Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Rush University Medical Center
Employer identification number
36-2174823
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
0 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
0 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000057
Software Version:
12.19.1011.1
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Rush University Medical Center
Employer identification number
36-2174823
Identifier
Return Reference
Explanation
Form 990 Part III Line 1 -- The mission of Rush University Medical Center is to provide the very best care for our patients. Our education and research endeavors, community service programs and relationships with other hospitals are dedicated to enhancing excellence in patient care for the diverse communities of the Chicago area now and in the future. The true impact of our mission isnt only visible within the boundaries of our Medical Center campus. We also see our mission take shape in the community health clinics, outreach and mentoring programs, and countless other community-based initiatives led by doctors, nurses, students and others at Rush.
Form 990 Part III Line 4D ---- Other program services Rush provides various services for the benefit of its patients and visitors, such as parking, food service and interpreter services. Rush also sponsors a number of programs in the community focused on improving health, expanding education in health-related careers, community-based research to reduce health disparities and initiatives to provide economic development and job creation. Rush programs influenced tens of thousands of lives in FY13.
Form 990 Part VI Section B Line 11A -- The information is compiled and reviewed internally by Corporate Finance. The return is reviewed by Deloitte Tax LLP before being submitted to the Audit Committee of the Board of Directors of Rush for review and approval. The return is distributed to the entire Board of Directors before it is filed.
Form 990 Part VI Section B Line 12C --- Rushs Board of Trustees, corporate officers, employees, faculty, students and members of its medical, nursing, professional and technical staffs must use their best efforts and judgment to avoid any influences which could compromise patient care, research, business transactions, objectivity or integrity. The comprehensive policy statement regarding conflicts of interest is applicable to the Rush Board of Trustees, corporate officers, employees, faculty, students and members of Rushs medical, nursing, professional and technical staffs. All employees are required to make a clear disclosure of any conflict of interest to their immediate supervisor at the earliest possible opportunity before an arrangement is entered into which would result in a conflict or as soon thereafter as the employee becomes aware that such a conflict exists. Supervisors may take action to address a conflict of interest as is consistent with policies of Rush including, but not limited to, the policies of the Department of Human Resources. Conflicts of interest are defined as circumstances that create a risk that professional judgments or actions regarding a primary interest will be unduly influenced by a secondary interest. Conflicts can be more or less severe. The severity of a conflict depends on 1 the likelihood that professional decisions made under the relevant circumstances would be unduly influenced by a secondary interest and 2 the seriousness of the harm or wrong that could result from such influence.
Under certain limited circumstances a conflict may be allowed to continue if such conflict cannot otherwise be eliminated, the likelihood of undue influence is minimized and the relationship is appropriately managed to reduce the risk of possible harm. Members of the Rush Board of Trustees and Rush Corporate Officers are required to disclose any conflicts to the Chairman or Vice Chairman or the secretary of the Rush Board of Trustees. An initial review will be undertaken by the Audit Committee of the Board, which shall make such recommendations as it deems appropriate to the Executive Committee of the Board. If time does not permit a full review by the Audit Committee, such initial review may be undertaken by the Chairman of the Board and Chairman of the Audit Committee. Thereafter, the Audit Committee shall submit the material facts of the conflict along with its recommendations to the Executive Committee which shall make a final determination on the matter.
Form 990 Part VI Section C Line 15A 15B -- The Compensation and Human Resources Committee uses an independent review, comparability data and contemporaneous substantiation to establish compensation packages for officers. All officer compensation packages are approved by the Compensation and Human Resources Committee.
Form 990 Part VI Section C Line 18 -- The Form 990 information is made available upon request through the Media Relations office of the Public Relations Department and/or Legal Affairs. The Form 990 is also available on Guidestar and on the Illinois Attorney Generals website.
Form 990 Part VI Section C Line 19 --Rush does not make its governing documents or conflict of interest policy available to the public. The financial statements are available through the Illinois Attorney Generals office.
Form 990 Part VI Section A Line 1a --The Executive Committee, between meetings of the trustees, shall have and exercise all of the authority of the voting trustees in the management of the corporation except to the extent, if any, that such authority shall be limited by resolution of the voting trustees and except for a amending the articles of incorporation b amending, altering or repealing the by-laws c adopting a plan of merger or consolidation with another corporation d authorizing the sale, lease, exchange or mortgage of all or substantially all of the property or assets of the corporation e authorizing the voluntary dissolution of the corporation f adopting a plan for the distribution of the assets of the corporation g electing, appointing or removing any trustee or officer of the corporation or h amending, altering or repealing any resolution of the voting trustees which by its terms provides that it shall not be amended, altered or repealed by the executive committee. The delegation of authority to the Executive Committee shall not operate to relieve the voting trustees or any single voting trustee of any responsibility imposed upon him or her by law. The Executive Committee shall consist of not fewer than 22 and not more than 28 voting trustees, including the Chairman, the Vice Chairmen and the Chief Executive Officer. The voting members of the Executive Committee shall be elected at the annual meeting of the voting trustees provided that any vacancy occurring or existing in the Executive Committee may be filled by an election held at any regular or special meeting of the voting trustees. Members of the Executive Committee shall serve until their successors have been elected.
Form 990 Part VI Section A Line 2 --W. James Farrell and Robert S. Morrison had a board relationship.-- Christine A. Edwards and William A. Downe had a board relationship. -- Christopher M. Crane, Sue Ling Gin and John W. Rogers Jr. had a board relationship. -- David B. Speer, Susan Crown and Robert S. Morrison had a board relationship. -- Charles A. Schrock, Pastora San Juan Cafferty and John W. Higgins had a board relationship.-- Sheila A. Penrose and Martin A. Nesbitt had a board relationship. -- James S. Metcalf, Fred A. Krehbiel and Donald G. Lubin, Esq. had a board relationship.-- Susan Crown and Charles A. Tribbett III had a board relationship.-- Susan Crown and Robert S. Morrison had a board relationship. -- Sheila A. Penrose and John W. Rogers, Jr. had a board relationship -- Pamela Forbes Lieberman and Robert P. DeCresce, MD had a business relationship.-- Matthew Bergman and Christine A. Edwards had a business relationship.-- Jesse H. Ruiz and Christopher M. Crane had a board relationship.-- Jesse H. Ruiz and Sue Ling Gin had a board relationship.-- Jesse H. Ruiz and John W. Rogers Jr. had a board relationship.-- Jesse H. Ruiz and Kip Kirkpatrick had a business relationship.-- John W. Rogers Jr. and E. David Coolidge III. had a business relationship .-- E. David Coolidge III and Andrew J. McKenna Jr. had a business relationship .-- Stephen N. Potter and Sandra P. Guthman had a business relationship . -- Gloria Santona, Esq, Robert S. Morrison , John W. Rogers Jr. and Michael J. OConnor had a board relationship -- H. John Gilbertson and Carl W. Stern had a business relationship Richard K. Davis and R. Anthony Davis had a family relationship.
Form 990 Part VI Section A Line 4 Rush amended its bylaws to i specify the range of its board size as not less than 94 nor more than 99 Article V, Section l ii add a majority quorum requirement for committee meetings Article VI, Section 1 and iii require the Quality of Care Committee to consider Medical Staff recommendations for medical staff appointments Article XII, Section 1b.
Form 990 Part VII Section A Line 1a -- Payments to Robert P. DeCresce, MD, Catherine Dimou, MD, Larry J. Goodman, MD and Anthony D. Ivankovich, MD were for their roles as employees not as trustees.
Form 990 Part XI Line 9 Postretirement related changes other than net periodic postretirement cost -- 62,775,702
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.