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.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
ADVOCATE SHERMAN HOSPITAL
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3075 Highland PkWY Suite 600
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Downers Grove, IL60515
D Employer identification number

36-2167920
E Telephone number

G Gross receipts $ 394,656,600
F Name and address of principal officer:
Linda Deering
3075 Highland Pkwy Ste 600
Downers Grove,IL60515
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.advocatehealth.com
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: 1887
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SERVE HEALTH NEEDS OF COMMUNITIES THROUGH WHOLISTIC PHILOSOPHY ROOTED IN FUNDAMENTAL UNDERSTANDING OF HUMANS AS CREATED IN THE IMAGE OF GOD.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 2,074
6 Total number of volunteers (estimate if necessary) ............. 6 337
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 836,194
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 924,623 524,906
9 Program service revenue (Part VIII, line 2g) ......... 200,733,883 298,002,422
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 10,441,434 6,157,457
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,445,462 2,622,358
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 214,545,402 307,307,143
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 47,925 24,217
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) 85,039,392 125,216,912
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).... 113,351,472 188,022,715
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 198,438,789 313,263,844
19 Revenue less expenses. Subtract line 18 from line 12....... 16,106,613 -5,956,701
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 531,510,100 504,091,796
21 Total liabilities (Part X, line 26)............. 369,107,943 360,266,823
22 Net assets or fund balances. Subtract line 21 from line 20..... 162,402,157 143,824,973
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
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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 (2014)
Form 990 (2014)
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: THE MISSION OF ADVOCATE SHERMAN HOSPITAL IS TO SERVE THE HEALTH NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A WHOLISTIC PHILOSOPHY ROOTED IN OUR FUNDAMENTAL UNDERSTANDING OF HUMAN BEINGS AS CREATED IN THE IMAGE OF GOD.
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 $ 216,784,969 including grants of $ 24,217 ) (Revenue $ 248,398,734 )
FORM 990, PART III, LINE 4A PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENTS' ABILITY TO PAY. AS PART OF ITS COMMUNITY BENEFITS STRATEGY AND ITS MISSION, ADVOCATE SHERMAN HOSPITAL (ASH) IS COMMITTED TO PROMOTING INITIATIVES THAT ENHANCE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED. AN EXAMPLE OF THIS IS THE HOSPITAL'S PROVISION OF CHARITY CARE. ASH OFFERS A VERY GENEROUS CHARITY CARE PROGRAM--REQUIRING NO PAYMENTS FROM THE PATIENTS MOST IN NEED, AND PROVIDING DISCOUNTS TO UNINSURED PATIENTS EARNING UP TO SIX TIMES THE FEDERAL POVERTY LEVEL AND TO INSURED PATIENTS EARNING UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. THE HOSPITAL ALSO CONSIDERS A PATIENT'S EXTENUATING CIRCUMSTANCES TO QUALIFY PATIENTS FOR CHARITY CARE. FOR UNINSURED PATIENTS, THE HOSPITAL WILL PRESUMPTIVELY PROVIDE CHARITY CARE IF THE FINANCIAL STATUS HAS BEEN VERIFIED BY A THIRD PARTY AND, IN SOME CASES, THE PATIENT IS NOT REQUIRED TO SUBMIT A SEPARATE CHARITY APPLICATION. IF PRESUMPTIVE CRITERIA IS NOT AVAILABLE FOR UNINSURED PATIENTS, THEN FINANCIAL ASSISTANCE ELIGIBILITY IS AVAILABLE USING AN INCOME-BASED SCREENING. ASH EXTENDS ITS INCOME-BASED FINANCIAL ASSISTANCE POLICY TO ITS INSURED PATIENTS AS WELL, ALSO TAKING INTO CONSIDERTION THE INSURED PATIENT'S EXTENUATING CIRCUMSTANCES. ALTHOUGH THE HOSPITAL'S CHARITY CARE POLICY IS VERY GENEROUS, ASH CONTINUES TO REVIEW AND REFINE ITS POLICY IN AN ONGOING EFFORT TO ENSURE THAT FINANCIAL ASSISTANCE IS AVAILABLE WHEN THEY NEED IT TO THOSE WHO NEED HELP. THE HOSPITAL MAINTAINS HIGHLY VISIBLE SIGNAGE AND BROCHURES IN MULTIPLE LANGUAGES TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL HELP AND FINANCIAL COUNSELORS. INFORMATION ABOUT THE CHARITY CARE PROGRAM AND CHARITY APPLICATIONS IS PROVIDED TO ALL UNINSURED PATIENTS DURING REGISTRATION AND IS MAILED TO THEM IN ADVANCE OF THE FIRST PATIENT BILLING. AFTER THAT, EACH UNINSURED PATIENT'S BILL INCLUDES SUMMARY INFORMATION REGARDING THE CHARITY CARE PROGRAM. ASH, AS A LEVEL II TRAUMA CENTER, IS DEDICATED TO PROVIDING EXPERT EMERGENCY CARE REGARDLESS OF THE PATIENTS' ABILITY TO PAY. THE HOSPITAL HAD 473 TRAUMA VISITS AND 64,241 EMERGENCY DEPARTMENT VISITS IN 2014.
4b (Code:   ) (Expenses $ 29,157,266 including grants of $   ) (Revenue $ 26,800,672 )
FORM 990, PART III, LINE 4B HEALTH CARE SERVICES PROVIDED BY PHYSICIANS, NURSES, CLINICIANS AND OTHER ASSOCIATES EMPLOYED BY ADVOCATE SHERMAN HOSPITAL. ASH CLINICIANS PROVIDE CARE TO THE COMMUNITY BOTH AT THE HOSPITAL AND IN THE COMMUNITY. ADVOCATE SHERMAN HOSPITAL HAS MORE THAN 30 YEARS OF CARDIOVASCULAR EXCELLENCE FOCUSING ON PROACTIVELY PREVENTING, DIAGNOSING AND TREATING AN ARRAY OF HEART CONDITIONS. AS AN ACCREDITED CHEST PAIN CENTER THROUGH THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, ADVOCATE SHERMAN HOSPITAL IS DEDICATED TO THE CARE OF ITS CARDIAC PATIENTS. THIS ACCREDITATION MEANS THAT ASH INTEGRATES THE INDUSTRY'S BEST PRACTICES TO PROVIDE THE BEST POSSIBLE OUTCOMES IN CARDIAC CARE. SHERMAN'S HEART FAILURE PROGRAM HAS ACHIEVED ADVANCED CERTIFICATION IN HEART FAILURE DESIGNATION FOR BEST PRACTICES IN CARING FOR HEART FAILURE PATIENTS. IN 2014, ASH EXPERIENCED 737 INPATIENT CARDIAC CATH CASES AND 653 INPATIENT CARDIOVASCULAR SURGERIES. ADVOCATE SHERMAN HOSPITAL IS RECOGNIZED AS A CENTER OF EXCELLENCE IN TREATING DISEASES AND INJURIES OF MUSCLES, BONES AND JOINTS AND IS A LEADER IN STATE-OF-THE-ART ORTHOPEDIC DIAGNOSTIC AND TREATMENT OPTIONS. DEPENDING ON THE INJURY OR ILLNESS, TREATMENT CAN RANGE FROM NON-SURGICAL OPTIONS SUCH AS CASTS, SPLINTS AND PHYSICAL THERAPY TO SURGICAL OPTIONS, FROM MINIMALLY INVASIVE ARTHROSCOPY TO TOTAL JOINT REPLACEMENT. IN 2014, ADVOCATE SHERMAN HOSPITAL PERFORMED 1,319 INPATIENT ORTHOPEDIC SURGERIES. ADVOCATE SHERMAN HOSPITAL'S CANCER CARE CENTER IS ACCREDITED THROUGH THE COMMISSION ON CANCER (CoC) AND THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC). ASH IS LEADING HEALTH BY PROMOTING HEALTHY LIFESTYLES, FOCUSING ON PREVENTATIVE AND INNOVATIVE MEDICINE, ESTABLISHING A COMPREHENSIVE GENETIC PROGRAM, SECURING NURSE NAVIGATION, ENHANCING THE ONCOLOGY SERVICE LINE (INPATIENT, OUTPATIENT & COMMUNITY), PARTNERING WITH AMERICAN CANCER SOCIETY, LIVING WELL, AND JOURNEY CARE AND PARTICIPATING IN A COLEMAN GRANT FOR SUPPORTIVE ONCOLOGY AND NCI/YALE GRANT FOR DISTRESS SCREENING. THERE IS ALSO A FOCUS ON NEW EDUCATION AND PREVENTION PROGRAMS INCLUDING COLORECTAL CANCER OUTREACH & SCREENINGS, LUNG CANCER SCREENING, ENHANCEMENTS TO GENETIC COUNSELING, ADDITION OF ONCOLOGY NURSE NAVIGATION RESOURCE AND ONCOLOGY FINANCIAL NAVIGATOR, AND PARTNERSHIP WITH ADVOCATE LUTHERAN GENERAL HOSPITAL FOR RESEARCH/CLINICAL TRIALS. ADVOCATE SHERMAN HOSPITAL'S PRIMARY STROKE CENTER IS ACCREDITED THROUGH DNV HEALTHCARE (DNV). THE SCOPE OF THE PROGRAM ENCOMPASSES THE ADULT POPULATION ENTERING INTO THE HOSPITAL WITH HEMORRHAGIC/ISCHEMIC STROKE OR TIA DIAGNOSIS. DATA IS ABSTRACTED, SUBMITTED AND REPORTED THROUGH THE GET WITH THE GUIDELINES STROKE DATA REGISTRY AND ALSO THE CENTER FOR MEDICARE & MEDICAID SERVICES. OTHER IMPORTANT HOSPITAL-BASED SERVICES INCLUDE A COMPREHENSIVE DIABETES CENTER, A BIRTHING CENTER PROFICIENT IN HANDLING HIGH RISK DELIVERIES, AND AN EMERGENCY DEPARTMENT AND LEVEL II TRAUMA CENTER. HOSPITAL CLINICIANS ALSO PROVIDE CARE TO PATIENTS AT SEVERAL OFF-SITE LOCATIONS INCLUDING THREE IMMEDIATE CARE CENTERS FOR IMAGING, LABORATORY, PHYSICAL REHABILITATION AND PRIMARY CARE SERVICES, AS WELL AS SERVICES PROVIDED AT A NURSING/REHABILITATION CENTER AND A STAND ALONE IMAGING CENTER. ASH CLINICIANS LEAD PRENATAL/CHILDBIRTH AND PARENTING EDUCATION CLASSES, DIABETES EDUCATION CLASSES, AS WELL AS SUPPORT GROUPS FOCUSED ON INDIVIDUALS STRUGGLING WITH HEALTH ISSUES SUCH AS DIABETES, HEART DISEASE, BREAST AND OTHER CANCERS, OSTOMIES, AND BREAST FEEDING. AS PART OF THE HOSPITAL'S SPEAKER'S BUREAU, CLINICIANS ALSO PARTICIPATE IN COMMUNITY HEALTH EVENTS, PROVIDING EDUCATION ON VARIOUS TOPICS OF INTEREST TO THE COMMUNITY SUCH AS TRAUMA/INJURY PREVENTION, AND HEALTH AND WELLNESS CLASSES.
4c (Code:   ) (Expenses $ 21,794,378 including grants of $   ) (Revenue $ 22,803,016 )
FORM 990, PART III, LINE 4C DESCRIPTION OF ADVOCATE SHERMAN HOSPITAL ADVOCATE SHERMAN HOSPITAL IS A 255-BED NOT-FOR-PROFIT HOSPITAL THAT PROVIDES ACUTE INPATIENT AND OUTPATIENT MEDICAL CARE TO INDIVIDUALS RESIDING IN THE GREATER ELGIN, ILLINOIS, AREA. FOUNDED IN 1888, THE HOSPITAL HAS EXPANDED ITS SERVICES TO SEVERAL OFF-SITE LOCATIONS, INCLUDING THREE IMMEDIATE CARE CENTERS, A NURSING/REHABILITATION CENTER AND A STAND ALONE IMAGING CENTER. AT ALL THESE SITES OF CARE, SHERMAN'S 650 PHYSICIANS AND 2,200 ASSOCIATES (EMPLOYEES) PROVIDE QUALITY AND COMPASSIONATE CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES RECEIVED. THE HOSPITAL MOVED TO ITS CURRENT LOCATION ON RANDALL ROAD FOLLOWING COMPLETION OF A NEW HOSPITAL BUILDING IN DECEMBER 2009. ASH JOINED THE ADVOCATE SYSTEM IN 2013 AND BECAME THE ELEVENTH HOSPITAL IN THE ADVOCATE HEALTH CARE NETWORK. ASH HAS BEEN RECOGNIZED FOR ITS COMMITMENT TO CONTInUALLY IMPROVING PERFORMANCE AND PATIENT CARE AS DEMONSTRATED THROUGH ITS ACHIEVEMENT OF SEVERAL AWARDS. CONSIDERED THE NATIONAL "GOLD STANDARD" FOR NURSING EXCELLENCE AMONG HOSPITALS, THE HOSPITAL HAS RECEIVED MAGNET RECOGNITION BY THE AMERICAN NURSES CREDENTIALING CENTER, AN AFFILIATE OF THE AMERICAN NURSES ASSOCIATION. MAGNET RECOGNITION IS GIVEN ONLY TO HOSPITALS THAT SATISFY A SET OF CRITERIA DESIGNED TO MEASURE STRENGTH AND QUALITY IN NURSING CARE--FOR WHICH LESS THAN SEVEN PERCENT OF HOSPITALS NATION-WIDE HAVE ACHIEVED THIS STATUS. IN ADDITION, ASH HAS RECEIVED A 2011 SILVER AWARD FROM THE LINCOLN FOUNDATION FOR PERFORMANCE EXCELLENCE FOR IMPROVING PERFORMANCE THROUGH BEST PRACTICES AND ITS CARE DELIVERY SYSTEM. THE CENTER FOR BREAST CARE AT ADVOCATE SHERMAN HOSPITAL IS DESIGNATED AS A BREAST IMAGING CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY FOR ITS DEDICATION TO IMPROVING WOMEN'S HEALTH. THE HOSPITAL IS ALSO AN ACCREDITED CHEST PAIN CENTER, WHICH MEANS THE HOSPITAL INTEGRATES THE INDUSTRY'S BEST PRACTICES AND NEWEST PARADIGMS TO PROVIDE THE BEST POSSIBLE OUTCOMES IN CARDIAC CARE. THE HOSPITAL'S STROKE CENTER IS CERTIFIED BY THE JOINT COMMISSION. THE HOSPITAL HAS IMPLEMENTED CODE BAT (BRAIN ATTACK TEAM), A RAPID RESPONSE TEAM OF TRAINED CLINICIANS TO ENSURE STROKE PATIENTS RECEIVE TIMELY AND EXPERT CARE. EARLY MEDICAL INTERVENTION IS CRITICAL TO LIMITING BRAIN DAMAGE AND IMPROVES OUTCOMES FOR MANY STROKE VICTIMS. THE HOSPITAL'S HEART FAILURE PROGRAM RECEIVED GOLD LEVEL RECOGNITION FROM THE AMERICAN HEART ASSOCIATION'S "GET WITH THE GUIDELINES-HEART FAILURE PROGRAM" FOR COMMITMENT TO IMPROVING QUALITY CARE. THE HOSPITAL HAS ALSO RECEIVED PLATINUM RECOGNITION FROM THE AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION FOR ITS CARDIAC OUTCOMES OVER FOUR CONSECUTIVE QUARTERS. advocate SHERMAN HOSPITAL'S HEALTHCARE PROVIDERS ARE ENGAGED IN ONGOING EFFORTS FOCUSED ON QUALITY IMPROVEMENT INITIATIVES. THESE PROVIDERS USE EVIDENCE-BASED PRACTICES AS AN APPROACH TO IMPROVE QUALITY WHILE REDUCING UNNECESSARY VARIATION IN PRACTICE, UNNECESSARY COST AND UNNECESSARY HOSPITALIZATION. THESE EFFORTS ARE DESIGNED TO MAINTAIN AND ENHANCE PATIENT, STAFF AND VISITOR SAFETY AND TO IMPROVE THE ENVIRONMENT OF CARE. ASH WAS ONE OF THE FIRST COMMUNITY HOSPITALS TO PERFORM OPEN-HEART SURGERY-A SIGNFICIANT ACHIEVEMENT FOR A COMMUNITY HOSPITAL IN 1972. SINCE THEN, THE HOSPITAL HAS BECOME THE RECOGNIZED REGIONAL HEART CENTER FOR THE NORTHWEST SUBURBS, RANKING THIRD IN THE CHICAGOLAND AREA IN PATIENT VOLUMES FOR OPEN-HEART SURGERY. WITH A TEAM OF NEARLY 50 CARDIOLOGISTS, ASH HAS OVER 35 YEARS OF EXERIENCE WITH OPEN HEART PROCEDURES AND ALL FORMS OF CARDIAC CARE. IN ADDITION TO A WIDE RANGE OF CARDIOVASCULAR SERVICES, THE HOSPITAL IS ALSO AN ACCREDITED CHEST PAIN CENTER WITH DEDICATED INTERVENTIONAL CARDIOLOGISTS, AND CARDIOLOGY AND EMERGENCY PERSONNEL TRAINED IN RAPID RESPONSE AND TREATMENT OF HEART ATTACKS, WHICH HELPS ENSURE REDUCED HEART MUSCLE DAMAGE AND SAVES LIVES. THE HOSPITAL'S CENTER FOR CANCER CARE OFFERS THE LATEST CANCER TREATMENTS AND STATE-OF-THE-ART TECHNOLOGY IN AN ENVIRONMENT CUSTOM-DESIGNED FOR HEALING AND COMPASSIONATE CARE. THE CENTER FOR ADVANCED LIVER & PANCREATIC CARE PROVIDES PATIENTS WITH ACCESS TO SPECIALIZED CARE FOR THE TREATMENT OF A WIDE RANGE OF LIVER AND PANCREATIC DISEASES THAT TYPICALLY HAVE ONLY BEEN TREATED AT ACADEMIC MEDICAL CENTERS. ASH ALSO PROVIDES COMMUNITY OUTREACH THROUGH HEALTH FAIRS, WELLNESS PROGRAMS AND OTHER SERVICES IN SUPPORT OF ITS MVP (MISSION, VALUES AND PHILOSOPHY). THE MISSION OF ADVOCATE SHERMAN HOSPITAL IS TO SERVE THE HEALTH NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A WHOLISTIC PHILOSOPHY ROOTED IN THE FUNDAMENTAL UNDERSTANDING OF HUMAN BEINGS AS CREATED IN THE IMAGE OF GOD. THE VALUES OF ADVOCATE SHERMAN HOSPITAL INCLUDE EQUALITY, COMPASSION, EXCELLENCE, PARTNERSHIP, AND STEWARDSHIP. THE PHILOSOPHY OF ADVOCATE SHERMAN HOSPITAL IS GROUNDED IN THE PRINCIPLES OF HUMAN ECOLOGY, FAITH AND COMMUNITY-BASED HEALTH CARE. THESE PRINCIPLES ARISE FROM AN UNDERSTANDING OF HUMAN BEINGS AS WHOLE PERSONS IN LIGHT OF THEIR RELATIONSHIPS WITH GOD, THEMSELVES, THEIR FAMILIES AND THE SOCIETY IN WHICH THEY LIVE. POPULATION SERVED ADVOCATE SHERMAN HOSPITAL PROVIDES QUALITY HEALTH CARE TO INDIVIDUALS REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. IN 2014, THE HOSPITAL'S 650 PHYSICIANS AND 2,200 ASSOCIATES (EMPLOYEES) TREATED 15,077 INPATIENT ADMISSIONS INCLUDING 2,740 DELIVERIES, AND HANDLED 193,423 OUTPATIENT VISITS ON THE HOSPITAL CAMPUS AND 104,111 TO OFFSITE IMMEDIATE CARE CENTSERS AND ONE IMAGING CENTER. AS A LEVEL II TRAUMA CENTER, ASH HAD 473 TRAUMA VISITS AND 64,261 EMERGENCY DEPARTMENT VISITS IN 2014. ADVOCATE SHERMAN HOSPITAL SERVES A PRIMARY SERVICE AREA (PSA) INCLUDING 295,700 PEOPLE WHO RESIDE IN THE COMMUNITIES OF ALGONQUIN, CARPENTERSVILLE, DUNDEE, ELGIN, GILBERTS, HUNTLEY, LAKE IN THE HILLS, AND SOUTH ELGIN. THE HOSPITAL SERVES A SECONDARY SERVICE AREA (SSA) INCLUDING 76,000 PEOPLE WHO RESIDE IN CRYSTAL LAKE, HAMPSHIRE AND MARENGO. THE PSA AND SSA COMMUNITIES ARE IN PRIMARILY SUBURBAN AREAS, LOCATED 45-60 MINUTES WEST OF DOWNTOWN CHICAGO. THE PERCENT OF THE POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL WAS 9.0 % FOR THE PSA AND 7.1% FOR THE SSA, COMPARED TO 13.7% FOR THE STATE IN 2014. THERE ARE SEVERAL COMMUNITIES IN THE SHERMAN PSA WHICH ARE FINANCIALLY CHALLENGED, WITH A HIGHER PERCENTAGE LIVING BELOW POVERTY THAN THE STATE, INCLUDING CARPENTERSVILLE WITH 16.1% OF THE POPULATION LIVING BELOW POVERTY, AND EAST ELGIN AT 15.1%. THE 2015 MEDIAN HOUSEHOLD INCOME IS $73,884 FOR THE PSA AND $79,144 FOR THE SSA. THE PSA HAS A HIGH PORTION OF THE POPULATION WITH LATINO ANCESTRY (28.9%) AS COMPARED TO THE SSA (12.8%) AND THE US (17.6%). BOTH THE PSA AND THE SSA HAVE LOW RATES OF POPULATION WITH AFRICAN AMERICAN ANCESTRY (4.6% AND 1.2%, RESPECTIVELY). COMMITMENT TO THE COMMUNITY EVEN IN THE FACE OF LOW REIMBURSEMENTS, ADVOCATE SHERMAN HOSPITAL IS DEDICATED TO MAINTAINING A STRONG PRESENCE WITHIN ITS COMMUNITY AND CONTINUES TO MONITOR EXPENDITURES TO MAKE CERTAIN THAT THE PROGRAMS AND SERVICES SUPPORTED ARE IN DIRECT RESPONSE TO COMMUNITY NEED. IN 2014, ASH PROVIDED OVER $50.2 MILLION IN COMMUNITY BENEFIT PROGRAMS AND SERVICES. THESE BENEFITS INCLUDED NOT ONLY THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID AND MEDICARE, FOR EXAMPLE, BUT ALSO THE COST FOR IMPLEMENTING AND SUSTAINING PROGRAMS SPECIFICALLY DESIGNED TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY. COMMUNITY BENEFITS PLAN, GOALS & EXAMPLES OF PROGRAM SERVICE ACCOMPLISHMENTS AS ONE OF ELEVEN ADVOCATE HEALTH CARE HOSPITALS, ADVOCATE SHERMAN HOSPITAL'S COMMUNITY BENEFITS EFFORTS ARE ALIGNED WITH ADVOCATE HEALTH CARE'S COMMUNITY BENEFITS PLAN. THE COMMUNITY BENEFITS PLAN WAS DEVELOPED TO ESTABLISH STRATEGIES FOR IMPROVING ACCESS TO CARE AND POSITIVELY AFFECTING THE HEALTH OF THE COMMUNITIES SERVED BY THE HOSPITAL. INCLUDED IN THE COMMUNITY BENEFITS PLAN ARE NOT ONLY PLANNED GOALS AND OBJECTIVES FOCUSED ON ADDRESSING NEEDS AS IDENTIFIED THROUGH A HOSPITAL-SPECIFIC COMMUNITY HEALTH NEEDS ASSESSMENT, BUT ALSO OTHER COMMUNITY BENEFITS SUCH AS CHARITY CARE, UNREIMBURSED MEDICAID AND MEDICARE. THE COMMUNITY BENEFITS PLAN SETS THE COURSE FOR STRENGTHENING EXISTING PARTNERSHIPS AND BUILDING NEW ONES WITH INDIVIDUALS AND ORGANIZATIONS WITHIN SHERMAN'S SERVICE AREA IN ORDER TO LEVERAGE AND MAXIMIZE THE IMPACT OF ITS PROGRAMS. ASH HAS SET GOALS AND OBJECTIVES TO ACCOMPLISH THIS STRATEGY. THE GOALS AND SOME CORRESPONDING EXAMPLES OF SERVICES ASH OFFERS ARE PROVIDED BELOW. GOAL 1: UNDERTAKE OR SUPPORT INITIATIVES THAT ENHANCE ACCESS TO HEALTH AND WELLNESS SERVICES WITHIN THE DIVERSE COMMUNITIES ADVOCATE HEALTH CARE SERVES. CHARITY CARE - ADVOCATE SHERMAN HOSPITAL OFFERS A VERY GENEROUS CHARITY CARE PROGRAM - REQUIRING NO PAYMENTS FROM THE PATIENTS MOST IN NEED, AND PROVIDING DISCOUNTS TO UNINSURED PATIENTS EARNING UP TO SIX TIMES THE FEDERAL POVERTY LEVEL AND TO INSURED PATIENTS EARNING UP TO
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet267,736,613
Form 990 (2014)
Form 990 (2014)
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
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
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
Yes
 
