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
Presence Our Lady of the Resurrection Medical
Center
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
5645 West Addison Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Chicago, IL60634
D Employer identification number

36-2644178
E Telephone number

G Gross receipts $ 114,034,627
F Name and address of principal officer:
JOHN BAIRD
5645 WEST ADDISON STREET
CHICAGO,IL60634
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.presencehealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1966
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 5
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 3
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 124
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 26,285
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) ......... 245,551 299,370
9 Program service revenue (Part VIII, line 2g) ......... 136,049,657 101,507,548
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,171,130 -31,619,015
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,885,236 2,194,733
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 143,351,574 72,382,636
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 54,948,161 53,447,331
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).... 88,904,407 60,379,793
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 143,852,568 113,827,124
19 Revenue less expenses. Subtract line 18 from line 12....... -500,994 -41,444,488
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 60,226,566 34,806,370
21 Total liabilities (Part X, line 26)............. 26,019,924 42,044,216
22 Net assets or fund balances. Subtract line 21 from line 20..... 34,206,642 -7,237,846
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (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: SEE SCHEDULE O
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 $ 99,659,866 including grants of $ 0 ) (Revenue $ 103,675,996 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet99,659,866
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 I..........
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 II........
4
 
No
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
............................
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
Yes
 
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
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
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 IV
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...
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....
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...................
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................
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
28b
 
No
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...
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
........................... Click to see attachment
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...................... Click to see attachment
32
Yes
 
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
0
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
 
 
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
0
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
 
 
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
5
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
3
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
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
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:
MediumBulletANTHONY J FILER
200 S WACKER DR
CHICAGO,IL60606 (312) 308-3289
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) Shirish Shah MD........................................................................
Director
1.0
.......................0.0
X           0 0 0
(2) Joseph D'Silva MD........................................................................
Director-June 2014
1.0
.......................0.0
X           0 0 0
(3) Father Jason Malave........................................................................
Director
1.0
.......................0.0
X           0 0 0
(4) Paul Skiem........................................................................
SYSTEM SR VICE PRESIDENT
1.0
.......................43.0
X   X       0 539,842 327,298
(5) John Baird........................................................................
RGN PRESIDENT & CEO-NWC
1.0
.......................42.0
X   X       0 531,719 121,301
(6) Vishnu Chundi MD........................................................................
Director Ex-Officio
1.0
.......................0.0
X           0 0 0
(7) David DiLoreto MD........................................................................
SYS CH MEDICAL & QUAL OFF
1.0
.......................43.0
X   X       0 610,992 151,703
(8) Patrick Quinn........................................................................
Assistant Treasurer
1.0
.......................40.0
    X       0 270,651 48,603
(9) Julie Roknich........................................................................
Assistant Secretary
1.0
.......................40.0
    X       0 196,072 28,035
(10) Jeannie C Frey........................................................................
Secretary
1.0
.......................50.0
    X       0 538,312 132,604
(11) Anthony J Filer........................................................................
Treasurer
1.0
.......................50.0
    X       0 806,181 188,879
(12) Dennis Fitzmaurice........................................................................
VICE PRESIDENT
40.0
.......................0.0
      X     257,669 0 17,309
(13) ELIZABETH PANKAU........................................................................
VP PATIENT CARE SVS & CNO
40.0
.......................0.0
      X     147,018 0 9,047
(14) ROSEMARIE WADE........................................................................
STAFF NURSE I WKND S
40.0
.......................0.0
        X   201,084 0 30,519
(15) DIANE ORTOLANO........................................................................
DIR REHAB SERVICES
40.0
.......................0.0
        X   148,249 0 9,068
(16) EUNICE BAI........................................................................
STAFF NURSE I
40.0
.......................0.0
        X   147,887 0 35,160
(17) MARGARET MCDERMOTT........................................................................
REG/ADMINISTRATOR
40.0
.......................0.0
        X   142,400 0 8,928
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) EMERITA BURGESS........................................................................
DIR NURSING
40.0
.......................0.0
        X   137,736 0 21,940
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,182,043 3,493,769 1,130,394
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet51
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
EA HEALTH CORPORATION,
440 STEVENS AVENUE SUITE 150
SOLANA BEACH,CA92075
PHYSICIANS SERVICES 269,729
US BANK CORPORATE TRUST,
PO BOX 70870
ST PAUL,MN551709705
CLINICAL AGENCY 1,153,096
CONTINENTAL ANESTHESIA LTD,
1301 W 22ND ST STE 601
OAK BROOK,IL60523
ANESTHESIA SERVICES 399,703
BARKER AND CASTRO LLC,
115 S LASALLE ST 2900
CHICAGO,IL60603
LEGAL SERVICES 278,681
NORTHWESTERN NEUROSURGICAL ASSOC S,
7447 W TALCOTT AVE STE 340
CHICAGO,IL60631
NEUROSURGICAL SVCS 198,500
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 MediumBullet8
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 299,370
e Government grants (contributions)1e 0
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 299,370
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REV 621990 101,507,548 101,507,548 0 0
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 101,507,548
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 32,776     32,776
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   10,000,200
b Less: cost or other basis and sales expenses   41,651,991
c Gain or (loss)   -31,651,791
d Net gain or (loss)..........MediumBullet -31,651,791     -31,651,791
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 MEANINGFUL USE & BLUE CRO 900099 1,632,561 1,632,561 0 0
b CHILD CARE CENTER 621500 62,274 62,274 0 0
c LAB SERVICES 621500 26,285 0 26,285 0
d All other revenue .... 473,613 473,613   0
e Total. Add lines 11a–11d ...... MediumBullet 2,194,733
12 Total revenue. See Instructions......MediumBullet 72,382,636 103,675,996 26,285 -31,619,015
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 .... 0 0
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0 0
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 .... 431,043 431,043 0 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0 0 0 0
7 Other salaries and wages .... 42,674,213 42,674,213 0 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,664,804 1,664,804 0 0
9 Other employee benefits ....... 5,573,315 5,573,315 0 0
10 Payroll taxes ........... 3,103,956 3,103,956 0 0
11 Fees for services (non-employees):        
a Management ...... 14,114,228   14,114,228 0
b Legal ......... 53,030 0 53,030 0
c Accounting ........... 0 0 0 0
d Lobbying ........... 0 0 0 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 0 0 0 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 14,912,742 14,912,742    
12 Advertising and promotion .... 3,711 3,711 0 0
13 Office expenses ....... 0 0 0 0
14 Information technology ...... 0 0 0 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 1,566,030 1,566,030 0 0
17 Travel ............ 4,806 4,806 0 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0   0 0
19 Conferences, conventions, and meetings .... 25,079 25,079 0 0
20 Interest ........... 1,094,349 1,094,349 0 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 5,927,691 5,927,691 0 0
23 Insurance .............. -1,909,951 -1,909,951 0 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 16,310,124 16,310,124 0 0
b IL MEDICAID TAX 5,154,235 5,154,235 0 0
c PROVISION FOR BAD DEBTS 1,817,899 1,817,899 0 0
d REPAIRS AND SERVICES 427,963 427,963 0 0
e All other expenses 877,857 877,857    
25 Total functional expenses. Add lines 1 through 24e 113,827,124 99,659,866 14,167,258 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 ............. 36,110 1 725,541
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 21,104,309 4 22,188,810
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 1,743,017 8 0
9 Prepaid expenses and deferred charges .......... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 126,851,838
b Less: accumulated depreciation ..... 10b 126,851,838 24,629,632 10c  
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 12,713,498 15 11,892,019
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 60,226,566 16 34,806,370
Liabilities 17 Accounts payable and accrued expenses ......... 1,207,705 17 1,080,409
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 24,812,219 25 40,963,807
26 Total liabilities. Add lines 17 through 25......... 26,019,924 26 42,044,216
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 .............. 34,206,642 27 -7,237,846
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here 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 ........... 34,206,642 33 -7,237,846
34 Total liabilities and net assets/fund balances ........ 60,226,566 34 34,806,370
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
72,382,636
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
113,827,124
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-41,444,488
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
34,206,642
5
Net unrealized gains (losses) on investments ...............
5
 
