TY 2012 Form 990

- TIN:

Form990

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)

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 09-01-2012 , 2012, and ending 08-31-2013

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)
225 E CHICAGO AVE PR DEPT BOX 26
Suite

Room/suite

City or town, state or country, and ZIP + 4
CHICAGO, IL606112991

D Employer identification number

36-3357006

E Telephone number

G Gross receipts $ 25,783,692

F Name and address of principal officer:
RON H BLAUSTEIN
225 E CHICAGO AVE BOX 269
CHICAGO,IL606112991

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

www.luriechildrens.org

H(a)

Is this a group return for
affiliates? Yes No

H(b)

Are all affiliates included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1984

M State of legal domicile: IL

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: TO OPTIMIZE PHILANTHROPY IN SUPPORT OF THE MISSION AND FUTURE OF THE CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	142
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	132
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	156
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	11,524
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	7,261

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	29,193,377	22,478,776
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	0	-1,934
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-3,731,124	-260,886
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	25,462,253	22,215,956
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	13,150,333	8,319,828
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	8,733,389	8,613,867
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	396,053	662,186
b	Total fundraising expenses (Part IX, column (D), line 25) 13,225,885
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	4,445,940	3,949,832
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	26,725,715	21,545,713
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,263,462	670,243
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	660,573	260,859
21	Total liabilities (Part X, line 26).............	3,439,067	2,501,430
22	Net assets or fund balances. Subtract line 21 from line 20.....	-2,778,494	-2,240,571

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

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

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) ............YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

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 ...............

Briefly describe the organization’s mission: TO OPTIMIZE PHILANTHROPY IN SUPPORT OF THE MISSION AND FUTURE OF THE CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ...................... Yes No

If “Yes,” describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................ Yes No

If “Yes,” describe these changes on Schedule O.

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 $ 8,319,828 including grants of $ 0 ) (Revenue $ 0 )
	Ann & Robert H. Lurie Children's Hospital of Chicago Foundation ("Lurie Children's Foundation"), an Illinois not for profit corporation and an organization described under Section 501(c)(3) of the Code, is responsible for fundraising for the Children's Hospital of Chicago Medical Center ("Parent") (FEIN 36-3357004), Lurie Children's Foundation's sole corporate member, and the Parent's affiliated tax-exempt organizations. Lurie Children's Foundation works with Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's") to coordinate fundraising. Much of the fundraising conducted is directly contributed to Lurie Children's. Gifts received by Lurie Children's Foundation are primarily held by and available for distribution to Lurie Children's, Ann & Robert H. Lurie Children's Hospital of Chicago Research Center ("Lurie Children's Research Center"), and to the other tax-exempt affiliates of the Parent, as appropriate, or as may be designated by the donor. Lurie Children's Foundation seeks to secure the financial resources for Lurie Children's and its affiliates needed to remain leaders in pediatric health care, research, education and advocacy. Lurie Children's Foundation fundraising activities include programs to develop major gifts, leadership gifts, planned giving and annual gifts. Lurie Children's Foundation receives fundraising support from fundraising organizations and an active team of volunteers to cultivate and secure contributions that advance the mission of Lurie Children's and its affiliates. These organizations devote fundraising efforts entirely or in part to Lurie Children's and its affiliates. Fundraising appeals by such organizations are coordinated with the Foundation's fundraising activities in order to avoid conflicting solicitations and to focus support on identified priorities.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses8,319,828

Form 990 (2012)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A Click to see attachment

........................

Yes

Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment

...

Yes

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 I..........

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 II........

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................

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 I Click to see attachment

........................

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 II Click to see attachment

...

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

....................

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 IV Click to see attachment

..............

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 V Click to see attachment

......

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.

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

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII Click to see attachment

.......

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII Click to see attachment

.......

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX Click to see attachment

............

11d

Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X Click to see attachment

11e

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X Click to see attachment

.........................

11f

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

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

Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....

14a

Did the organization maintain an office, employees, or agents outside of the United States?.....

14a

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

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

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...

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).... Click to see attachment

Yes

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............ Click to see attachment

Yes

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment

Yes

20a

Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....

20a

If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Form 990 (2012)

Page 4

Part IV

Checklist of Required Schedules (continued)

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

Yes

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

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

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

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

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

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment

25b

Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment

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 current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment

28a

A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment

28b

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment

28c

Yes

Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M.. Click to see attachment

Yes

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............. Click to see attachment

Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................

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

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

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...

35b

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

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 VI Click to see attachment

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. ............

Yes

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

Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

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 ..................

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)

Did the organization have unrelated business gross income of $1,000 or more during the year?...

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....

Yes

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)?..........................

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.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............

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?...

If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

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?....................

Yes

If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....

Yes

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If “Yes,” indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................

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?............

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?..........

Did the organization make a distribution to a donor, donor advisor, or related person?.......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

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

If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

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

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

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..

14b

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

Enter the number of voting members of the governing body at the end of the tax year .....................

142

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.

Enter the number of voting members included in line 1a, above, who are independent ...................

