TY 2013 Form 990

(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)
(1) Mark Metzger........................................................................ Chairman of the Board/Director	1.00 .......................2.00	X
(2) William Skoglund........................................................................ Vice Chairman of the Board/Director	1.00 .......................2.00	X
(3) Thomas Alexander Beg 1113........................................................................ Director	1.00 .......................2.00	X
(4) Trish Anen........................................................................ Director	1.00 .......................2.00	X
(5) James Baka Beg 1113........................................................................ Director	1.00 .......................2.00	X
(6) Cati Cederoth........................................................................ Director	1.00 .......................2.00	X
(7) Alice Daniele M D........................................................................ Vice Chief of Staff/Director	1.00 .......................2.00	X
(8) Bruce Dienst........................................................................ Director	1.00 .......................2.00	X
(9) Richard Edelman........................................................................ Director	1.00 .......................2.00	X
(10) Ronald Hem........................................................................ Director	1.00 .......................2.00	X
(11) Dennis Keane MD........................................................................ Past Chief of Staff/Dir	1.00 .......................2.00	X
(12) Herbert Knight........................................................................ Director	1.00 .......................2.00	X
(13) Maryanne Locklin........................................................................ Director	1.00 .......................2.00	X
(14) Dave Mead........................................................................ Director	1.00 .......................2.00	X
(15) Avery Miller........................................................................ Director	1.00 .......................2.00	X
(16) Jerome Roberts........................................................................ Director	1.00 .......................2.00	X
(17) Christine Sobek........................................................................ Director	1.00 .......................2.00	X

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Andrew VanEekeren Beg 1113........................................................................ Director	1.00 .......................2.00	X					0	0
(19) Suresh Velagapudi MD........................................................................ Chief of Staff/Director	1.00 .......................2.00	X					13,750	0
(20) Barry Finn........................................................................ President & CEO/Director	40.00 .......................3.00	X	X				1,003,214	420,789
(21) Brenda VanWyhe........................................................................ Sr. VP, Finance & CFO/Treasurer	40.00 .......................3.00		X				386,416	83,725
(22) Ryan Asmus........................................................................ VP General Counsel/Secretary	40.00 .......................3.00		X				298,461	73,773
(23) Lynn Scott........................................................................ Assistant Secretary	40.00 .......................3.00		X				74,537	16,573
(24) Steve Lowenthal MD........................................................................ Sr. VP, Medical Affairs & CMO	40.00 .......................0.00			X			666,281	43,457
(25) John Diederich........................................................................ Sr. VP, Operations & COO	40.00 .......................1.00			X			473,725	139,218
(26) Diane Homan MD........................................................................ VP, Quality & PSO	40.00 .......................0.00			X			430,149	100,724
(27) Dennis DeMasie........................................................................ VP, Information Technology & CIO	40.00 .......................0.00			X			328,546	84,047
(28) Mary Shilkaitis........................................................................ VP, Patient Care Services & CNO	40.00 .......................0.00			X			306,638	79,446
(29) Alex Pope........................................................................ VP, Philanthropy & CDO	40.00 .......................1.00			X			265,770	60,142
(30) Gail Bumgarner........................................................................ Sr. VP, Strategy	40.00 .......................0.00			X			332,897	27,033
(31) David Petasnick........................................................................ Assistant VP, Ancillary Services	40.00 .......................0.00			X			211,016	27,312
(32) Suzanne Sterchi........................................................................ Assistant VP, Patient Care	40.00 .......................0.00			X			219,097	35,365
(33) Sepehr Sani MD........................................................................ Physician	40.00 .......................0.00				X		1,016,045	27,976
(34) Dimitry Ruban MD........................................................................ Physician	40.00 .......................0.00				X		906,391	47,282
(35) Todd Guynn MD........................................................................ Physician	40.00 .......................0.00				X		875,004	56,915
(36) Ellen Embry MD........................................................................ Physician	40.00 .......................0.00				X		574,342	48,143
(37) Courtney Virgilio MD........................................................................ Physician	40.00 .......................0.00				X		564,589	48,914
(38) Barbara Graham........................................................................ VP, Philanthropy & CDO	0.00 .......................0.00					X	111,229	6,118

(A) Name and business address	(B) Description of services	(C) Compensation
Sodexho4880 Paysphere CircleChicagoIL60674	Food and Cleaning Service	3,576,508
AnthelioOne Lincoln Ctr Ste 200 5400 LBJDallasTX75240	Medical Records Management	2,109,135
Advocate Medical Group1875 Dempster Suite 325Park RidgeIL60068	Medical Services	941,712
Anderson Mikos Architects1420 Kensington Road Suite 306Oak BrookIL60523	Architects	728,220
Fox Valley Acute Dialysis1300 WaterfordAuroraIL60504	Dialysis	699,208
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 28