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
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-7,237,846
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
 
No
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
 
 
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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 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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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 .................   1,736,659 1,736,659
b Buildings ................   74,144,109 74,144,109 0
c Leasehold improvements ............   2,544,537 2,544,537 0
d Equipment ................   48,835,005 50,121,664 -1,736,659
e Other .................   41,528 41,528 0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 0
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
(1) REINSURANCE RECEIVABLE 1,114,000
(2) SUNDRY RECEVIABLE 453,811
(3) DUE FROM AFFILIATES 10,324,208






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 11,892,019
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
DUE TO THIRD PARTY PAYORS 6,304,585
DUE TO AFFILIATES 23,724,222
MALPRACTICE LIABILITY 10,935,000






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 40,963,807
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, Part X, Line 2 FIN 48 (ASC740) FOOTNOTE PRESENCE HEALTH RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF DECEMBER 31, 2014 AND 2013, PRESENCE HEALTH DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS.
Schedule D (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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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) ..
  8,453 7,772,735 0 7,772,735 6.940 %
b Medicaid (from Worksheet 3,
column a) ....
  988 21,475,049 19,227,105 2,247,944 2.010 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
  0 0 0 0 0 %
d Total Financial Assistance
and Means-Tested
Government Programs .
  9,441 29,247,784 19,227,105 10,020,679 8.950 %
Other Benefits
29 3,305 75,894 11,422 64,472 0.060 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
7 257 317,368 4,900 312,468 0.280 %
g Subsidized health services
(from Worksheet 6) ..
  0 1,692,824 826,821 866,003 0.770 %
h Research (from Worksheet 7) 1 0 23,000 0 23,000 0.020 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
5 105 17,516 0 17,516 0.020 %
j Total. Other Benefits .. 42 3,667 2,126,602 843,143 1,283,459 1.150 %
k Total. Add lines 7d and 7j . 42 13,108 31,374,386 20,070,248 11,304,138 10.100 %
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   0 0 0 0 0 %
2 Economic development   0 0 0 0 0 %
3 Community support 1 1,284 20,559 0 20,559 0.020 %
4 Environmental improvements   0 0 0 0 0 %
5 Leadership development and training for community members   0 0 0 0 0 %
6 Coalition building   0 0 0 0 0 %
7 Community health improvement advocacy   0 0 0 0 0 %
8 Workforce development   0 0 0 0 0 %
9 Other   0 0 0 0 0 %
10 Total 1 1,284 20,559 0 20,559 0.020 %
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
Yes
 
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
1,817,899
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
0
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
49,963,693
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
50,698,380
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-734,687
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 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 PRESENCE OUR LADY OF RES MED CTR
5645 WEST ADDISON STREET
CHICAGO,IL60634
HTTP://WWW.PRESENCEHEALTH.ORG
0001719
X X         X     A
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)
PRESENCE OUR LADY OF RES MED CTR
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   No
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   No
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.PRESENCEHEALTH.ORG/COMMUNITY REPORTS
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)

PRESENCE OUR LADY OF RES MED CTR
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)