132

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? .................

Yes

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? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

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? ....................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

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.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

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

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

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

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

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

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?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

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

If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

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.

Own website Another's website Upon request Other (explain in Schedule O)

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.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBullet

RON H BLAUSTEIN225 ECHCIAGO AVE PR DEPTBOX 1ChicagoIL606112991 (312) 227-7133

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.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

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.

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.

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
(A) Name and Title
(1) JIMMY ALEXANDER........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(2) CONSTANTINE ALEXANDRAKIS........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(3) CARL ALLEGRETTI........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(4) MICHAEL ALVAREZ........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(5) SARAH BAINE........................................................................ VICE CHAIR	1.0 .......................0.0	X	0	0	0
(6) ROBERT R BELLICK........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(7) IRWIN BENUCK MD........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(8) MEREDITH BLUHM-WOLF........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(9) MICHAEL BORKOWSKI........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(10) MARGARET W BRENNAN........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(11) SUZANNE M BURNS........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(12) JOHN J BUTTITA........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(13) MICHAEL S CANMANN........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(14) ALAN CHAPMAN........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(15) MOHINI CHOPRA........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(16) ELEANOR O CLARKE........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0
(17) JAMES M CLARY........................................................................ DIRECTOR	1.0 .......................0.0	X	0	0	0