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	50,133	50,133
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	6,845,374		6,845,374
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	96,973,328	72,729,996	24,243,332
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,181,320	3,135,990	1,045,330
9	Other employee benefits .......	16,401,255	12,300,941	4,100,314
10	Payroll taxes ...........	8,462,233	6,346,675	2,115,558
11	Fees for services (non-employees):
a	Management ......	6,131,581	4,598,686	1,532,895
b	Legal .........	238,769		238,769
c	Accounting ...........	198,435		198,435
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	32,459	24,344	8,115
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	5,224,877	3,918,658	1,306,219
12	Advertising and promotion ....	1,459,885	1,459,885
13	Office expenses .......	61,337,408	46,003,056	15,334,352
14	Information technology ......	8,677,771	6,508,328	2,169,443
15	Royalties ..
16	Occupancy ...........	7,263,107	5,447,330	1,815,777
17	Travel ............	234,219	175,664	58,555
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	95,268	71,451	23,817
20	Interest ...........	6,915,573	6,915,573
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	16,617,834	16,617,834
23	Insurance ..............	11,756,207	8,817,155	2,939,052
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	Medicaid Provider Tax	15,077,933	15,077,933
b	Consulting	836,370	836,370
c	Laundry	802,315	802,315
d	Collection Fees	612,104	612,104
e	All other expenses	906,387	526,766	379,621
25	Total functional expenses. Add lines 1 through 24e	277,332,145	212,977,187	64,354,958	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	201,623	1	213,480
2	Savings and temporary cash investments .........	20,000,117	2	19,157,212
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	34,476,997	4	40,320,674
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	4,710,289	8	4,606,762
9	Prepaid expenses and deferred charges ..........	8,183,012	9	8,803,680
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	320,281,178
b	Less: accumulated depreciation .....	10b	190,039,962	131,496,347	10c	130,241,216
11	Investments—publicly traded securities ..........	199,247,683	11	237,158,566
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	24,873,663	15	18,487,872
16	Total assets. Add lines 1 through 15 (must equal line 34)......	423,189,731	16	458,989,462
	17	Accounts payable and accrued expenses .........	121,151,507	17	121,505,916
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	89,816,495	20	89,609,546
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	22,948,153	25	22,741,928
26	Total liabilities. Add lines 17 through 25.........	233,916,155	26	233,857,390
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	184,865,539	27	219,954,035
28	Temporarily restricted net assets ...........	4,408,037	28	5,178,037
29	Permanently restricted net assets ...........		29
	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 ...........	189,273,576	33	225,132,072
34	Total liabilities and net assets/fund balances ........	423,189,731	34	458,989,462

- 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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. 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—2013. 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—2012. 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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. 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) 2013

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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

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 for 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 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization Copley Memorial Hospital Inc c/o Rush-Copley Medical Ctr

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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization Copley Memorial Hospital Inc c/o Rush-Copley Medical Ctr

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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

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) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

47,769

Total. Add lines 1c through 1i ...............................

47,769

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	Copley Memorial Hospital is a member of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by Copley Memorial Hospital to these organizations is attributable to lobbying activities.

Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

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) 2013

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 ....	11,161,160	11,131,204	10,648,390	9,770,170	9,053,445
b	Contributions ........	1,178,338	980,802	1,409,175	878,220	716,725
c	Net investment earnings, gains, and losses	1,068,336	712,783	364,134	1,349,773	613,671
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	1,476,767	1,663,629	1,290,495	1,349,773	613,671
f	Administrative expenses ....
g	End of year balance ......	11,931,067	11,161,160	11,131,204	10,648,390	9,770,170

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

Board designated or quasi-endowment SchDMd Bullet

1.000 %

Permanent endowment SchDMd Bullet

57.000 %

Temporarily restricted endowment SchDMd Bullet

42.000 %

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)

Yes

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

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	16,923,937		16,923,937
b	Buildings ................	184,457,372	104,155,442	80,301,930
c	Leasehold improvements ............
d	Equipment ................	112,995,002	85,884,520	27,110,482
e	Other .................	5,904,867		5,904,867
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				130,241,216

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Long Term Deferred Rent Obligation		495,652
Deferred Gain on Sale Long Term		10,345,637
Long Term SERP		4,588,038
Long Term Market Adjustment Swap Liability		7,312,601





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		22,741,928
2. Liability for uncertain tax positions 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) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	337,485,721
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	19,140,690
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	7,544,252
e	Add lines 2a through 2d .....................			2e	26,684,942
3	Subtract line 2e from line 1.....................			3	310,800,779
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	548,821
c	Add lines 4a and 4b.......................			4c	548,821
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	311,349,600

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	285,055,635
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	7,723,490
e	Add lines 2a through 2d......................			2e	7,723,490
3	Subtract line 2e from line 1.....................			3	277,332,145
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	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	277,332,145

Part XIII

Supplemental Information

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.

Return Reference	Explanation
Part V, Line 4:	Rush Copley Foundation holds the Voris (income for CMH Cancer Care), Kobisk (Board restricted income to CMH), Copley (income unrestricted) and Dobbins (income for CMH Women's Health) Endowments. Rush Copley Foundation also holds a Quasi Nursing Endowment (income for CMH Future of Nursing Scholarships). These funds are held for the benefit of Copley Memorial Hospital.
Part XI, Line 2d - Other Adjustments:	RCCC revenue to reconcile to CMH corporate not consolidated 4,031,810. RCCC revenue elimination to reconcile to CMH corporate not consolidated 2,195,209. Swap value adjustment -179,238. Rental expenses-2020 Ogden POB1 & 1100 W Veterans Pkwy Yorkville POB 1,496,471.
Part XI, Line 4b - Other Adjustments:	Contributions not reported on Line 1 included in income 548,821.
Part XII, Line 2d - Other Adjustments:	RCCC expenses to reconcile to CMH corporate not consolidated 6,227,019. Rental expenses-2020 Ogden POB1 & 1100 W Veterans Pkwy Yorkville POB 1,496,471.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 30000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other 60000.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	7,029,068		7,029,068	2.530 %
b	Medicaid (from Worksheet 3, column a) ....	65,372,714	48,254,124	17,118,590	6.170 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	72,401,782	48,254,124	24,147,658	8.700 %
Other Benefits		90,399		90,399	0.030 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	90,399		90,399	0.030 %
f	Health professions education (from Worksheet 5) ..	5,271,575	589,848	4,681,727	1.690 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	53,998		53,998	0.020 %
j	Total. Other Benefits ..	5,415,972	589,848	4,826,124	1.740 %
k	Total. Add lines 7d and 7j .	77,817,754	48,843,972	28,973,782	10.440 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

41,627,648

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

4,162,765

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

76,578,759

Enter Medicare allowable costs of care relating to payments on line 5.....