PRESENCE OUR LADY OF RES MED CTR
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   No
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
PART V, SECTION B, LINE 4 IN PRESENCE HEALTH'S 2012 SCHEDULE H (FORM 990), IT WAS INDICATED THAT THE CHNA WAS COMPLETED IN 2012. ALTHOUGH THE QUANTITATIVE AND QUALITATIVE DATA WAS COLLECTED AND COMPILED IN 2012, THE CHNA REPORT WAS NOT MADE PUBLICLY AVAILABLE UNTIL THE BEGINNING OF 2013. THE CHNA COMPLETION DATE HAS BEEN UPDATED ON THIS FORM TO 2013 TO BE CONSISTENT WITH WHEN THE IRS DEEMS THE CHNA TO BE CONDUCTED (THE DATE ON WHICH THE CHNA REPORT IS PUBLISHED AND MADE "WIDELY AVAILABLE.")
PART V, SECTION B, LINE 5 A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS A COLLABORATIVE COMMUNITY PROCESS OF IDENTIFYING AND PRIORITIZING A COMMUNITY'S HEALTH NEEDS, ACCOMPLISHED THROUGH THE COLLECTION AND ANALYSIS OF DATA, INCLUDING INPUT FROM COMMUNITY STAKEHOLDERS. IN JULY 2012, A CHNA STEERING COMMITTEE WAS FORMED TO REPRESENT STAKEHOLDERS WITHIN THE POLRMC COMMUNITY, AS WELL AS TO PROVIDE OVERSIGHT AND INPUT THROUGHOUT THE CHNA PROCESS. THE COMMITTEE'S ROLE IS ALSO TO ASSIST IN THE IDENTIFICATION OF DATA-DRIVEN COMMUNITY PRIORITIES AND TO ENGAGE STAKEHOLDERS IN COMMUNITY SOLUTIONS THROUGH PARTNERSHIPS AND COLLABORATION. BY TAKING ON A COMMUNITY APPROACH TO BOTH THE ASSESSMENT AND IMPLEMENTATION STRATEGIES, THE GOAL IS TO ENSURE THE DATA, PROCESSES, AND OUTPUTS ADD VALUE TO ALL COMMUNITY PARTNERS, NOT JUST THE HOSPITAL.
ENGAGEMENT OF PUBLIC HEALTH EXPERTISE PRESENCE HEALTH FORMALLY ENGAGED THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) FOR ASSISTANCE IN PLANNING AND EXECUTING THE CHNA PROCESS. IPHI SERVED AS AN EXPERT PUBLIC HEALTH CONSULTANT THROUGHOUT THE CHNA TIMELINE. FURTHER, IPHI PROVIDED INVALUABLE ASSISTANCE IN OBTAINING PARTNERSHIPS WITH THE LOCAL AND COUNTY HEALTH DEPARTMENTS. GIVEN THE VAST NUMBER OF COUNTY HOSPITALS SERVED BY THE SAME HEALTH DEPARTMENT IN COOK COUNTY, RESOURCE ALLOCATION WAS DIFFICULT TO OBTAIN. AS SUCH, IPHI FUNCTIONED AS A LIAISON ROLE BETWEEN PRESENCE HEALTH AND THE HEALTH DEPARTMENTS SO AS TO OBTAIN ENGAGEMENT THROUGH PUBLIC DATA SHARING AND LINKAGES WITH IMPLEMENTATION PLANS. CONVERSATIONS WERE FACILITATED BETWEEN THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH SO AS TO CONTINUALLY INFORM ALL PARTIES OF CHNA PROCESS INPUTS AND OBTAIN BOTH FEEDBACK AND SUPPORT.
CHNA STEERING COMMITTEE TO PROVIDE COMMUNITY LEVEL OVERSIGHT FOR THE PROCESS, A DIVERSE GROUP OF COMMUNITY STAKEHOLDERS AND PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER REPRESENTATIVES FROM ITS SERVICE AREA (THE CHICAGO COMMUNITY AREAS OF: JEFFERSON PARK, DUNNING, MONTCLARE, BELMONT CRAGIN, HERMOSA AND PORTAGE PARK) WERE INVITED TO PARTICIPATE ON THE CHNA STEERING COMMITTEE. TO ENSURE REPRESENTATIVE ENGAGEMENT, PERSONAL INVITATIONS WERE SENT TO ORGANIZATIONS REPRESENTING CULTURAL, LINGUISTIC, RACIAL, ETHNIC, AND OTHER MINORITY GROUPS. IN ADDITION, INDIVIDUALS WITH SPECIALIZED QUALIFICATIONS IN DEALING WITH SPECIAL POPULATIONS OR CLINICAL GROUPS WERE SOLICITED FOR THEIR PARTICIPATION. FINALLY, EFFORTS WERE MADE TO INCLUDE INDIVIDUALS ON THE CHNA STEERING COMMITTEE WITH PUBLIC HEALTH EXPERTISE. THOSE WHO COMMITTED TO THE ASSESSMENT AND PLANNING PROCESS BECAME THE 30 MEMBERS OF THE CHNA STEERING COMMITTEE, WHICH CONTINUES TO MEET REGULARLY TO PROVIDE FEEDBACK AND OVERSIGHT, ASSESS PROGRESS, AND MODIFY PLANS AS NEEDED. THE AGENCIES REPRESENTED ON THE CHNA STEERING COMMITTEE ARE LISTED BELOW: - PORTAGE PARK CHAMBER OF COMMERCE - HERMOSA COMMUNITY ORGANIZATION - METROPOLITAN FAMILY SERVICES, NORTH CENTER - PRIMECARE COMMUNITY HEALTH CENTER - POLISH AMERICAN ASSOCIATION - LUTHERAN SOCIAL SERVICES OF ILLINOIS - BELMONT-CENTRAL CHAMBER OF COMMERCE - SISTER BONAVENTURE CHILDREN'S CHOICE LEARNING CENTER - COALITION TO SAVE OUR MENTAL HEALTH CENTERS - OLD IRVING PARK COMMUNITY CLINIC - MATHER LIFEWAYS - NORTHWEST SIDE HOUSING CENTER
COMMUNITY HEALTH PROFILE THE COMMUNITY HEALTH PROFILE IS A COMPILATION OF SECONDARY DATA (DATA ALREADY PUBLISHED AND AVAILABLE) ABOUT A PARTICULAR COMMUNITY. THE PROFILE PROVIDES COMPARATIVE INFORMATION TO ASSIST IN UNDERSTANDING THE NEEDS AND PRIORITIES OF A COMMUNITY. THE COMMUNITY HEALTH PROFILE FOR POLRMC ANALYZED OVER 50 INDICATORS. EXAMPLE INDICATORS INCLUDE: POPULATION TRENDS, RACE, INCOME, POVERTY LEVELS, AND PERCENTAGE OF UNINSURED, HEALTH PROFESSIONAL SHORTAGES, LEADING CAUSES OF DEATH, TEEN BIRTHS, BIRTH WEIGHTS, TOBACCO USE, PHYSICAL ACTIVITY, CRIME RATES, AND FOOD INSECURITY. THE COMMUNITY HEALTH PROFILE CAN BE FOUND ONLINE AT WWW.PRESENCEHEALTH.ORG/COMMUNITY.