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
(A) Name and Title
(18) THOMAS COLEMAN JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(19) JOHN D COONEY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(20) ADAM C COOPER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(21) SAMANTHA A COSTANZO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(22) LESTER CROWN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(23) THOMAS P DANIS JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(24) SUSAN B DEPREE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(25) MAUREEN C DEROSE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(26) LABEED DIAB........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(27) DEBRA DIMAGGIO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(28) JOHN O DOERGE JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(29) HOLLY K DURAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(30) LEON G EPSTEIN MD........................................................................ DIRECTOR	1.0 .......................40.0	X		0	343,452	25,000
(31) ELEANOR EVANGELIDES........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(32) LESLI FALK........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(33) ROBERT FELDGREBER........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(34) JOHN D FERN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(35) WALTER C FLORENCE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(36) KIMBERLY G FRIESEN........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(37) PHILIP K FUENTES........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(38) PATRICK R GALLAGHER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(39) ROBERT GALLO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(40) RUTH GELLER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(41) CATHERINE H GLEDHILL........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(42) MICHAEL P GOLDMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(43) LAUREN GORTER........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(44) LOUIS J GRABOWSKY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(45) SABRINA P GRACIAS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(46) MATHEW GRAY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(47) MELVIN GRAY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(48) LISA NAPARSTEK GREEN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(49) THOMAS P GREEN MD........................................................................ EX-OFFICIO DIR/PRES&CHAIR PFF	1.0 .......................40.0	X		0	711,642	56,990
(50) JOHN J GREISCH........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(51) DAVID D GRUMHAUS JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(52) THOMAS D GRUSECKI........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(53) STEVEN C HALL MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(54) TODD HAMILTON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(55) ANDEE HARRIS........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(56) JOHN A HATHERLY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(57) ROBERT W HAUSWIRTH........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(58) RICHARD A HEISE JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(59) MARY JC HENDRIX PHD........................................................................ EX-OFF DIR PRS/SI OFF RCH. CTR	1.0 .......................40.0	X		0	592,224	87,015
(60) DAVID HELLER........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(61) DANIEL J HENNESSY........................................................................ VICE CHAIR	4.0 .......................0.0	X		0	0	0
(62) ELIZABETH B HERRINGTON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(63) DAVID G HERRO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(64) VICKI S HEYMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(65) JENIECE HIGGINS........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(66) MEGAN HODES........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(67) LAUREN HOLINGER MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(68) DIANE C HOLMES MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(69) ROBERT D HORNE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(70) TIMOTHY M HURD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(71) KEITH W JAFFEE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(72) CHARLES H JAMES III........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(73) KIRK B JOHNSON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(74) JENNIFER JUST........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(75) MALCOLM S KAMIN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(76) RONALD KAMINSKI........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(77) WILLIAM K KANE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(78) MICHAEL KELLEHER MD........................................................................ EX-OFFICIO DIR/CMO, HOSP.	1.0 .......................40.0	X		0	342,351	54,083
(79) BRIAN P KERWIN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(80) ANTHONY K KESMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(81) MICHAEL B KLEIN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(82) KURT F KOHLMEYER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(83) THOMAS J KOTEL........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(84) MICHAEL B KRAINES........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(85) JAMES A KUEHNLE JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(86) ROSS S LASER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(87) BERNARD L LAYTON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(88) ZACHARY D LAZAR JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(89) G ANTHONY LORENZ........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(90) DANIEL T W LUM MD........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(91) ROBERT D LUSE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(92) PATRICK M MAGOON........................................................................ EX-OFF DIR/CEO, MED CTR/HOSP.	1.0 .......................40.0	X		0	1,475,376	888,042
(93) MITCHELL J MANASSA........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(94) PETER J MARINO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(95) BARRY MASEK........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(96) PETER D MCDONALD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(97) DAVID MCHUGH........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(98) WILLIAM J MCKENNA........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(99) DAVID G MCLONE MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(100) LIGIA MENDEZ........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(101) LOUISE C MILLS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(102) STEVEN H MOGUL........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(103) MIMI MURLEY........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(104) ROBERT S MURLEY........................................................................ CHAIRMAN	1.0 .......................0.0	X		0	0	0
(105) JAMES C MURRAY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(106) SATISH NANDAPURKAR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(107) BRIAN L NEWMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(108) LESLIE H NEWMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(109) SUSAN B NOYES........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(110) TIMOTHY O'BRIEN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(111) EDWARD OGATA MD........................................................................ EX-OFFICIO DIR/CMO/HOSP.	1.0 .......................40.0	X		0	631,873	44,664
(112) DAVID ORMESHER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(113) SEAN O'SCANNLAIN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(114) PEER PEDERSEN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(115) LORNA PFAELZER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(116) ORREN PICKELL........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(117) MARC E PIERCE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(118) ALEXANDER PRAMENKO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(119) SETH A PROSTIC........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(120) MAUREEN M RAIHLE........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(121) MICHAEL A REINSDORF........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(122) J CHRISTOPHER REYES........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................7.0	X		0	0	0
(123) MARLETA REYNOLDS MD........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(124) ELLEN S ROBBINS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(125) LYNN ROSINSKY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(126) NANCY RODKIN ROTERING........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(127) WILLIAM J RYAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(128) GREGORY H SACHS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(129) SCOTT SAGERMAN MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(130) ROBERT E SARAZEN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(131) PETER K SHAGORY........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(132) JEFFREY R SHAW........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(133) JOSEPH W SHENTON JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(134) SCOTT SHERIDAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(135) JOHN S SMITH........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(136) KRISTI SNYDERMAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(137) MOLLY SOUTH........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(138) THOMAS STAT........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(139) W RICK STEARNS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(140) ROBIN H STEINHORN MD........................................................................ DIRECTOR PFF/MD	1.0 .......................40.0	X		0	359,866	26,607
(141) GARY C STEPHANS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(142) LISBETH C STIFFEL........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(143) DANIEL P SULLIVAN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(144) THOMAS J SULLIVAN........................................................................ PRES. & EX-OFFICIO DIRECTOR	1.0 .......................40.0	X	X	0	657,717	49,566
(145) SHELLY A SUN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(146) ROSLYNNE SUPERA........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(147) RICHARD TANNENBAUM........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(148) MARK TAYLOR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(149) ROGER R TAYLOR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(150) T SANDS THOMPSON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(151) TODD W TILLEMANS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(152) EDWARD S TRAISMAN MD........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(153) MONSIGNOR KENNETH VELO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(154) KENNETH A VIELLIEU........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(155) DERRY WEYERHAEUSER........................................................................ VICE CHAIR/DIRECTOR	1.0 .......................0.0	X		0	0	0
(156) KEVIN W WILLER........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(157) VICTORIA WILLER........................................................................ EX-OFFICIO DIRECTOR	1.0 .......................0.0	X		0	0	0
(158) DONALD R WILSON JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(159) ROBERT J WINTER JR........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(160) LINDA S WOLF........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(161) DON YANNIAS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(162) MS JIA ZHAO........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(163) MICHAEL C EVANGELIDES........................................................................ VICE CHAIRMAN	1.0 .......................0.0	X		0	0	0
(164) JULIE M HOWARD........................................................................ DIRECTOR (SINCE 1/28/2009)	1.0 .......................0.0	X		0	0	0
(165) ALICE G ARCHABAL........................................................................ V.P. DEVELOPMENT FNDTN.	1.0 .......................40.0		X	0	266,878	37,423
(166) PAULA M NOBLE........................................................................ CFO/TREAS./MED. CTR. & AFFILTS	1.0 .......................40.0		X	0	611,982	219,546
(167) DONNA S WETZLER........................................................................ GEN CNSL&CORP SEC/MED.CTR &AFF	1.0 .......................40.0		X	0	1,212,966	41,772
(168) SHERWOOD D ZELLERMAYER........................................................................ CHIEF COMMUNICATIONS OFFICER	1.0 .......................40.0		X	0	283,462	34,521

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	7,489,789	1,565,229

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

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 ..............

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...........................

Yes

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 ........

