Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 09-01-2013 , 2013, and ending 08-31-2014
BCheck if applicable:
CName of organization
Ann & Robert H Lurie Children's Hospital of
Chicago
Doing Business As
Lurie Children's
 
Number and street (or P.O. box if mail is not delivered to street address)
225 E Chicago Ave PR DEPT BOX 2
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL606112991
D Employer identification number

36-2170833
E Telephone number

G Gross receipts $ 1,812,362,706
F Name and address of principal officer:
Patrick M Magoon
225 E Chicago Ave
Chicago,IL606112991
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.luriechildrens.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1894
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: LURIE CHILDREN'S IS A PEDIATRIC ACADEMIC MEDICAL CTR PROVIDING PATIENT CARE & EDUC FOR PHYSICIANS & OTHER MED PROFESSIONALS, AND IS ALSO A LEADER IN PEDIATRIC RESEARCH & ADVOCACY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 107
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 92
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 5,034
6 Total number of volunteers (estimate if necessary) ............. 6 1,391
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,600,002
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 977,149
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 33,666,839 34,762,729
9 Program service revenue (Part VIII, line 2g) ......... 623,112,154 681,383,048
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 34,311,424 42,925,580
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,084,828 3,435,165
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 694,175,245 762,506,522
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 34,726,354 35,813,687
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) 314,534,356 316,727,033
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 316,084,320 330,882,257
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 665,345,030 683,422,977
19 Revenue less expenses. Subtract line 18 from line 12....... 28,830,215 79,083,545
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,112,229,339 2,195,275,694
21 Total liabilities (Part X, line 26)............. 689,405,164 613,546,583
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,422,824,175 1,581,729,111
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: WE ARE DEDICATED TO THE HEALTH AND WELL-BEING OF ALL CHILDREN. AS THE PEDIATRIC TEACHING FACILITY FOR NORTHWESTERN UNIVERSITY'S FEINBERG SCHOOL OF MEDICINE, THIS COMMITMENT DRIVES US TO BE A LEADER IN: - PEDIATRIC HEALTH CARE DELIVERY - RESEARCH INTO THE PREVENTION, CAUSES AND TREATMENT OF DISEASES THAT AFFECT CHILDREN - EDUCATION FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS - ADVOCACY FOR CHILDREN AS A CHARITABLE ORGANIZATION, WE SERVE CHILDREN AND THEIR FAMILIES TO THE BEST OF OUR ABILITIES AND TO THE LIMITS OF OUR RESOURCES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 601,073,156 including grants of $ 35,813,687 ) (Revenue $ 684,270,705 )
Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's") in Chicago, Illinois owns and operates the only full-service, independent, freestanding pediatric hospital in Illinois. This not-for-profit, tertiary care hospital, founded in 1882, provides patient care 24 hours-per-day, 7 days-per-week. Lurie Children's has 288 licensed beds and provides a full range of inpatient and outpatient care and related ancillary services. Lurie Children's provides more care than any other hospital provider in Illinois in nearly every pediatric medical and surgical specialty. As a major academic tertiary care medical center, Lurie Children's has served patients from 50 states, and 48 countries. Lurie Children's is a designated Level I pediatric trauma center for the City of Chicago, with a Level III neonatal nursery that serves as a regional referral center in the State of Illinois Perinatal Network. Lurie Children's ability to treat the most critically ill infants in its neonatal intensive care unit ("NICU") is demonstrated by statistics for fiscal year 2014 which show that 56% of all transports into its NICU were from other Level III nurseries in metropolitan Chicago. In 2014, Lurie Children's has been ranked as the 8th best children's hospital in the country by U.S. News & World Report. In addition, Lurie Children's is the only pediatric hospital in Illinois to be ranked by U.S. News & World Report in all 10 pediatric specialties. Lurie Children's is the home to the world's first pediatric center for autonomic medicine and was the first pediatric hospital in Illinois to perform the Berlin Heart procedure, a breakthrough technology that helps children awaiting heart transplants. In the fiscal year ending August 31, 2014, Lurie Children's, through more than 620,000 patient visits, served more than 174,000 children who came from all over the State of Illinois and beyond to access the more than 70 specialties offered by Lurie Children's. During this period there were 503,183 outpatient visits including 336,431 visits in Lincoln Park (including 4,317 observation cases) including 51,729 emergency room visits and 110,844 outpatient visits at the satellite facilities. Lurie Children's is the largest provider of Medicaid services to Illinois children. In total, during the State of Illinois' fiscal year 2014, Lurie Children's provided approximately 65% more outpatient and inpatient Medicaid services than the next highest Illinois hospital. Lurie Children's pediatric-specialist physicians provide more specialty care to children insured by the State of Illinois' All Kids (Medicaid) program than any other specialty care provider. Lurie Children's maintains a charity care policy under which it provides healthcare services free of charge or at a greatly reduced rate to children whose families are unable to pay for the charges associated with their medical care. For the fiscal year ended August 31, 2014, the total unreimbursed care and community benefit (as reported in the FY 2014 audit of Lurie Children's and its affiliates) provided by Lurie Children's and its affiliates was approximately $125 million, including $84.7 million in costs associated with unreimbursed services and charity care provided by Lurie Children's and its affiliated physician groups and $41.7 million for other community benefit including, but not limited to, resident and fellow expenses of $16.8 million, research funding $7.7 million, operation of a community clinic support $2.8 million, child advocacy programs $1.7 million and the provision of language assistance, pastoral care, social work, art and music therapies, hospital volunteer services, transplant family housing and other family support services $7.9 million. Lurie Children's undertakes a broad range of services and activities in addition to patient care that support its charitable mission. Lurie Children's functions as a teaching and research institution whose efforts have contributed considerably to improvements in the quality of life and healthcare for children. Lurie Children's supports community medical needs through a variety of outreach programs and educational programs. In December 2001, Lurie Children's became the first pediatric hospital in the nation and the first hospital in Illinois to receive the Magnet Award from the American Nurses Credentialing Center. Lurie Children's was awarded this designation again in 2005 and 2010. Today, while the status is the most sought-after nation-wide honor in hospital nursing, fewer than 1% of hospitals have achieved the accomplishment of maintaining the designation three or more times. Lurie Children's is one of the major pediatric teaching hospitals in the U.S., serving as the pediatric teaching facility and the primary pediatric practice site of Northwestern University's Feinberg School of Medicine ("NUFSM") for resident physicians, fellows and medical students in pediatric specialties and sub-specialties. This program is consistently one of the most sought after in the country. In academic year 2013-2014, over 1,522 individuals applied for the 31 available positions. Lurie Children's has 212 pediatric residents and fellows in various pediatric training programs from NUFSM for which Lurie Children's serves as the primary site. Lurie Children's also offers clinical experiences in pediatrics to medical students, nursing students, and students in other allied health fields. Lurie Children's is affiliated with 20 nursing education programs. In academic year 2013-2014, there were 1,520 student placements, including 347 third and fourth year medical students, 833 nursing students, and 324 allied health students. Lurie Children's has completed construction of a new, 288-licensed bed, acute care, pediatric hospital to replace its old hospital facilities which is named the "Ann & Robert H. Lurie Children's Hospital of Chicago." This new facility which opened June 9, 2012, is in close proximity to NUFSM and will facilitate Lurie Children's ability to continue to build upon its academic and research ties in a family-centered environment and state-of-the-art pediatric care facility that will foster the provision of compassionate care. Lurie Children's role as a regional referral center for a variety of pediatric diseases and illnesses has created many research opportunities to study and treat them and Lurie Children's research arm, Stanley Manne Children's Research Institute ("Stanley Manne Research Institute") is one of the nation's few centers dedicated solely to pediatric research. See the tax information return of Lurie Children's affiliate, Stanley Manne Children's Research Institute (36-3357005). Alone, or in collaboration with other community partners, Lurie Children's provides programs to support the health and well-being of children beyond the walls of the hospital, particularly in under-resourced communities. Hospital physicians and staff provide expertise at local, city, state and national levels. The hospital also engages in strategic organizational partnerships. An emphasis has been on school-based partnerships to support the learning and safety accommodations and socialization of students with special health care needs. The hospital provides training and staff development to school personnel to strengthen their clinical and classroom management of these children. Through its work with students directly and in providing staff training and development with Chicago Public Schools ("CPS") over the past 18 years, Lurie Children's has reached more than 30,000 students. Programs address specific conditions such as epilepsy, ADHD, HIV infection, and impaired hearing. Other programs educate personnel about managing technology-dependent children and aiding children transitioning from the hospital back to school. Collaborations with the Chicago Park District (CPD) have included playground safety inspections and coach training in concussion management that provides a safety net for all participants in park athletic programs and playground activities. Other community health activities include a partnership by Hospital hematologists with the American Red Cross Blood Services to launch a cooperative sickle cell blood donor program to increase the number of blood donations by African Americans to help children with sickle cell disease who require frequent blood transfusions. Lurie Children's is a driving member of the Consortium to Lower Obesity in Chicago Children (CLOCC) to confront childhood obesity in Chicago. CLOCC is currently working with the City of Chicago to promote healthy eating and physical activity and is also piloting programs in Englewood, Humboldt Park, Lower West Side, Rogers Park West Garfield Park, and West Town neighborhoods in Chicago. Lurie Children's recently unveiled an anti-violence movement called Strengthening Chicago's Youth ("SCY"). SCY's mission is to build capacity among hundreds of public and private stakeholders to collaborate and mobilize am