COMMUNITY INPUT REPORT THE COMMUNITY INPUT PROCESS WAS COMPLETED BETWEEN AUGUST AND OCTOBER 2012. THE PROCESS INCLUDED CREATING AND ADMINISTERING A COMMUNITY INPUT SURVEY IN SPANISH, POLISH AND RUSSIAN AS WELL AS ENGLISH, FACILITATING THREE FOCUS GROUPS, AND COMPLETING AN ASSET AND RESOURCES INVENTORY. THE COMMUNITY SURVEY EXPLORED RESIDENTS' PERCEPTIONS OF ISSUES SURROUNDING QUALITY OF LIFE, HEALTH, AND SOCIAL FACTORS AND COLLECTED RESPONDENTS' DEMOGRAPHICS INCLUDING INSURANCE COVERAGE. NINE HUNDRED FIFTY ONE (951) COMMUNITY RESIDENTS COMPLETED THE SURVEY. THE COMMUNITY INPUT REPORT CAN BE FOUND ONLINE AT WWW.PRESENCEHEALTH.ORG/COMMUNITY. IN CONJUNCTION WITH THE CHNA STEERING COMMITTEE AND NUMEROUS COMMUNITY STAKEHOLDERS, AN INVENTORY OF COMMUNITY ASSETS WAS THEN CONDUCTED SO AS TO DETERMINE EXISTING HEALTH RESOURCES THAT COULD BE BUILT UPON OR COLLABORATED WITH TO CONDUCT THE WORK OF POLRMC'S MINISTRY. THE COMMUNITY ASSET MATRIX CAN BE FOUND IN APPENDIX 1 OF THE COMMUNITY INPUT REPORT ONLINE AT WWW.PRESENCEHEALTH.ORG/COMMUNITY.
PART V, SECTION B, LINE 7D PRINT COPIES ARE AVAILABLE UPON REQUEST. IN ADDITION, COPIES WERE MAILED TO COMMUNITY PARTNERS WHO COLLECTED COMMUNITY INPUT AND PARTICIPATED IN THE CHNA PROCESS FOR MORE SPECIFIC DISSEMINATION OF FINDINGS. PARTNERS WERE ALSO PROVIDED LINKS TO THE WEBSITE VIA EMAIL FOR DISSEMINATION TO THEIR MAILING LISTS AND RESPECTIVE CONSTITUENTS.
PART V, SECTION C, LINE 11 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER'S (POLRMC) CHNA STEERING COMMITTEE FOLLOWED A NINE-STEP PROCESS IN IDENTIFYING COMMUNITY NEEDS. THIS INVOLVED: DEFINING COMMUNITY FOR CHNA; FORMING A STEERING COMMITTEE; UPDATING AND DEVELOPING A MISSION, VALUES AND VISION; CONDUCTING THE CHNA THROUGH DEFINED INDICATORS AND GATHERING INPUT THROUGH FOCUS GROUPS AND SURVEYS; SYNTHESIZING AND ANALYZING ASSESSMENT DATA, IDENTIFYING KEY ISSUES AND PRIORITIZING NEEDS; DEVELOPING HIGH LEVEL ACTION PLANS; AND DEVELOPING AND COMMUNICATING THE CHNA REPORT. POLRMC THEN WORKED WITH THE CHNA STEERING COMMITTEE TO IDENTIFY THE PRIORITY ISSUES THAT WERE DEEMED MOST SIGNIFICANT IN THE COMMUNITY. THE FOLLOWING THEMES SURFACED ACROSS ALL DATA COLLECTION METHODS AND WERE PRIORITIZED BY THE CHNA STEERING COMMITTEE AS THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY: - COORDINATION OF CARE - RISK FACTORS FOR CHRONIC DISEASE - ACCESS TO PRIMARY CARE THE CHNA STEERING COMMITTEE ALSO DETERMINED THAT ADDRESSING ECONOMIC DISPARITIES, HEALTH LITERACY, AFFORDABILITY AND LANGUAGE BARRIERS WILL BE ADDRESSED THROUGHOUT ALL PRIORITIES AND STRATEGIES SO AS TO ENSURE A FOCUS ON THE MOST VULNERABLE AND UNDERSERVED POPULATIONS. POLRMC TOOK STEPS TO ADDRESS ALL OF THESE NEEDS IN 2014 AS FOLLOWS: COORDINATION OF CARE IN RESPONSE TO A DEMONSTRATED NEED OF IMPROVING TRANSITIONS OF CARE/COORDINATION OF CARE BETWEEN HEALTHCARE AND SOCIAL SERVICES PROVIDERS, POLRMC HAS PARTNERED WITH PRIMECARE COMMUNITY HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER, TO IMPROVE ACCESS TO PRIMARY CARE PROVIDERS FOR THOSE USING POLRMC'S EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE. THE COORDINATION OF CARE OBJECTIVE WAS TO IDENTIFY A VIABLE SYSTEM TO ASSESS THE NUMBER OF REFERRALS TO PRIMECARE BY DECEMBER 31, 2013. THE STRATEGIES EMPLOYED IN MEETING THAT OBJECTIVE WAS CREATING AN ACTION TEAM TO IDENTIFY THE REFERRAL PROCESS BETWEEN POLRMC AND PRIMECARE. FURTHER, THE LEADERSHIP OF PRIMECARE AND POLRMC MET BI-MONTHLY TO ASSESS THE REFERRAL PROCESS AND STRATEGIZE IMPROVEMENTS. POLRMC ALSO PROVIDED MEETING ROOM SPACE, ADDITIONAL ROOM SPACE TO PRIMECARE, AND CONFERENCE CALLS ACCESS. POLRMC HAD VOLUNTEERS CALL UNINSURED EMERGENCY DEPARTMENT PATIENTS TO INFORM THEM ABOUT COUNTYCARE REQUIREMENTS AND REFERRED THEM TO PRIMECARE FOR ENROLLMENT. MOREOVER, THERE WAS AN EFFORT ON BEHALF POLRMC STAFF TO ENCOURAGE AND ASSIST POLMRC PHYSICIAN SPECIALISTS TO BECOME COUNTYCARE PROVIDERS. THE PRIMECARE STAFF HELD TWO LECTURES AT POLRMC TO INFORM COMMUNITY MEMBERS ABOUT THE AFFORDABLE CARE ACT. PRIMECARE STAFF ALSO HOSTED AN INFORMATION SESSION FOR FORTY-FIVE POLRMC STAFF MEMBERS REGARDING COUNTYCARE REQUIREMENTS, HOW TO IDENTIFY PATIENTS AND COMMUNITY MEMBERS WHO QUALIFY AND WHERE TO SEND THEM TO ENROLL. EMAILS WERE SENT TO COMMUNITY PARTNERS AND LOCAL