Section B. Independent Contractors

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
AGENCY EA, 311 W WALTON STREETCHICAGOIL60610	MRKTNG EVENT/CNSLTNG	1,784,915
RUSS REID COMPANY, 2 NORTH LAKE AVEPASADENACA91101	DIRECT MAIL CNSLTNG	913,204
CHILDREN'S MIRACLE NETWORK, 205 WEST 700 SOUTHSALT LAKE CITYUT84101	FUNDRAISING	532,904
KORZENOWSKI DESIGN, 266 W LAKE STREETELMHURSTIL60126	GRAPHIC DESIGN/PRNT	309,034
FIRST LOOK FOR CHARITY, 18W200 Butterfield RoadOAK BROOK TERRACEIL60181	FUNDRAISING	181,635
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 5

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
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		8,297,819
d	Related organizations...1d		2,367,553
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		11,813,404

g	Noncash contributions included in lines 1a-1f:$		182,579
h	Total. Add lines 1a-1f.......			22,478,776
			Business Code
2a
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			0
3	Investment income (including dividends, interest, and other similar amounts).......			0
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		0
b	Less: cost or other basis and sales expenses		1,934
c	Gain or (loss)		-1,934
d	Net gain or (loss)..........			-1,934			-1,934
8a	Gross income from fundraising events (not including $ 8,297,819 of contributions reported on line 1c). See Part IV, line 18 ..
	a		2,436,393
b	Less: direct expenses ...b		2,882,840
c	Net income or (loss) from fundraising events..			-446,447			-446,447
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		270,450
b	Less: direct expenses ...b		217,209
c	Net income or (loss) from gaming activities...			53,241			53,241
10a	Gross sales of inventory, less returns and allowances .
	a		598,073
b	Less: cost of goods sold ..b		465,753
c	Net income or (loss) from sales of inventory..			132,320		11,524	120,796
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			22,215,956		11,524	-274,344

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	8,319,828	8,319,828
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	0	0	0	0
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	0	0	0
7	Other salaries and wages	7,166,460	0	0	7,166,460
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	405,985	0	0	405,985
9	Other employee benefits .......	667,223	0	0	667,223
10	Payroll taxes ...........	374,199	0	0	374,199
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	5,000	0	0	5,000
c	Accounting ...........	0	0	0	0
d	Lobbying ...........	0	0	0	0
e	Professional fundraising services. See Part IV, line 17	662,186			662,186
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	471,806	0	0	471,806
12	Advertising and promotion ....	701,135	0	0	701,135
13	Office expenses .......	1,018,592	0	0	1,018,592
14	Information technology ......	340,934	0	0	340,934
15	Royalties ..	0	0	0	0
16	Occupancy ...........	293,710	0	0	293,710
17	Travel ............	110,447	0	0	110,447
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0	0	0	0
19	Conferences, conventions, and meetings ....	13,699	0	0	13,699
20	Interest ...........	0	0	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization .....	36,993	0	0	36,993
23	Insurance ..............	0	0	0	0
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	DUES AND LICENSES	558,528	0	0	558,528
b	Events	201,975	0	0	201,975
c	Entertainment	74,924	0	0	74,924
d	Professional Development	24,298	0	0	24,298
e	All other expenses	97,791			97,791
25	Total functional expenses. Add lines 1 through 24e	21,545,713	8,319,828	0	13,225,885
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 if following SOP 98-2 (ASC 958-720).	0	0	0	0

Form 990 (2012)

Page 11


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			0	1	0
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			0	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			0	8	0
9	Prepaid expenses and deferred charges ..........			621,646	9	260,859
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,614,953
b	Less: accumulated depreciation .....	10b	1,614,953	38,927	10c
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......			660,573	16	260,859
17	Accounts payable and accrued expenses .........			3,439,067	17	2,501,430
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			0	25	0
26	Total liabilities. Add lines 17 through 25.........			3,439,067	26	2,501,430
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			-2,778,494	27	-2,240,571
28	Temporarily restricted net assets ...........			0	28	0
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			-2,778,494	33	-2,240,571
34	Total liabilities and net assets/fund balances ........			660,573	34	260,859

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 ...............

Total revenue (must equal Part VIII, column (A), line 12) ............

22,215,956

Total expenses (must equal Part IX, column (A), line 25) ............

21,545,713

Revenue less expenses. Subtract line 2 from line 1 ..............

670,243

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

-2,778,494

Net unrealized gains (losses) on investments ...............

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

Other changes in net assets or fund balances (explain in Schedule O) ........

-132,320

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

-2,240,571

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response to any question in this Part XII ..............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

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:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

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:

Separate basis Consolidated basis Both consolidated and separate basis

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?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

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?

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

Form 990 (2012)

Form 990, Special Condition Description:

Special Condition Description

Additional Data

Software ID:
Software Version:

- TIN:

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.

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

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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).

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 ..................................................

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

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


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

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.") ....	28,663,831	21,014,536	24,846,108	29,193,377	22,478,776	126,196,628
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	28,663,831	21,014,536	24,846,108	29,193,377	22,478,776	126,196,628
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)..						13,579,581
6	Public support. Subtract line 5 from line 4.						112,617,047

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..	28,663,831	21,014,536	24,846,108	29,193,377	22,478,776	126,196,628
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	0	0	0	0	0	0
9	Net income from unrelated business activities, whether or not the business is regularly carried on..	0	0	29,665	29,728	18,154	77,547
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..						0
11	Total support (Add lines 7 through 10).						126,274,175

Gross receipts from related activities, etc. (see instructions) ..................