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 (2014)
Form 990 (2014)
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 domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
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................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) 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 "Yes," 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
Yes
 
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
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
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
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
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 (2014)
Form 990 (2014)
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
222
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,074
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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2014)
Form 990 (2014)
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
19
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
14
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
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJAMES DOHENY
3075 HIGHLAND PKWY SUITE 600
DOWNERS GROVE,IL60515 (630) 929-5543
Form 990 (2014)
Form 990 (2014)
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) Linda Deering........................................................................
President, Director
40.0
.......................2.0
X   X       563,718 0 185,081
(2) William Hoffer........................................................................
Chairperson, Director
1.0
.......................1.0
X   X       0 0 0
(3) Rev Dr Nathaniel Edmond........................................................................
Vice Chairperson, Director
1.0
.......................5.0
X   X       0 0 0
(4) Audrey Reed........................................................................
Assistant Secretary, Director
1.0
.......................2.0
X   X       0 0 0
(5) David Bear........................................................................
Assistant Treasurer, Director
1.0
.......................0.0
X   X       0 0 0
(6) Roger Bielinski MD........................................................................
Director
1.0
.......................0.0
X           0 0 0
(7) John Chapman........................................................................
Director
1.0
.......................1.0
X           0 0 0
(8) James Dan MD........................................................................
Director
1.0
.......................43.0
X           0 1,382,300 263,198
(9) Tracy Ellis........................................................................
Director
1.0
.......................0.0
X           0 0 0
(10) Rick Jakle........................................................................
Director
1.0
.......................5.0
X           0 0 0
(11) Sharon Jakle........................................................................
Director
1.0
.......................0.0
X           0 0 0
(12) Kenneth Koehler........................................................................
Director
1.0
.......................1.0
X           0 0 0
(13) Lawrence Kosinski MD........................................................................
Director
1.0
.......................0.0
X           0 0 0
(14) Craig Lamp........................................................................
Director
1.0
.......................0.0
X           0 0 0
(15) Ashok Mehta MD........................................................................
Director
1.0
.......................0.0
X           0 0 0
(16) Scott Richmond........................................................................
Director
1.0
.......................0.0
X           0 0 0
(17) William P Santulli........................................................................
Director
1.0
.......................43.0
X           0 2,492,478 779,240
Form 990 (2014)
Form 990 (2014)
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) Solomon Secemsky MD........................................................................
Director
1.0
.......................40.0
X           0 409,706 40,338
(19) Michael Seigle MD........................................................................
Director
1.0
.......................0.0
X           0 0 0
(20) Linda Wallace........................................................................
Director
1.0
.......................0.0
X           0 0 0
(21) Shuja Valika MD........................................................................
Director-Nov 2014
1.0
.......................0.0
X           0 0 0
(22) Judith Balcitis........................................................................
VP, Chief Nursing officer
40.0
.......................0.0
    X       253,162 0 45,326
(23) David Cartwright........................................................................
Interim VP, Finance
1.0
.......................40.0
    X       0 263,316 48,356
(24) Trent Gordon........................................................................
VP, Strategy Planning
40.0
.......................0.0
    X       0 170,548 42,729
(25) Bruce Hyman........................................................................
Vice President, Medical Mgmt
40.0
.......................0.0
    X       289,824 0 49,065
(26) Kate Kovich........................................................................
Vice President, Patient Safety
40.0
.......................0.0
    X       0 220,615 46,473
(27) Brian Liedlich........................................................................
Vice President, Development
40.0
.......................0.0
    X       0 147,006 0
(28) Mary Martini........................................................................
VP, Professional Services
40.0
.......................0.0
    X       239,950 0 41,218
(29) Tom Nitz........................................................................
VP, Ancillary Services
40.0
.......................1.0
    X       233,996 0 272,485
(30) Frederick Rajan........................................................................
VP, Mission & Spiritual care
40.0
.......................0.0
    X       0 110,185 89,909
(31) Katie Bata........................................................................
VP, Human Resources-Feb 2014
40.0
.......................0.0
    X       33,987 242,903 40,056
(32) Melissa O'Neil........................................................................
VP, Human Resources
40.0
.......................0.0
    X       0 205,199 27,535
(33) Dominic J Nakis........................................................................
Treasurer
1.0
.......................46.0
    X       0 1,774,769 348,593
(34) Gail D Hasbrouck........................................................................
Secretary
1.0
.......................48.0
    X       0 1,150,732 188,617
(35) James Doheny........................................................................
Assistant Treasurer
1.0
.......................49.0
    X       0 454,164 54,251
(36) Ian Jones........................................................................
VP, Clinical Performance-Jan14
40.0
.......................0.0
    X       115,124 0 14,037
(37) Eric Krueger........................................................................
VP, Finance-June 2014
40.0
.......................0.0
    X       524,388 0 107,872
(38) Eva Price........................................................................
Chief Perfusionist
40.0
.......................0.0
        X   158,387 0 7,524
(39) Patrick Uplegger........................................................................
Director Pharmacy
40.0
.......................0.0
        X   158,286 0 24,094
(40) Rex Krieger........................................................................
Perfusionist
40.0
.......................0.0
        X   150,864 0 17,975
(41) Paula Morton........................................................................
Director Perioperative Svcs
40.0
.......................0.0
        X   150,035 0 29,543
(42) Kathy Cisco........................................................................
Dir ED/Inpatient/Critical care
40.0
.......................0.0
        X   148,942 0 31,530
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,020,663 9,023,921 2,795,045
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet117
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Aramark Healthcare Support Services,
25271 Network Place
Chicago,IL606731252
Hospital Services 2,155,814
Marberry Laundry LLC,
315 E Main Sreet
St Charles,IL60174
Laundry Services 607,712
Ernst Young LLP,
155 N Wacker Drive Suite 2000
Chicago,IL606066429
Professional Service 304,705
Westside Mechanical Group Inc,
2007 Corporate Lane
Naperville,IL60563
Mechanical HVAC Serv 227,814
Medical Recovery Specialists LLC,
2250 E Devon Avenue Suite 352
Des Plaines,IL60018
Collection Services 218,495
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 MediumBullet10
Form 990 (2014)
Form 990 (2014)
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 69,381
e Government grants (contributions)1e 455,525
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
0
h Total. Add lines 1a-1f.......MediumBullet 524,906
 Program Service RevenueAmt Business Code
2a Blue Cross / Managed Care 622110 141,450,354 141,010,092 440,262 0
b Medicare / Medicaid 622110 97,813,420 97,691,341 122,079 0
c Pharmacy 622110 31,153,362 31,153,362 0 0
d Laboratory 621511 24,974,023 24,974,023 0 0
e Program Service Revenue 622110 2,611,263 2,368,282 242,981 0
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 298,002,422
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 3,206,513     3,206,513
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,188,188  
b Less: rental expenses    
c Rental income or (loss) 1,188,188 0
d Net rental income or (loss).......MediumBullet 1,188,188     1,188,188
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 89,512,853 787,548
b Less: cost or other basis and sales expenses 85,621,092 1,728,365
c Gain or (loss) 3,891,761 -940,817
d Net gain or (loss)..........MediumBullet 2,950,944     2,950,944
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 Cafeteria Revenue 722212 974,140 0 0 974,140
b Miscellaneous 900099 243,502 0 30,872 212,630
c Management Fees 541611 216,528 0 0 216,528
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,434,170
12 Total revenue. See Instructions......MediumBullet 307,307,143 297,197,100 836,194 8,748,943
Form 990 (2014)
Form 990 (2014)
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 domestic organizations and domestic governments. See Part IV, line 21 .... 19,217 19,217
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 5,000 5,000
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 .... 2,969,236   2,969,236 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) .... 99,528 99,528 0 0
7 Other salaries and wages .... 96,276,534 91,963,401 4,313,133 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,031,632 4,026,641 4,991 0
9 Other employee benefits ....... 14,869,569 14,717,874 151,695 0
10 Payroll taxes ........... 6,970,413 6,714,245 256,168 0
11 Fees for services (non-employees):        
a Management ...... 0 0 0 0
b Legal ......... 78,702 0 78,702 0
c Accounting ........... 111,255 0 111,255 0
d Lobbying ........... 18,221 0 18,221 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 458,370 0 458,370 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 18,627,462   18,627,462  
12 Advertising and promotion .... 184,730 165,050 19,680 0
13 Office expenses ....... 5,492,953 4,980,915 512,038 0
14 Information technology ...... 13,138,998 73,399 13,065,599 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 6,480,780 6,045,061 435,719 0
17 Travel ............ 179,088 126,192 52,896 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 .... 210,348 136,104 74,244 0
20 Interest ........... 11,796,401 11,796,401 0 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 21,793,417 20,586,756 1,206,661 0
23 Insurance .............. 1,664,172 1,645,016 19,156 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 49,691,357 49,798,971 -107,614 0
b Other 18,634,408 15,991,062 2,643,346 0
c Bad Debt 17,490,519 17,490,519 0 0
d Public Assessment Fee 10,070,964 10,070,964 0 0
e All other expenses 11,900,570 11,284,297 616,273  
25 Total functional expenses. Add lines 1 through 24e 313,263,844 267,736,613 45,527,231 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      
Form 990 (2014)
Form 990 (2014)
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 ............. 10,450,033 1 20,474,982
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ........... 85,141 3 0
4 Accounts receivable, net ............. 35,938,557 4 49,362,675
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 ............. 4,427,360 7 4,150,199
8 Inventories for sale or use .............. 4,464,511 8 4,770,666
9 Prepaid expenses and deferred charges .......... 2,871,485 9 2,198,375
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 323,053,970
b Less: accumulated depreciation ..... 10b 32,413,986 305,359,620 10c 290,639,984
11 Investments—publicly traded securities .......... 129,068,180 11 107,467,004
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 3,174,961
14 Intangible assets ............... 641,667 14 0
15 Other assets. See Part IV, line 11 ........... 38,203,546 15 21,852,950
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 531,510,100 16 504,091,796
Liabilities 17 Accounts payable and accrued expenses ......... 44,383,592 17 44,340,799
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 10,258
20 Tax-exempt bond liabilities ............. 176,969,843 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 1,069,192 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.................... 146,685,316 25 315,915,766
26 Total liabilities. Add lines 17 through 25......... 369,107,943 26 360,266,823
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 .............. 162,256,825 27 143,679,641
28 Temporarily restricted net assets ........... 145,332 28 145,332
29 Permanently restricted net assets ........... 0 29 0
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 ........... 162,402,157 33 143,824,973
34 Total liabilities and net assets/fund balances ........ 531,510,100 34 504,091,796
Form 990 (2014)
Form 990 (2014)
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
307,307,143
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
313,263,844
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-5,956,701
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
162,402,157
5
Net unrealized gains (losses) on investments ...............
5
-3,240,463
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
-9,380,020
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
143,824,973
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
 