CHURCHES ABOUT COUNTYCARE AND HOW COMMUNITY MEMBERS CAN APPLY. POLRMC SPECIALISTS AGREED TO BECOME COUNTYCARE PROVIDERS. DUE TO THE SUCCESS OF PRIMECARE IN TERMS OF AMOUNT OF PATIENTS ENROLLED AT THE PORTAGE PARK LOCATION, A ROOM IN THE HOSPITAL WAS GIVEN TO PRIMECARE FOR GROUP SESSIONS. RISK FACTORS FOR CHRONIC DISEASE THE GOAL OF THE CHRONIC DISEASE CHNA ACTION TEAM IS TO EDUCATE THE COMMUNITY OF THEIR RISK FOR CHRONIC ILLNESS. SPECIFIC GOALS IN RESPONSE TO THIS CRUCIAL COMMUNITY NEED WERE TO: PROVIDE PROGRAMS TO MEASURE OVERALL HEALTH OF PROGRAM PARTICIPANTS RELATED TO BLOOD PRESSURE AND CHOLESTEROL; INCREASE COMMUNITY AWARENESS OF THEIR RISK FOR DIABETES; DEVELOP A COMPREHENSIVE COMMUNITY BASED EDUCATION PROGRAM FOR CHRONIC DISEASE IN THE COMMUNITY; AND DEVELOP A PROGRAM TO PROMOTE PHYSICAL ACTIVITY, FITNESS, AND MOBILITY TO COMMUNITY MEMBERS. THESE OBJECTIVES CULMINATED INTO LECTURES AND HEALTH-RELATED EVENTS. DUE TO ITS EFFECTIVENESS, THESE PROGRAMS CONTINUE TO EXPAND. SPANISH SPEAKING POLRMC STAFF ALSO MADE SURE TO ATTEND VARIOUS LOCAL SCHOOL MEETINGS TO ESTABLISH COMMUNITY RELATIONSHIPS AND ASSESS WHAT THE COMMUNITY WANTED POLRMC TO DO TO HELP PREVENT CHRONIC ILLNESS IN THEIR FAMILIES. SPANISH EDUCATIONAL OFFERINGS WERE ALSO DEVELOPED AND PRESENTED. POLRMC OFFERED FREE MONTHLY BLOOD PRESSURE SCREENINGS WHICH INCLUDED PROFESSIONAL COUNSELING RELATED TO READINGS AND FOLLOW-UP RECOMMENDATIONS. SOME BLOOD PRESSURE SCREENINGS TOOK PLACE OFFSITE, AT COMMUNITY FAIRS AND EVENTS. A SIMILAR PROGRAM WAS IMPLEMENTED RELATED TO CHOLESTEROL, EXCEPT THAT LIPID PANELS WERE LOW COST RATHER THAN FREE. PARTICIPANTS IN THE CHOLESTEROL READING PROGRAM RECEIVED FOLLOW-UP LETTERS WITH RESULTS AND AN EXPLANATION OF HOW THOSE RESULTS COMPARED TO THE AMERICAN HEART ASSOCIATION'S (AHA) GUIDELINES. POLRMC ALLOCATED STAFF TO PROVIDE THE SCREENINGS. ALL ATTENDEES WERE ENCOURAGED TO CONTINUE MONITORING BLOOD PRESSURE READINGS TO MAINTAIN GOOD HEALTH AND PREVENT CHRONIC ILLNESS. THESE CHOLESTEROL SCREENINGS WERE PROVIDED THREE TIMES PER YEAR AT THE HOSPITAL AS WELL AS AT HEART FEST. OTHER CHOLESTEROL RELATED AWARENESS INITIATIVES INCLUDED DISTRIBUTING LITERATURE ON WHAT CHOLESTEROL READINGS MEANT, AND A "KNOW YOUR NUMBERS" LECTURE DELIVERED BY POLRMC STAFF AT COMMUNITY PARTNER LOCATIONS (ST. PASCAL'S CHURCH AND MATHER'S CAF). IN ADDITION TO PROVIDING MONTHLY SCREENINGS, POLRMC STAFF ATTENDED LOCAL HEALTH FAIR AND RESEARCHED AND OBTAINED INFORMATION FROM THE AHA. DIABETES RELATED PROGRAMS WERE ALSO IMPLEMENTED IN AN EFFORT TO INCREASE COMMUNITY AWARENESS OF THE DISEASE. THIS INVOLVED OFFERING LOW COST A1C SCREENINGS AT THE HOSPITAL (THREE TIMES PER YEAR) ALONG WITH COUNSELING AND PROVIDING ACCUCHECK GLUCOSE READINGS AT COMMUNITY EVENTS. FURTHERMORE, POLRMC HOSTED A MONTHLY SUPPORT GROUP TO HELP COMMUNITY MEMBERS DEAL WITH THE EMOTIONAL SIDE OF A DIABETES DIAGNOSIS. ANOTHER OBJECTIVE WAS TO DEVELOP A COMPREHENSIVE COMMUNITY BASED EDUCATION PROGRAM FOR CHRONIC DISEASE IN THE COMMUNITY. THIS WAS ACCOMPLISHED IN PART BY CREATING A PROGRAM FOR CHILDREN AND THEIR PARENTS TO EDUCATE THEM ON HEALTHY FOOD OPTIONS, WHICH INCLUDED TEACHING HEALTHY MEAL PREPARATION. ANOTHER PART OF THE COMPREHENSIVE PROGRAM WAS EDUCATING CHILDREN AND THEIR PARENTS ON THE BENEFITS OF SAFE PHYSICAL ACTIVITY AS WELL AS FREE OPTIONS FOR KEEPING KIDS SAFELY ACTIVE DURING THE WINTER AND SUMMER. POLRMC MADE SURE TO MEET WITH PRESENCE RESURRECTION MEDICAL CENTER TO DISCUSS ACTIVITIES TO ELIMINATE DUPLICATION OF EFFORTS DUE TO SERVICE OVERLAP TO STREAMLINE OVERALL EFFICIENCY. PARENTS WERE GIVEN LISTS OF EDUCATION OFFERING TO ASSESS WHAT PROGRAMS THEY WOULD LIKE RELATED TO CHRONIC ILLNESS. SIXTY-ONE FAMILIES COMPLETED AN EATING HEALTHY AND STAYING ACTIVE SURVEY. A PROGRAM TO PROMOTE PHYSICAL ACTIVITY, FITNESS AND MOBILITY WAS ALSO DEVELOPED FOR COMMUNITY MEMBERS. TO IMPLEMENT THE PROGRAM, A WALKING CLUB WAS CREATED AT A WELL-KNOWN LOCAL AREA PARK, PORTAGE PARK. POLRMC STAFF, ALONG WITH PARTICIPANTS, ATTENDED WEEKLY WALKING SESSIONS AT THE PARK. PRE AND POST TESTING WAS ADMINISTERED BY THE PHYSICAL THERAPY DEPARTMENT TO ASSESS OUTCOMES. PARTICIPANTS ALSO RECEIVED EDUCATIONAL HANDOUTS. PORTAGE PARK ADVERTISED THE AVAILABILITY OF THE CLUB AND PROVIDED MEETING SPACE FOR THE GROUP. A POLRMC PHYSICIAN PAID ADMISSION FOR THE CLUB MEMBERS AT THE POLRMC 5K WALK/RUN. POLRMC ALSO HOSTED A 5K WALK/RUN WITH ADMISSION PAID FOR BY CARDIOLOGISTS, ATTRACTING 200 