13,447,991

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

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

89.185 %

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

86.430 %

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 ....................... right arrow

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 ..................... right arrow

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 ..................................................... right arrow

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 ................................................ right arrow

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

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.)..

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

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

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 ........ right arrow

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 ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... 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 ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO FOUNDATION

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	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (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 ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO FOUNDATION

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
ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

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

(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

(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

(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

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? .......................................

Yes No

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.

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.

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

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:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................	1,614,953	1,614,953	0
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				0

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. 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
ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	Ruffalo Cody 65 Kirkwood North Road SW Cedar Rapids, IA52404	see part iv		No	10,000	10,132	-132
	ArtsMarketing 260 King Street East Suite 500, Toronto CAM5A 4L5	see part iv		No	0	50,000	-50,000
	Thompson Associates 112 Westwood Pl 250 Brentwood, TN37027	see part iv		No	0	49,500	-49,500
	Russ Reid Company 2 North Lake Avenue Suite 600 Pasadena, CA91101	see part iv		No	983,359	515,767	467,592
	Donor Care Center 480 W Tuscarawas Ave Barberton, OH44203	see part iv		No	82,006	36,787	45,219





Total .................					1,075,365	662,186	413,179

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2012

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Gala (event type)	(b) Event #2 Radiothon-Mix (event type)	(c) Other events 215 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	1,489,351	1,460,674	7,784,187	10,734,212
2	Less: Contributions . .	1,266,175	1,460,674	5,570,970	8,297,819
3	Gross income (line 1 minus line 2) . . .	223,176		2,213,217	2,436,393
4	Cash prizes . . .
5	Noncash prizes . .
6	Rent/facility costs . .	136,640	32,872		169,512
7	Food and beverages .	173,364			173,364
8	Entertainment . . .	25,150	3,644		28,794
9	Other direct expenses .	92,888	34,000	2,384,282	2,511,170
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				2,882,840
11	Net income summary. Combine line 3, column (d), and line 10. ..........				-446,447

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

270,450

Cash prizes . . . .

160,000

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

57,209

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

217,209

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

53,241

Enter the state(s) in which the organization operates gaming activities: IL

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2012

Page 3

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

100.000 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Mary Pelican

Address

225 East Chicago Avenue
Chicago,IL60611

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Mary Pelican

Gaming manager compensation right arrow

$ 0

Description of services provided right arrow

Director of Finance

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	Return Reference	Explanation
RUFFALO CODY - professional telemarketing services		Foundation paid a flat fee of $10,132 to Ruffalo Cody (based in Iowa) for their telemarketing services to support the LAG (Lead Annual Gift) fundraising effort. Foundation received $10,000 in revenue as a result of the telemarketing efforts which is reported in Statement of Revenue (Part VIII, Line 1f). Contract ended in October 2012 with vendor. ArtsMarketing Services - Planned Giving consultant Phone marketing program to talk to donors about charitable planned gifts. There is no money that exhanges hands at this time and as such zero reflected in above 990's. This is deferred giving (800 hours of phone marketing). Thompson & Associates - Planned Giving consultant Provides planned giving expertise and leads donors through a personalized and comprehensive charitable estate planning process to the Hospital. (no money received in FY13 as these are all deferred gifts). RUSS REID - Direct response / annual giving Foundation paid a total of $1,036,361 to Russ Reid during FY13 to provide direct mail packages, design and services. The total piece that is related to their consulting fee and design/publication fee is only $515,767 and the other $520,594 relates to printing, production, material design, etc. Foundation received $983,359 in contributions as a result of the direct mail efforts which is reported in Statement of Revenue (Part VIII, Line 1f). DONOR CARE CENTER, INC - telemarketing/phone solicitations Foundation received $82,006 in contributions as a result of the telemarketing efforts which is reported in Statement of Revenue (Part VIII, Line 1f).

Schedule G (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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
ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number
36-3357006

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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	(h) Purpose of grant or assistance
(1) LURIE CHILDREN'S 225 E CHICAGO AVE CHICAGO,IL60611	36-2170833	501(c)(3)	193,950	MISSION SUPPORT
(2) LURIE CHILDREN'S 225 E CHICAGO AVE CHICAGO,IL60611	36-2170833	501(c)(3)	8,125,878	MISSION SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
Form 990, Schedule I	Description of Organization's Procedures for Monitoring the Use of Grants	Foundation Finance Management reviews all philanthropic funds on a regular basis. Financial fund management reports are generated monthly and distributed electronically to all Fund Administrators and Directors for review. Fund Accountants work with Administrators and Directors regularly to monitor activity, to ensure compliance with donor intent, and to review appropriateness of expenditures against budgetary guidelines and donor direction.

Schedule I (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

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? .......