86,407,433

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-9,828,674

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	Copley Memorial Hospital 2000 Ogden Avenue Aurora,IL605044206 www.rushcopley.com 2150791	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Copley Memorial Hospital
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Section C, Supplemental Info.

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 600.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Copley Memorial Hospital	Part V, Section B, Line 3: In conducting the Community Health Needs Assessment, the hospital took into account input from persons who represent the broad interests of the community served. This included community residents and experts in a range of areas including public health, minority populations, disparities in health care, social determinants of health, and health & social services.Persons who represent the broad interests of the community served included:- Board of Directors- Hospital Administration- Community Health Needs Committee- Partnerships with Kane County- Partnershhips with Kendall County- Communtiy Health Survey- Focus Groups- Secondary Data AnalysisFor complete details about how the hospital took into account input from persons who represent the broad interests of the community served, the hospital's community health needs assessment can be accessed at:http://www.rushcopley.com/about/community-health-needs-assessment-report/
Copley Memorial Hospital	Part V, Section B, Line 4: The Kane County Health Department, Rush-Copley Medical Center, Cadence Health Delnor Hospital, Presence Mercy Medical Center, Presence St. Joseph Hospital (Elgin), and Advocate Sherman Hospital worked together along with other community partners to develop the County's IPLAN (Illinois Project for Local Assessment of Needs). The IPLAN is a community health assessment and planning process that is conducted every five years by local health jurisdictions in Illinois.The collaborative participation in the planning process, plan development and identification of the health needs for the County served as a foundation for the development of each of the hospital's respective Community Health Needs Assessments.
Copley Memorial Hospital	Part V, Section B, Line 5d: http://www.rushcopley.com/about/community-health-needs-assessment-report/
Copley Memorial Hospital	Part V, Section B, Line 6i: Rush Copley began implementation of strategies identified in the strategy implementation plan for the three health need priorities.-Development of healthy weight web page.-Developed a funding program and partnership with Walgreens to provide medication assistance to those in need.-Also worked with Walgreens on a Well Transition program to ensure chronic disease patients understand their home medication and have an available resource to ask questions once discharged.-Worked with community leaders to develop a standard evidence based approach for Diabetes.-Created and implemented a web based inventory of universal medication assistance program.
Copley Memorial Hospital	Part V, Section B, Line 7: The following identified communtiy health needs were not addressed:Infant MortalityRush-Copley Medical Center is already addressing this health need through a number of on-going initiatives, including:- Participation in the Perinatal Network with Rush University and providing Neonatal Intensive Care Services- Active participation in the Kane County Breastfeeding Coalition- Hired Breastfeeding Peer Counselors to support Lactation services- Monthly communication with The Circle of Wise Women - a group of African American community women committed to acting together to reduce infant mortality- Partner with Federally Qualified Health Care Centers to promote prenatal education classes- Preventing elective deliveries before 39 weeks gestation, without medical justification- In collaboration with IDOT, hosts car seat safety checks- "Text 4 Baby" initiative- Working closely with the Kane County Health Department's Perinatal Committee toward preventing infant mortality as well as reducing health disparitiesRush-Copley Medical Center will continue to focus on this need and be an active community partner in the development and implementation of new strategies and initiatives.Communicable diseases- The reduction of communicable diseases in the community is a public health issue for which the local health departments acknowledge primary responsibility and leadership oversight. - Rush-Copley Medical Center continues to be a collaborative partner that provides on-going supportive services to the local health departments regarding this health issue.Mental and behavioral health- As identified during the prioritization exercise, Rush-Copley does not provide mental or behavioral health services and it would not be feasible for the hospital to develop this type of program. Therefore, the hospital would not be able to have a measurable impact on this need.- There are a great number of organizations in the community already addressing this need (as listed in the CHNA).- The hospital currently works closely with area mental and behavioral health programs in the community in order to assist patients in accessing care.Housing conditions- Housing conditions are societal factors that are outside the health care system, therefore the hospital is not in a position to directly impact these needs.- However, the hospital will continue to collaborate with other agencies and support initiatives for these health issues, including working with the Kendall County Health Department to develop a distribution program for home radon detection kits through the medical group practice as well as through the hospital's car seat safety check program.
Copley Memorial Hospital	Part V, Section B, Line 14g: Our financial assistance policy is listed on our website. Also we have a spot on the bills that we send to the patients that states we have a financial assistance policy. In addition, our patient financial staff will discuss the policy with the patients if they see that a need for assistance might exist.
Copley Memorial Hospital	Part V, Section B, Line 20d: Total charges before discounts are the same for all patients. Discounts are then applied to total charges to determine amounts billed to patients. At a minimum, patients with income less than or equal to 300% of the Federal Poverty Level (FPL) will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 300% of the FPL but not exceeding 600% of the FPL will receive a discount on the services provided to them. Additionally, for any pure self pay patient (someone presenting with no insurance regardless of income), there is a 30% uninsured discount automatically applied against total charges.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	River West Radiation Center LLC 1221 N Highland Avenue Aurora,IL605044206	JV Oncology
2	Community Alliance Home Health 4050 Healthway Drive Aurora,IL605044206	JV Home Health
3	Rush-Copley Healthcare Center 1100 West Vererans Parkway Yorkville,IL60560	Free Standing Emergency Care, Radiology, Lab, and Occupational Health Servic
4	Rush-Copley Cardiovascular Consultants 2000 Ogden Avenue Aurora,IL605044206	Cardiovascular Services
5	Midwest Center for Advanced Imaging 4355 Montgomery Road Naperville,IL60564	Radiology Services
6	Midwest Center for Advanced Imaging 963 129th Infantry Dr Suite 140 Joliet,IL60431	Radiology Services
7
8
9
10