No
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
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 section 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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

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
2014
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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


(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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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) (2014)

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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (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) 2014


Schedule C (Form 990 or 990-EZ) 2014
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? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
0
d
Mailings to members, legislators, or the public? .........................
 
No
0
e
Publications, or published or broadcast statements? .......................
 
No
0
f
Grants to other organizations for lobbying purposes? .......................
 
No
0
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
0
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
0
i
Other activities? ..........................
Yes
 
18,221
j
Total. Add lines 1c through 1i ...............................
18,221
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
FORM 990, SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES ADVOCATE SHERMAN HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, THE ILLINOIS HOSPITAL ASSOCIATION, AND THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. THESE ORGANIZATIONS, AS PART OF THEIR MISSIONS, ADVOCATE IN THE GENERAL ASSEMBLY AND IN CONGRESS ON LEGAL AND POLICY ISSUES THAT AFFECT HEALTHCARE INCLUDING QUALITY, AFFORDABILITY, PATIENT ACCESS, AND ACCREDITATION. A PORTION OF THE ANNUAL MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE HOSPITAL ALSO REIMBURSES ASSOCIATES FOR DUES AND EDUCATIONAL EXPENSES PAID TO VARIOUS PROFESSIONAL AND MEMBERSHIP ORGANIZATIONS. ADVOCATE SHERMAN HOSPITAL ENDEAVORS TO IDENTIFY THE PORTION OF THESE DUES OR FEES ATTRIBUTABLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2014

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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 value of contributions to (during year)    
3 Aggregate value of 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)
Revenue 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
Revenue 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) 2014

Schedule D (Form 990) 2014
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, for escrow or custodial account liability?
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 ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
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 .................   32,504,177 32,504,177
b Buildings ................   237,819,280 16,953,794 220,865,486
c Leasehold improvements ............   2,744,480 536,707 2,207,773
d Equipment ................   46,394,864 15,264,204 31,130,660
e Other .................   3,591,169 -340,719 3,931,888
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 290,639,984
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
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
I/C NOTES PAYABLE-SHERMAN 261,169,422
BLUE CROSS TAKEBACKS 29,233,642
IBNR PROV INS LOSS 11,613,000
ACCR INS & CLAIMS COST 6,513,103
BLUE CROSS DUE-CURRENT YEAR 3,362,399
THIRD PARTY PAYOR TRANSFERS 3,145,367
EXECUTIVE SERP 870,422
REMEDIATION COST ACCRUAL 8,411

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 315,915,766
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) 2014

Schedule D (Form 990) 2014
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 (losses) 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 (Form 990) 2014

Additional Data


Software ID:  
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 Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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
Central America and the Caribbean 1 1 Program Services Self-Insurance 101,497
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 1 1 101,497
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 1 1 101,497
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
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)
(a)(c) Region (b)(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) 2014
Schedule F (Form 990) 2014Page 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) 2014
Schedule F (Form 990) 2014
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; do not file with Form 990)............................
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; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
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 (Form 990) 2014
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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 criteria used 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
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    7,857,539   7,857,539 2.660 %
b Medicaid (from Worksheet 3,
column a) ....
    49,836,783 34,315,760 15,521,022 5.250 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    57,694,322 34,315,760 23,378,561 7.910 %
Other Benefits
    429,398   429,398 0.150 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    186,325   186,325 0.060 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    26,607   26,607 0.010 %
j Total. Other Benefits ..     642,330   642,330 0.220 %
k Total. Add lines 7d and 7j .     58,336,652 34,315,760 24,020,891 8.130 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
17,490,519
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
1,305,738
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
79,819,534
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
98,159,432
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-18,339,898
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 %
1Algonquin Surg Ctr
 