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable 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
(1)LEON G EPSTEIN MDDIRECTOR	(i) (ii)	0 313,253	0 28,675	0 1,524	0 25,000	0	0 368,452	0 0
(2)THOMAS P GREEN MDEX-OFFICIO DIR/PRES&CHAIR PFF	(i) (ii)	0 511,961	0 198,889	0 792	0 25,000	0 31,990	0 768,632	0 0
(3)MARY JC HENDRIX PHDEX-OFF DIR PRS/SI OFF RCH. CTR	(i) (ii)	0 502,280	0 89,428	0 516	0 66,028	0 20,987	0 679,239	0 0
(4)MICHAEL KELLEHER MDEX-OFFICIO DIR/CMO, HOSP.	(i) (ii)	0 322,917	0 18,918	0 516	0 25,000	0 29,083	0 396,434	0 0
(5)PATRICK M MAGOONEX-OFF DIR/CEO, MED CTR/HOSP.	(i) (ii)	0 706,384	0 740,395	0 28,597	0 873,442	0 14,600	0 2,363,418	0 53,837
(6)EDWARD OGATA MDEX-OFFICIO DIR/CMO/HOSP.	(i) (ii)	0 385,385	0 226,065	0 20,423	0 26,980	0 17,684	0 676,537	0 0
(7)ROBIN H STEINHORN MDDIRECTOR PFF/MD	(i) (ii)	0 359,436	0	0 430	0 25,000	0 1,607	0 386,473	0 0
(8)THOMAS J SULLIVANPRES. & EX-OFFICIO DIRECTOR	(i) (ii)	0 338,554	0 292,835	0 26,328	0 24,244	0 25,322	0 707,283	0 69,460
(9)ALICE G ARCHABALV.P. DEVELOPMENT FNDTN.	(i) (ii)	0 205,876	0 52,624	0 8,378	0 16,099	0 21,324	0 304,301	0 0
(10)PAULA M NOBLECFO/TREAS./MED. CTR. & AFFILTS	(i) (ii)	0 379,215	0 216,308	0 16,459	0 206,069	0 13,477	0 831,528	0 0
(11)DONNA S WETZLERGEN CNSL&CORP SEC/MED.CTR &AFF	(i) (ii)	0 280,850	0 164,602	0 767,514	0 23,176	0 18,596	0 1,254,738	0 757,282
(12)SHERWOOD D ZELLERMAYERCHIEF COMMUNICATIONS OFFICER	(i) (ii)	0 199,911	0 81,212	0 2,339	0 21,242	0 13,279	0 317,983	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Supplemental Compensation Information	Schedule J, Part I, Line 3	Pursuant to the bylaws of Children's Hospital of Chicago Medical Center ("Medical Center"), the Governance Committee of the Medical Center is charged to review and approve senior executive compensation for the Medical Center and its affiliates. The Governance Committee has adopted a written executive compensation philosophy which it follows when it reviews and approves the compensation and benefits of the organization's senior management, including the President/Chief Executive Officer and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of a compensation consultant and information from a variety of sources (specified on Schedule J), the Governance Committee confirmed the total amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations. Outside legal counsel also serves an integral role in advising the Governance Committee with respect to federal tax requirements in setting compensation and the establishment of the "rebuttable presumption of reasonableness" under the federal tax law intermediate sanctions rules. The process followed by the Governance Committee, including a description of the data relied upon and the Governance Committee's decisions, was thoroughly and contemporaneously documented. The Governance Committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness, that all such amounts are reasonable and do not exceed fair market value for the services provided. The Governance Committee was comprised of members of the Medical Center and the Ann and Robert H. Lurie Children's Hospital of Chicago Boards of Directors who were determined to be disinterested for these purposes. The Governance Committee conducts an ongoing, regular review of the disinterested status of its members, and will take appropriate action with respect to anyone having an interest with respect to one or more executives so as to preserve the application of the rebuttable presumption of reasonableness. Schedule J, part I, Question 4b The following listed individuals have an amount included in Schedule J, Part II, Column (C) for an amount accrued but not vested under THE MEDICAL CENTER supplemental executive retirement plan ("SERP"): Patrick Magoon $719,218 Paula M. Noble $179,575 Benefits earned under the SERP are non-vested forms of deferred compensation that fund the employee's eventual retirement benefit. These benefits are provided in exchange for all of the employee's years of service to the organization, and the cost of the benefits will vary from year to year based on interest rates, age, and many other factors. The amounts are at risk and will not be paid unless and until the employee has provided substantial future services to the organization. Benefits under the SERP vest at age 62, and are forfeited if the employee leaves the organization voluntarily before age 62 (except upon the sole discretion of the Board, and only if the participant has reached at least age 55 with at least 10 years of service). Participants who voluntarily leave the organization before age 55 forfeit their entire SERP benefit upon termination. Also in response to question 4b, Donna S. Wetzler received a vested payment of $765,622 from the supplemental retirement benefits under the SERP, and therefore had multi-year SERP benefits included in her taxable income. In this case, the taxable amount represents the vested value of benefits earned over many years of service to the organization, and which were taxable and paid in 2012. The vast majority of the SERP payment was reported on prior Form 990's as deferred compensation as the benefits were being earned. Schedule J, part II The following individuals are not compensated by the reporting organization for his or her service as a director. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Pediatric Faculty Foundation for the individual's substantial and full-time services as an employee. For more details, please refer to the 2012 Form 990 of Pediatric Faculty Foundation, FEIN 36-3279680. Thomas P. Green, MD Mary J. C. Hendrix, PhD The following individuals are not compensated by the reporting organization for his or her service as a director or officer. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) for the individual's substantial and full-time services as an employee. For more details, please refer to the 2012 Form 990 of Lurie Children's, FEIN 36-2170833. Alice G. Archabal Patrick M. Magoon Paula M. Noble Edward Ogata, MD Thomas J. Sullivan Donna S. Wetzler Sherwood D. Zellermayer