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 expensesMediumBullet601,073,156
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
316
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
5,034
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
107
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
92
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletRON H BLAUSTEIN225 ECHICAGO AVEChicagoIL606112991 (312) 227-7133
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) CARL S ALLEGRETTI........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(2) JOHN J ALLEN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(3) PATRICK J ALLIN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(4) JOHN AMBOIAN JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(5) SARAH BAINE........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(6) PETER B BENSINGER JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(7) ANDREW T BERLIN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(8) MARGARET W BRENNAN........................................................................
DIRECTOR
1.0
.......................3.0
X           0 0 0
(9) JULIA BROWN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(10) ALAN BULLEY III........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(11) DAVID BUNNING........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(12) GREGORY C CASE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(13) JOHN A CHALLENGER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(14) ALAN CHAPMAN........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(15) ELEANOR O CLARKE........................................................................
DIRECTOR
1.0
.......................3.0
X           0 0 0
(16) KEVIN M CONNELLY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(17) JOHN D COONEY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) LESTER CROWN........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(19) CONSTANCE CURRAN RN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(20) PATRICE PURCELL DECORREVONT........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(21) PEDRO DEJESUS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(22) SUSAN B DEPREE........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(23) JAMES DEROSE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(24) WILLIAM J DEVERS JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(25) LABEED DIAB........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(26) JOHN O DOERGE JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(27) JAMES S DONALDSON MD........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................40.0
X           0 579,886 238,128
(28) CHARLES W DOUGLAS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(29) DENNIS J DRESCHER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(30) ANA DUTRA........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(31) DONALD J EDWARDS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(32) KAREN A ENG........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(33) MICHAEL C EVANGELIDES........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(34) TYRONE C FAHNER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(35) LESLI FALK........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................3.0
X           0 0 0
(36) MITCHELL FEIGER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(37) DIANA S FERGUSON........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(38) MICHAEL W FERRO JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(39) VENITA E FIELDS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(40) DAVID FOX JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(41) JOHN S GATES JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(42) BERT A GETZ JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(43) LAUREN GORTER........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................2.0
X           0 0 0
(44) THOMAS P GREEN MD........................................................................
EX-OFFICIO DIR/PRES&CHAIR PFF
1.0
.......................43.0
X           0 765,187 57,204
(45) JOSEPH GREGOIRE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(46) JOHN J GREISCH........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(47) DAVID D GRUMHAUS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(48) DAVID D GRUMHAUS JR........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(49) ARLINGTON GUENTHER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(50) BRUCE R HAGUE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(51) TODD M HAMILTON........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(52) DAVID A HELFAND........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(53) MARY JC HENDRIX PHD........................................................................
EX-OFFICIO DIR/PRES/SCI OFF
1.0
.......................43.0
X           0 632,391 87,930
(54) DANIEL J HENNESSY........................................................................
DIRECTOR
1.0
.......................5.0
X           0 0 0
(55) JAMES P HICKEY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(56) MARK A HOPPE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(57) KYM A HUBBARD........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(58) KIRK B JOHNSON........................................................................
DIRECTOR
1.0
.......................4.0
X           0 0 0
(59) W BRUCE JOHNSON........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(60) ANTHONY K KESMAN........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(61) RICHARD P KIPHART........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(62) NANCY KNOWLES........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(63) LETICIA P KOROVESSIS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(64) FRED L KREHBIEL........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(65) ADAM M KRIGER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(66) GERALD R LANZ........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(67) ERIC P LEFKOFSKY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(68) PETER I LIBER MD........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(69) LYLE LOGAN........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(70) TOM LONG........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(71) SHELLEY A LONGMUIR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(72) DANIEL TW LUM MD........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................2.0
X           0 0 0
(73) PATRICK M MAGOON........................................................................
EX-OFFIC DIR/CEO, MED CTR/HOSP
40.0
.......................4.0
X   X       1,272,214 0 496,545
(74) MITCHELL J MANASSA........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(75) ROXANNE MARTINO........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(76) PETER D MCDONALD........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(77) DAVID P MCHUGH........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................3.0
X           0 0 0
(78) ANDREW J MCKENNA........................................................................
DIRECTOR & VICE CHAIR
1.0
.......................1.0
X           0 0 0
(79) WILLIAM J MCKENNA........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(80) JAMES J MCNULTY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(81) DEIDRA MERRIWETHER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(82) LOUISE C MILLS........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(83) JOHN C MOORE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(84) ROBERT S MURLEY........................................................................
VICE CHAIR & DIRECTOR
1.0
.......................2.0
X           0 0 0
(85) DANIEL J MURPHY........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(86) ERIC G NEILSON MD........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................2.0
X           0 0 0
(87) DAVID NEITHERCUT........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(88) WILLIAM NEUSTADT........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(89) LESLIE H NEWMAN........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(90) NANCY A PACHER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(91) CHAKA M PATTERSON........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(92) DOUGLAS A PERTZ........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(93) LORNA S PFAELZER........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(94) KENNETH PIGOTT........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(95) ASHISH PRASAD........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(96) MICHAEL PUCKER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(97) GERALD D PUTNAM........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(98) MOHAN P RAO PHD........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(99) DIANA M RAUNER PhD........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(100) THOMAS R REUSCHE........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(101) J CHRISTOPHER REYES........................................................................
MED. CNTR./HOSP. CHAIR
7.0
.......................8.0
X           0 0 0
(102) MARLETA REYNOLDS MD........................................................................
EX-OFFICIO DIRECTOR
1.0
.......................3.0
X           0 0 0
(103) PETER C ROBERTS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(104) BETSY B ROSENFIELD........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(105) MANUEL SANCHEZ........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(106) H WILLIAM SCHNAPER MD........................................................................
EX-OFFICIO DIRECTOR/ PFF MD
1.0
.......................1.0
X           0 305,486 49,392