ancillary Surgery Center 25.500 %   49.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ADVOCATE SHERMAN HOSPITAL
1425 N RANDALL ROAD
ELGIN,IL601232300
HTTP://WWW.ADVOCATEHEALTH.COM/HOPE/
license no.0005884
X X         X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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)
Advocate Sherman Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): www.advocatehealth.com/CHNAREPORTS
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Advocate Sherman Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Advocate Sherman Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23 Yes  
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
facility information PART V, SEC B, LINE 2 N/A PART V, SEC B, LINE 3J N/A PART V, SEC B, LINE 5 ADVOCATE SHERMAN HOSPITAL PARTICIPATED IN TWO COMMUNITY HEALTH NEEDS ASSESSMENTS BY WORKING COLLABORATIVELY WITH THE MCHENRY COUNTY HEALTH DEPARTMENT AND KANE COUNTY HEALTH DEPARTMENT AS WELL AS OTHER COMMUNITY-BASED ORGANIZATIONS. FOR PURPOSES OF THE CHNA, THE COMMUNITY WAS DEFINED AS THE PRIMARY AND SECONDARY SERVICE AREAS FOR ADVOCATE SHERMAN HOSPITAL, LOCATED IN BOTH KANE AND MCHENRY COUNTIES. THE MCHENRY COUNTY ASSESSMENT COLLABORATIVE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: *ADVOCATE SHERMAN HOSPITAL, ELGIN, IL *ADVOCATE GOOD SHEPHERD HOSPITAL, BARRINGTON, IL *CENTEGRA HEALTH SYSTEM, MCHENRY, IL *CRYSTAL LAKE CHAMBER OF COMMERCE, CRYSTAL LAKE, IL *ENVIRONMENTAL DEFENDERS, CRYSTAL LAKE, IL *1ST CONGREGATIONAL CHURCH OF CRYSTAL LAKE, CRYSTAL LAKE, IL *LEADERSHIP GREATER MCHENRY COUNTY, MCHENRY, IL *MCHENRY COUNTY COLLEGE, CRYSTAL LAKE, IL *MCHENRY COUNTY COMMUNITY FOUNDATION, WOODSTOCK, IL *MCHENRY COUNTY CONSERVATION DISTRICT, WOODSTOCK, IL *MCHENRY COUNTY DEPARTMENT OF HEALTH, WOODSTOCK, IL *LEAGUE OF UNITED LATIN AMERICAN CITIZENS, CRYSTAL LAKE, IL *MCHENRY COUNTY MENTAL HEALTH BOARD, CRYSTAL LAKE, IL *PIONEER CENTER (HUMAN SERVICES ORGANIZATION), MCHENRY, IL *SENIOR SERVICES ASSOCIATES, INC., WOODSTOCK, IL *UNITED WAY OF GREATER MCHENRY COUNTY, MCHENRY, IL *WOODSTOCK CHRISTIAN LIFE (HEARTHSTONE), WOODSTOCK, IL *WOODSTOCK COMMUNITY UNIT SCHOOL DISTRICT 200, WOODSTOCK, IL *VILLAGE OF PRAIRIE GROVE, PINGREE GROVE, IL THE MCHENRY COUNTY SURVEY CONSISTED OF A RANDOM DISTRIBUTION HOUSEHOLD SURVEY SENT TO 8,000 HOMES PROPORTIONAL TO ZIP CODES WITHIN THE COUNTY. 1,128 SURVEYS WERE RETURNED (14.1% RESPONSE RATE). FOCUS GROUPS WERE CONDUCTED WITH 11 GROUPS OF WHICH WERE: AT-RISK YOUTH, HOMELESS PERSONS, LATINO ADULTS, LOW-INCOME ADULTS, PARENTS OF YOUTH/ CHILDREN WITH MENTAL ILLNESS, PERSONS WITH A DEVELOPMENTAL DISABILITY, PERSONS WITH MENTAL ILLNESS, SENIORS, UNEMPLOYED AND DISLOCATED WORKERS, VETERANS, AND YOUNG ADULTS AGES 18-24. IN ADDITION, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH 34 COMMUNITY LEADERS. A COMMUNITY ANALYSIS WAS ALSO PROVIDED. THE KANE COUNTY SURVEY COLLABORATIVE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: *ADVOCATE SHERMAN HOSPITAL, ELGIN, IL *KANE COUNTY HEALTH DEPARTMENT, AURORA, IL *DELNOR COMMUNITY HOSPITAL, GENEVA, IL *PROVENA ST. JOSEPH HOSPITAL, ELGIN, IL *PROVENA MERCY HOSPITAL, AURORA, IL *INC BOARD NFP (COMMUNITY MENTAL HEALTH FUNDING ALLIANCE), AURORA, IL *RUSH COPLEY MEDICAL CENTER, AURORA, IL THE KANE COUNTY SURVEY CONSISTED OF A PHONE SURVEY TO RESIDENTS OF THE COUNTY WITH A RANDOM DIGIT-DIAL SAMPLE. THERE WERE 2,008 COMPLETED SURVEYS WITH A RESPONSE RATE OF 35.2%. THE NUMBER OF HOUSEHOLDS THAT COMPLETED BOTH THE ADULT AND CHILD SURVEYS WAS 79.5%. THE SURVEY WAS CONDUCTED IN BOTH ENGLISH AND SPANISH BY THE NORTHERN ILLINOIS UNIVERSITY PUBLIC OPINION LAB. THE SURVEY'S FOCUS WAS ON PHYSICAL HEALTH, MENTAL HEALTH, MEDICAL HISTORY, CURRENT HEALTH PRACTICES, DEMOGRAPHICS AND HEALTH OF CHILD LIVING IN HOUSEHOLD. PART V, SEC B, LINE 6A ADVOCATE GOOD SHEPHERD HOSPITAL, BARRINGTON, IL CENTEGRA HEALTH SYSTEMS, MCHENRY, IL PROVENA ST. JOSEPH'S HOSPITAL, ELGIN, IL PROVENA MERCY MEDICAL CENTER, AURORA, IL RUSH COPLEY HOSPITAL, AURORA, IL DELNOR COMMUNITY HOSPITAL, GENEVA, IL PART V, SEC B, LINE 6B MCHENRY COUNTY COLLABORATIVE ASSESSMENT *CRYSTAL LAKE CHAMBER OF COMMERCE, CRYSTAL LAKE, IL *ENVIRONMENTAL DEFENDERS, CRYSTAL LAKE, IL *1ST CONGREGATIONAL CHURCH OF CRYSTAL LAKE, CRYSTAL LAKE, IL *LEADERSHIP GREATER MCHENRY COUNTY, MCHENRY, IL *MCHENRY COUNTY COLLEGE, CRYSTAL LAKE, IL *MCHENRY COUNTY COMMUNITY FOUNDATION, WOODSTOCK, IL *MCHENRY COUNTY CONSERVATION DISTRICT, WOODSTOCK, IL *MCHENRY COUNTY DEPARTMENT OF HEALTH, WOODSTOCK, IL *LEAGUE OF UNITED LATIN AMERICAN CITIZENS, CRYSTAL LAKE, IL *MCHENRY COUNTY MENTAL HEALTH BOARD, CRYSTAL LAKE, IL *PIONEER CENTER (HUMAN SERVICES ORGANIZATION), MCHENRY, IL *SENIOR SERVICES ASSOCIATES, INC., WOODSTOCK, IL *UNITED WAY OF GREATER MCHENRY COUNTY, MCHENRY, IL *WOODSTOCK CHRISTIAN LIFE (HEARTHSTONE), WOODSTOCK, IL *WOODSTOCK COMMUNITY UNIT SCHOOL DISTRICT 200, WOODSTOCK, IL *VILLAGE OF PRAIRIE GROVE, PINGREE GROVE, IL KANE COUNTY COLLABORATIVE ASSESSMENT *KANE COUNTY HEALTH DEPARTMENT, AURORA, IL *INC BOARD NFP (COMMUNITY MENTAL HEALTH FUNDING ALLIANCE), AURORA, IL PART V, SEC B, LINE 7D N/A PART V, SEC B, LINE 11 ADVOCATE SHERMAN HOSPITAL HAS BEEN WORKING COLLABORATIVELY WITH THE MCHENRY COUNTY DEPARTMENT OF HEALTH AND THE KANE COUNTY HEALTH DEPARTMENT TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. IN THE PROCESS, SHERMAN HAS BEEN CONTRIBUTING THROUGH A VARIETY OF RESOURCES, MONEY AND TIME. SHERMAN ASSOCIATES SERVE IN KEY LEADERSHIP ROLES IN THE OVERSIGHT COMMITTEES OF BOTH COUNTIES AS WELL AS MANY SUBCOMMITTEES. THE COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS FOR BOTH COUNTIES IDENTIFIED THE FOLLOWING PRIORITY AREAS: (1) INFORMATION & REFERRAL SYSTEM; (2) ACCESS TO DENTAL CARE FOR LOW INCOME POPULATION; (3) ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES (KANE COUNTY DEFINED THIS AREA AS POOR SOCIAL AND EMOTIONAL HEALTH); (4) OBESITY; (5) CANCER; (6) CHRONIC DISEASE; (7) INFANT MORTALITY; AND (8) CHILDHOOD LEAD POISONING. THESE PRIORITIES WERE IDENTIFIED IN BOTH COUNTIES THROUGH THE MAPP PROCESS WHICH INCLUDED ALL MEMBERS OF THE COLLABORATIVE. PRIORITIES ADDRESSED SHERMAN HOSPITAL'S LEADERSHIP CONSIDERED THE HEALTH NEEDS OF THE COMMUNITY THAT WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS AND SELECTED THREE PRIORITIES BASED ON AVAILABILITY OF RESOURCES AND OPPORTUNTIES FOR INTERVENTION, INCLUDING: (1) BREAST CANCER; (2) OBESITY/ NUTRITION; AND (3) INFORMATION AND REFERRAL. BREAST CANCER THE GOAL WAS TO INCREASE ACCESS TO BREAST CANCER SCREENINGS FOR THE LOW INCOME FEMALE HISPANIC POPULATION. THE PERFORMANCE MEASURE WAS TO INCREASE THE NUMBER OF REFERRALS MADE FOR SCREENING MAMMOGRAMS AS COMPARED TO THE ACTUAL NUMBER OF MAMMOGRAMS COMPLETED. * ADVOCATE SHERMAN HOSPITAL AUXILIARY HAS BEEN PROVIDING ANNUAL FUNDING TO THE WOMEN'S ORGANIZATION FOR WELLNESS (WOW) TO PAY FOR WOMEN TO RECEIVE FREE MAMMOGRAMS. WOW DISTRIBUTES A VOUCHER TO THE PATIENT AT HEALTH EVENTS OR THROUGH GREATER ELGIN FAMILY CARE CENTER OR THE VISITING NURSES ASSOCIATION. IN 2014, NEARLY 90 VOUCHERS FOR SCREENING MAMMOGRAMS WERE PROVIDED TO HISPANIC FEMALES FOR SERVICES AT SHERMAN OF WHICH 80 PATIENTS WERE SCREENED. * THE HOSPITAL WORKED WITH WOW TO PROVIDE EDUCATIONAL INFORMATION TO LOW INCOME HISPANIC FEMALES DURING TWO OUTREACH PROGRAMS IN THE COMMUNITY. NO PRE OR POST EVALUATIONS WERE PROVIDED AT THESE EVENTS. SHERMAN HOSTED ITS ANNUAL PAMPERING AND PREVENTION BREAST CANCER EDUCATION PROGRAM IN OCTOBER 2014. THE GOAL OF THIS PROGRAM WAS TO CONNECT WOMEN TO SERVICES IN THE COMMUNITY RELATED TO SURVIVORSHIP, HEALTH EDUCATION RESOURCES AND SCREENINGS. IN ADDITION TO SEVERAL PHYSICIANS AND INSPIRATIONAL SPEAKERS, THERE WAS REPRESENTATION FROM SEVERAL ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY (EDUCATIONAL RESOURCES), WOW (BREAST SELF-EXAM, INFORMATION AND SCREENING MAMMOGRAM VOUCHERS), ELGIN COMMUNITY COLLEGE NURSING PROGRAM (BLOOD PRESSURE SCREENING), BRA FITTING, PARAFFIN WAX TREATMENTS FOR HANDS, SHERMAN CANCER CARE CENTER (RESOURCES ON SERVICES). THERE WERE 50 PEOPLE THAT ATTENDED THIS EVENT AND THERE WAS ONE REFERRAL TO WOW FOR A SCREENING MAMMOGRAM. OBESITY THE HOSPITAL'S GOAL WAS TO DECREASE OBESITY FOR LOW INCOME COMMUNITY MEMBERS. THE KEY PERFORMANCE MEASURE IDENTIFIED WAS THE TOTAL NUMBER OF POUNDS OF PRODUCE DONATED FROM THE HOSPITAL'S GARDEN TO FOOD FOR GREATER ELGIN. * SHERMAN NATURAL PRAIRIE & COMMUNITY GARDEN MASTER GARDENS (PARTNERSHIP WITH THE UNIVERSITY OF ILLINOIS MASTER GARDEN PROGRAM) AND COMMUNITY GARDENERS PROVIDED OVER 340 POUNDS OF PRODUCE WHICH WAS DONATED TO THE FOOD FOR GREATER ELGIN FOOD PANTRY IN 2014. * IN ADDITION, THE HOSPITAL'S COMMUNITY GARDEN COMMITTEE PARTNERED WITH FOOD FOR GREATER ELGIN TO HAVE THEIR OWN GARDEN BED AT SHERMAN. VOLUNTEERS AND STAFF FROM THE FOOD PANTRY MANNED THE GARDEN AND HARVESTED ALL CROPS FOR THEIR CLIENTS. * HOSPITAL DIETITIANS PROVIDED HEALTHY SEASONAL RECIPES ON A MONTHLY BASIS TO FOOD PANTRY CLIENTS. THE RECIPES WERE AVAILABLE FOR ALL CLIENTS IN ENGLISH AND SPANISH AND PROVIDED NUTRITIONAL INFORMATION USING ITEMS COLLECTED AT THE PANTRY. INFORMATION & REFERRAL THE GOAL WAS TO INCREASE HEALTH SCREENINGS AND FOLLOW-UP CARE FOR THE COMMUNITY MEMBERS WHO USE THE FOOD PANTRY. THE HOSPITAL PROVIDES FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS TO THE FOOD PANTRY CLIENTS ON A MONTHLY BASIS AND TRACKS THE NUMBER OF PATIENTS SERVED. IF A PATIENT IS SCREENED AND FALLS INTO A HIGH RISK CATEGORY, HOSPITAL STAFF PARTNER WITH GREATER ELGIN FAMILY CARE CENTER (AN FQHC) TO TALK WITH THE PATIENT ON SITE, AND IF NEEDED, TO SCHEDULE AN APPOINTMENT AT THEIR CLINIC FOR FOLLOW-UP CARE. EDUCATION IS PROVIDED TO THESE PATIENTS AS NEEDED. * NUMBE
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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?17
Name and address Type of Facility (describe)
1 Sherman MOB - Elgin
1435 Randall
Elgin,IL60120
Patient Care - OUT Patient
2 Sherman MOB - Crystal Lake
4900 S Route 31
Crystal Lake,IL60014
Patient Care - Out Patient
3 Sherman MOB - Elgin Chicago
999-1019 E Chicago Street
Elgin,IL60120
Patient Care - Out Patient
4 Sherman Immediate Care
2320 Royal Boulevard
Elgin,IL60120
Patient Care - Out Patient
5 Sherman Immediate Care - Algonquin
600 Randall Road Suite 210/230
Algonquin,IL60102
Patient Care - Out Patient
6 Sherman Immediate Care - Streamwood
550 South Boulevard
Streamwood,IL60107
Patient Care - Out Patient
7 Sherman Immediate Care - Barlett
1052-54 Norwood Lane
Barlett,IL60103
Patient Care - Out Patient
8 Sherman West Court - Larkin
1950 Larkin Avenue
Elgin,IL60120
Patient Care - Out Patient
9 Sherman West Court - 826 Prospect
826 Prospect Boulevard
Elgin,IL60120
Patient Care - Out Patient
10 The Centre of Elgin - Symphony
100 Symphony Way
Elgin,IL60120
Patient Care - Out Patient
11 The Centre of Elgin - Fletcher
745 Fletcher Drive
Elgin,IL60120
Patient Care - Out Patient
12 The Centre of Elgin - Penny
201 Penny Avenue Suite 100
East Dundee,IL60118
Patient Care - Out Patient
13 Sherman Immediate Care - South Elgin
2000 McDonald Road
South Elgin,IL60177
Patient Care - Out Patient
14 Sherman Immediate Care - Hampshire
1000 S State Street
Hampshire,IL60140
Patient Care - Out Patient
15 Sherman Immediate Care - Bartlett
864 Sterns Road Suite 103
Bartlett,IL60103
Patient Care - Out Patient
16 Sherman Immediate Care - Elgin
1140 N Mclean Blvd Suite E F
Elgin,IL60120
Patient Care - Out Patient
17 Sherman Immediate Care - Crystal Lake
741 McHenry Avenue
Crystal Lake,IL60014
Patient Care - Out Patient
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
Form 990, Schedule H, Part I, Line 3C N/A
Form 990, Schedule H, Part I, Line 6A A SYSTEM-WIDE COMMUNITY BENEFIT REPORT IS FILED BY: ADVOCATE HEALTH CARE NETWORK 3075 HIGHLAND PARKWAY, DOWNERS GROVE, IL 60515. EIN 36-2167779
Form 990, Schedule H, Part I, Line 7 A COST-TO-CHARGE RATIO, DERIVED FROM SCHEDULE H INSTRUCTIONS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7A. SCHEDULE H INSTRUCTIONS WORKSHEET 3, UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7B. A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINES 7E, 7F, 7G, AND 7I.
Form 990, Schedule H, Part I, Line 7E ADVOCATE SHERMAN HOSPITAL PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES TO THE COMMUNITIES IN WHICH IT SERVES. ADVOCATE SHERMAN HOSPITAL PROVIDES LANGUAGE SERVICES TO ALL THOSE IN NEED IN ORDER TO PROVIDE BETTER ACCESS TO CARE FOR ALL COMMUNITY MEMBERS. IN ADDITION, OTHER PROGRAMS ARE CARRIED OUT WITH THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH, ACCESS TO HEALTH SERVICES AND GENERAL HEALTH KNOWLEDGE. THESE SERVICES DO NOT GENERATE PATIENT BILLS, HOWEVER, CERTAIN PROGRAMS OR SERVICES MAY HAVE NOMINAL FEES.
Form 990, Schedule H, Part I, Line 7G ADVOCATE SHERMAN HOSPITAL PROVIDES SUBSIDIZED HEALTH SERVICES TO THE COMMUNITY. THESE SERVICES ARE PROVIDED DESPITE CREATING A FINANCIAL LOSS FOR ADVOCATE SHERMAN HOSPITAL. THESE SERVICES ARE PROVIDED BECAUSE THEY MEET AN IDENTIFIED COMMUNITY NEED. IF ADVOCATE SHERMAN HOSPITAL DID NOT PROVIDE THE CLINICAL SERVICE, IT IS REASONABLE TO CONCLUDE THAT THESE SERVICES WOULD NOT BE AVAILABLE TO THE COMMUNITY.
Form 990, Schedule H, Part I, Line 7H ADVOCATE SHERMAN HOSPITAL CONDUCTS NUMEROUS RESEARCH ACTIVITIES FOR THE ADVANCEMENT OF MEDICAL AND HEALTH CARE SERVICES. HOWEVER, THE UNREIMBURSED COST OF SUCH RESEARCH ACTIVITIES IS NOT READILY DETERMINABLE AND NO AMOUNT IS BEING REPORTED FOR PURPOSES OF THE 2014 FORM 990, SCHEDULE H.