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JPMORGAN CHASE	L. CROWN'S SON IS A DIR	285,807	FINANCIAL SERVICES		No
(2) JPMORGAN CHASE	P.CROWN'S SPOUSE IS A DIR	285,807	FINANCIAL SERVICES		No
(3) BANK OF AMERICA	STEPHANS'S SPOUSE IS OFCR	169,403	FINANCIAL SERVICES		No

Part V

Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	14	182,579	Median price
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it

must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2012)

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Use of outside parties to solicit, process, or sell noncash contributions	Schedule M, Part I, Line 32b	ALL SECURITIES (NON-CASH DONATIONS) ARE SENT DIRECTLY TO NORTHERN TRUST. NORTHERN TRUST AS CUSTODIAN AND BROKER SELLS THE SECURITIES IMMEDIATELY. FOR DONOR RECOGNITION PURPOSES, GIFTS ARE VALUED AT THE MEDIAN PRICES ON THE DAY THE SECURITIES ARE RECEIVED. FOR ACCOUNTING PURPOSES, VALUES ARE RECONCILED MONTHLY FOR ANY GAIN/LOSS ON THE SALE OF SECURITIES.

Schedule M (Form 990) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Identifier	Return Reference	Explanation
Explanation of Negative Net Assets/Fund Balance	Part I, Line 22	In 2009, the board of the hospital approved the consolidation of ownership of the investment assets on the books of the hospital. All balances of cash, restricted investments, restricted net assets, pledge receivable, annuities, and securities lending that were previously on the Foundation's books were re-designated to the Hospital's books. While the Foundation no longer reports these restricted assets of cash contributions from donors or donor related events on its books, the Foundation does still bear the expenses related to all fundraising events and activities. Allocation of Salary Expenses Form 990, Part V, Question 2 Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's") pays and issues Forms W-2 to employees who work for Ann & Robert H. Lurie Children's Hospital of Chicago Foundation (Lurie Children's Foundation). The allocation of the salary costs are disclosed on Form 990, Part IX, Statement of Functional Expenses. DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, QUESTION 2 Paula Crown has a business relationship with Michael Canmann. Lester Crown has a business relationship with Michael Canmann. Lester Crown is the father-in-law of Paula H. Crown. Edward J. Wehmer and Charles James III have a business relationship. Jennifer Just has a business relationship with Joseph Scoby. Arlington Guenther has a business relationship with Barry Masek. Michael P. Goldman has a business relationship with Keith W. Jaffee. Julie Howard, Linda Wolf and Richard Heise have business relationships.
Description of Classes of Members or Stockholders	Form 990, Part VI, Question 6	Children's Hospital of Chicago Medical Center ("Medical Center") is the organization's sole corporate member.
Description of Classes of Persons and the Nature of Their Rights	Form 990, Part VI, Question 7a	The organization's sole corporate member, the Medical Center, has certain reserved powers, including the power to appoint and remove all directors of the organization.
Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights	Form 990, Part VI, Question 7b	The Medical Center, through its board of directors or designated committee, as the sole corporate member of the organization, has certain reserved powers with respect to appointment and removal of directors, appointment of certain officers, approval of amendments to governing documents, approval of financial matters, and approval of significant transactions including, but not limited to, merger, dissolution, disposition of assets other than in the ordinary course of business, and creation of subsidiaries.
Describe the Process used by Management &/or Governing Body to Review 990	Form 990, Part VI, Question 11B	A public disclosure copy of the organization's fiscal year 2013 Form 990 was provided to each member of the Medical Center and Lurie Children's Audit Committee (of the Board). The Audit Committee is the Committee of the Medical Center charged with the oversight of audit and tax matters for the parent and affiliates. During a special audit committee meeting, and before the Form 990 was filed, the Audit Committee was provided a detailed review of the Form 990 by the Chief Financial Officer ("CFO") and the organization's Director of Tax Compliance. The CFO and Director of Tax Compliance also responded to the Audit Committee Members' questions and afforded the opportunity for detailed discussion of the form 990, prior to the Audit Committee taking action to approve the filing of the Form 990. As part of its annual return preparation process, the organization on an ongoing basis consulted its tax consulting firm and outside tax legal counsel, both of which possess expertise in health care and tax-exempt return preparation, to advise and assist in the preparation of the Form 990. These advisors worked closely with the organization's finance and internal legal personnel and other members of the organization's team assembled to participate in the preparation of the Form 990. Prior to presenting the Form 990 to the board's audit committee, the organization's team, including its advisors, met frequently to discuss and review drafts of the form.