COMMUNITY MEMBERS. PARTICIPANTS INCLUDED SIXTY-TWO MEMBERS FROM PORTAGE PARK SCHOOL AND TWENTY-NINE MEMBERS FROM DR. JOSE PRIETO SCHOOL. ACCESS TO PRIMARY CARE PRESENCE HEALTH IMPLEMENTED A COMMUNITY-WIDE ENROLLMENT STRATEGY ACROSS THE SYSTEM IN RESPONSE TO ACCESS TO HEALTH NEEDS WITH THE GOAL OF DECREASING THE PERCENTAGE OF ILLINOIS RESIDENTS WITHOUT HEALTH INSURANCE. A MULTI-DISCIPLINARY ENROLLMENT STEERING COMMITTEE EMPLOYED A FOUR-PRONGED APPROACH IN AN EFFORT TO ACHIEVE THE GOAL: CERTIFIED APPLICATION COUNSELORS, IN-PERSON COUNSELOR PARTNERSHIPS, DIRECTIONAL SUPPORT AND NAVIGATION, AND PUBLIC OUTREACH AND EDUCATION. CERTIFIED APPLICATION COUNSELORS (CACS) LEVERAGED HOSPITAL-LEVEL CAPACITY TO ASSIST UNINSURED COMMUNITY MEMBERS WITH ENROLLMENT BY OCTOBER 2013. ALL 12 PRESENCE HEALTH HOSPITALS WERE REGISTERED AS CAC ORGANIZATIONS THROUGH CMS. CACS WERE TRAINED TO ENROLL CONSUMERS IN EXPANDED MEDICAID AND THE MARTKETPLACE. THE EXISTING ROLE OF HOSPITAL FINANCIAL COUNSELORS WAS EXPANDED TO INCREASE MEDICAID "REACH" FROM IN-HOUSE TO COMMUNITY POPULATION. PRESENCE HEALTH ASSUMED STAFFING COSTS TO COVER NON-PRODUCTIVE TIME WHILE TRAINING THE FINANCIAL COUNSELORS AND PATIENT ACCESS LEADERS. THESE EFFORTS CONTINUED THROUGH 2014 TO ADDRESS THE PRESSING NEED. CONTRACTED PARTNERSHIPS WITH LOCAL IN-PERSON COUNSELOR (IPC) GRANTEES WERE CREATED TO EXPAND CAPACITY FOR COMMUNITY ENROLLMENT. THIS INVOLVED A LOCAL NETWORK ANALYSIS OF IPC GRANT RECIPIENTS AND REGULARLY SCHEDULED TIMES AT MINISTRY SITES FOR IPC PARTNERS TO ASSIST COMMUNITY MEMBERS WITH ENROLLMENT. POLRMC MADE EFFORTS TO ENSURE ENROLLMENT SUPPORT PROVIDED LINGUISTIC AND CULTURAL COMPETENCY THROUGHOUT. PRESENCE HEALTH PROVIDED SPACE IN HIGH
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
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
PART I, LINE 3C - CHARITY CARE ELIGIBILITY CRITERIA THIS QUESTION IS NOT APPLICABLE BECAUSE PRESENCE HEALTH USES THE FEDERAL POVERTY GUIDELINES.
PART I, LINE 6A PRESENCE HEALTH, THE SYSTEM PARENT CORPORATION OF PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER (POLRMC), PUBLISHED A COMMUNITY BENEFIT REPORT FOR 2014, WHICH DETAILS THE COMBINED CHARITABLE IMPACT PRESENCE HEALTH FACILITIES HAVE WITHIN THE COMMUNITIES THEY SERVE. IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR 2014, POLRMC PUBLISHES A MINISTRY-SPECIFIC IMPLEMENTATION STRATEGY WHICH OUTLINES THE GOALS AND OBJECTIVES POLRMC HAS ESTABLISHED TO ADDRESS THE PRIORITIZED NEEDS OF ITS COMMUNITY. THE PRESENCE HEALTH SYSTEM IS REFERENCED IN THIS DOCUMENT, BUT OTHER HOSPITALS WITHIN THE PRESENCE HEALTH SYSTEM FILE THEIR OWN 990S AND SCHEDULE H.
PART I, LINE 6B THE 2014 PRESENCE HEALTH COMMUNITY BENEFIT REPORT WAS MADE PUBLICLY AVAILABLE THROUGH A VARIETY OF WAYS TO SHARE THE INFORMATION WITH THE COMMUNITY AT LARGE: - PRINT VERSION OF REPORT - THE REPORT WILL BE MAILED TO COMMUNITY PARTNERS, ELECTED OFFICIALS AND LOCAL LEADERS. - WEBSITE - A ROBUST COMMUNITY SECTION HAS BEEN DEVELOPED AND CAN BE FOUND ONLINE AT WWW.PRESENCEHEALTH.ORG/COMMUNITY. THIS SECTION INCLUDES AN ONLINE, DOWNLOADABLE FILE OF THE 2014 COMMUNITY BENEFIT REPORT. PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER HAS ITS OWN MINISTRY LINK ON THIS PAGE. THROUGH THIS LINK, COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DOCUMENTS SPECIFIC TO PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER CAN BE DOWNLOADED, INCLUDING A COMMUNITY-FRIENDLY CHNA FLIPBOOK, THE SOURCE DOCUMENTS OF ALL DATA REVIEWED, AN OVERALL CHNA REPORT, AND AN IMPLEMENTATION STRATEGY. - POWERPOINT PRESENTATION - A STANDARD POWERPOINT OF THE ENTIRE 2014 COMMUNITY BENEFIT REPORT HAS BEEN MADE AVAILABLE. A CUSTOMIZED VERSION OF THIS PRESENTATION HAS ALSO BEEN CREATED FOR PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER TO SHARE WITH THE COMMUNITY, WHICH SHOWS THE LOCAL COMMUNITY BENEFIT CONTRIBUTIONS, PERSONS SERVED, AND THE 2014 PRIORITIZED COMMUNITY NEEDS.
PART I, LINE 7G COSTS FROM PHYSICIAN CLINICS ARE NOT INCLUDED IN SUBSIDIZED SERVICE TOTALS.
PART I, LINE 7, COLUMN F PER 2014 INSTRUCTIONS FOR SCHEDULE H (FORM 990), THE BAD DEBT EXPENSE OF $1,817,899 HAS BEEN REMOVED FROM THE DENOMINATOR IN CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN LINE 7.
PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY THE COST-TO-CHARGE RATIO WAS USED TO DETERMINE SCHEDULE H, PART I, LINE 7A, FINANCIAL ASSISTANCE AT COST. SCHEDULE H, PART I, LINE 7B, UNREIMBURSED MEDICAID, WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. THE REMAINING AMOUNTS REPORTED ON LINE 7 ARE REPORTED AT COST.