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Copley Memorial Hospital	Part V, Section B, Line 3: In conducting the Community Health Needs Assessment, the hospital took into account input from persons who represent the broad interests of the community served. This included community residents and experts in a range of areas including public health, minority populations, disparities in health care, social determinants of health, and health & social services.Persons who represent the broad interests of the community served included:- Board of Directors- Hospital Administration- Community Health Needs Committee- Partnerships with Kane County- Partnershhips with Kendall County- Communtiy Health Survey- Focus Groups- Secondary Data AnalysisFor complete details about how the hospital took into account input from persons who represent the broad interests of the community served, the hospital's community health needs assessment can be accessed at:http://www.rushcopley.com/about/community-health-needs-assessment-report/
Copley Memorial Hospital	Part V, Section B, Line 4: The Kane County Health Department, Rush-Copley Medical Center, Cadence Health Delnor Hospital, Presence Mercy Medical Center, Presence St. Joseph Hospital (Elgin), and Advocate Sherman Hospital worked together along with other community partners to develop the County's IPLAN (Illinois Project for Local Assessment of Needs). The IPLAN is a community health assessment and planning process that is conducted every five years by local health jurisdictions in Illinois.The collaborative participation in the planning process, plan development and identification of the health needs for the County served as a foundation for the development of each of the hospital's respective Community Health Needs Assessments.
Copley Memorial Hospital	Part V, Section B, Line 5d: http://www.rushcopley.com/about/community-health-needs-assessment-report/
Copley Memorial Hospital	Part V, Section B, Line 6i: Rush Copley began implementation of strategies identified in the strategy implementation plan for the three health need priorities.-Development of healthy weight web page.-Developed a funding program and partnership with Walgreens to provide medication assistance to those in need.-Also worked with Walgreens on a Well Transition program to ensure chronic disease patients understand their home medication and have an available resource to ask questions once discharged.-Worked with community leaders to develop a standard evidence based approach for Diabetes.-Created and implemented a web based inventory of universal medication assistance program.
Copley Memorial Hospital	Part V, Section B, Line 7: The following identified communtiy health needs were not addressed:Infant MortalityRush-Copley Medical Center is already addressing this health need through a number of on-going initiatives, including:- Participation in the Perinatal Network with Rush University and providing Neonatal Intensive Care Services- Active participation in the Kane County Breastfeeding Coalition- Hired Breastfeeding Peer Counselors to support Lactation services- Monthly communication with The Circle of Wise Women - a group of African American community women committed to acting together to reduce infant mortality- Partner with Federally Qualified Health Care Centers to promote prenatal education classes- Preventing elective deliveries before 39 weeks gestation, without medical justification- In collaboration with IDOT, hosts car seat safety checks- "Text 4 Baby" initiative- Working closely with the Kane County Health Department's Perinatal Committee toward preventing infant mortality as well as reducing health disparitiesRush-Copley Medical Center will continue to focus on this need and be an active community partner in the development and implementation of new strategies and initiatives.Communicable diseases- The reduction of communicable diseases in the community is a public health issue for which the local health departments acknowledge primary responsibility and leadership oversight. - Rush-Copley Medical Center continues to be a collaborative partner that provides on-going supportive services to the local health departments regarding this health issue.Mental and behavioral health- As identified during the prioritization exercise, Rush-Copley does not provide mental or behavioral health services and it would not be feasible for the hospital to develop this type of program. Therefore, the hospital would not be able to have a measurable impact on this need.- There are a great number of organizations in the community already addressing this need (as listed in the CHNA).- The hospital currently works closely with area mental and behavioral health programs in the community in order to assist patients in accessing care.Housing conditions- Housing conditions are societal factors that are outside the health care system, therefore the hospital is not in a position to directly impact these needs.- However, the hospital will continue to collaborate with other agencies and support initiatives for these health issues, including working with the Kendall County Health Department to develop a distribution program for home radon detection kits through the medical group practice as well as through the hospital's car seat safety check program.
Copley Memorial Hospital	Part V, Section B, Line 14g: Our financial assistance policy is listed on our website. Also we have a spot on the bills that we send to the patients that states we have a financial assistance policy. In addition, our patient financial staff will discuss the policy with the patients if they see that a need for assistance might exist.
Copley Memorial Hospital	Part V, Section B, Line 20d: Total charges before discounts are the same for all patients. Discounts are then applied to total charges to determine amounts billed to patients. At a minimum, patients with income less than or equal to 300% of the Federal Poverty Level (FPL) will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 300% of the FPL but not exceeding 600% of the FPL will receive a discount on the services provided to them. Additionally, for any pure self pay patient (someone presenting with no insurance regardless of income), there is a 30% uninsured discount automatically applied against total charges.

Schedule H (Form 990) 2013

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

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....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including 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? ................

Yes

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

Yes

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) 2013

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)Barry FinnPresident & CEO/Director	(i) (ii)	639,978 0	348,305 0	14,931 0	383,850 0	36,939 0	1,424,003 0	0 0
(2)Brenda VanWyheSr. VP, Finance & CFO/Treasurer	(i) (ii)	257,868 0	120,853 0	7,695 0	58,980 0	24,745 0	470,141 0	0 0
(3)Ryan AsmusVP General Counsel/Secretary	(i) (ii)	198,754 0	91,697 0	8,010 0	42,060 0	31,713 0	372,234 0	0 0
(4)Steve Lowenthal MDSr. VP, Medical Affairs & CMO	(i) (ii)	390,128 0	179,912 0	96,241 0	14,247 0	29,210 0	709,738 0	0 0
(5)John DiederichSr. VP, Operations & COO	(i) (ii)	331,494 0	133,008 0	9,223 0	104,249 0	34,969 0	612,943 0	0 0
(6)Diane Homan MDVP, Quality & PSO	(i) (ii)	285,628 0	132,255 0	12,266 0	66,615 0	34,109 0	530,873 0	0 0
(7)Dennis DeMasieVP, Information Technology & CIO	(i) (ii)	218,733 0	99,551 0	10,262 0	49,097 0	34,950 0	412,593 0	0 0
(8)Mary ShilkaitisVP, Patient Care Services & CNO	(i) (ii)	213,469 0	83,572 0	9,597 0	45,909 0	33,537 0	386,084 0	0 0
(9)Alex PopeVP, Philanthropy & CDO	(i) (ii)	174,749 0	83,001 0	8,020 0	27,316 0	32,826 0	325,912 0	0 0
(10)Gail BumgarnerSr. VP, Strategy	(i) (ii)	240,566 0	85,305 0	7,026 0	13,012 0	14,021 0	359,930 0	0 0
(11)David PetasnickAssistant VP, Ancillary Services	(i) (ii)	169,237 0	41,590 0	189 0	8,063 0	19,249 0	238,328 0	0 0
(12)Suzanne SterchiAssistant VP, Patient Care	(i) (ii)	178,207 0	40,281 0	609 0	8,570 0	26,795 0	254,462 0	0 0
(13)Sepehr Sani MDPhysician	(i) (ii)	897,690 0	22,106 0	96,249 0	14,247 0	13,729 0	1,044,021 0	0 0
(14)Dimitry Ruban MDPhysician	(i) (ii)	773,173 0	107,742 0	25,476 0	14,452 0	32,830 0	953,673 0	0 0
(15)Todd Guynn MDPhysician	(i) (ii)	597,083 0	210,152 0	67,769 0	14,247 0	42,668 0	931,919 0	0 0
(16)Ellen Embry MDPhysician	(i) (ii)	387,558 0	140,884 0	45,900 0	14,247 0	33,896 0	622,485 0	0 0
(17)Courtney Virgilio MDPhysician	(i) (ii)	340,576 0	181,073 0	42,940 0	14,247 0	34,667 0	613,503 0	0 0
(18)Barbara GrahamVP, Philanthropy & CDO	(i) (ii)	0 0	0 0	111,229 0	0 0	6,118 0	117,347 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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.

Return Reference	Explanation
Part I, Line 1a	The organization provides to all employees the use of an athletic facility that is owned and operated by a related tax exempt organization.
Part I, Line 4a:	Barbara Graham received a severance payment of $109,814 in calendar year 2013 from Copley Memorial Hospital pursuant to her severance agreement. Part I, Line 4b: SERP PLAN of CMH (Accruals): Barry Finn $369,603, Mary Shilkaitis $34,329, John Diederich $90,002, Steve Lowenthal $0, Dennis DeMasie $36,691, Diane Homan $51,751, Brenda VanWyhe $44,644, Alex Pope $27,001, Gail Bumgarner $0, and Ryan Asmus $31,671. Please note that these amounts are included in the amounts listed on Schedule J, Part II, Column C. There is no constructive receipt of these amounts by the individuals until they are paid out as they are subject to a substantial risk of forfeiture. Any individual payouts would be included as reportable compensation on the recipient's annual W2 form. Steve Lowenthal received payments in 2013 of $77,277.
Part I, Line 7:	Incentive bonus plan based on a series of approved strategic accomplishments.
Part II, Column (B)(ii):	Physician Bonus & incentive compensation: Physician bonuses were paid based on individual productivity goals

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number
36-2170840

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Illinois Finance Authority	86-1091967	45200FHN2	05-28-2008	34,772,005	See Part VI		X		X		X
B	Illinois Finance Authority	86-1091967	45200FTZ2	02-10-2009	34,075,527	Construction of Replace Hosp & ICU addition		X		X		X
C	Illinois Finance Authority	86-1091967	45200FYT0	07-29-2009	25,912,180	New Construction Hospital Campus		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	34,772,005		34,075,527		25,912,180
4 Gross proceeds in reserve funds . . . . . . . . . . . .	3,090,947		3,394,358		2,592,491
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	540,878		498,260		401,472
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	32,745,950		32,745,950		22,919,490
11 Other spent proceeds . . . . . . . . . . . . . .	34,231,127
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2009		2009		2009
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X	X		X
b Exception to rebate? . . . . . . . .		X		X		X
c No rebate due? . . . . . . . .	X			X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

Schedule K, Part I, Bond Issues:

(a) Issuer Name: Illinois Finance Authority (f) Description of Purpose: Construction of Replace Hosp & ICU addition. Schedule K, Part I, line A, column (e): Issue Price of bonds of $34,772,005 does not tie to Form 8038 Part III Line 21(b) of $98,278,724. This is because the $34,772,005 is Copley Memorial Hospital's 35.38% prorata share of the $98,278,724 Obligated Group amount issued. Schedule K, Part I, line A, column (f): The Series 2006B Fixed Rate bonds currently refunded (as a reissuance) the Series 2006B Auction Rate bonds issued 8/17/2006, which were issued to refund pre-2003 bond issues. Schedule K, Part IV, Line 2c, Column A: The Series 2006B Fixed Rate bonds' rebate calculation that concluded that there was no liability (and hence no Form 8038-T to file) was completed on May 28, 2013.

Schedule K (Form 990) 2013

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

Return Reference	Explanation
Form 990, Part VI, Section A, line 2	Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related Rush-Copley Medical Center entity boards. Barry Finn, CMH President & CEO/Director, and William Skoglund, CMH Vice Chairman of the Board/Director, have a business relationship. Barry Finn is a board member at Old Second National Bank and William Skoglund is the Chairman and CEO at Old Second National Bank. Mr. Skoglund does not serve on Copley Memorial Hospital's compensation committee and has recused himself from any discussions or votes that involve Mr. Finn's salary.
Form 990, Part VI, Section A, line 4	Copley Memorial Hospital, Inc. has amended and restated its bylaws which became effective October 29, 2103. The approval powers of the corporate member were amended.
Form 990, Part VI, Section A, line 6	Rush-Copley Medical Center, Inc. ("RCMC") is the sole corporate member of Copley Memorial Hospital, Inc. ("CMH"), Rush-Copley Medical Group, NFP ("RCMG"), Copley Ventures, Inc. ("CV"), and Rush-Copley Foundation ("RCF").
Form 990, Part VI, Section A, line 7a	CMH's Board of Directors includes at least nine (9) individuals elected by the sole corporate member, RCMC. Each of these elected directors is also a member of the Governing Board of CMH's sole corporate member, RCMC. The election and re-election of all CMH directors is at the direction of RCMC at the annual Governing Board meeting. Vacancies on the CMH Board of Directors are filled by CMH's sole corporate member, RCMC. In accordance with certain procedural requirements stated in the bylaws, elected directors may be removed by the affirmative vote of two-thirds of the board of directors of CMH's sole corporate member, RCMC.
Form 990, Part VI, Section A, line 7b	The Board of Directors of CMH's sole corporate member, RCMC, has the following exclusive powers over CMH: (1) the election of the Board of Directors; (2) any amendment to the Articles of Incorporation or Bylaws of this Corporation (3) the borrowing of any sum, the principal of which exceeds $500,000.00, or which has a stated term of greater than one year, or which is secured by a mortgage of all or any portion of the Corporation's real property or the creation of a security interest in the Corporation's assets, including personal property and revenues, for the benefit of the lender, lessor or vendor, or the defeasance, advance payment or cancellation of any outstanding debt of the category described herein; (4) any voluntary dissolution, merger, consolidation, sale or transfer of any of the Corporation's assets (above a material dollar threshold as a percentage of the Corporation's assets as determined in conjunction with the Corporate Member) or any creation of a subsidiary or affiliate of this Corporation; (5) application to the Illinois Health Facilities Planning Board or any successor for a permit or certificate of need for a proposed activity, whether or not involving a capital expenditure; (6) Approval of all new or changes to existing annual and long-term capital and operational budgets or long-term or master strategic plans; (7) any agreement or transaction, either of which is of a material nature, with another corporation controlled by or affiliated with the Corporate Member or which is a subsidiary of the Corporate Members; (8) sale of any of the Corporation's real property or interest therein or purchases of any additional real estate; (9) the audited financial statements and bond disclosures of the Corporation; (10) selection and annual evaluation of the President; and (11) the annual audited financial statements and bond disclosures of the Corporation.
Form 990, Part VI, Section B, line 11	The Form 990 tax return is prepared by our external tax advisor with data provided by our organization. A draft of the Form 990 is provided to management for review and comment. The Board of Directors is provided with an approved copy of the Form 990 before it is filed.
Form 990, Part VI, Section B, line 12c	Annually, Officers, Directors, Key Employees, Management Team (Department Directors and Managers), and Billing Office personnel of Copley Memorial Hospital, Inc. are required to disclose interests that could give rise to conflicts. The conflict of interest statements are submitted and reviewed by the Chief Compliance Officer and the Audit and Corporate Integrity Committee of the Board. Those key personnel with conflicts are advised to recuse themselves from participating in decision-making related to the conflict.
Form 990, Part VI, Section B, line 15	With respect to the CEO/VP's of the organization and key senior management, the organization follows a compensation approval procedure annually that involves approval of proposed and final compensation arragements by the organization's Compensation Committee and full board of Directors using comparability data, as well as contemporaneous documentation of compensation decisions in minutes.
Form 990, Part VI, Section C, line 19	Form 990 available upon request. The organization does not make its governing documents or conflict of interest policy available to the public. Copies of the financial statements (whether or not audited) are provided upon reasonable request such as for a bank loan or to a bond rating agency. The financial statements are available on the Attorney General's website.
Form 990, Part XI, line 9:	Transfer of assets to affiliates-net -17,402,098. Change in interest in net assets of Foundation 281,687. Swap value adjustment -179,238.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Copley Memorial Hospital Inc
c/o Rush-Copley Medical Ctr

Employer identification number

36-2170840

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on 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) Rush Copley Medical Center Inc 2000 Ogden Avenue Aurora,IL60504 36-3193787	Parent Company	IL	Section 501(c)(3)	Schedule A, Line 11a	N/A		No
(2) Rush Copley Health Care System Inc 2000 Ogden Avenue Aurora,IL60504 36-3584043	Bridge Board RCMC & RUMC	IL	Section 501(c)(3)	Schedule A, Line 11a	N/A		No
(3) Rush-Copley Foundation 2000 Ogden Avenue Aurora,IL60504 36-3093877	Grants to Charitable Organizations	IL	Section 501(c)(3)	Schedule A, Line 7	Rush-Copley Medical Center Inc	Yes
(4) Copley Ventures Inc 2000 Ogden Avenue Aurora,IL60504 36-3370216	Rental Prop., Infirmary Care, and Healthplex Fitness Center	IL	Section 501(c)(3)	Schedule A, Line 3	Rush-Copley Medical Center Inc	Yes
(5) Rush University Medical Center 1700 West Van Buren Street Chicago,IL60612 36-2174823	Hospitals	IL	Section 501(c)(3)	Schedule A, Line 3	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Yorkville Physical Therapy & Sports Medicine Center LLC 2000 Ogden Avenue Aurora,IL60504 36-4236345	Physical Therapy & Sports Medicine	IL	N/A
(2) Rush Copley Cardiovascular Consultants LLC 2000 Ogden Avenue Aurora,IL60504 27-3234201	Cardiovascular Medicine	IL	Rush-Copley Medical Center Inc	Related	-2,208,392	3,090,132		No			No	99.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on 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) Rush Copley Medical Group NFP 2000 Ogden Avenue Aurora,IL60504 36-3235315	Physician Practices	IL	N/A	C				No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