Description of Process to Monitor Transactions for Conflicts of Interest	Form 990, Part VI, Question 12c	On an annual basis, the Medical Center and its affiliates submit a comprehensive questionnaire to Board Members, senior management and purchasing personnel requiring disclosure of all interests that could give rise to actual or potential conflicts of interest. The Medical Center initiates follow up contact with those who do not respond and to clarify responses, where necessary. The Medical Center reviews each disclosure and provides a summary of relevant disclosures for the review and approval of its Governance Committee. Pursuant to the conflicts of interest policy of the Medical Center and affiliates ("Corporation"), directors, officers, physician leaders, and others who are subject to the policy are required To promptly and fully disclose in writing any actual, apparent or potential conflict of interest to the president of the Corporation and General Counsel. This disclosure shall be provided to the Governance Committee of the Corporation which shall consider all conflicts of interest issues and, if appropriate, shall provide such written disclosure to the directors, board committees considering the proposed transaction or other appropriate parties. In addition, on an annual basis, the corporation surveys each individual subject to the policy as to the existence of actual or potential conflicts of interest. The corporation will not enter into an agreement, transaction or other arrangement involving a conflict of interest unless the disinterested members of the governance committee of the corporation's Board of Directors determine by a majority vote that appropriate safeguards to protect the charitable mission of the corporation have been implemented. The subject interested person may not be present when the vote is taken. If it is determined that a conflict of interest exists, a disinterested person or committee of disinterested members may be assigned to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the Board or Committee shall determine whether the Corporation can obtain a more advantageous transaction or arrangement, with reasonable efforts, from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction is in the Corporation's best interest and for its own benefit and whether the transaction is fair and reasonable to the Corporation, and shall make its decision as to whether to enter into the transaction or arrangement.
Offices & Positions for Which Process was Used, & Year Process was Begun	Form 990, Part VI, Questions 15a & 15b	The authority to review and approve executive compensation has been delegated to the Governance Committee of the Medical Center Board of Directors ("Governance Committee"). The Governance Committee has adopted a written executive compensation philosophy which it follows when it reviews and approves the compensation and benefits of the organization's senior management, including the President and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of an independent compensation consultant and information from a variety of sources, such as compensation surveys, the Governance Committee confirmed the total amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations. Outside legal counsel also serves an integral role in advising the governance committee with respect to federal tax requirements in setting compensation and the establishment of the rebuttable presumption of reasonableness. The process followed by the governance committee, including a description of the data relied upon and the governance Committee's decisions, was thoroughly and contemporaneously documented. The Governance committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness under federal tax law, that all such amounts are reasonable and do not exceed fair market value for the services rendered. The Governance Committee was comprised of members of the Medical Center and the Lurie Children's Boards of Directors who were determined disinterested for these purposes. The Governance Committee conducts an ongoing and periodic review of the disinterested status of its members, and will take appropriate action with respect to anyone having an interest with respect to one or more executives so as to preserve the application of the rebuttable presumption of reasonableness.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public	Form 990, Part VI, Question 19	The organization's financial statements are publicly available online at www.dacbond.com. The organization's articles of incorporation and annual reports are available through the Illinois Secretary of State. The organization also makes its general governing documents available to the general public upon request. Other Changes in Net Assets or Fund Balances Form 990, Part XI, Line 5 Founder's Board Activity ($132,320)

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:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF
CHICAGO FOUNDATION

Employer identification number

36-3357006

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) LURIE CHILDREN'S HOSP OF CHIC RSCH CTR 225 E CHICAGO AVE Chicago,IL60611 36-3357005	RESEARCH	IL	501(c)3	4	Medical Ctr		No
(2) PEDIATRIC FACULTY FOUNDATION INC 225 E CHICAGO AVE CHICAGO,IL60611 36-3279680	HLTH CRE/RSCH	IL	501(c)3	11 III-FI	Medical Ctr		No
(3) CHILDREN'S HOSPITAL OF CHICAGO MED CTR 225 E CHICAGO AVE CHICAGO,IL60611 36-3357004	Health Care	IL	501(c)3	11 III-FI	NA		No
(4) LURIE CHILDREN'S 225 E CHICAGO AVE CHICAGO,IL60611 36-2170833	Hospital	IL	501(c)3	3	Medical Ctr		No
(5) CMH SELF INSURANCE FOUNDATION 225 E CHICAGO AVE CHICAGO,IL60611 36-6638400	INSURANCE	IL	501(c)3	11 III-FI	Medical Ctr		No
(6) KINDNESS IS DOING SOMETHING SPCL FR KIDS 1 S DEARBORN ST CHICAGO,IL60603 36-3778441	SUPPORT	IL	501(c)3	7	medical ctr		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) CMMC INSURANCE CO LTD 225 E CHICAGO AVE Chicago,IL60611 000000000	SELF INSURANCE	CJ	MEDICAL CTR	CORPORATION

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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)	(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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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:
Software Version: