCEDURES AND GUIDELINES:SINAI HEALTH SYSTEM HAS AN EXECUTIVE COMPENSATION COMMITTEE TO SUPPORT THE ORGANIZATION PERFORMANCE OF SINAI HEALTH SYSTEMS AND ITS RELATED ENTITIES THROUGH THE ALIGNMENT OF EXECUTIVE COMPENSATION WITH SYSTEM STRATEGIES AND PROGRAMS AND ENSURE COMPLIANCE WITH APPLICABLE LAW. THE VOTING MEMBERS OF THE COMMITTEE ARE INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE ESTABLISHES DETAILED GOALS ANNUALLY OR MORE FREQUENTLY AS CIRCUMSTANCES REQUIRE. THE COMMITTEE ESTABLISHES DETAILED GOALS ANNUALLY FOR THE PRESIDENT AND CEO AND OTHER EXECUTIVES, AND REVIEWS PERFORMANCE AGAINST THESE GOALS ON AN ANNUAL BASIS. THE COMMITTEE ANNUALLY ENGAGES AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT TO BENCHMARK THE SALARIES AND BENEFITS OF THE ORGANIZATION'S ASSISTANT VICE PRESIDENT AND ABOVE. COMPENSATION IS BASED ON DETAILED WRITTEN PERFORMANCE OF THE PRESIDENT AND CEO, EACH ELEMENT OF COMPENSATION,DATA OF COMPENSATION PROGRAM IN EFFECT FOR CEOS OF COMPARABLE ORGANIZATIONS, AND CONDUCTS AN ANNUAL REVIEW OF CEO PERFORMANCE AGAINST ESTABLISHED GOALS. THE COMMITTEE MAINTAINS WRITTEN MINUTES WHICH ARE MAINTAINED IN EXECUTIVE ADMINISTRATION.
Schedule J (Form 990) 2012

Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
Identifier Return Reference Explanation
Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases = $26341
Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Governing documents, conflict of interest and financial statements are made available upon request and after review by management.
Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Sinai Health System has an Executive Compensation Committee to support the organizational performance of Sinai Health System and its related entities through the alignment of executive compensation with system strategies and programs and ensure compliance with applicable law. The voting members of the Committee are independent members of the Board of Directors. The Committee meets twice annually or more frequently as circumstances require. The Committee establishes detailed goals annually for the President and CEO and other executives, and reviews performance against these goals on an annual basis. The Committee annually engages an outside, independent compensation consultant to benchmark the salaries and benefits of the organization's Assistant Vice Presidents and above, as well as a few directors. Compensation is based on detailed written performance appraisals and external market data. In executive session, the Committee reviews the performance of the President and CEO, each element of compensation, data of compensation programs in effect for CEOs of comparable organizations, and conducts an annual review of CEO performance against established goals. The Committee maintains written minutes which are maintained in Executive Administration.
Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The Conflict of Interest Disclosure Form is completed and signed annually by all board members, employed physicians, management personnel as well as other employees who are in a position to influence purchasing decisions, affiliations or referrals, hiring decisions or contracts.The Conflict of Interest Disclosure Form is completed on appointment to the Board of Directors of Sinai Health System or any one of its entities, upon hire for any relevant job category or at the time of appointment to the Medical Staff. In addition to the annual filing of the form, an update is required to be filed any time there has been a change. Conflicts disclosed on the Conflict of Interest Disclosure Form are taken into consideration when making board committee assignments. In addition, individuals who have a conflict of interest must abstain from participating in decisions affecting the interested parties and make it clear why they are abstaining.If the potential for conflict of interest exists, employees and physicians are required to discuss the situation with management. Board Members of the Sinai Health System or any of its entities should report potential conflicts to the Chief Integrity Officer who will review potential conflicts with the Sinai Health System Chief Executive Officer and Chairman of the Board of Directors.
Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process The 990 was initially prepared by the Finance Staff with multi disciplinary inputfrom Public Affairs, Corporate Integrity and other appropriate staff of theorganization. The 990 was then reviewed by Senior Finance staff and other members ofSenior Leadership. Ernst & Young,LLP reviewed the return for the organization. Priorto the filing, the 990 was reviewed and discussed with the Executive Committee ofthe Board of Directors. The 990 was also made available to the full Board ofDirectors.
Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member has certain reserved powers over significant corporate actions, including matters such as appointment of corporate officers, amendment of governing documents, approval of a merger, consolidation or dissolution, approval of budgets and strategic plans, approval of independent certified public accountants for the organization, and approval of non-budgeted long-term debt.
Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Board members are nominated by the Board Recruitment, Education and Nominating Committee of the sole corporate member, Sinai Health System, and elected by the members from among those persons approved for appointment by the sole corporate member.
Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Sinai Health System, EIN 36-3166895, is sole member.
Form 990, Part VI, Line 1a Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee The Executive Committee of Mount Sinai Hospital consists of the Board Chairman, and at least 15 but no more than 17, members of the Board of Directors. The Board Chairman appoints the members of the Executive Committee. The Executive Committee has the power to transact regular business of the corporation during the period between meetings of the Board, subject to limitations imposed by the Board or law. When action is taken by the Executive Committee, it is reported to the Board.
Form 990, Part III, Line 4d Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: PHARMACY and SUPPORTSINAI HEALTH SYSTEM PROVIDES UNDERGRADUATE TRAINING FOR MEDICAL STUDENTS IN SIX MAJOR SPECIALTIES- MEDICINE, SURGERY, OBSTETRIC/GYNECOLOGY, PEDIATRICS, PSYCHIATRY AND PHYSICAL MEDICINE AS WELL AS A NUMBER OF SUB SPECIALTIES. THE HOUSE STAFF PROGRAM PROVIDES TRAINING FOR RESIDENTS AND FELLOWS IN MAJOR CLINICAL AREAS. IN 2008,RELATIONSHIPS WITH ACADEMIC MEDICAL CENTERS WERE EXPANDED THAT ENRICH THE PATIENT CARE RESOURCES AVAILABLE THOUGH AFFILIATIONS WITH NORTHWESTERN MEMORIAL HOSPITAL, THE UNIVERSITY OF CHICAGO MEDICAL CENTER, RUSH UNIVERSITY MEDICAL CENTER, THE UNIVERSITY OF ILLINOIS-CHICAGO AND ROSALIND FRANKLIN UNIVERSITY. RESEARCH PROGRAMS AT MOUNT SINAI HOSPITAL ARE ONGOING IN SEVERAL FIELDS INCLUDING CANCER DETECTION AND TREATMENT, CHILD ABUSE, TRAUMA AND EMERGENCY MEDICINE, PEDIATRIC HIV/AIDS, UROLOGY, RHEUMATOLOGY, HEMATOLOGY AND NEONATOLOGY.
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


Software ID: 12000229
Software Version: 2012v2.0
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
MOUNT SINAI HOSPITAL MEDICAL CENTER
 
Employer identification number

36-1509000
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
(1) SINAI COMMUNITY PHARMACY INC
CALIFORNIA AVE 15TH STREET
CHICAGO,IL60608
36-3832319 		PHARMACY IL -143,842 607,848 MOUNT SINAI HOSPITAL
 
(2) SINAI TOUHY PHARMACY LLC
2907 W TOUHY AVE
CHICAGO,IL60645
36-3305449 		PHARMACY IL 58,692 176,198 MOUNT SINAI HOSPITAL
 








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) HOLY CROSS HOSPITAL

2701 W 68TH ST

CHICAGO,IL60629
36-2170133 		HEALTHCARE IL 501(C)(3) 3 SINAI HEALTH SYSTEM
 
Yes
 
(2) SINAI HEALTH SYSTEM

CALIFORNIA AVE AT 15TH ST

CHICAGO,IL60608
36-3166895 		SUPPORT ORGANIZATION IL 501(C)(3) 11A Type 1 N/A
 
No
(3) SCHWAB REHABILITATION HOSPITAL AND CARE

CALIFORNIA AVE AT 15TH ST

CHICAGO,IL60608
36-2179802 		HEALTHCARE IL 501(C)(3) 3 Sinai Health System
 
Yes
 
(4) SINAI COMMUNITY INSTITUTEINC

2653 W OGDEN AVE

CHICAGO,IL60608
36-3932824 		HEALTHCARE IL 501(C)(3) 7 Sinai Health System
 
Yes
 
(5) MOUNT SINAI COMMUNITY FOUNDATION

CALIFORNIA AVE AT 15TH ST

CHICAGO,IL60608
36-3305449 		HEALTHCARE IL 501(C)(3) 11A Type 1 Sinai Health System
 
Yes
 




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) HAWTHORNE WORKS MEDICAL IMAGING

747 ASH STREET
WINNETKA,IL60093
20-3364703 		IMAGING IL MOUNT SINAI HOSPITAL
  		related 145,556 503,322   No   Yes   51.000 %












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












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
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
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
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
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) SCHWAB REHABILITATION HOSPITAL AND CARE

 p 855,000 COST
(2) SCHWAB REHABILITATION HOSPITAL AND CARE

 l 1,488,375 COST
(3) SCHWAB REHABILITATION HOSPITAL AND CARE

 j 20,258 COST
(4) MOUNT SINAI COMMUNITY FOUNDATION

 m 17,620,391 COST
(5) MOUNT SINAI COMMUNITY FOUNDATION

 j 486,516 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


Software ID: 12000229
Software Version: 2012v2.0