Yes

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

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

Yes

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Rush Copley Medical Group NFP	A	594,599	Fair Market Value
(2) Rush Copley Foundation	C	548,821	Fair Market Value
(3) Rush Copley Foundation	I	60,508	Fair Market Value
(4) Rush Copley Medical Center Inc	I	17,402,098	Fair Market Value
(5) Copley Ventures Inc	K	613,931	Fair Market Value
(6) Rush Copley Foundation	Q	488,313	Fair Market Value
(7) Copley Ventures Inc	R	468,000	Fair Market Value

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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 V?UBI 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 V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To provide advanced medicine with quality outcomes and extraordinary care.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	20
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	18
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	2,116
6	Total number of volunteers (estimate if necessary) .............	6	250
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	893,313	548,821
9	Program service revenue (Part VIII, line 2g) .........	273,284,274	291,634,837
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	15,780,198	12,073,736
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,484,366	7,092,206
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	296,442,151	311,349,600
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	31,010	50,133
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)	125,217,858	132,863,510
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	128,759,262	144,418,502
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	254,008,130	277,332,145
19	Revenue less expenses. Subtract line 18 from line 12.......	42,434,021	34,017,455
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	423,189,731	458,989,462
21	Total liabilities (Part X, line 26).............	233,916,155	233,857,390
22	Net assets or fund balances. Subtract line 21 from line 20.....	189,273,576	225,132,072

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 212,977,187 including grants of $ 50,133 ) (Revenue $ 298,519,369 )
	Copley Memorial Hospital's mission is to provide advanced medicine with quality outcomes and extraordinary care. The focus on advanced medicine is concentrated in Copley Memorial Hospital's centers of excellence or "Institutes." Institutes represent the major service lines of the medical center: Cancer Care; Emergency Services; Heart & Vascular; Neuroscience; and Women's Health. The designation of Institutes allows the organization to prioritize among diverse opportunities and focus resources on these service lines. To that end, the medical center seeks to serve the community in ways that engage, educate and empower. In 2013, Copley Memorial Hospital proudly collaborated with dozens of civic and community groups to impact the knowledge, health and well being of the community. Copley Memorial Hospital offers free educational programs ranging from hand hygiene education aimed at preschool and primary grade school aged children to annual seminars educating adults about diabetes, heart health, cancer prevention, weight control, smoking cessation and more.A bimonthly newsletter is published and highlights health information and calendar of events info to 90,000+ households throughout the hospital service area. Free and reduced cost health screenings are regularly offered including free blood pressure monitoring on a walk-in basis.Two electronic newsletters also highlighting health information, news and events are emailed monthly: Healthy eUpdate and FitNotes. These newsletters average 13,500 and 3,300 emails respectfully.Highlighted Health Programming includes:During 2013, Copley Memorial Hospital sponsored, partnered or participated in over 600 community-based programs and events with special emphasis on improving the health and wellness of adults, children and underserved populations. Nutrition and Weight LossFour programs aimed at providing sound nutrition advice and weight loss strategies were held during the year. Topics included women and weight loss, strength training, and one pot meals. 20 people attended.Diabetes Presentations about diabetes and related screenings were conducted throughout the year at various community locations. Fasting glucose and blood pressure screenings were provided to over 600 community members. 156 people attended diabetes education classes.Smoking CessationThe Freedom from Smoking class was offered four times with a total of 15 participants. This free eight-week program provides support and the skills needed to quit smoking. Three sessions were conducted in English and one session was conducted in Spanish.Cancer Awareness and InformationThe Help for You program on breast cancer education was provided at the Latina Health Fair, African American Health Fair, Communities in School's Back to School Fair, Susan G. Komen races and the mobile Consulate. Educational materials were provided to over 400 participants. Dr. Gor presented a program "Get the Scoop on the Scope" to 19 participants. The Caring Forward Cancer Survivorship program was provided on a quarterly basis with at total of 15 attendees. Additional venues where information to 150 participants was provided on cancer and sun safety include Play it Safe, church health fairs and the Health and Wellness Symposium. At the annual celebration of National Cancer Survivors Day, there were more than 400 participants in attendance.Latina Talks (Platicas Para Mujeres) and Community TalksLatina Talks (Platicas Para Mujeres) is an educational series geared toward the healthcare needs of Latina women. Latina Talks is offered eight times a year from September through April targeting Latina women in the Fox Valley area. Topics presented by professional healthcare providers include: Moving Forward After Cancer, Exercise and Zumba Demonstration, Diabetes and Obesity, Nutrition in the Latino Community, Cholesterol, Gluten & Sodas and more. Typically, between 10 and 25 women attend the monthly sessions. In addition, Rush-Copley partners with Aurora University nursing students to provide free child care. The student nurses also provide education topics such as playground safety and activities that promote exercise to the children. Over 150 women have benefited from the presentations in the last year and over 100 children have attended child care which takes place in the preschool classroom of the Prisco Community Center.Expanding on the Latina Talks program, Rush-Copley in collaboration with the Aurora Public Library offered three Community Talks for both men and women, in Spanish. Topics included an interactive session on Emotional Health and Communication, Layman's Guide to Mental Health and Reducing Obesity in the Latino Community. More than 60 community members participated in the Community Talks series.Older Adult EducationEducational and interactive talks designed to provide seniors with health information and education are presented regularly at the Beecher Community Center in Yorkville in collaboration with Senior Services Associates, Inc. This program called "Wellness is a Way of Life," reaches approximately 300 seniors annually."The Breakfast Club," a program that targets the senior community at large, provides bi-monthly presentations that include question and answer sessions on healthcare topics. The program takes place at Sunnymere, an assisted living facility in Aurora, and is attended annually by 150 seniors.Pregnancy and ChildbirthPrenatal education classes are offered to couples who are pregnant or considering having a baby. Class topics include New Advances in Infertility, C-Section, Bringing Home Baby and Child Safety. Tours of the Family Birth Center are also provided. Over 1,700 people participated in 2013.VascularSeveral PVD screenings took place through the year as well as programs that discussed healthy legs and veins. Over 175 people benefitted from these activities. Movement DisordersFour community programs were offered to people who were experiencing or care for a person experiencing a movement disorder. 224 people attended these programs. Ongoing programs include land exercises, water exercises, art therapy, Parkinson's disease and essential tremor support with over 100 participants.WomenOver 300 women attended programs aimed specifically for them. Topics in the Women to Women series included Women's Wellness Below the Waist, 9 Tips in 90 Minutes, Heart Health and Think Pink. Other program topics included Financial Freedom and Continence. Physician Referral and Service LineCopley Memorial Hospital offers a free physician and information referral telephone service to the community. This service allows community members to talk with a call advisor to match a person's health needs and preferences with the physician of their choice or link callers to services provided by the medical center. Over 11,500 people used this service in 2013.WebsiteCopley Memorial Hospital's website, rushcopley.com, with translation available into dozens of languages, offers access to free health information, a health encyclopedia, and a symptom checker. In 2013, there were over 963,000 visits to rushcopley.com.Charity CareIt is an inherent part of the Hospital's mission to provide necessary medical care free of charge, or at a discount, to individuals without insurance or other means of paying for such care. As the amounts determined to qualify for charity care are not pursued for collection, they are not reported as net patient service revenue. Patients who would otherwise qualify for charity care but who do not provide adequate information would be characterized as bad debt and included in the provision for uncollectible accounts. The Hospital also incurs losses related to the unreimbursed costs of providing services to Medicaid patients.The Hospital has an established charity care policy and maintains records to identify and monitor the level of charity care it provides. The Hospital provides free care to all patients who apply and support income and asset levels of less than 300% of the current-year poverty level, a 30% discount to all uninsured patients regardless of ability to pay, and discounts balances to patients under 600% of the poverty level. Interest-free payment plans are also provided. These charity care records include the estimated cost of unreimbursed services provided and supplies furnished under its charity care policy and the excess of cost over reimbursement for Medicaid patients. The estimated cost of charity care provided is determined using a ratio of cost to gross charges and multiplying that ratio by the gross unreimbursed charges associated with providing care to charity patients. The Hospital also monitors the unreimbursed cost of patient bad debts.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses212,977,187