Form 990, Schedule H, Part I, Line 7, Column (F) $17,490,519 OF BAD DEBT EXPENSE WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS REMOVED FROM THE DENOMINATOR FOR PURPOSES OF SCHEDULE H, PART I, LINE 7, COLUMN (F).
Form 990, Schedule H, Part II N/A
Form 990, Schedule H, Part III, Line 2-4 THE FOOTNOTES TO ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES' AUDITED FINANCIAL STATEMENTS DO NOT SPECIFICALLY ADDRESS BAD DEBT EXPENSE; RATHER, THE FOOTNOTE DESCRIBES ADVOCATE'S PATIENT ACCOUNTS RECEIVABLE POLICY AND THE PERCENTAGE OF ACCOUNTS RECEIVABLE THAT THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERS (SEE PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS). FOR 2014, FOR ADVOCATE SHERMAN HOSPITAL, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERED 13.7% OF NET PATIENT ACCOUNTS RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. ADVOCATE SHERMAN HOSPITAL EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYER CLASS, HISTORICAL COLLECTION EXPERIENCE, AND TRENDS IN HEALTH CARE INSURANCE PROGRAMS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 IS BASED ON THE RATIO OF PATIENT CARE COST TO CHARGES. THE UNREIMBURSED COST OF BAD DEBT WAS CALCULATED BY APPLYING THE ORGANIZATION'S COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) TO THE ORGANIZATION'S BAD DEBT PROVISION PER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS RECEIVED. ADVOCATE MAKES EVERY EFFORT TO IDENTIFY THOSE PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BY STRICTLY ADHERING TO ITS FINANCIAL ASSISTANCE POLICY. WE BELIEVE THAT ADVOCATE HAS A POPULATION OF PATIENTS WHO ARE UNINSURED OR UNDERINSURED BUT WHO DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION OR ARE NOT IDENTIFIED THROUGH OTHER MEANS AS PERMITTED IN THE POLICY. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) WHICH COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY, WAS BASED UPON SELF PAY PATIENT ACCOUNTS WHICH HAD AMOUNTS WRITTEN OFF TO BAD DEBTS. OUR METHOD WAS TO BEGIN WITH THE SELF-PAY PORTION OF BAD DEBT EXPENSE PROVISION. THE SELF PAY PORTION EXCLUDES THOSE PATIENTS WHO HAD CHARITY APPLICATIONS PENDING AT THE TIME OF SERVICE. THIS COST WAS THEN REDUCED BY CHARGES IDENTIFIED AS TRUE BAD DEBT EXPENSE, INCLUDING COPAYS FOR PATIENTS WHO QUALIFIED FOR LESS THAN 100% FINANCIAL ASSISTANCE. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE REMAINING CHARGES, TO DETERMINE THE VALUE (AT COST) OF PATIENT ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT. WE BELIEVE THIS PROCESS IS A REASONABLE BASIS FOR OUR ESTIMATE. AS WE ARE ONLY CONSIDERING SELF-PAY ACCOUNTS WRITTEN OFF TO BAD DEBT FOR THIS ESTIMATE, THIS ESTIMATE DOES NOT INCLUDE THE IMMEDIATE 30% DISCOUNT TO CHARGES WHICH IS APPLIED TO ALL SELF-PAY PATIENTS. IT ALSO DOES NOT INCLUDE ACCOUNT BALANCES OR CO-PAYS OF NON-SELF PAY ACCOUNTS WHICH ARE WRITTEN OFF TO BAD DEBT WHEN THE PATIENT HAS NO OTHER FINANCIAL RESOURCES TO PAY THESE AMOUNTS AND THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE. BAD DEBT AMOUNTS HAVE BEEN EXCLUDED FROM OTHER COMMUNITY BENEFIT AMOUNTS REPORTED THROUGHOUT SCHEDULE H.
Form 990, Schedule H, Part III, Line 8 THE SHORTFALL OF $18,339,898 ON PART III, LINE 7 IS THE UNREIMBURSED COST OF PROVIDING SERVICES FOR MEDICARE PATIENTS AND SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE PROVIDING THESE SERVICES WITHOUT REIMBURSEMENT LESSENS THE BURDENS OF GOVERNMENT OR OTHER CHARITIES THAT WOULD OTHERWISE BE NEEDED TO SERVE THE COMMUNITY. FOR ADVOCATE SHERMAN HOSPITAL'S OPERATIONS, THE UNREIMBURSED COST OF MEDICARE WAS CALCULATED BY APPLYING THE ORGANIZATION'S COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) AND FOR NON-HOSPITAL OPERATIONS THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES TO THE ORGANIZATION'S MEDICARE, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS AND/OR CONTRIBUTIONS RECEIVED THAT WERE DESIGNATED FOR THE PAYMENT OF MEDICARE PATIENT BILLS.
Form 990, Schedule H, Part III, Line 9B ADVOCATE SHERMAN HOSPITAL MAINTAINS BOTH WRITTEN FINANCIAL ASSISTANCE AND BAD DEBT/COLLECTION POLICIES. THE BAD DEBT/COLLECTION POLICY DOES NOT APPLY TO THOSE PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THEREFORE SUCH PATIENTS ARE NOT SUBJECT TO COLLECTION PRACTICES.
Form 990, Schedule H, Part VI, Line 2 NEEDS ASSESSMENT ADVOCATE SHERMAN HOSPITAL DID NOT ENGAGE IN OTHER ASSESSMENTS.
Form 990, Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ADVOCATE SHERMAN HOSPITAL ASSISTS PATIENTS WITH ENROLLMENT IN GOVERNMENT-SUPPORTED PROGRAMS FOR WHICH THEY ARE ELIGIBLE AND IN SECURING REIMBURSEMENT FROM AVAILABLE THIRD PARTY RESOURCES. FINANCIAL COUNSELING IS PROVIDED TO HELP PATIENTS IDENTIFY AND OBTAIN PAYMENT FROM THIRD PARTIES, INCLUDING ILLINOIS MEDICAID, ILLINOIS CRIME VICTIMS FUND, ETC., AS WELL AS TO DETERMINE ELIGIBILITY UNDER ADVOCATE SHERMAN HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ADVOCATE UTILIZES A FINANCIAL SCREENING SOFTWARE PROGRAM TO HELP IDENTIFY PUBLIC ASSISTANCE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE OR ADVOCATE'S FINANCIAL ASSISTANCE AT THE TIME OF REGISTRATION OR AS SOON AS PRACTICABLE THEREAFTER. IN ADDITION, HEALTHADVISOR, ADVOCATE'S EDUCATION REGISTRATION AND PHYSICIAN REFERRAL TELEPHONE CENTER, SERVES AS A COMMUNITY RESOURCE PROVIDING REFERRALS TO GOVERNMENT-FUNDED AND OTHER PROGRAMS VIA TELEPHONE FROM 8 A.M. TO 6 P.M., MONDAY THROUGH FRIDAY. ADVOCATE SHERMAN HOSPITAL ASSISTS PATIENTS WITH APPLYING FOR ADVOCATE'S OWN FINANCIAL ASSISTANCE/CHARITY CARE SERVICES, IF PATIENTS ARE NOT ELIGIBLE FOR GOVERNMENT-SUPPORTED PROGRAMS. ADVOCATE SHERMAN HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY. MEANS OF COMMUNICATION INCLUDE: 1. THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HOSPITAL SERVICES INCLUDES A STATEMENT THAT FINANCIAL COUNSELING, INCLUDING FINANCIAL ASSISTANCE CONSIDERATION, IS AVAILABLE UPON REQUEST. 2. SIGNS ARE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS. 3. BROCHURES ARE PLACED IN HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS, AND WILL INCLUDE GUIDANCE ON HOW A PATIENT MAY APPLY FOR MEDICARE, MEDICAID, ALL KIDS, FAMILY CARE ETC., AND THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. A HOSPITAL CONTACT AND TELEPHONE NUMBER FOR FINANCIAL ASSISTANCE IS INCLUDED. 4. A HANDOUT SUMMARIZING ADVOCATE'S FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION IS GIVEN TO UNINSURED PATIENTS WHO RECEIVE MEDICALLY NECESSARY HOSPITAL SERVICES AT THE EARLIEST PRACTICAL TIME OF SERVICE. 5. ADVOCATE'S WEBSITE POSTS NOTICE IN A PROMINENT PLACE THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLANATION OF THE FINANCIAL ASSISTANCE APPLICATION PROCESS, AND ENABLE PRINTING OF THE FINANCIAL ASSISTANCE APPLICATION. 6. HOSPITAL BILLS TO UNINSURED PATIENTS INCLUDE A REQUEST THAT THE PATIENT INFORM THE HOSPITAL OF ANY AVAILABLE HEALTH INSURANCE COVERAGE, AND INCLUDE A SUMMARY OF ADVOCATE'S FINANCIAL ASSISTANCE POLICY, A FINANCIAL ASSISTANCE APPLICATION, AND A TELEPHONE NUMBER TO REQUEST FINANCIAL ASSISTANCE.
Form 990, Schedule H, Part VI, Line 4 COMMUNITY INFORMATION ADVOCATE SHERMAN HOSPITAL SERVES A PRIMARY SERVICE AREA (PSA) INCLUDING 295,700 PEOPLE WHO RESIDE IN THE COMMUNITIES OF ALGONQUIN, CARPENTERSVILLE, DUNDEE, ELGIN, GILBERTS, HUNTLEY, LAKE IN THE HILLS AND SOUTH ELGIN. THE HOSPITAL SERVES A SECONDARY SERVICE AREA (SSA) INCLUDING 76,000 PEOPLE WHO RESIDE IN CRYSTAL LAKE, HAMPSHIRE AND MARENGO. THE PSA AND SSA COMMUNITIES ARE IN PRIMARILY SUBURBAN AREAS, LOCATED 45-60 MINUTES WEST OF DOWNTOWN CHICAGO. THE PERCENT OF THE POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL WAS 9.0 % FOR THE PSA AND 7.1% FOR THE SSA, COMPARED TO 13.7% FOR ILLINOIS STATE-WIDE IN 2014. THERE ARE SEVERAL COMMUNITIES IN THE SHERMAN PSA WHICH ARE FINANCIALLY CHALLENGED, WITH A HIGHER PERCENTAGE LIVING BELOW POVERTY THAN THE STATE, INCLUDING CARPENTERSVILLE WITH 16.1% OF THE POPULATION LIVING BELOW POVERTY, AND EAST ELGIN AT 15.1%. THE 2015 MEDIAN HOUSEHOLD INCOME IS $73,884 FOR THE PSA AND $79,144 FOR THE SSA. THE POPULATION RESIDING IN THE SHERMAN PSA IS PRIMARILY COVERED BY MEDICARE AND COMMERCIAL INSURANCE WITH 14.7% COVERED BY MEDICAID AND 4.8% UNINSURED IN 2014. THE RESIDENTS OF THE SHERMAN SSA HAD SLIGHTLY LOWER RATES OF MEDICAID AND NO INSURANCE, WITH 10.8 % COVERED BY MEDICAID AND 4.2% OF THE POPULATING BEING UNINSURED. CARPENTERSVILLE AND EAST ELGIN EXPERIENCE HIGHER RATES. CARPENTERSVILLE HAD 19.8% OF THE POPULATION COVERED BY MEDICAID AND 5.7% UNINSURED; AND EAST ELGIN HAS 22.8% OF THE POPULATION COVERED BY MEDICAID AND 6.4% UNINSURED IN 2014. UNEMPLOYMENT RATES AMONG RESIDENTS 16+ YEARS OLD FOR THE SHERMAN PSA AND SSA WERE 6.9% AND 7.0%, RESPECTIVELY, WHICH IS SLIGHTLY HIGHER THAN THE STATE RATE OF 6.6% IN 2014. THERE WERE COMMUNITIES WITH PARTICULARLY HIGH UNEMPLOYMENT RATES, INCLUDING CARPENTERSVILLE (8.9%) AND LAKE IN THE HILLS (8.0%). EDUCATIONAL ATTAINMENT, A KEY DEMOGRAPHIC INDICATOR FOR HEALTH CARE, IS LOW FOR THE POPULATION OF THE SHERMAN PSA COMPARED TO THE STATE OF ILLINOIS. THE PERCENT OF RESIDENTS OVER 25 YEARS OLD WITHOUT A HIGH SCHOOL DIPLOMA IS 14.7% FOR THE PSA AND 8.6% FOR THE SSA, AS COMPARED TO 13.0 % FOR THE STATE OF ILLINOIS. BOTH THE PSA AND THE SSA ARE YOUNG WITH 27.8% AND 25.3% OF THE POPULATION LESS THAN 18 YEARS OLD, RESPECTIVELY, AS COMPARED TO 23.4% FOR THE US IN 2014. CORRESPONDINGLY, THE PSA AND THE SSA HAVE A LOW PERCENT OF ELDERLY, WITH ONLY 6.9% AND 7.6% OVER THE AGE OF 70, AS RESPECTIVELY COMPARED TO 9.5% FOR THE US OVERALL IN 2014. THE PSA HAS A HIGH PORTION OF THE POPULATION WITH LATINO ANCESTRY (28.9%) AS COMPARED TO THE SSA (12.8%) AND THE US (17.6%). BOTH THE PSA AND THE SSA HAVE LOW RATES OF POPULATION WITH AFRICAN AMERICAN ANCESTRY (4.6% AND 1.2%, RESPECTIVELY). THE SHERMAN HOSPITAL SERVICE AREA IS SERVED BY SEVERAL OTHER HOSPITALS, INCLUDING: ST. JOSEPH (ELGIN), ST. ALEXIUS (HOFFMAN ESTATES), CENTEGRA-WOODSTOCK, GOOD SHEPHERD (BARRINGTON), AND DELNOR (GENEVA). ADDITIONALLY, THERE ARE SEVERAL FEDERALLY QUALIFIED HEALTH CENTERS INCLUDING GREATER ELGIN FAMILY CARE CENTER IN ELGIN AND CARPENTERSVILLE, AUNT MARTHA'S IN CARPENTERSVILLE AND VISITING NURSES ASSOCIATION (VNA) IN ELGIN.
Form 990, Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH SHERMAN HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS REPRESENTING THE COMMUNITY WHO ARE NOT ASSOCIATES. THE HOSPITAL ALSO PROVIDES COMMUNITY EDUCATION VIA A SPEAKERS BUREAU THAT INCLUDES PHYSICIANS, NURSES AND HOSPITAL LEADERS. VARIOUS SUPPORT GROUPS ARE ALSO PROVIDED BY THE HOSPITAL FOR THE COMMUNITY AT-LARGE INCLUDING COLOSTOMY, MENDED HEARTS, HEART FAILURE RECOVERY, MOM TO MOM, BREASTFEEDING, BRAINWORKS, ETC. OTHER COMMUNITY INITIATIVES THAT SHERMAN HOSPITAL IS INVOLVED IN ARE: * ALIGNMENT COLLABORATIVE EDUCATION (ACE)-ACE IS LED BY THE PRESIDENT OF SHERMAN HOSPITAL AS AN OUTREACH OPPORTUNITY TO INCREASE EDUCATION FOR THE RESIDENTS OF THE GREATER ELGIN AREA. THE MISSION OF ACE IS TO ALIGN COMMUNITY RESOURCES IN SUPPORT OF PUBLIC SCHOOL STRATEGIES TO RAISE STUDENT ACHIEVEMENT, IMPROVE THE HEALTH AND HAPPINESS OF ELGIN AREA CHILDREN, CREATE RESPONSIBLE, PRODUCTIVE AND CONTRIBUTING MEMBERS OF SOCIETY, AND ADVANCE THE ECONOMIC AND SOCIAL WELL-BEING OF THE ELGIN COMMUNITY. ACE ENVISIONS THAT ALL STUDENTS STARTING KINDERGARTEN ARE PREPARED TO LEARN, READING AT GRADE LEVEL BY 3RD GRADE, GRADUATING FROM HIGH SCHOOL WITH MARKETABLE EMPLOYMENT SKILLS AND/OR ENROLLING IN POST-SECONDARY EDUCATION. THESE STUDENTS WILL LEAVE HIGH SCHOOL PREPARED TO BE CONTRIBUTING ADULTS EAGER TO LIVE AND WORK IN THEIR COMMUNITY. * THE HISPANIC HEALTH TASK FORCE-CREATED BY SHERMAN HOSPITAL, THE HISPANIC HEALTH TASK FORCE HAS BEEN INSTRUMENTAL IN COLLABORATING WITH COMMUNITY ORGANIZATIONS WHO SERVE THE HISPANIC POPULATION REGARDING HEATH NEEDS/BARRIERS. THIS TEAM IDENTIFIED THREE AREAS OF FOCUS (1) BARRIERS TO ACCESSING HEALTHCARE; (2) CULTURAL/ECONOMIC BARRIERS; AND (3) HEALTH BEHAVIORS. SHERMAN HOSPITAL PROVIDED A HEALTHY FAMILY FUN FAIR IN SEPTEMBER 2014 WHICH FOCUSED ON PROVIDING EDUCATION IN ENGLISH AND SPANISH ON HEALTHY EATING, EXERCISE AND MORE TO OVER 165 PARTICIPANTS, 80% OF WHICH WERE HISPANIC. * ACTIVATE ELGIN-ACTIVATE ELGIN IS A CITY-WIDE INITIATIVE TO ENGAGE ALL SECTORS OF THE COMMUNITY TO WORK IN HARMONY, PROVIDING ALL RESIDENTS WITH OPPORTUNITIES TO IMPROVE THEIR HEALTH, WELL-BEING AND OVERALL QUALITY OF LIFE. ACTIVATE ELGIN, FOR WHICH SHERMAN HOSPITAL IS A FOUNDING MEMBER, BEGAN IN 2006. THE HOSPITAL PARTNERS WITH COMMUNITY GROUPS TO IMPLEMENT A WIDE VARIETY OF HEALTH PROMOTION ACTIVITIES INCLUDING THE CREATION OF HEALTH EDUCATION MATERIALS, WELLNESS PROJECTS WITHIN ELGIN SCHOOLS, HEALTHY KID'S DAY, AND A WALK WITH THE MAYOR. ANOTHER INITIATIVE WAS TO PROVIDE SUPPORT FOR 35 MINI-GRANTS TO VARIOUS COMMUNITY ORGANIZATIONS AND BUSINESSES TO HELP CREATE PROGRAMS AND SERVICES TO MAKE ELGIN A HEALTHIER COMMUNITY. ACTIVATE ELGIN'S SIGNATURE EVENT IS MARCH INTO HEALTH, A MONTH-LONG OFFERING OF EVENTS, ACTIVITIES AND EDUCATIONAL SESSIONS ORGANIZED AND HELD BY SHERMAN HOSPITAL'S PARTNER ORGANIZATIONS - ALL FOCUSED ON HELPING LOCAL RESIDENTS ADOPT HEALTHIER LIFESTYLES. * KANE COUNTY SAFE KIDS COALITION-THIS COALITION IS FOCUSED ON HEALTH AND SAFETY FOR CHILDREN (CAR SEAT CHECKS, BIKE HELMETS, TIP OVERS, ETC). SHERMAN HOSPITAL PROVIDES LEADERSHIP ON THE GOVERNING BOARD AS WELL AS CONTRIBUTES THE TIME OF ASSOCIATES TRAINED TO ASSIST AT COMMUNITY EVENTS. ENVIRONMENTAL IMPROVEMENTS 1. MENTORING AND EDUCATION ADVOCATE HEALTH CARE IS COMMITTED TO GREENING HEALTH CARE BECAUSE IT IS THE RIGHT THING TO DO. CARING FOR OUR EARTH IS STRONGLY CONNECTED TO OUR MISSION