PART II - COMMUNITY BUILDING ACTIVITIES COMMUNITY BUILDING ACTIVITIES INCLUDE PROGRAMS THAT IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSES AND SOCIAL DETERMINANTS OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL HAZARDS. PARTICIPATION IN COLLABORATIVE COMMUNITY EFFORTS TO PROMOTE PUBLIC HEALTH INITIATIVES IS ALSO INCLUDED, SUCH AS ENGAGEMENT IN COALITIONS AND ADVOCACY FOR HEALTH IMPROVEMENT. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER ENGAGES IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES WHICH ULTIMATELY IMPROVE THE HEALTH OF THE COMMUNITIES WE ARE PRIVILEGED TO SERVE, EVEN THOUGH THEY ARE NOT SPECIFIC HEALTH ACTIVITIES. EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDE: - ALL OF OUR HOSPITALS WORK TO SUPPORT DISASTER READINESS AND EMERGENCY PREPAREDNESS. THIS WORK GOES ABOVE AND BEYOND ANY LICENSURE REQUIREMENTS TO PROACTIVELY ENSURE OUR COMMUNITIES ARE SAFE AND PREPARED IF A DISASTER SHOULD PRESENT ITSELF. - PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER PARTICIPATES IN SEVERAL COMMUNITY COALITIONS, SUCH AS BUILDING A HEALTHIER CHICAGO. BUILDING A HEALTHIER CHICAGO IS A COLLABORATIVE OF MORE THAN 150 LOCAL AND NATIONAL STAKEHOLDERS INCLUDING: US DEPARTMENT OF HEALTH AND HUMAN SERVICES - REGION V, CHICAGO DEPARTMENT OF PUBLIC HEALTH, INSTITUTE OF MEDICINE IN CHICAGO, AND THE CHICAGO MEDICAL SOCIETY. THE GOAL OF BUILDING A HEALTHIER CHICAGO IS TO IMPROVE THE HEALTH OF CHICAGO'S RESIDENTS AND EMPLOYEES THROUGH THE INTEGRATION OF NEW AND EXISTING PUBLIC HEALTH, BUSINESS, MEDICINE AND COMMUNITY EFFORTS. THE GOALS ARE GEARED TOWARD ACHIEVING: REDUCTION OF HEALTH RISKS, IMPROVEMENT OF HEALTH SYSTEMS, AND ELIMINATION OF HEALTH DISPARITIES. IT IS OUR BELIEF THAT WORKING IN COLLABORATION WITH COMMUNITY PARTNERS HELPS TO BUILD THE FOUNDATION FOR A HEALTHIER COMMUNITY.
PART III, SECTION A, LINE 2 THERE ARE NO ESTIMATES OF BAD DEBT INCLUDED. BAD DEBT IS AT TOTAL EXPENSE.
PART III, SECTION A, LINE 3 FOR TAX RETURN PURPOSES THE BAD DEBT EXPENSE IS SHOWN ON PART IX. THE PROVISION FOR FINANCIAL ASSISTANCE POLICY ALLOWS FOR ACCOUNTS IN BAD DEBT TO BE APPROVED FOR FINANCIAL ASSISTANCE IF THE PATIENT MEETS THE CRITERIA. THERE ARE POSSIBLE FINANCIAL ASSISTANCE ACCOUNTS IN BAD DEBT, ALTHOUGH THE EXACT PERCENTAGE IS UNKNOWN AS WE DO NOT HAVE THE APPROPRIATE TOOLS TO DETERMINE THIS PERCENTAGE ACCURATELY.
PART III, SECTION A, LINE 4 FOR TAX RETURN PURPOSES THE BAD DEBT EXPENSE IS SHOWN ON PART IX, STATEMENT OF FUNCTIONAL EXPENSE. FOR AUDIT PURPOSES THE ORGANIZATION FOLLOWS ASU 2011-07 PRESENTATION. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENTS' ACCOUNTS RECEIVABLE, PRESENCE HEALTH ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOUCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, PRESENCE HEALTH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE PATIENTS ARE SCREENED AGAINST THE PRESENCE HEALTH CHARITY CARE POLICY AND UNINSURED DISCOUNT POLICY. FOR ANY REMAINING PATIENT RESPONSIBILITY BALANCE, PRESENCE HEALTH RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATE (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
PART III, SECTION B, LINE 8 THE ORGANIZATION COMPUTES THE MEDICARE SHORTFALL BASED ON A RATIO OF COST TO CHARGES. PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER BELIEVES IT IS IMPORTANT FOR THE COMMUNITY AND THE IRS TO BE MADE AWARE OF GOVERNMENT SHORTFALLS, SPECIFICALLY MEDICARE. HOWEVER, WE ACKNOWLEDGE THAT MEDICARE SHORTFALLS MAY BE EXPERIENCED BY OTHER THAN NON-PROFIT HEALTHCARE ORGANIZATIONS. AS SUCH, PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER DOES NOT BELIEVE THAT MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT.