(107) ZALDWAYNAKA SCOTT........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(108) CHRISTOPHER SEGAL........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(109) SMITA N SHAH........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(110) VIRGINIA K SIMMONS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(111) JOHN H SIMPSON........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(112) STEPHEN A SMITH........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(113) THOMAS S SOULELES........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(114) STEPHEN T STEERS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(115) EMILY H STOECKEL........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(116) SANTHANAM SURESH MD........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(117) MONSIGNOR KENNETH VELO........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(118) MATTHEW M WALSH........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(119) EDWARD J WEHMER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(120) BRIAN E WILLIAMS........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(121) ROBERT J WINTER........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(122) LINDA S WOLF........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(123) JAMES WOOTEN JR........................................................................
DIRECTOR
1.0
.......................1.0
X           0 0 0
(124) MS JIA ZHAO........................................................................
DIRECTOR
1.0
.......................2.0
X           0 0 0
(125) MICHAEL D KELLEHER MD........................................................................
EX-OFFICIO DIRECTOR/CMO/HOSP.
1.0
.......................42.0
    X       0 563,573 55,211
(126) RON BLAUSTEIN........................................................................
CFO MED. CNTR. & AFFLTS
40.0
.......................5.0
    X       348,751 0 42,265
(127) JONI M DUNCAN........................................................................
CHIEF HR OFFICER
40.0
.......................0.0
    X       324,469 0 43,227
(128) SUSAN H GORDON........................................................................
CHIEF COMMUNIC & EXT AFFAIRS
40.0
.......................0.0
    X       361,486 0 110,812
(129) MONICA HEENAN........................................................................
CHIEF AMBULATORY EXECUTIVE
40.0
.......................0.0
    X       364,296 0 37,391
(130) STANLEY B KROK........................................................................
CHIEF INFORMATION OFFICER
40.0
.......................0.0
    X       538,522 0 49,159
(131) MAUREEN T MAHONEY........................................................................
CHIEF EXCELLENCE OFFICER
40.0
.......................0.0
    X       314,277 0 35,031
(132) MAUREEN MURPHY........................................................................
CHIEF MARKETING & MANAGED CARE
40.0
.......................0.0
    X       344,532 0 44,212
(133) PAULA M NOBLE........................................................................
CFO/TREAS/MED CT&AFF-THRU 5/14
40.0
.......................5.0
    X       592,294 0 223,562
(134) MICHELLE M STEPHENSON........................................................................
CHIEF PT CARE OFCR/NURSE EXEC
40.0
.......................1.0
    X       458,774 0 97,905
(135) DONNA S WETZLER........................................................................
GEN CNSL&CORP SEC MED/CR.&AFF
40.0
.......................5.0
    X       598,615 0 44,049
(136) FRANCIA E HARRINGTON........................................................................
PRESIDENT FNDTN, BEGN 8/14
1.0
.......................1.0
      X     0 0 0
(137) THOMAS J SULLIVAN........................................................................
PRESIDENT FNDTN, THRU 10/13
40.0
.......................1.0
      X     527,541 0 47,097
(138) NANCY M BORDERS........................................................................
ASSOCIATE GENERAL COUNSEL
40.0
.......................0.0
        X   349,234 0 48,607
(139) SHERRI R EWING........................................................................
ASSOC CHIEF NURSE EXECUTIVE
40.0
.......................0.0
        X   242,697 0 27,495
(140) MORLEY I KERSCHNER........................................................................
ADMIN REVENUE CYCLE
40.0
.......................0.0
        X   259,355 0 31,051
(141) EDWARD T SCHUBNELL........................................................................
ADMIN MED-SURG SVC
40.0
.......................0.0
        X   247,944 0 38,797
(142) PHILIP V SPINA........................................................................
CHIEF ADMINISTRATIVE OFFC LCRC
40.0
.......................1.0
        X   252,661 0 47,008
(143) SHERWOOD D ZELLERMAYER........................................................................
CHF PUBLC AFF COMM,THRU 12/12
0.0
.......................0.0
          X 266,937 0 173
(144) ROBERT J POWELL........................................................................
CHIEF HR OFFICER, THRU 10/12
0.0
.......................0.0
          X 268,968 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,933,567 2,846,523 1,952,251
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet383
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
MORTENSON POWER, 25 NW POINT BLVDELK GROVE VILLAGEIL60007 CONSTRUCTION 11,575,071
MCGAW MEDICAL CENTER, 303 E CHICAGO AVECHICAGOIL60611 PROF MED SVCS 16,315,078
CHILDRENS SURGICAL FOUNDATION, 737 N Michigan Ave 2050CHICAGOIL60611 PROF MED SVCS 6,295,194
CROTHALL HEALTHCARE INC, 955 CHESTERBROOK BLVDWAYNEPA19087 SUPPORT SVCS 7,993,994
FACULTY PRACTICE PLAN, 225 E Chicago AvenueCHICAGOIL60611 PROF MED SVCS 11,425,296
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet310
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 0
d Related organizations...1d 1,394,073
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
33,368,656
g Noncash contributions included in lines
1a-1f:$
6,624,052
h Total. Add lines 1a-1f.......MediumBullet 34,762,729
 Program Service RevenueAmt Business Code
2a PATIENT CARE & PROGRAMS 621110 460,554,265 460,554,265 0 0
b MEDICARE/MEDICAID 621110 175,103,013 175,103,013 0 0
c GRANTS-FED/STATE/AGENCY 621110 37,964,364 37,964,364 0 0
d REFERENCE LAB REVENUE 621500 937,453 864,231 73,222 0
e PARKING GARAGES 812930 2,888,301 0 262,267 2,626,034
f All other program service revenue . 3,935,652 1,592,664   2,342,988
g Total. Add lines 2a–2f........MediumBullet 681,383,048
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 11,121,816   1,264,513 9,857,303
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0     0
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 3,639,982  
b Less: rental expenses 204,818  
c Rental income or (loss) 3,435,164 0
d Net rental income or (loss).......MediumBullet 3,435,165 2,887,657   547,508
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,070,714,660 10,740,470
b Less: cost or other basis and sales expenses 1,042,825,247 6,826,119
c Gain or (loss) 27,889,413 3,914,351
d Net gain or (loss)..........MediumBullet 31,803,764     31,803,764
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 762,506,522 678,966,194 1,600,002 47,177,597
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 35,813,687 35,813,687
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0 0
4 Benefits paid to or for members 0 0
5 Compensation of current officers, directors, trustees, and key employees .... 6,880,017 1,926,457 4,953,560 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0 0 0 0
7 Other salaries and wages 251,707,194 218,709,607 32,997,587 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,098 5,122 976 0
9 Other employee benefits ....... 40,734,026 34,786,351 5,947,675 0
10 Payroll taxes ........... 17,399,698 15,081,475 2,318,223 0
11 Fees for services (non-employees):        
a Management ...... 0 0 0 0
b Legal ......... 1,515,604 0 1,515,604 0
c Accounting ........... 405,999 0 405,999 0
d Lobbying ........... 316,182 316,182 0 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 4,115,148 0 4,115,148 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 27,235,555 12,104,345 15,131,210 0
12 Advertising and promotion .... 2,336,606 1,873 2,334,733 0
13 Office expenses ....... 32,840,512 32,513,756 326,756 0
14 Information technology ...... 20,567,192 17,490,568 3,076,624 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 13,856,302 11,909,826 1,946,476 0
17 Travel ............ 1,150,240 781,401 368,839 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0 0 0 0
19 Conferences, conventions, and meetings .... 2,197,817 2,125,477 72,340 0
20 Interest ........... 20,940,988 20,939,663 1,325 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 62,892,544 60,395,634 2,496,910 0
23 Insurance .............. 18,732,745 18,732,745 0 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical supplies 65,703,065 65,703,065 0 0
b Medical admin & teaching 15,380,369 15,380,369 0 0
c Medicaid provider tax 19,950,643 19,950,643 0 0
d Bad debt provision 5,649,422 5,649,422 0 0
e All other expenses 15,095,324 10,755,488 4,339,836  
25 Total functional expenses. Add lines 1 through 24e 683,422,977 601,073,156 82,349,821 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 MediumBullet if following SOP 98-2 (ASC 958-720). 0 0 0 0
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 92,578,925 2 88,879,248
3 Pledges and grants receivable, net ........... 72,492,656 3 58,325,462
4 Accounts receivable, net ............. 44,902,504 4 53,482,214
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 6,748,159 8 7,045,592
9 Prepaid expenses and deferred charges .......... 7,813,197 9 11,091,095
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,394,746,345
b Less: accumulated depreciation ..... 10b 448,684,016 988,609,853 10c 946,062,329
11 Investments—publicly traded securities .......... 555,989,044 11 618,253,910
12 Investments—other securities. See Part IV, line 11 ..... 294,357,461 12 369,265,260
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 48,737,540 15 42,870,584
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 2,112,229,339 16 2,195,275,694
Liabilities 17 Accounts payable and accrued expenses ......... 76,427,453 17 75,483,733
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 456,993,354 20 377,712,035
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 155,984,357 25 160,350,815
26 Total liabilities. Add lines 17 through 25......... 689,405,164 26 613,546,583
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 1,093,692,944 27 1,215,337,905
28 Temporarily restricted net assets ........... 180,588,558 28 209,535,725
29 Permanently restricted net assets ........... 148,542,673 29 156,855,481
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 1,422,824,175 33 1,581,729,111
34 Total liabilities and net assets/fund balances ........ 2,112,229,339 34 2,195,275,694
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
762,506,522
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
683,422,977
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
79,083,545
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,422,824,175
5
Net unrealized gains (losses) on investments ...............
5
77,469,268
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
2,352,123
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,581,729,111
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (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) right arrow (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).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet 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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on 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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  

Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










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

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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

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


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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
4,139
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
494,313
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
130,055
j
Total. Add lines 1c through 1i ...............................
628,507
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
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
2013 FORM 990 SCHEDULE C SUPPLEMENTAL INFORMATION To further their collective mission, Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's") and its affiliates, by virtue of their role in providing complex care and care for children, partner with and frequently interact with members of the government in developing policies applicable to children's health and well-being. In 1994, Lurie Children's established a Public Policy Committee of the Board of Directors to recommend institutional positions on legislation and regulation that would enable Lurie Children's and its affiliates to enhance the health and well-being of children. Over the years, the Public Policy Committee has recommended positions on public policy matters affecting children's health and well-being and to garner government funding to support the exempt activities of Lurie Children's and its affiliates and for the development and construction of a new hospital which replaced the old facility of Lurie Children's. This new facility facilitates Lurie Children's ability to continue to build upon its academic and research ties in a family-centered environment and state-of-the-art facility that will foster the provision of compassionate care. Examples of policy initiatives for which Lurie Children's has advocated include: preventing transmission of HIV from mothers to newborns; prevention of childhood injury (unintentional and violent); prevention of child abuse; prevention of childhood obesity; and improving access to health insurance for children. Read more about our current institutional public positions at https://www.luriechildrens.org/en-us/community/government-relations/policy -prorities-positions/Pages/index.aspx. In addition, when state and federal legislators or committees need experts to analyze and testify as to how a pending bill would affect children's health in Illinois, they often look to Lurie Children's and its affiliates. In recent years, employees, officers and physicians of Lurie Children's and its affiliates have testified before elected officials and government policymakers in Washington, DC, Springfield and Chicago on issues ranging from the benefits of children passenger safety and helmet laws to the prevention of concussions in youth, funding for graduate medical education and Medicaid reform. In addition, Lurie Children's engages in lobbying activities to seek appropriate Medicaid funding of the substantial services provided by Lurie Children's and its affiliates to Medicaid-eligible patients in Illinois. Lurie Children's also seeks funding, on a state and federal level, for various initiatives that will enhance patient care. On the federal level, Lurie Children's, in connection with other children's teaching hospitals, works to protect and enhance funding for the Medicaid program and graduate medical education for 54 freestanding children's teaching hospitals in the United States.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. 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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 390,269,609 380,180,030 373,934,512 355,075,654 345,631,973
b Contributions ........ 5,062,066 4,236,209 1,354,036 4,592,742 3,257,533
c Net investment earnings, gains, and losses 25,646,001 14,828,946 15,030,547 21,332,401 10,720,980
d Grants or scholarships ..... 8,538,431 8,423,615 8,001,784 7,066,285 1,635,773
e Other expenditures for facilities
and programs ........
1,787,234 551,961 2,137,281   2,899,059
f Administrative expenses ....          
g End of year balance ...... 410,652,011 390,269,609 380,180,030 373,934,512 355,075,654
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet43.060 %
b
Permanent endowment SchDMd Bullet38.200 %
c
Temporarily restricted endowment SchDMd Bullet18.740 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   38,541,977 38,541,977
b Buildings ................   1,055,732,174 280,810,333 774,921,841
c Leasehold improvements ............   20,703,981 0 20,703,981
d Equipment ................   148,153,738 78,748,220 69,405,518
e Other .................   131,614,475 89,125,463 42,489,012
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 946,062,329
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other 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    
(3)Other
(A) Alternative Investments
369,265,260 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 369,265,260
Part VIII
Investments—Program 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.)Small Bullet  
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.)...........Small Bullet  
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 0
SELF INSURANCE LIABILITY 105,116,074
DUE TO THIRD PARTIES 11,290,133
ACCRUED PENSION LIABILITY 30,779,440
ASSET RETIREMENT COSTS 3,587,936
LEASE OBLIGATIONS 9,577,232




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 160,350,815
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

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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
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
Schedule D, Part V, Line 4 Intended use of endowment funds Lurie Children's endowment fund consists of individual donor-restricted endowment funds and funds designated by its Board to function as endowments. The net assets associated with endowment funds, including those funds designated by the Board to function as endowments, are classified and reported based on the existence or absence of donor-imposed restrictions. Effective June 30, 2009, Illinois passed Uniform Prudent Management of Institutional Funds Act ("UPMIFA"). Lurie Children's has, after obtaining advice of outside counsel, interpreted UPMIFA as sustaining the preservation of the original gift as of the gift date of the donor-restricted endowment funds absent explicit donor stipulations to the contrary. As a result of this interpretation, Lurie Children's classifies as permanently restricted net assets, (a) the original value of gifts donated to the permanent endowment, (b) the original value of subsequent gifts to the permanent endowment, and (c) accumulations to the permanent endowment made in accordance with the direction of the applicable donor gift instrument at the time the accumulation is added to the fund. The remaining portion of the donor-restricted endowment fund that is not classified in permanently restricted net assets is classified as temporarily restricted net assets until those amounts are appropriated for expenditure by Lurie Children's in a manner consistent with the donor intent and standard of prudence prescribed by UPMIFA. Where the Board designates unrestricted funds to function as endowments they are classified as unrestricted net assets.
Schedule D (Form 990) 2013

Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
Sub-Saharan Africa     Program Services MEDICAL 45,885
North America     Investments   1,142,417
Central America and the Caribbean     Investments   165,490,305
Europe (Including Iceland and Greenland)     Investments   88,211,053
Middle East and North Africa     Investments   685,092
Sub-Saharan Africa     Investments   414,350
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     255,989,102
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     255,989,102
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Schedule F, Part V Organization's Procedures for Monitoring Use of Grant Funds Outside the US Travel grants of approximately $2,000 - $2,500 are provided to third year medical residents that travel to the Republic of Tanzania, the Federal Democratic Republic of Nepal, the Plurinational State of Bolivia and the Togolese Republic to provide medical care on a volunteer basis. The travel grants are intended to cover some of the costs related to transportation costs, as well as housing and meals while outside the United States. The medical residents are provided approximately half of the grant prior to their departure and the remaining half upon their return to the United States.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
  0 1,388,305 0 1,388,305 0.200 %
b Medicaid (from Worksheet 3,
column a) ....
  0 260,245,335 206,306,373 53,938,962 7.960 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
  0 0 0 0 0 %
d Total Financial Assistance
and Means-Tested
Government Programs .
  0 261,633,640 206,306,373 55,327,267 8.160 %
Other Benefits
  0 9,518,475 0 9,518,475 1.400 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
  0 20,415,624 2,803,691 17,611,933 2.600 %
g Subsidized health services
(from Worksheet 6) ..
  0 15,315,902 0 15,315,902 2.260 %
h Research (from Worksheet 7)   0 46,963,422 39,760,467 7,202,955 1.060 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
  0 1,495,820 56,072 1,439,748 0.220 %
j Total. Other Benefits ..   0 93,709,243 42,620,230 51,089,013 7.540 %
k Total. Add lines 7d and 7j .   0 355,342,883 248,926,603 106,416,280 15.700 %
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
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,649,422
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,868,596
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
4,786,803
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,795,083
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,280
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
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
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Lurie Children's
225 E Chicago Ave PR Dept Box 26
Chicago,IL606112991
www.luriechildrens.org
0005843
X   X X   X X      
Schedule H (Form 990) 2013
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)
Lurie Children's
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)
1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
3 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 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):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
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.%
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: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the 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
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible 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? ............................ 21   No
If "Yes," explain in Part VI.
22 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? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
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
Part V, Line 3 The Community Health Needs Assessment Committee ("CHNA Committee") which includes representatives of public health agencies, organizations that serve communities in Chicago conducted meetings, reviewed data and provided input based upon each individual's expertise, knowledge and experiences, concerning the scope and severity, urgency, of community needs and the feasibility and effectiveness of possible interventions. The CHNA Committee input was prioritized based on Lurie Children's four priorities that drive all of its efforts in the Hospital and community. The four priorities include: 1) Pediatric health care delivery; 2) Research into prevention, causes and treatment of diseases that affect children; 3) Education for physicians, nurses, and allied health professionals; 4) Advocacy for general well being of all children. Members of the CHNA Committee included: -Roderick (Eric) Jones, PhD, Director of Epidemiology, Chicago Department of Public Health -Berneice Mills-Thomas, Executive Director, Near North Health Services Corporation -Lucy Gomez, Health Outreach Director, Logan Square Neighborhood Association -Omar Duque, President and CEO, Illinois Hispanic Chamber of Commerce -Pamela Spadino, Lurie Children's Family Advisory Board -Eric Schroeder, President, Lurie Children's Family Advisory Board -Tim Weaver, Student, DePaul University (Lurie Children's Patient) -AJ Williams, Student (Lurie Children's Patient) Part V, Line 13 -In an effort to make our patients, families and the broader community aware of Lurie Children's financial assistance program, Lurie Children's has taken a number of steps to widely publicize this policy including: -Posting of legible signage in heavily trafficked patient areas such as admitting, emergency department and ambulatory registration areas; -Providing pamphlets and brochures in plain language summaries, in both English and Spanish during the admission and/or discharge process and throughout the organization; -Providing notice of availability of free or discounted care and other forms of communications; -Offering patient and family counseling sessions with registrars, patient accounting staff, or financial counselors either before, during or after the time of service, as appropriate; -Ensuring Hospital staff of Financial Counselors are knowledgeable and available to assist the patient and family in completing necessary financial assistance applications: -Providing information regarding the Hospital's Financial Assistance policy on the Hospital's website. policy on the Hospital's website. Part V, Line 19d In calculating the amounts generally billed (AGB), Lurie Children's has selected the "look-back" method whereby the AGB is determined based on actual past claims paid to Lurie Children's by Medicare fee-for-service together with all private health insurers paying claims to the Hospital. The AGB percentage will be calculated at least annually by dividing the sum of all claims that have been paid in full during the prior 12 month period by the sum of the gross charges for those claims. This resulting percentage is then applied to an individual's gross charges to reduce the bill.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
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?13
Name and address Type of Facility (describe)
1 Lurie Children's Pediatrics - Uptown
4867 N Broadway Avenue
Chicago,IL60640
Outpatient Medical Services
2 Lurie Children's OTP Ctr in Westchester
2301 Enterprise Dr
Westchester,IL60154
Outpatient Medical & Ambulatory Surgical Services
3 Lurie Children's OTP Ctr in Glenview
2150 Pfingsten Rd
Glenview,IL60025
Outpatient Medical Services
4 Lurie Children's OTP CTR in Arlington Ht
880 W Central Rd Suite 6400
Arlington Heights,IL60005
Outpatient Medical Services
5 Lurie Children's OTP Ctr in New Lenox
1870 N Silver Cross Blvd Ste 100
New Lenox,IL60451
Outpatient Medical Services
6 Lurie Children's OTP Ctr in Lake Forest
900 N Westmoreland Suite 209
Lake Forest,IL60045
Outpatient Medical Services
7 Lurie Children's OTP Ctr in Lincoln Park
2515 N Clark Street/467 W Deming
Chicago,IL60614
Outpatient Medical Services
8 Lurie Children's OTP Ctr in Westbrook
11301 W Cermak Rd
Westchester,IL60154
Outpatient MEDICAL SERVICES
9 Lurie Children's OTP Ctr in Winfield
25 N WINFIELD ROAD
Winfield,IL60190
Outpatient Medical Services
10 Lurie Children's at Northwestern Med
300 Randall Rd Bldg 302 Suite 102
Geneva,IL60134
Outpatient Center-Delnor
11 CDH Proton Center
4455 Weaver Parkway
Warrenville,IL60555
Outpatient Medical Services
12 Outpatient Services in Grayslake
1475 E Belvidere Rd RTE 120 STE
Grayslake,IL600302012
Outpatient Medical Services
13 Outpatient Services in Lincoln Square
5215 N California Ave
Chicago,IL60625
Outpatient Medical Services
Schedule H (Form 990) 2013
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
Part V, Line 3 The Community Health Needs Assessment Committee ("CHNA Committee") which includes representatives of public health agencies, organizations that serve communities in Chicago conducted meetings, reviewed data and provided input based upon each individual's expertise, knowledge and experiences, concerning the scope and severity, urgency, of community needs and the feasibility and effectiveness of possible interventions. The CHNA Committee input was prioritized based on Lurie Children's four priorities that drive all of its efforts in the Hospital and community. The four priorities include: 1) Pediatric health care delivery; 2) Research into prevention, causes and treatment of diseases that affect children; 3) Education for physicians, nurses, and allied health professionals; 4) Advocacy for general well being of all children. Members of the CHNA Committee included: -Roderick (Eric) Jones, PhD, Director of Epidemiology, Chicago Department of Public Health -Berneice Mills-Thomas, Executive Director, Near North Health Services Corporation -Lucy Gomez, Health Outreach Director, Logan Square Neighborhood Association -Omar Duque, President and CEO, Illinois Hispanic Chamber of Commerce -Pamela Spadino, Lurie Children's Family Advisory Board -Eric Schroeder, President, Lurie Children's Family Advisory Board -Tim Weaver, Student, DePaul University (Lurie Children's Patient) -AJ Williams, Student (Lurie Children's Patient) Part V, Line 13 -In an effort to make our patients, families and the broader community aware of Lurie Children's financial assistance program, Lurie Children's has taken a number of steps to widely publicize this policy including: -Posting of legible signage in heavily trafficked patient areas such as admitting, emergency department and ambulatory registration areas; -Providing pamphlets and brochures in plain language summaries, in both English and Spanish during the admission and/or discharge process and throughout the organization; -Providing notice of availability of free or discounted care and other forms of communications; -Offering patient and family counseling sessions with registrars, patient accounting staff, or financial counselors either before, during or after the time of service, as appropriate; -Ensuring Hospital staff of Financial Counselors are knowledgeable and available to assist the patient and family in completing necessary financial assistance applications: -Providing information regarding the Hospital's Financial Assistance policy on the Hospital's website. policy on the Hospital's website. Part V, Line 19d In calculating the amounts generally billed (AGB), Lurie Children's has selected the "look-back" method whereby the AGB is determined based on actual past claims paid to Lurie Children's by Medicare fee-for-service together with all private health insurers paying claims to the Hospital. The AGB percentage will be calculated at least annually by dividing the sum of all claims that have been paid in full during the prior 12 month period by the sum of the gross charges for those claims. This resulting percentage is then applied to an individual's gross charges to reduce the bill.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number
36-2170833
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) STANLEY MANNE CHILDREN'S RESEARCH INSTITUTE
225 E CHICAGO AVE
CHICAGO,IL606112991
36-3357005 501(c)(3) 7,216,419 0     MISSION SUPPORT
(2) CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CTR
225 E CHICAGO AVE
CHICAGO,IL606112991
36-3357004 501(c)(3) 510,138 0     MISSION SUPPORT
(3) PEDIATRICS FACULTY FOUNDATION INC
225 E CHICAGO AVE
CHICAGO,IL606112991
36-3279680 501(c)(3) 9,527,403 0     MISSION SUPPORT
(4) STANLEY MANNE CHILDREN'S RESEARCH INSTITUTE
225 E CHICAGO AVE
CHICAGO,IL606112991
36-3357005 501(c)(3) 4,150,721 0     Released from ristriction
(5) PEDIATRICS FACULTY FOUNDATION INC
225 E CHICAGO AVE
CHICAGO,IL606112991
36-3279680 501(c)(3) 7,197,461 0     RELEASED FROM RESTRICTION
(6) LURIE CHILDRENS MEDICAL GROUP LLC
225 E CHICAGO AVE
CHICAGO,IL606112991
36-4187449 501(c)(3) 805,258 0     RELEASED FROM RESTRICTION
(7) LURIE CHILDRENS MEDICAL GROUP LLC
225 E CHICAGO AVE
CHICAGO,IL606112991
36-4187449 501(c)(3) 1,424,192 0     MISSION SUPPORT
(8) ALMOST HOME KIDS
7 S 721 ROUTE 53
NAPERVILLE,IL60540
36-3822010 501(c)(3) 1,406,998 0     MISSION SUPPORT
(9) ALMOST HOME KIDS
7 S 721 ROUTE 53
NAPERVILLE,IL60540
36-3822010 501(c)(3) 56,072 0     Released from restriction
(10) CHILDREN'S SURGICAL FOUNDATION
225 E CHICAGO AVE
CHICAGO,IL60610
36-3283051 501(C)(3) 2,500,837       ACADEMIC GRANT
(11) VOICES FOR ILLINOIS CHILDREN INC
208 S LASALLE ST STE 1490
CHICAGO,IL60604
36-3480909 501(C)(3) 10,000       MISSION SUPPORT
(12) HEALTH PARTNERS CARE COORDINATION LLC
225 E CHICAGO AVE
CHICAGO,IL606112991
35-2503476 501(C)(3) 985,438       MISSION SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants We review all grant funds on a monthly basis. Financial reports are generaYed monthly and distributed electronically to all fund directors and the Office of Sponsored Projects (OSP) for review. Expenditures are reviewed for appropriateness and against budgetary guidelines by the Finance Office (Fund Accounting). OSP and Fund Accounting work with the investigators to monitor their activity and make sure they are in compliance with the terms of the award.
Schedule I (Form 990) 2013


Additional Data


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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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
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? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)JAMES S DONALDSON MDEX-OFFICIO DIRECTOR (i)
(ii)
0
483,854
0
93,741
0
2,291
0
211,402
0
26,726
0
818,014
0
0
(2)THOMAS P GREEN MDEX-OFFICIO DIR/PRES&CHAIR PFF (i)
(ii)
0
538,805
0
224,858
0
1,524
0
25,500
0
31,704
0
822,391
0
0
(3)MARY JC HENDRIX PHDEX-OFFICIO DIR/PRES/SCI OFF (i)
(ii)
0
527,585
0
104,014
0
792
0
66,528
0
21,402
0
720,321
0
0
(4)MICHAEL D KELLEHER MDEX-OFFICIO DIRECTOR/CMO/HOSP. (i)
(ii)
0
408,793
0
154,264
0
516
0
25,500
0
29,711
0
618,784
0
0
(5)PATRICK M MAGOONEX-OFFIC DIR/CEO, MED CTR/HOSP (i)
(ii)
742,070
0
485,310
0
44,834
0
482,009
0
14,536
0
1,768,759
0
59,857
0
(6)H WILLIAM SCHNAPER MDEX-OFFICIO DIRECTOR/ PFF MD (i)
(ii)
0
263,151
0
41,543
0
792
0
25,500
0
23,892
0
354,878
0
0
(7)RON BLAUSTEINCFO MED. CNTR. & AFFLTS (i)
(ii)
236,302
0
107,868
0
4,581
0
19,193
0
23,072
0
391,016
0
0
0
(8)JONI M DUNCANCHIEF HR OFFICER (i)
(ii)
225,913
0
89,529
0
9,027
0
19,729
0
23,498
0
367,696
0
0
0
(9)SUSAN H GORDONCHIEF COMMUNIC & EXT AFFAIRS (i)
(ii)
255,437
0
98,825
0
7,224
0
100,652
0
10,160
0
472,298
0
0
0
(10)MONICA HEENANCHIEF AMBULATORY EXECUTIVE (i)
(ii)
261,783
0
101,393
0
1,120
0
21,627
0
15,764
0
401,687
0
0
0
(11)STANLEY B KROKCHIEF INFORMATION OFFICER (i)
(ii)
281,299
0
111,059
0
146,164
0
27,057
0
22,102
0
587,681
0
0
0
(12)MAUREEN T MAHONEYCHIEF EXCELLENCE OFFICER (i)
(ii)
226,551
0
87,229
0
497
0
21,418
0
13,613
0
349,308
0
0
0
(13)MAUREEN MURPHYCHIEF MARKETING & MANAGED CARE (i)
(ii)
292,852
0
37,814
0
13,866
0
27,429
0
16,783
0
388,744
0
0
0
(14)PAULA M NOBLECFO/TREAS/MED CT&AFF-THRU 5/14 (i)
(ii)
398,661
0
190,837
0
2,796
0
209,940
0
13,622
0
815,856
0
0
0
(15)ROBERT J POWELLCHIEF HR OFFICER, THRU 10/12 (i)
(ii)
0
0
0
0
268,968
0
0
0
0
0
268,968
0
0
0
(16)MICHELLE M STEPHENSONCHIEF PT CARE OFCR/NURSE EXEC (i)
(ii)
316,456
0
123,302
0
19,016
0
78,504
0
19,401
0
556,679
0
0
0
(17)DONNA S WETZLERGEN CNSL&CORP SEC MED/CR.&AFF (i)
(ii)
294,847
0
144,238
0
159,530
0
24,079
0
19,970
0
642,664
0
0
0
(18)SHERWOOD D ZELLERMAYERCHF PUBLC AFF COMM,THRU 12/12 (i)
(ii)
31,349
0
20,303
0
215,285
0
173
0
0
0
267,110
0
0
0
(19)THOMAS J SULLIVANPRESIDENT FNDTN, THRU 10/13 (i)
(ii)
337,044
0
178,686
0
11,811
0
25,106
0
21,991
0
574,638
0
0
0
(20)NANCY M BORDERSASSOCIATE GENERAL COUNSEL (i)
(ii)
255,075
0
93,055
0
1,104
0
22,327
0
26,280
0
397,841
0
0
0
(21)SHERRI R EWINGASSOC CHIEF NURSE EXECUTIVE (i)
(ii)
193,968
0
47,950
0
779
0
18,217
0
9,278
0
270,192
0
0
0
(22)MORLEY I KERSCHNERADMIN REVENUE CYCLE (i)
(ii)
218,665
0
32,008
0
8,682
0
18,623
0
12,428
0
290,406
0
0
0
(23)EDWARD T SCHUBNELLADMIN MED-SURG SVC (i)
(ii)
205,336
0
29,990
0
12,618
0
26,763
0
12,034
0
286,741
0
0
0
(24)PHILIP V SPINACHIEF ADMINISTRATIVE OFFC LCRC (i)
(ii)
215,303
0
36,470
0
888
0
22,998
0
24,010
0
299,669
0
0
0
Schedule J (Form 990) 2013