TO SERVE THE HEALTH NEEDS OF TODAY'S PATIENTS AND FAMILIES WITHOUT COMPROMISING THE NEEDS OF FUTURE GENERATIONS. BY CONSERVING RESOURCES, MINIMIZING EXPOSURE TO CHEMICALS AND CONSTRUCTING ECO-FRIENDLY BUILDINGS AND LANDSCAPES, ADVOCATE IS MAKING STRIDES TO REDUCE THE ENVIRONMENTAL IMPACT OF HEALTH CARE AND THE BURDEN OF HEALTH CARE COSTS. ADVOCATE HAS COMMITTED RESOURCES TO SHARING ITS BEST PRACTICES IN WASTE REDUCTION, AND ENERGY AND WATER MANAGEMENT. REDUCING WASTE AND CONSERVING ENERGY AND WATER USE HAS A DIRECT BENEFIT ON THE HEALTH OF LOCAL COMMUNITIES VIA CLEANER COMMUNITIES, HEALTHIER AIR QUALITY, REDUCED GREEN HOUSE GASES, AND PRESERVATION OF NATURAL RESOURCES. ADVOCATE SHARES BEST PRACTICES FOR WATER MANAGEMENT WITH OTHER NONPROFIT HOSPITALS LOCALLY AND NATIONALLY. IN 2014, ADVOCATE HEALTH CARE CONTINUED ITS LEADERSHIP ROLE AS ONE OF SEVERAL U.S. HEALTH SYSTEMS WHO FOUNDED AND SPONSOR A NATIONAL CAMPAIGN, THE HEALTHIER HOSPITALS INITIATIVE (HHI). HHI SERVES AS A GUIDE FOR HOSPITALS TO COMMIT TO IMPROVING THE HEALTH AND SAFETY OF PATIENTS, STAFF AND COMMUNITIES AND LOWERING COSTS THROUGH CONSERVATION PRACTICES BY USING FREE STEP-BY-STEP GUIDES AND HOSPITAL-TO-HOSPITAL MENTORING TO IMPLEMENT THE HHI CHALLENGES IN THE CATEGORIES OF LEADERSHIP, HEALTHIER FOODS, LESS WASTE, LEANER ENERGY, SAFER CHEMICALS AND SMARTER PURCHASING. AS OF DECEMBER 2014, NEARLY 1,100, OR OVER 20% OF THE NATION'S HOSPITALS ENROLLED IN THE HHI. 2014 MARKS THE FINAL YEAR OF THE THREE YEAR NATIONAL CAMPAIGN. OVER THE COURSE OF THREE YEARS, HHI HOSPITALS HAVE ACCOMPLISHED REDUCTIONS IN MEAT PURCHASING, INCREASED PURCHASING OF LOCAL AND SUSTAINABLE FOOD, REDUCED EXPOSURE TO TOXIC CHEMICALS THROUGH GREEN CLEANING PROGRAMS AND CONVERSION OF MEDICAL PRODUCTS FREE FROM PVC AND DEHP AND DECREASED ENERGY AND WASTE. ADVOCATE'S ANNUAL REPORT ON ENVIRONMENTAL STEWARDSHIP AND HEALTH AND WELLNESS PROGRAMS CAN BE FOUND AT: HTTP://STREAM.ADVOCATEHEALTH.COM/WEBFILES/2015/14SUPPORT2464/ ADVOCATE HEALTH CARE SYSTEM 2014 ENVIRONMENTAL INITIATIVES: *REDUCED CUMULATIVE (ELEVEN HOSPITALS) HOSPITAL ENERGY CONSUMPTION BY 3.5 PERCENT IN TWELVE MONTHS ENDING 12/30/14, AND 17.2 PERCENT SINCE 2008 * ENERGY REDUCTIONS EQUATE TO: * SAVED $15,000,000 IN ENERGY COSTS SINCE 2008 * REDUCING NEARLY 10,000 ILLINOIS HOUSEHOLDS OF ELECTRICITY USE FOR ONE YEAR * REDUCING CARBON EMISSIONS BY NEARLY 25,000 CARS OFF THE ROAD FOR ONE YEAR * RECYCLED OVER 3,300 TONS OF WASTE FROM HOSPITAL OPERATIONS * RECYCLED 94 PERCENT OF CONSTRUCTION AND DEMOLITION DEBRIS * SAVED 28 TONS OF WASTE FROM LANDFILL AND SAVED OVER $2.4 MILLION VIA MEDICAL DEVICE REPROCESSING * ENDORSED SYSTEM-WIDE HEALTHY AND SUSTAINABLE FOOD GUIDELINES TO IMPROVE THE HEALTH OF OUR PATIENTS, ASSOCIATES, VISITORS, COMMUNITIES AND THE ENVIRONMENT BY INCREASING ACCESS TO FRESH, HEALTHY FOOD IN AND AROUND ADVOCATE HEALTH CARE FACILITIES AND TO PROMOTE FOOD DELIVERY PRACTICES THAT ARE ECOLOGICALLY SOUND, ECONOMICALLY VIABLE AND SOCIALLY RESPONSIBLE IN THE WAY WE PURCHASE FOOD AND SUPPLIES. * RECOGNIZED TWENTY FIVE STAFF MEMBERS WITH ENVIRONMENTAL STEWARDSHIP AWARDS FOR DEMONSTRATING OUTSTANDING EFFORTS TO CARE FOR THE EARTH AND RESOURCE CONSERVATION * CONTRIBUTED TO OPENLANDS, ONE OF THE OLDEST METROPOLITAN CONSERVATION ORGANIZATIONS IN THE NATION AND THE ONLY SUCH GROUP WITH A REGIONAL SCOPE IN THE GREATER CHICAGO REGION * ANNOUNCED A NEW FURNITURE AND INTERIORS PURCHASING STANDARD THAT SPECIFIES ALL PRODUCTS TO BE FREE OF PERFLUORINATED COMPOUNDS, PVC (VINYL), DEHP, FORMALDEHYDE, AND HALOGENATED FLAME RETARDANTS (WHERE CODE PERMISSIBLE). * CONTINUED TO ENGAGE STAFF TO CONSERVE RESOURCES IN THEIR WORK ENVIRONMENTS THROUGH THE SUSTAINABLE WORK SPACE CERTIFICATION PROGRAM AT ALL ADVOCATE SITES. THE PROGRAM, LED BY DEPARTMENTAL GREEN ADVOCATES, REWARDS PATIENT CARE UNITS AND SUPPORT SERVICE WORK AREAS FOR ACTIVELY PARTICIPATING IN WASTE MINIMIZATION AND ENERGY REDUCTION THROUGH RECYCLING, PRINT MANAGEMENT AND ENERGY REDUCTION BEST PRACTICES. * 20 PERCENT REDUCTION SYSTEM-WIDE IN OFFICE PAPER USAGE SINCE 2008
Form 990, Schedule H, Part VI, Line 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. AS AN EXTENSION OF ITS MISSION, ADVOCATE HEALTH CARE SUPPORTS SYSTEM-WIDE PROGRAMS THAT MEET THE NEEDS OF BOTH ITS PATIENTS AS WELL AS THE COMMUNITIES SERVED. ADVOCATE HEALTH CARE'S BOARD OF DIRECTORS, SENIOR LEADERSHIP AND ASSOCIATES (EMPLOYEES) ARE COMMITTED TO POSITIVELY AFFECTING THE HEALTH STATUS AND QUALITY OF LIFE OF INDIVIDUALS AND POPULATIONS IN COMMUNITIES SERVED BY ADVOCATE THROUGH PROGRAMS AND PRACTICES THAT REFLECT ADVOCATE'S WHOLISTIC PHILOSOPHY. TO THAT END, THEY CONTINUE TO UNDERTAKE AND SUPPORT INITIATIVES THAT ENHANCE ACCESS TO HEALTH AND WELLNESS SERVICES WITHIN THE DIVERSE COMMUNITIES THAT ADVOCATE SERVES. SYSTEM LEADERSHIP IS BOTH DESIGNED TO DIRECT AND SUPPORT THE HOSPITALS IN THEIR EFFORTS TO ADDRESS IDENTIFIED COMMUNITY NEEDS. IN 2010, A MULTI-DISCIPLINARY TEAM OF INDIVIDUALS AT THE SYSTEM LEVEL HAVING OVERSIGHT RESPONSIBILITY FOR COMMUNITY BENEFITS REPORTING AND THE CHNA PROCESS WAS CONVENED TO LEAD THE HOSPITALS THROUGH THE CHNA PROCESS TO MEET STATE AND FEDERAL REGULATORY REQUIREMENTS. THIS TEAM, CALLED THE COMMUNITY HEALTH STEERING COMMITTEE, MET FREQUENTLY TO ASSURE THAT: THE HOSPITAL COMMUNITY HEALTH LEADERS ARE EDUCATED REGARDING HOW TO CONDUCT A CHNA; SITE COMMUNITY HEALTH COUNCILS ARE DEVELOPED AND MAINTAINED; THOSE CONDUCTING THE CHNA PROCESS PULL DATA FROM RELIABLE SOURCES; SOUND ASSUMPTIONS ARE MADE BASED ON THAT DATA; INTERNAL ADVOCATE AND COMMUNITY RESOURCES ARE MAPPED TO DETERMINE STRENGTHS AND WEAKNESSES; ACHIEVABLE NEEDS ARE SELECTED AS PRIORITIES; AND PLANNED INITIATIVES ARE GROUNDED IN EVIDENCE-BASED PROGRAMS THAT WILL YIELD RELIABLE OUTCOMES TO DETERMINE IMPACT. TO FOCUS THESE EFFORTS THROUGHOUT ADVOCATE HEALTH CARE, THE COMMUNITY BENEFITS PLAN WAS WRITTEN. THE PLAN'S BROAD GOALS AND OBJECTIVES WERE DESIGNED TO STRUCTURE SYSTEM-WIDE COMMUNITY BENEFITS ACTIVITIES WITHIN A STRATEGIC FRAMEWORK. INCLUDED IN THE COMMUNITY BENEFITS PLAN ARE NOT ONLY PLANNED GOALS AND OBJECTIVES FOCUSED ON ADDRESSING NEEDS AS IDENTIFIED THROUGH THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, BUT ALSO OTHER SYSTEM-WIDE EFFORTS TO ADDRESS THE BROADER ISSUES OF DISPARITY AND ACCESS SUCH AS PROVIDING CHARITY CARE TO THE UNDER AND UNINSURED. ADVOCATE'S COMMUNITY BENEFITS PLAN WAS DEVELOPED TO ESTABLISH STRATEGIES FOR IMPROVING ACCESS TO CARE AND POSITIVELY AFFECTING THE HEALTH OF THE COMMUNITIES THAT ADVOCATE SERVES. THE PLAN SETS THE COURSE FOR STRENGTHENING EXISTING PARTNERSHIPS AND BUILDING NEW ONES WITH INDIVIDUALS AND ORGANIZATIONS WITHIN ADVOCATE'S SERVICE AREAS IN ORDER TO LEVERAGE AND MAXIMIZE THE IMPACT OF ITS PROGRAMS. ADVOCATE'S COMMUNITY BENEFITS PLAN GOALS ARE AS FOLLOWS. GOAL 1: OPTIMIZE ADVOCATE'S ABILITY TO LEVERAGE ITS COMMUNITY HEALTH RESOURCES AND CONTINUE PROGRAMS THAT BENEFIT THE COMMUNITY BY PROSPECTIVELY ALIGNING SYSTEM AND SITE PLANS AND ACTIVITIES. IN ORDER TO ASSURE ALIGNMENT BETWEEN SITE AND SYSTEM GOALS, QUALITY AND CONSISTENCY AMONGST THE HOSPITALS' CHNAS AND TO LEVERAGE THE HOSPITALS' STAFF TIME AND CHNA EFFORTS, THE SYSTEM LEVEL COMMUNITY HEALTH STEERING COMMITTEE PROVIDED A STANDARDIZED CHNA PROCESS, TOOLS, EDUCATION AND STRUCTURE. SPECIFIC EXAMPLES OF THE SUPPORT PROVIDED BY THE STEERING COMMITTEE TO ENABLE THE HOSPITALS TO REALIZE THEIR COMMUNITY HEALTH GOALS AND OBJECTIVES ARE AS FOLLOWS. * A STANDARDIZED CHNA PROCESS THAT INCLUDED DEVELOPMENT OF A COMMUNITY HEALTH COUNCIL AT EACH HOSPITAL WITH BOTH HOSPITAL AND COMMUNITY REPRESENTATION. THE COUNCILS WERE CHARGED WITH MANAGING THEIR SITE'S ASSESSMENT, EXAMINING DATA, SITE AND COMMUNITY RESOURCES, SELECTING KEY PRIORITIES TO ADDRESS AND DEVELOPING A COMMUNITY HEALTH PLAN. * PURCHASE OF AND INSTRUCTION ON HOW TO USE SURVEY RESULTS AND THE ASSESSMENT TOOL DEVELOPED BY PROFESSIONAL RESEARCH CONSULTANTS. * LED A SERIES OF WORKSHOPS OVER THREE YEARS WITH INTERNAL AND EXTERNAL SPEAKERS PROFICIENT IN CHNAS, IDENTIFYING RELIABLE DATA SOURCES, PRIORITY SETTING, AND SELECTING EVIDENCE-BASED INTERVENTIONS. * SET THE COMMUNITY HEALTH LEADERSHIP COUNCIL'S AGENDAS, A COUNCIL COMPRISED OF COMMUNITY HEALTH STAKEHOLDERS FROM ACROSS ADVOCATE, TO FOCUS ON CHNA OBJECTIVES. * MANAGED HOSPITAL PROGRESS AGAINST SYSTEM ANNUAL TIMELINES TO ACHIEVE THE THREE-YEAR VISION, REQUIRING ANNUAL CHNA PROGRESS REPORTS AND THEIR REVIEW AND ENDORSEMENT BY THE HOSPITAL GOVERNING COUNCILS EACH YEAR. * PROVIDED ONGOING CONSULTATION ON AN AS NEED BASIS THROUGHOUT THE PROCESS. * ENGAGED AND FUNDED AN OUTSIDE CHNA CONSULTANT TO MEET ONE-ON-ONE WITH THE SITE COMMUNITY HEALTH LEADERS AND REVIEW CHNA PROGRESS AND PROVIDE GUIDANCE IN AREAS OF DIFFICULTY OR UNCERTAINTY. * PROVIDED AN OVERVIEW OF THE CHNA RESULTS AND PLANNED INTERVENTIONS TO THE MISSION & SPIRITUAL COMMITTEE OF THE ADVOCATE HEALTH CARE BOARD OF DIRECTORS TO SECURE THE COMMITTEE'S ENDORSEMENT. * A STANDARDIZED FORMAT FOR HOSPITALS TO USE IN DRAFTING THEIR CHNAS AND IMPLEMENTATION PLANS, WHICH SYSTEM LEADERS THEN REVIEWED AND EDITED FOR CONSISTENCY, ACCURACY AND QUALITY OF CONTENT. * WORKED WITH SYSTEM LEVEL MEDIA CENTER AND WEB TEAM TO DEVELOP PLACEMENT AND POSTING OF CHNA REPORTS & IMPLEMENTATION PLANS TO MEET PPACA/IRS REGULATORY REPORTING REQUIREMENTS. * IN PREPARATION FOR THE NEXT CHNA CYCLE, ADVOCATE PURCHASED THE HEALTHY COMMUNITIES INSTITUTE'S CHNA TOOL IN LATE 2013 AND PAID THE ANNUAL FEE FOR ONGOING SUPPORT FOR TRAINING AND THE ADDITION OF 2013 AND 2014 UPDATES AT THE SYSTEM LEVEL. FOR 2015, THE TOOL IS EXPECTED TO ALSO SUPPORT THE WORK OF THE COUNTY CHNA COLLABORATIVES. WITH SUPPORT FROM THE SYSTEM LEVEL, ALL ADVOCATE'S HOSPITALS ARE PARTICIPATING IN THESE COLLABORATIVE ASSESSMENTS WITH OTHER ADVOCATE AND NON-ADVOCATE HOSPITALS AND THEIR COUNTY AND LOCAL PUBLIC HEALTH DEPARTMENTS. THESE COLLABORATIVES REMOVE DUPLICATION OF STAFF TIME AND EFFORT WHILE FORGING AND STRENGTHENING RELATIONSHIPS AMONG PARTICIPATING ORGANIZATIONS, LEVERAGING THEIR ABILITY TO POSITIVELY IMPACT KEY NEEDS AS IDENTIFIED THROUGH THE ASSESSMENT PROCESS. THROUGH ADVOCATE'S HOSPITAL-BASED SERVICES, AS WELL AS ITS PARTICIPATION IN PROVIDING PROGRAMS AND SERVICES IN THE COMMUNITY, ADVOCATE PROMOTES A SHARED APPROACH TO COMMUNITY BENEFITS. IN ADDITION TO HOSPITAL/COMMUNITY SPECIFIC PROGRAMS, THERE ARE ALSO PROGRAMS ADDRESSING NEEDS OF BROAD GEOGRAPHIC PORTIONS OF ADVOCATE'S SERVICE AREA WHICH ARE MANAGED AND FUNDED AT THE SYSTEM LEVEL. THESE PROGRAMS INCLUDE THE FOLLOWING. ADVOCATE'S HEALTHY STEPS PROGRAM SPECIALISTS TOUCHED THE LIVES OF 6,248 YOUNG CHILDREN IN 2014 THROUGH CHILDHOOD PROGRAMS WITHIN PEDIATRIC/FAMILY PRACTICE RESIDENCIES AT ADVOCATE ILLINOIS MASONIC MEDICAL CENTER, AND THE ADVOCATE CHILDREN'S HOSPITAL OAK LAWN AND PARK RIDGE CAMPUSES. THIS SYSTEM-WIDE PROGRAM USES A NATIONAL MODEL TO ENGAGE PARENTS AS PARTNERS WITH PHYSICIANS IN THEIR CHILDREN'S HEALTH. HEALTHY STEPS SPECIALISTS HELP BRIDGE THE TWO GROUPS BY PREPARING PARENTS TO TAKE AN ACTIVE ROLE IN, AND PHYSICIANS TO ASSESS AND MEET MORE EFFECTIVELY, A RANGE OF CHILD DEVELOPMENT NEEDS. IN 2014, 9,981 DEVELOPMENTAL SCREENINGS WERE PROVIDED AND 411 FAMILIES WERE REFERRED TO COMMUNITY SERVICES FOR FOLLOW UP. IN ADDITION, HEALTHY STEPS HAS TRAINED AND PROVIDED TECHNICAL ASSISTANCE TO PRIMARY CARE PROVIDERS ACROSS THE STATE TO IMPROVE PREVENTIVE PRACTICES IN THEIR SITE AROUND TOPICS SUCH AS USE OF VALIDATED TOOLS FOR DEVELOPMENTAL AND SOCIAL EMOTIONAL CONCERNS, AS WELL AS FAMILY RISK FACTOR SCREENINGS (SUCH AS POSTPARTUM DEPRESSION, DOMESTIC VIOLENCE, TRAUMA, AND PSYCHOSOCIAL ISSUES). PRIMARY CARE PROVIDERS AND THEIR STAFF ARE TAUGHT HOW TO WORK CLOSELY WITH LOCAL COMMUNITY RESOURCES FOR REFERRAL AND FOLLOW-UP CARE. DURING 2014, ADVOCATE HEALTHY STEPS CONSULTANTS PROVIDED 91 PRESENTATIONS IN 42 PRIMARY CARE SITES TO 585 PHYSICIANS AND THEIR STAFFS THROUGHOUT THE STATE OF ILLINOIS. THESE PROVIDERS CARE FOR APPROXIMATELY 78,715 CHILDREN BETWEEN BIRTH AND AGE THREE. CURRENTLY, HEALTHY STEPS IS FOCUSING ON DEVELOPMENTAL BEHAVIORAL MENTAL HEALTH TRAINING FOR PRIMARY CARE PROVIDERS. THE STAFF ALSO MEETS REGULARLY WITH APPROXIMATELY 20 COMMUNITY ORGANIZATIONS, AND WORKS WITH PEDIATRIC AND FAMILY MEDICINE RESIDENCY PROGRAMS, PEDIATRIC NURSE PRACTITIONERS AND PHYSICIAN ASSISTANT PROGRAMS THROUGHOUT THE STATE. THE ADVOCATE CHILDHOOD TRAUMA TREATMENT PROGRAM (CTTP) OFFERS HOPE AND HEALING TO CHILDREN WHO HAVE EXPERIENCED MALTREATMENT, PSYCHOLOGICAL TRAUMA AND SEXUAL ABUSE. CLINICIANS WORK WITH A CHILD'S ENTIRE SUPPORT NETWORK - PARENTS, THE SCHOOL AND MORE - TO HELP FOSTER A SAFE ENVIRONMENT FOR THE CHILD. CTTP IS ONE OF JUST A HANDFUL OF PROGRAMS IN ILLINOIS THAT SPECIALIZES IN THE SEXUAL ABUSE OF CHILDREN. IN 2014, CTTP SERVED 168 CHILDREN AND ADOLESCENTS, AS WELL AS 415 ADULTS, CAREGIVERS, PARENTS AND OTHERS. IN ADDITION, THE PROGRAM HAS PARTNERED WITH "DARKNESS
Form 990, Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT IL
Schedule H (Form 990) 2014
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 Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
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), 501(c)(4), and 501(c)(29) organizations 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) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Linda DeeringPresident, Director (i)
(ii)
428,325
...............................
0
37,324
...............................
0
98,069
...............................
0
164,125
...............................
0
20,956
...............................
 
748,799
...............................
0
0
...............................
 
2Judith BalcitisVP, Chief Nursing officer (i)
(ii)
230,266
...............................
0
19,883
...............................
0
3,013
...............................
0
26,569
...............................
0
18,757
...............................
 
298,488
...............................
0
0
...............................
 
3David CartwrightInterim VP, Finance (i)
(ii)
0
...............................
223,408
0
...............................
39,033
0
...............................
875
0
...............................
24,011
0
...............................
24,345
0
...............................
311,672
0
...............................
 
4Trent GordonVP, Strategy Planning (i)
(ii)
0
...............................
155,588
0
...............................
18,982
0
...............................
-4,022
0
...............................
15,446
0
...............................
27,283
0
...............................
213,277
0
...............................
 
5Bruce HymanVice President, Medical Mgmt (i)
(ii)
276,090
...............................
0
13,186
...............................
0
548
...............................
0
24,011
...............................
0
25,054
...............................
 
338,889
...............................
0
0
...............................
 
6Kate KovichVice President, Patient Safety (i)
(ii)
0
...............................
183,872
0
...............................
25,677
0
...............................
11,066
0
...............................
19,317
0
...............................
27,156
0
...............................
267,088
0
...............................
 
7Mary MartiniVP, Professional Services (i)
(ii)
222,134
...............................
0
17,814
...............................
0
2
...............................
0
25,486
...............................
0
15,732
...............................
 
281,168
...............................
0
0
...............................
 
8Tom NitzVP, Ancillary Services (i)
(ii)
205,104
...............................
0
25,314
...............................
0
3,578
...............................
0
254,005
...............................
0
18,480
...............................
 
506,481
...............................
0
0
...............................
 
9Frederick RajanVP, Mission & Spiritual care (i)
(ii)
0
...............................
85,181
0
...............................
17,274
0
...............................
7,730
0
...............................
12,556
0
...............................
77,353
0
...............................
200,094
0
...............................
 
10Katie BataVP, Human Resources-Feb 2014 (i)
(ii)
30,194
...............................
226,953
0
...............................
18,337
3,793
...............................
-2,387
 
...............................
21,411
 
...............................
18,645
33,987
...............................
282,959
0
...............................
0
11Melissa O'NeilVP, Human Resources (i)
(ii)
0
...............................
174,785
0
...............................
20,092
0
...............................
10,322
0
...............................
17,838
0
...............................
9,697
0
...............................
232,734
0
...............................
 
12Dominic J NakisTreasurer (i)
(ii)
0
...............................
622,258
0
...............................
773,328
0
...............................
379,183
0
...............................
325,841
0
...............................
22,752
0
...............................
2,123,362
0
...............................
323,744
13Gail D HasbrouckSecretary (i)
(ii)
0
...............................
469,637
0
...............................
392,669
0
...............................
288,426
0
...............................
166,445
0
...............................
22,172
0
...............................
1,339,349
0
...............................
154,711
14James DohenyAssistant Treasurer (i)
(ii)
0
...............................
315,161
0
...............................
109,226
0
...............................
29,777
0
...............................
24,011
0
...............................
30,240
0
...............................
508,415
0
...............................
 
15Eric KruegerVP, Finance-June 2014 (i)
(ii)
162,220
...............................
0
120,506
...............................
0
241,662
...............................
0
88,786
...............................
0
19,086
...............................
 
632,260
...............................
0
0
...............................
 
16James Dan MDDirector (i)
(ii)
0
...............................
516,652
0
...............................
568,516
0
...............................
297,132
0
...............................
241,684
0
...............................
21,514
0
...............................
1,645,498
0
...............................
233,483
17William P SantulliDirector (i)
(ii)
0
...............................
871,072
0
...............................
1,090,000
0
...............................
531,406
0
...............................
748,459
0
...............................
30,781
0
...............................
3,271,718
0
...............................
432,420
18Solomon Secemsky MDDirector (i)
(ii)
0
...............................
350,000
0
...............................
40,311
0
...............................
19,395
0
...............................
21,411
0
...............................
18,927
0
...............................
450,044
0
...............................
 
19Eva PriceChief Perfusionist (i)
(ii)
101,262
...............................
0
0
...............................
0
57,125
...............................
0
6,058
...............................
0
1,466
...............................
 
165,911
...............................
0
0
...............................
 
20Patrick UpleggerDirector Pharmacy (i)
(ii)
158,420
...............................
0
0
...............................
0
-134
...............................
0
14,959
...............................
0
9,135
...............................
 
182,380
...............................
0
0
...............................
 
21Rex KriegerPerfusionist (i)
(ii)
97,928
...............................
0
0
...............................
0
52,936
...............................
0
10,955
...............................
0
7,020
...............................
 
168,839
...............................
0
0
...............................
 
22Paula MortonDirector Perioperative Svcs (i)
(ii)
131,598
...............................
0
0
...............................
0
18,437
...............................
0
14,113
...............................
0
15,430
...............................
 
179,578
...............................
0
0
...............................
 
23Kathy CiscoDir ED/Inpatient/Critical care (i)
(ii)
152,760
...............................
0
0
...............................
0
-3,818
...............................
0
14,413
...............................
0
17,117
...............................
 
180,472
...............................
0
0
...............................
 
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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, Line 4a SEVERANCE PAYMENTS ERIC KRUEGER, VICE PRESIDENT, FINANCE, TERMINATED HIS EMPLOYMENT WITH ADVOCATE SHERMAN HOSPITAL IN 2014 AND WILL RECEIVE SEVERANCE IN 2015 AND BEYOND WHICH IS INCLUDED IN COLUMN (C). THOMAS NITZ, VICE PRESIDENT, ANCILLARY SERVICES, TERMINATED HIS EMPLOYMENT WITH ADVOCATE SHERMAN HOSPITAL IN 2014 AND WILL RECEIVE SEVERANCE IN 2015 AND BEYOND WHICH IS INCLUDED IN COLUMN (C). Form 990, Schedule J, Part I, Line 4b SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN GAIL HASBROUCK, SENIOR VICE PRESIDENT-GENERAL COUNSEL AND CORPORATE SECRETARY, IS VESTED IN A NON-QUALIFIED RETIREMENT PLAN. AS SUCH ANY CONTRIBUTIONS ARE TAXED CURRENTLY. THERE IS NO DEFERRED COMPONENT. THE CURRENT YEAR CONTRIBUTION AMOUNT IS $44,003. ADVOCATE PROVIDES A TARGET REPLACEMENT SENIOR EXECUTIVE RETIREMENT PLAN. THE CONTRIBUTIONS TO THIS PLAN ARE VESTED AND TAXABLE AFTER FIVE YEARS OF SERVICE. THE FOLLOWING EMPLOYEES ARE VESTED IN THE PLAN AND THEREFORE THE CONTRIBUTIONS ARE REPORTED AS COMPENSATION ON THE W-2: WILLIAM SANTULLI $301,001, DOMINIC NAKIS $216,494, GAIL HASBROUCK $134,329, JAMES DAN M.D. $168,324 and LINDA DEERING $45,821. WILLIAM SANTULLI IS A PARTICIPANT IN A SECTION 457(F) RETENTION INCENTIVE BENEFIT PLAN. THE PLAN IS CURRENTLY NOT VESTED. THE PLAN IS CONTINGENT ON EMPLOYMENT AND VESTS WHEN THE PARTICPANT REACHES 60 YEARS OF AGE. THE CURRENT YEAR AMOUNT EARNED IS $223,547.
Form 990, Schedule J, Part I, Line 7 INCENTIVE PAYMENTS ARE BASED UPON A FORMULA. THE AMOUNTS ARE CALCULATED AFTER CERTAIN PERFORMANCE AND OPERATING GOALS ARE ACHIEVED. THE COMPENSATION COMMITTEE CAN EXERCISE DISCRETION OVER WHETHER INCENTIVE COMPENSATION IS PAID OUT ANNUALLY.
Schedule J (Form 990) 2014

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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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 Benefiting 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) 2014
Schedule L (Form 990 or 990-EZ) 2014
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) Juliet Dunning Family Member - Dunning 33,069 Employment    
(2) bridget deering Family Member - Deering 17,647 Employment    
(3) kelly deering Family Member - Deering 48,812 Employment    
(4) craig lamp general contractor 123,749 construction services    
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) 2014

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 990-EZ 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
2014
Open to Public
Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
Return Reference Explanation
PART VI, SECTION A, LINE 6 corporate member THE BYLAWS PROVIDE FOR ADVOCATE HEALTH CARE NETWORK AS THE SOLE CORPORATE MEMBER.
PART VI, SECTION A, LINE 7A power to elect other members ADVOCATE SHERMAN HOSPITAL HAS A SOLE CORPORATE MEMBER, ADVOCATE HEALTH CARE NETWORK WHO ELECTS ITS DIRECTORS.
PART VI, SECTION A, LINE 7B governance decisions THE FOLLOWING REQUIRE A RECOMMENDATION INITIATED BY THE BOARD OF DIRECTORS AND THE SUBSEQUENT APPROVAL BY THE CORPORATE MEMBER, ADVOCATE HEALTH CARE NETWORK, TO BE VALID: A) APPOINTMENT OF THE MEMBERS OF THE BOARD OR ITS AFFILIATES, OTHER THAN THE EX OFFICIO DIRECTORS; B) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION OR ITS AFFILIATES; C) AMENDMENT OF THE BYLAWS OF THE CORPORATION OR ITS AFFILIATES; D) IMPLEMENTATION OF ANY CHANGE TO THE STRUCTURE OR OPERATION OF THE CORPORATION OR ITS AFFILIATES THAT COULD AFFECT THE CORPORATION'S OR ANY AFFILIATE'S TAX-EXEMPT STATUS; E) ADOPTION OF A STRATEGIC PLAN; F) APPROVAL OF THE CORPORATION'S OR ANY AFFILIATE'S ANNUAL CAPITAL PLAN; G) APPROVAL OF THE CORPORATION'S OR ANY AFFILIATE'S ANNUAL OPERATING BUDGET; H) TRANSFER OR ENCUMBRANCE OF ANY OF THE CORPORATION'S OR ANY AFFILIATE'S ASSETS BY PURCHASE, SALE, CAPITAL LEASE, MORTGAGE, DISPOSITION OR HYPOTHECATION IN EXCESS OF LIMITS ESTABLISHED BY THE CORPORATE MEMBER'S FINANCIAL APPROVAL POLICY; I) FILING OF A CERTIFICATE OF NEED OR EXEMPTION APPLICATION (OR ANY AMENDMENT THERETO) BY THE CORPORATION OR ANY AFFILIATE; J) DISSOLVING OR WINDING-UP THE CORPORATION, OR AN AFFILIATE, OR ABANDONING AN ENTIRE BUSINESS ENTERPRISE THEREOF; K) FILING ANY ACTION IN BANKRUPTCY OR RECEIVERSHIP REGARDING THE CORPORATION OR ANY AFFILIATE; L) THE SALE OR TRANSFER OF ANY MEMBER INTEREST, STOCK, OR OTHER OWNERSHIP INTEREST IN ANY AFFILIATE OF THE CORPORATION; M) THE MERGER OR CONSOLIDATION OF THE CORPORATION OR ANY AFFILIATE, OR THE FORMATION OF ANY PARTNERSHIP, CO-SPONSORSHIP ARRANGEMENT OR JOINT VENTURE BETWEEN OR AMONG THE CORPORATION OR ANY AFFILIATE AND ANY THIRD PARTY; N) ADOPTION OR AMENDMENT OF ANY POLICY, PROTOCOL OR PROCEDURE THAT IS INCONSISTENT WITH ONE OR MORE OF THE CORPORATE MEMBER'S SYSTEM-WIDE POLICIES, PROTOCOLS OR PROCEDURES OR THE CORPORATE MEMBER'S ARTICLES OF INCORPORATION AND/OR BYLAWS; PROVIDED, HOWEVER, THAT THIS COLLABORATIVE AUTHORITY DOES NOT ABROGATE THE POWER OF THE BOARD TO ADOPT POLICIES, PROTOCOLS AND/OR PROCEDURES FOR WHICH NO SYSTEM-WIDE POLICY, PROTOCOL OR PROCEDURE EXISTS AND THAT ARE RELATED SOLELY TO THE INTERNAL OPERATIONS OF THE CORPORATION AND/OR ANY OF ITS AFFILIATES; AND O) APPOINTMENT OF THE CORPORATION'S OFFICERS IDENTIFIED IN SECTION 6.2 OF THE CORPORATION'S BYLAWS. THE CORPORATE MEMBER MAY TAKE THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OR RECOMMENDATION OF THE BOARD OF DIRECTORS: A)REMOVAL OF ANY OF THE MEMBERS OF THE BOARD "FOR CAUSE" IN ACCORDANCE WITH SECTION 3.15 OF THE CORPORATION'S BYLAWS; B)THE INCURRENCE OR MODIFICATION OF SHORT OR LONG-TERM DEBT AND LEASE OBLIGATIONS; C)APPOINTMENT OR REMOVAL OF THE CORPORATION'S PRESIDENT OR CHIEF FINANCIAL OFFICER ("CFO"); D)ADOPTION OF AN ANNUAL CAPITAL PLAN FOR THE CORPORATION, BUT ONLY AFTER THE CORPORATE MEMBER HAS MADE A GOOD FAITH DETERMINATION THAT THE BOARD HAS NOT RECOMMENDED AN ACCEPTABLE ANNUAL CAPITAL PLAN IN A TIMELY MANNER; AND E)ADOPTION OF AN ANNUAL OPERATING BUDGET FOR THE CORPORATION, BUT ONLY AFTER THE CORPORATE MEMBER HAS MADE A GOOD FAITH DETERMINATION THAT THE BOARD HAS NOT RECOMMENDED AN ACCEPTABLE ANNUAL OPERATING BUDGET IN A TIMELY MANNER.
PART VI, SECTION B, LINE 11B tax preparation and review process ADVOCATE'S TAX PREPARATION PROCESS INCLUDES ONGOING CONSULTATION WITH ITS OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE, TAX, AND LEGAL ASSOCIATES AND OTHER MEMBERS OF THE ORGANIZATION'S TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF THE FORM 990. THE FORM 990 IS REVIEWED BY FINANCE MANAGEMENT, THE TAX MANAGER, THE VP OF FINANCE/CORPORATE CONTROLLER, THE CHIEF FINANCIAL OFFICER, AND ADVOCATE'S OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL. PRIOR TO PRESENTING THE FORM 990 TO THE BOARD OF DIRECTOR'S AUDIT COMMITTEE IN NOVEMBER, THE ORGANIZATION'S TEAM--INCLUDING ITS ADVISORS--MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF THE FORM 990. AT THE NOVEMBER AUDIT COMMITTEE MEETING, THE VP OF FINANCE/CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER COORDINATED A REVIEW OF THE FORM 990 WITH COMMITTEE MEMBERS, AS THE AUDIT COMMITTEE IS THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH OVERSIGHT OF AUDIT AND TAX MATTERS. THE VP OF FINANCE/CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER RESPONDED TO THE AUDIT COMMITTEE MEMBERS' QUESTIONS AND PROVIDED THE OPPORTUNITY FOR DETAILED DISCUSSION OF THE FORM 990. THE CHANGES IDENTIFIED WERE INCORPORATED, AND THEN A COMPLETE COPY OF THE FINAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE THE FORM 990 WAS FILED.
PART VI, SECTION B, LINE 12C conflict of interest policy THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO VARIOUS PEOPLE, INCLUDING MEMBERS OF ADVOCATE'S BOARD OF DIRECTORS, GOVERNING COUNCILS, OFFICERS, ASSOCIATES, VOLUNTEERS, AND MEDICAL STAFF MEMBERS WITH ADMINISTRATIVE RESPONSIBILITIES. ANNUALLY, THE COMPLIANCE DEPARTMENT SENDS THIS POLICY AND THE ADVOCATE CODE OF BUSINESS CONDUCT TO A RANGE OF INDIVIDUALS WHO MAY BE IN A POSITION TO EXERCISE SUBSTANTIAL INTEREST OVER A PARTICULAR MATTER (DEFINED AS "INTERESTED PERSONS"). THEY ARE REQUIRED TO READ THE POLICIES AND PROVIDE THE COMPLIANCE DEPARTMENT WITH A DISCLOSURE STATEMENT, WHICH IDENTIFIES ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER REVIEWS THE DISCLOSURES AND PROVIDES A REPORT TO THE SYSTEM BUSINESS CONDUCT (COMPLIANCE) COMMITTEE, EXECUTIVE MANAGEMENT TEAM AND THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. THE REPORT IS THEN PROVIDED, IN RELEVANT PART, TO THE SITE CHIEF EXECUTIVE OFFICERS. POTENTIAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE DEPARTMENT ON A CASE BY CASE BASIS. FOLLOW-UP PROCEDURES CONDUCTED ARE UNIQUE TO THE GIVEN CIRCUMSTANCE AND MAY INCLUDE REVIEWING THE POTENTIAL CONFLICT WITH THE INTERESTED PERSON OR INVESTIGATING THE MATTER IN CONSULTATION WITH THE INTERESTED PERSON'S SUPERVISOR AND/OR SITE MANAGEMENT. IN CIRCUMSTANCES WHERE THE INTERESTED PERSON IS NOT A MEMBER OF THE BOARD OR GOVERNING COUNCIL OR A COMMITTEE THEREOF OR A PERSON OF INTEREST, AND IT IS DETERMINED THAT THERE IS AN ACTUAL CONFLICT OF INTEREST, THE SUPERVISOR OF THE INDIVIDUAL IS RESPONSIBLE FOR MAKING AN APPROPRIATE RESPONSE--POTENTIALLY INCLUDING A RESTRICTION OF THE INDIVIDUAL'S JOB DUTIES WITH RESPECT TO THE MATTER GIVING RISE TO THE CONFLICT.
Form 990, Part VI, Line 15A & 15B executive compensation EXECUTIVE COMPENSATION AT ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES IS BASED ON A BOARD-APPROVED STRATEGY THAT GUIDES THE CORPORATION IN ESTABLISHING COMPENSATION OPPORTUNITIES FOR EXECUTIVES, MANAGERS, PROFESSIONALS AND EMPLOYEES. IN THIS STRATEGY, SPECIFIC MARKET COMPENSATIONS ARE IDENTIFIED AND THE DESIRED LEVEL OF COMPETITIVENESS IN THOSE MARKETS SPECIFIED. IN ADDITION, THE LINKAGE OF EXECUTIVE PAY TO PERFORMANCE IS ARTICULATED AND HOW THIS RELATIONSHIP IS TO BE MAINTAINED IS OUTLINED. TO SUPPORT AND IMPLEMENT THE COMPENSATION STRATEGY, FIVE BASIC ELEMENTS ARE UTILIZED. THESE ELEMENTS ARE: -A SOLID, RELIABLE AND TESTED JOB EVALUATION METHODOLOGY, -ACCURATE, QUALITY AND RELEVANT COMPENSATION SURVEY INFORMATION, -A CONSISTENT ANNUAL PROCESS FOR UPDATING THE COMPENSATION LEVELS, -AN ACTIVE BOARD REVIEW PROCESS THAT ASSURES COMPLIANCE WITH THE COMPENSATION STRATEGY AND ONGOING REVIEW OF THE PERFORMANCE OF THE ORGANIZATION, AND -ACTIVE REVIEW AND AUDITING OF COMPENSATION BY EXTERNAL INDEPENDENT CONSULTANTS.
Form 990, Part VI, Line 19 availability of documents, conflict of interest policy & financial statements THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH THE FOLLOWING WEBSITES: DACBOND.COM (DIGITAL ASSURANCE CERTIFICATION LLC) EMMA.MSRB.ORG (ELECTRONIC MUNICIPAL MARKET ACCESS) THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
Form 990, Part XI, Line 9 Other changes in the assets or fund balances merger of health visions into advocate sherman hospital (9,423,272) capital transfer - grant adjustment (5,560) book/tax difference related to joint ventures 48,812 Total (9,380,020)
Form 990, Part XII, Line 3B A-133 AUDIT ADVOCATE'S 2014 A-133 AUDIT, WHICH COVERS ADVOCATE SHERMAN HOSPITAL'S ACTIVITIES, IS NOT DUE UNTIL SEPTEMBER 30, 2015.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


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

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ADVOCATE SHERMAN HOSPITAL
 
Employer identification number

36-2167920
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) Advocate Health Care Network
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-2167779
Parent Corp IL 501(c)(3) 11-III-FI NA
 
 
No
(2) Advocate Condell Medical Center
3075 Highland Parkway Ste 600

Downers Grove,IL60515
26-2525968
Health Care IL 501(c)(3) 3 AHHC
 
 
No
(3) Advocate North Side Health Network
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-3196629
Health Care IL 501(c)(3) 3 AHHC
 
 
No
(4) Advocate Health & Hospitals Corporation
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-2169147
Health Care IL 501(c)(3) 3 AHCN
 
 
No
(5) Advocate Charitable Foundation
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-3297360
Fundraising IL 501(c)(3) 7 AHCN
 
 
No
(6) EHS Home Health Care Service Inc
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-2913108
Home Care IL 501(c)(3) 9 AHHC
 
 
No
(7) Meridian Hospice
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-3158667
Hospice Care IL 501(c)(3) 9 EHSHHCS
 
 
No
(8) Hispano Care Inc
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-3606486
Health Care IL 501(c)(3) 9 ANSHN
 
 
No
(9) Sherman West Court
3075 Highland Parkway Ste 600

Downers Grove,IL60515
36-3725580
Nursing Care IL 501(c)(3) 9 ASH
 
Yes
 
(10) Sherman Home Health Care Corporation
901 Center Street Ste 2001A

Elgin,IL60120
36-3330085
Home care IL 501(c)(3) 9 ASH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) Dreyer Mercy Ambulatory Surg Ctr Pshp

1221 N Hiland Ave
Aurora,IL60506
36-3890298
Medical Services IL NA
 
                 
(2) ADVOCATE SW AMB SUR CTR

18200 la grande
tinley park,IL60487
36-4437931
medical services 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) Advocate Home Care Products

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-3315416
Health Services IL NA
 
C Corp         No
(2) Advocate Health Centers Inc

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-4217291
Medical Services IL NA
 
C Corp         No
(3) Evangelical Services Corporation

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-3208101
Mgmt Services IL NA
 
C Corp         No
(4) High Technology Inc

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-3368224
Medical Services IL NA
 
C Corp         No
(5) Dreyer Clinic Inc

1877 W Downer Place
Aurora,IL60506
36-2690329
Medical Services IL NA
 
C Corp         No
(6) BroMenn Physician Management Corporation

3075 Highland Parkway Suite 600
Downers Grove,IL60515
37-1313150
Medical Services IL NA
 
C Corp         No
(7) Parkside Center Condo Association

1775 West Dempster Street
Park Ridge,IL60068
36-3452486
Property Mgmt IL NA
 
C Corp         No
(8) Advocate Insurance SPC

878 Wt Bay Rd PO Box 1159
Grand Cayman   KY1-1102
CJ
98-0422925
Insurance CJ NA
 
C Corp         No
(9) Midwest Heart Specialists Ltd

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-2841923
Medical Services IL NA
 
C Corp         No
(10) Sherman Health Insurance Company Ltd

878 Wt Bay Rd PO Box 1159
Grand Cayman   KY1-1102
CJ
98-0703036
Insurance CJ NA
 
C Corp         No
(11) Health Visions Inc

3075 Highland Parkway Suite 600
Downers Grove,IL60515
36-3780082
Medical Services IL NA
 
C Corp       Yes  
(12) Sherman Group Practice Inc

3075 Highland Parkway Suite 600
Downers Grove,IL60515
26-2891035
Medical Services IL NA
 
C Corp         No
(13) Sherman Physician Group Inc

3075 Highland Parkway Suite 600
Downers Grove,IL60515
26-4800497
Medical Services IL NA
 
C Corp         No
(14) ShermanChoice Inc

1425 N Randall Road
Elgin,IL60123
36-4058392
Phys-Hospital org IL NA
 
C Corp       Yes  
(15) The Delphi Group IV Inc

1425 N Randall Road
Elgin,IL60123
36-4017279
Health Cost Mgmt IL NA
 
C Corp       Yes  
(16) Sherman Ventures Inc

934 Center Street
Elgin,IL60120
36-4292309
Holding Company IL NA
 
C Corp       Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
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
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
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
(1) advocate health care network

1-D 6,015,000 cost
(2) advocate health care network

1-R 2,622,018 cost
(3) advocate sherman west court

1-a 86,238 cost
(4) advocate sherman west court

1-l 291,882 cost
(5) advocate sherman west court

1-q 96,892 cost
(6) Sherman Health Insurance Company

1-r 101,497 cost
(7) ADVOCATE CHARITABLE FOUNDATION

1-C 69,381 COST
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) 2014
Schedule R (Form 990) 2014
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) 2014
Additional Data


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