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	9,058,097	0	1,426,952

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		548,821
e	Government grants (contributions)1e

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			548,821
			Business Code
2a	Net Patient Svc. Rev.		621110	269,820,611	269,820,611
b	Medicaid Tax Revenue		621110	23,515,539	23,515,539
c	Other Program Revenue		900099	-1,701,313	-1,701,313
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			291,634,837
3	Investment income (including dividends, interest, and other similar amounts).......			5,678,547			5,678,547
4	Income from investment of tax-exempt bond proceeds..			188,241			188,241
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	1,257,574
b	Less: rental expenses	1,514,685
c	Rental income or (loss)	-257,111
d	Net rental income or (loss).......			-257,111			-257,111
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	76,165,390	2,085,204
b	Less: cost or other basis and sales expenses	71,520,158	523,488
c	Gain or (loss)	4,645,232	1,561,716
d	Net gain or (loss)..........			6,206,948			6,206,948
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	Outside Service Rev.		621990	6,884,532	6,884,532
b	Cafeteria Revenue		621990	233,594			233,594
c	Gift Shop Revenue		453220	220,576			220,576
d	All other revenue ....			10,615			10,615
e	Total. Add lines 11a–11d ......			7,349,317
12	Total revenue. See Instructions......			311,349,600	298,519,369	0	12,281,410


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			201,623	1	213,480
2	Savings and temporary cash investments .........			20,000,117	2	19,157,212
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			34,476,997	4	40,320,674
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			4,710,289	8	4,606,762
9	Prepaid expenses and deferred charges ..........			8,183,012	9	8,803,680
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	320,281,178
b	Less: accumulated depreciation .....	10b	190,039,962	131,496,347	10c	130,241,216
11	Investments—publicly traded securities ..........			199,247,683	11	237,158,566
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			24,873,663	15	18,487,872
16	Total assets. Add lines 1 through 15 (must equal line 34)......			423,189,731	16	458,989,462
17	Accounts payable and accrued expenses .........			121,151,507	17	121,505,916
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			89,816,495	20	89,609,546
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			22,948,153	25	22,741,928
26	Total liabilities. Add lines 17 through 25.........			233,916,155	26	233,857,390
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			184,865,539	27	219,954,035
28	Temporarily restricted net assets ...........			4,408,037	28	5,178,037
29	Permanently restricted net assets ...........				29
	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 ...........			189,273,576	33	225,132,072
34	Total liabilities and net assets/fund balances ........			423,189,731	34	458,989,462