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
Form 990, Schedule J, Part I, Question 1a The organization provides membership in a club and a professional organization used by Patrick Magoon, the Medical Center and Lurie Children's Chief Executive Officer, for business purposes. Such membership is treated by the organization as a working-condition fringe benefit and is, therefore, excluded from the individual's taxable income. The organization provides for business purposes only membership in a club used by Thomas Sullivan, who in the fiscal year relating to this Form 990 served as President of the Ann & Robert H. Lurie Children's Hospital of Chicago Foundation. Such membership is treated by the organization as a working-condition fringe benefit and is therefore, excluded from the individual's taxable income. Form 990, Schedule J, Part I, Line 3 Pursuant to the bylaws of Children's Hospital of Chicago Medical Center ("Medical Center"), the Governance Committee of the Medical Center is charged to review and approve senior executive compensation for the Medical Center and its affiliates. The Governance Committee has adopted a written executive compensation philosophy which it follows when it reviews and approves the compensation and benefits of the organization's senior management, including the President/Chief Executive Officer and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of a compensation consultant and information from a variety of sources (specified on Schedule J), the Governance Committee confirmed the total amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations. Outside legal counsel also serves an integral role in advising the Governance Committee with respect to federal tax requirements in setting compensation and the establishment of the "rebuttable presumption of reasonableness" under the federal tax law intermediate sanctions rules. The process followed by the Governance Committee, including a description of the data relied upon and the Governance Committee's decisions, was thoroughly and contemporaneously documented. The Governance Committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness, that all such amounts are reasonable and do not exceed fair market value for the services provided. The Governance Committee was comprised of members of the Medical Center and the Ann and Robert H. Lurie Children's Hospital of Chicago Boards of Directors who were determined to be disinterested for these purposes. The Governance Committee conducts an ongoing, regular review of the disinterested status of its members, and will take appropriate action with respect to anyone having an interest with respect to one or more executives so as to preserve the application of the rebuttable presumption of reasonableness. Form 990, Schedule J, Part I, Question 4a The following listed individuals received severance payments during the applicable year under a mutual separation agreement that qualifies for disclosure under line 4a. Robert J. Powell $250,675 Sherwood D. Zellermayer $201,859 Form 990, Schedule J, Part I, Question 4b The following listed individuals participated in the organization's supplemental executive retirement plan ("SERP") and earned unvested benefits during 2013, which are reported in Column (C): James S. Donaldson, MD $180,496 Susan H. Gordon $ 76,506 Patrick M. Magoon $445,645 Paula M. Noble $182,391 Michelle M. Stephenson $ 53,277 Benefits earned under the SERP are non-vested forms of deferred compensation that fund the employee's eventual retirement benefit. These benefits are provided in exchange for all of the employee's years of service to the organization, and the cost of the benefits will vary from year to year based on interest rates, age, and many other factors. The amounts are at risk and will not be paid unless and until the employee has provided substantial future services to the organization. Benefits under the SERP vest at age 62, and are forfeited if the employee leaves the organization voluntarily before age 62 (except upon the sole discretion of the Board, and only if the participant has reached at least age 55 with at least 10 years of service). Participants who voluntarily leave the organization before age 55 forfeit their entire SERP benefit upon termination. Also in response to question 4b, the following individuals received vested payments from the supplemental retirement benefits under the SERP, and therefore had SERP benefits included in their taxable income: Stan Krok, $144,239 and Donna S. Wetzler $157,524. In each case, the taxable amount represents the vested amount of benefits for service to the organization, and which became paid and taxable in 2013. The Governance Committee of the organization's Board of Directors annually reviews all forms of executive compensation and benefits, including all reported vested and nonvested SERP benefits, and has concluded, as the result of a process that it is designed to qualify for the rebuttable presumption of reasonableness, that total compensation and the benefits provided are reasonable. Form 990, Schedule J, Part I, Question 7 The organization provides annual incentive compensation to senior management under a senior management incentive compensation plan. These amounts are included in Schedule J, Part II, Column B (ii). The plan is designed to offer opportunities for additional compensation tied to performance against pre-determined financial, patient satisfaction, patient safety and individual goals approved in advance by the Governance Committee of the Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) and the Children's Hospital of Chicago Medical Center (Medical Center), which serves as the Compensation Committee of Lurie Children's and Medical Center. Due to the CEO's unique role in setting and driving the long-term strategic mission and operational performance of the entire organization, the Governance Committee of Lurie Children's and Medical Center previously established a long-term incentive plan ("LTI") under which the CEO, Patrick Magoon, was the sole participant. Mr. Magoon was eligible to earn additional compensation for achievement of very challenging, long-term goals that were established in advance by the Governance Committee. The LTI also served as a means for retention since amounts earned became vested on a rolling basis over a multi-year period. The LTI has been completed, and the final award was determined and previously reported on a Form 990 as having been earned but not yet vested and taxable. During the reporting year, Schedule J, Part II, Column (B)(ii) includes $59,857, which represents the portion of the final LTI incentive award that became vested and payable in 2013. The Governance Committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness under federal tax law, that all such amounts are reasonable and do not exceed fair market value for the services provided. Form 990, Schedule J, Part II The following individuals are not compensated by the reporting organization for his or her service as a director. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Pediatrics Faculty Foundation for the individual's substantial and full-time services as an employee. For more details, please refer to the 2013 Form 990 of Pediatrics Faculty Foundation, FEIN 36-3279680. Thomas P. Green, MD Michael D. Kelleher, MD Mary J.C. Hendrix, PhD H. William Schnaper, MD James Donaldson, MD is not compensated by the reporting organization for his service as a director. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Children's Hospital of Chicago Medical Center for the individual's substantial and full-time services as an employee. For more details, please refer to the 2013 Form 990 of the Children's Hospital of Chicago Medical Center, FEIN 36-3357004.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet 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.

SchKMediumBulletInformation 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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number
36-2170833
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
Yes No Yes No Yes No
A Illinois Finance Authority
 
86-1091967 45200FGC7 05-15-2008 377,043,130 SEE SCHEDULE K PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0      
2 Amount of bonds legally defeased . . . . . . . . . . . 0      
3 Total proceeds of issue . . . . . . . . . . . . . . 383,720,219      
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0      
5 Capitalized interest from proceeds . . . . . . . . . . . 45,353,927      
6 Proceeds in refunding escrows . . . . . . . . . . . . 0      
7 Issuance costs from proceeds . . . . . . . . . . . . 3,119,559      
8 Credit enhancement from proceeds . . . . . . . . . . . 6,305,197      
9 Working capital expenditures from proceeds . . . . . . . . . 0      
10 Capital expenditures from proceeds . . . . . . . . . . . 328,941,535      
11 Other spent proceeds . . . . . . . . . . . . . . 0      
12 Other unspent proceeds . . . . . . . . . . . . . . 0      
13 Year of substantial completion . . . . . . . . . . . . 2012
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X            
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . 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            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
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              
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              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . 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? X              
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 . . SchKMediumBullet 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 . . . . . . . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 %      
7 Does the bond issue meet the private security or payment test? . . . . .   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            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X            
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              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X            
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X            
b Exception to rebate? . . . . . . . .   X            
c No rebate due? . . . . . . . . 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            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . . 0
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
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            
b Name of provider . . . . . . . . . 0
 
 
 
 
 
 
 
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            
7 Has the organization established written procedures to monitor the requirements of section 148? . . . 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              
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
. Form 990, Schedule K, Part I Line A: Illinois Finance Authority Revenue Bonds, Series 2008A and Series 2008B (The Children's Memorial Hospital) The proceeds of the sale of the series 2008A/B Bonds were used to (i) pay or reimburse the payment of a portion of the costs of constructing and equipping the Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's"), (ii) pay a portion of the interest on the Series 2008A and Series 2008B Bonds during the construction period, (iii) fund a debt service reserve fund for the Series 2008B Bonds, and (iv) pay certain expenses incurred in connection with the issuance of the Series 2008A and Series 2008B Bonds. The proceeds initially used to fund a debt service reserve were subsequently used to reimburse the payment of additional costs of constructing and equipping Lurie Children's. Form 990, Schedule K, Part II, Line 3 Column A: The amount of $383,720,219 reported in Part I Line 3 includes total issue proceeds of $377,043,130 and investment income of $6,677,089. Form 990, Schedule K, Part IV, Line 2c Column A: June 1, 2011
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Alexis Baby Family Member of Baine 51,093 Employment   No
(2) JPMorgan Chase L.Crown's son is a Dir 417,518 Financial Services   No
(3) Northern Trust L.Crown's daught is a Dir 280,583 Financial Services   No
(4) JPMorgan Chase DeCorrevont is an Ofcr 417,518 Financial Services   No
(5) Sidley Austin LLP Douglas is Ptnr & CoChair 364,760 Legal Services   No
(6) Merge Healthcare Ferro is an Officer 491,528 Information Technology Svcs   No
(7) Northern Trust Logan is an Officer 280,583 Financial Services   No
(8) W W Grainger Merriwether is an Officer 189,313 Material Supplies   No
(9) Rachel Foote Family Member of P.Magoon 13,996 Employment   No
(10) Robert Sullivan Family Mbr of A.Mckenna 25,474 Employment   No
(11) Catherine Watkins Family Mbr of H.T.Watkins 20,448 Employment   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.

Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 30 6,624,052 MARKET
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I-13, Line 32b Third parties hired to process noncash contributions ALL SECURITIES (NON-CASH DONATIONS) ARE SENT DIRECTLY TO NORTHERN TRUST. NORTHERN TRUST AS CUSTODIAN AND BROKER SELLS THE SECURITIES IMMEDIATELY. FOR DONOR RECOGNITION PURPOSES, GIFTS ARE VALUED AT THE MEDIAN PRICES ON THE DAY THE SECURITIES ARE RECEIVED. FOR ACCOUNTING PURPOSES, VALUES ARE RECONCILED FOR ANY GAIN/LOSS ON THE SALE OF SECURITIES.
Schedule M (Form 990) (2013)
Additional Data


Software ID:  
Software Version:  
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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
Return Reference Explanation
Form 990, Part VI, Question 2 Description of Relationships *Peter Bensinger is the father of Peter Bensinger, Jr. *Peter Bensinger Jr. and Peter Bensinger have a business relationship. *David Bunning and Daniel J. Hennessy have a business relationship. *Bert A. Getz, Jr. and Edward J. Wehmer have a business relationship. *Doug Pertz and Todd Hamilton have a business relationship. *Allan Bulley III and Thomas Souleles have a business relationship. *Allan Bulley III and Bert A. Getz, Jr. have a business relationship. *Allan Bulley III and Greg Case have a business relationship. *Robert S. Murley and Patrick J. Allin have a business relationship. *Allan Bulley III and Donald J. Edwards have a business relationship. *William Devers, Jr. and Michael W. Ferro, Jr. have a business relationship. *Andrew J. McKenna is the father of William J. McKenna. *Adam Kriger and Andrew J. McKenna have a business relationship. *David D. Grumhaus is the father of David D. Grumhaus, Jr. *Michael W. Ferro, Jr., Linda Wolf and John Canning, Jr. have a business relationship. *Mark A. Hoppe and Mitchell Feiger have a business relationship.
Form 990, Part VI, Question 7b Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights Rights The Medical Center, through its Board of Directors or designated committee, as the sole corporate member of the organization, has certain reserve powers with respect to appointment and removal of directors, appointment of certain officers, approval of amendments to governing documents, approval of financial matters, and approval of significant transactions including, but not limited to, merger, dissolution, disposition of assets other than in the ordinary course of business, and creation of subsidiaries.
Form 990, Part VI, Question 11B Describe the Process used by Management &/or Governing Body to Review Form 990 A public disclosure copy of the organization's fiscal year 2014 form 990 Was provided to each member of the medical center and Lurie Children's Audit committee (of the board). The audit committee is the committee of The medical center charged with the oversight of audit and tax matters For the parent and affiliates. During a special audit committee meeting, And before the form 990 was filed, the audit committee was provided a Detailed review of the form 990 by the chief financial officer ("CFO"). The cfo and outside tax advisor also responded to the audit committee members' questions and afforded the opportunity for detailed discussion of the Form 990, prior to the audit committee taking action to approve the filing of the form 990. As part of its annual return preparation process, the organization on an ongoing basis consulted its tax consulting firm and outside tax legal Counsel, both of which possess expertise in health care and tax-exempt Return preparation, to advise and assist in the preparation of the form 990. These advisors worked closely with the organization's finance and Internal legal personnel and other members of the organization's team assembled to participate in the preparation of the form 990. Prior to presenting the form 990 to the board's audit committee, the Organization's team, including its advisors, met frequently to discuss And review drafts of the form.
Form 990, Part VI, Question 12c Description of Process to Monitor Transactions for Conflicts of Interest On an annual basis, the Medical Center and its affiliates provide a comprehensive questionnaire to its board members, senior management and purchasing personnel posing questions about actual or potential conflicts of interest. The Medical Center initiates follow up contact to those who do not respond and to clarify responses, where necessary. The Medical Center reviews each disclosure and provides a summary of relevant disclosures for the review and approval of its governance committee. Pursuant to the conflicts of interest policy of the Medical Center and affiliates ("Corporation"), directors, officers, physician leaders, and others who are subject to the policy are required to promptly and fully disclose in writing any actual, apparent or potential conflict of interest to the president of the Corporation and General Counsel. This disclosure shall be provided to the Governance Committee of the Corporation which shall consider all conflicts of interest issues and, if appropriate, shall provide such written disclosure to the directors, board committees considering the proposed transaction or other appropriate parties. In addition, on an annual basis, the corporation surveys each individual subject to the policy as to the existence of actual or potential conflicts of interest. The corporation will not enter into an agreement, transaction or other arrangement involving a conflict of interest unless the disinterested members of the Governance Committee of the Corporation's Board of Directors determine by a majority vote that appropriate safeguards to protect the charitable mission of the Corporation have been implemented. The subject interested person may not be present when the vote is taken. If it is determined that a conflict of interest exists, a disinterested person or committee of disinterested members may be assigned to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the board or committee shall determine whether the Corporation can obtain a more advantageous transaction or arrangement, with reasonable efforts, from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction is in the Corporation's best interest and for its own benefit and whether the transaction is fair and reasonable to the Corporation, and shall make its decision as to whether to enter into the transaction or arrangement.
Form 990, Part VI, Questions 15a & 15b Offices & Positions for Which Process was Used, & Year Process was Begun The authority to review and approve executive compensation has been delegated to the Governance Committee of Children's Hospital of Chicago Medical Center Board of Directors ("Governance Committee"). The Governance Committee has adopted a written executive compensation philosophy which it follows when it reviews and approves the compensation and benefits of the organization's senior management, including the President/Chief Executive Officer and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of a compensation consultant and information from a variety of external sources (specified on schedule J), the Governance Committee confirmed the total amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations for functionally similar positions. Outside Legal counsel also serves an integral role in advising the Governance Committee with respect to federal tax requirements in setting compensation and the establishment of the rebuttable presumption of reasonableness. The process followed by the Governance Committee, including a description of the data relied upon and the Governance Committee's decisions, was thoroughly and contemporaneously documented. The Governance Committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness under federal tax law, that all such amounts are reasonable and do not exceed fair market value for the services provided. The Governance Committee was comprised of members of Children's Hospital of Chicago Medical Center and Ann & Robert H. Lurie Children's Hospital of Chicago Boards of Directors who were determined disinterested for these purposes. The Governance Committee conducts an ongoing and periodic review of the disinterested status of its members, and will take appropriate action with respect to anyone having an interest with respect to one or more executives so as to preserve the application of the rebuttable presumption of reasonableness.
Form 990, Part VI, Question 19 Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public The organization's financial statements are publicly available online at www.dacbond.com. The organization's articles of incorporation and annual reports are available through the Illinois Secretary of State. The organization also makes its general governing documents available to the general public upon request. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES GRANTS RELEASED FROM RESTRICTIONS $1,606,639 NET ASSETS TRANSF FROM NEWLY AFFL ORGANIZATIONS $3,738,353 OTHER (RESTRICTED) $ 931,015 PLEDGE RECEIVABLE WRITE-OFFS ($ 247,042) PENSION ADJUSTMENT ($7,065,378) FOUNDERS' BOARD ACTIVITIES $ 165,536 CHANGE IN FAIR VALUE OF PERPETUAL TRUSTS $3,223,000 ---------- $2,352,123 ----------
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:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
Ann & Robert H Lurie Children's Hospital of
Chicago
Employer identification number

36-2170833
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?
Yes No
(1) STANLEY MANNE CHILDREN'S RESC INSTITUTE

225 E CHICAGO AVE

Chicago,IL60611
36-3357005
RESEARCH IL 501(C)(3) 4 Medical Ctr
 
 
No
(2) LURIE CHILDREN'S HOSPITAL OF CHICAGO FDN

225 E CHICAGO AVE

Chicago,IL60611
36-3357006
FUNDRAISING IL 501(C)(3) 7 Medical Ctr
 
 
No
(3) CHILDREN'S HOSPITAL OF CHICAGO MED CTR

225 E CHICAGO AVE

Chicago,IL60611
36-3357004
HEALTH CARE IL 501(C)(3) 11 III-FI NA
 
 
No
(4) Pediatrics Faculty Foundation Inc

225 E CHICAGO AVE

Chicago,IL60611
36-3279680
HLTH CRE/RSCH IL 501(C)(3) 11 III-FI Medical Ctr
 
 
No
(5) CMH Self Insurance Foundation

225 E CHICAGO AVE

Chicago,IL60611
36-6638400
INSURANCE IL 501(C)(3) 11 III-FI MEDICAL CTR
 
 
No
(6) MCGAW MEDICAL CTR OF NORTHWESTERN UNIV

645 NORTH MICHIGAN AVE 1058

CHICAGO,IL60611
36-2656113
SUPPORTNG ORG IL 501(C)(3) 11 III-FI NA
 
 
No
(7) ALMOST HOME KIDS

7 S 721 ROUTE 53

NAPERVILLE,IL60540
36-3822010
TRANSITION CR IL 501(C)(3) 9 MEDICAL CTR
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
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


Yes No Yes No
(1) LURIE CHILDRENS CIN LLC

225 E CHICAGO AVE
CHICAGO,IL606112991
90-1025439
CONTRACTING SVCS IL NA
 
                 












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
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CMMC Insurance Co LTD

225 E CHICAGO AVE
CHICAGO,IL60611
98-1049532
SELF INSURANCE CJ MEDICAL CTR
 
CORPORATION          












Schedule R (Form 990) 2013
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2013
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2013
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


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