PART III, SECTION C, LINE 9B COLLECTION POLICIES ARE THE SAME FOR ALL PRESENCE HEALTH ENTITIES, WHICH INCLUDES PRESENCE our lady of the resurrection medical center'S PATIENTS. PATIENTS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION VIA POSTED NOTIFICATIONS AND ON EVERY ACCOUNT STATEMENT THAT IS SENT TO THEM. THIS INFORMATION IS AVAILABLE IN A NUMBER OF LANGUAGES. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE REVENUE CYCLE. PER THE PROVISION FOR FINANCIAL ASSISTANCE POLICY, THE COLLECTION PROCESSIS AS FOLLOWS: 1. PRE-LITIGATION REVIEW. PRIOR TO AN ACCOUNT BEING AUTHORIZED FOR THE FILING OF SUIT FOR NON-PAYMENT OF A PATIENT BILL, A FINAL REVIEW OF THE ACCOUNT WILL BE CONDUCTED AND APPROVED BY THE FINANCIAL COUNSELING REPRESENTATIVE (OR DESIGNEE) TO MAKE SURE THAT NO APPLICATION OF FINANCIAL ASSISTANCE WAS EVER RECEIVED AND THAT THERE EXISTS OBJECTIVE EVIDENCE THAT THE PATIENT DOES HAVE SUFFICIENT FINANCIAL MEANS TO PAY ALL OR PART OF HIS/HER BILL. PRIOR TO A COLLECTIONS SUIT BEING FILED, THE SELF-PAY COLLECTIONS DIRECTOR MUST REVIEW AND APPROVE. 2. RESIDENTIAL LIENS. NO HOSPITAL WILL PLACE A LIEN ON THE PRIMARY RESIDENCE OF A PATIENT WHO HAS BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE/CHARITY CARE, FOR PAYMENT OF THE PATIENT'S UNDISCOUNTED BALANCE DUE. FURTHER, IN NO CASE WILL ANY HOSPITAL EXECUTE ALIEN BY FORCING THE SALE OR FORECLOSURE OF THE PRIMARY RESIDENCE OF ANY PATIENT TO PAY FOR ANY OUTSTANDING MEDICAL BILL. 3. NO USE OF BODY ATTACHMENTS. NO HOSPITAL WILL USE BODY ATTACHMENTS TO REQUIRE ANY PERSON, WHETHER RECEIVING FINANCIAL ASSISTANCE/CHARITY CARE DISCOUNTS OR NOT, TO APPEAR IN COURT. 4. COLLECTION AGENCY REFERRALS. EACH HOSPITAL FINANCE ACCOUNTING WILL ENSURE THAT ALL COLLECTION AGENCIES USED TO COLLECT PATIENT BILLS PROMPTLY REFER ANY PATIENT WHO INDICATES FINANCIAL NEED, OR OTHER WISE APPEARS TO QUALIFY FOR FINANCIAL ASSISTANCE/CHARITY CARE DISCOUNTS, TO AFINANCIAL COUNSELOR TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR SUCHA CHARITABLE DISCOUNT. FOR MORE INFORMATION ABOUT THE PRESENCE HEALTH FINANCIAL ASSISTANCE PROGRAM, SEE WWW.PRESENCEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE.
PART VI, 2 - NEED ASSESSMENT IN ADDITION TO CONDUCTING CHNAS EVERY THREE (3) YEARS, PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER JOINS FORCES WITH LOCAL COMMUNITY ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY ON AN ONGOING BASIS. WE PARTICIPATE IN A VARIETY OF COALITIONS, COMMISSIONS, COMMITTEES, BOARDS, PARTNERSHIPS AND PANELS. OUR COMMUNITY OUTREACH WORKERS AND LIAISONS SPEND AMPLE TIME IN THE COMMUNITY POLRMC SERVES, AND BRING BACK FIRST-HAND KNOWLEDGE OF COMMUNITY NEEDS. WE ALSO SOLICIT GUIDANCE AND INVITE INPUT FROM A GROUP OF EXTERNAL PARTICIPANTS TO REVIEW OUR COMMUNITY BENEFIT PLAN, NEIGHBORHOOD RELATIONS, AND DATA SUPPLEMENTS TO ADVISE US ON THE PRIORITY NEEDS AND DIRECTIONS WITH REGARD TO COMMUNITY NEEDS. EXTERNAL GROUP PARTICIPANTS INCLUDE REPRESENTATIVES FROM THE PUBLIC HEALTH DEPARTMENT, LOCAL ALDERMEN AND REPRESENTATIVES, LEADERS FROM COMMUNITY BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES, COALITIONS AND ASSOCIATIONS. THESE PARTICIPANTS ARE EXPERTS IN A WIDE RANGE OF AREAS INCLUDING: PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH CARE DISPARITIES, MENTAL HEALTH, AND HEALTH AND SOCIAL SERVICES. SOLICITING FEEDBACK FROM THIS GROUP HELPS US TO ENSURE WE ARE AWARE OF THE MOST PRESSING COMMUNITY HEALTH NEEDS. PRESENCE HEALTH MINISTRIES ALSO COMPLETE MEDICAL STAFF DEVELOPMENT PLANS. THESE PLANS ARE CONDUCTED BY EXTERNAL CONSULTANTS, WHO PROVIDE AN INDEPENDENT ASSESSMENT OF THE NEED FOR PHYSICIANS BY SPECIALTY WITHIN THE HOSPITAL'S PRIMARY SERVICE AREA AS DEFINED BY STARK REGULATIONS. WE ALSO REVIEW AND ANALYZE OUR OWN INTERNAL PATIENT DATA (INPATIENT AND EMERGENCY DEPARTMENT UTILIZATION) ON AN ANNUAL BASIS TO UNCOVER ANY NEW COMMUNITY HEALTH TRENDS. WE REVIEW PURCHASED AND PUBLICLY AVAILABLE DATA AND ANALYSES ON THE MARKET, DEMOGRAPHICS, AND HEALTH SERVICE UTILIZATION.
PART VI, 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PRESENCE HEALTH HOSPITAL MINISTRIES PROACTIVELY COMMUNICATE THE AVAILABILITY OF OUR FINANCIAL ASSISTANCE/CHARITY CARE PROGRAMS BY USING MULTIPLE TYPES OF APPROPRIATE MEDIA AND IN MULTIPLE APPROPRIATE LANGUAGES. THE MECHANISMS USED BY PRESENCE HEALTH HOSPITALS TO COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE/CHARITY CARE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: 1. SIGNAGE. SIGNS ARE POSTED PROMINENTLY THROUGHOUT HIGH TRAFFIC AREAS OF OUR MINISTRIES, AS WELL AS WITHIN OUR INPATIENT AND OUTPATIENT REGISTRATION/PATIENT ADMITTING AREAS AND EMERGENCY DEPARTMENTS. SIGNS STATE THAT PATIENTS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE/CHARITY CARE DISCOUNTS, AND DESCRIBE HOW TO OBTAIN MORE INFORMATION, INCLUDING IDENTIFICATION OF APPROPRIATE HOSPITAL REPRESENTATIVES BY TITLE. SIGNS ARE IN MULTIPLE LANGUAGES. 2. PROVISION OF FINANCIAL ASSISTANCE MATERIALS TO UNINSURED PATIENTS. PRESENCE HEALTH HOSPITALS PROVIDE A SUMMARY OF ITS FINANCIAL ASSISTANCE PROGRAMS AND A FINANCIAL ASSISTANCE APPLICATION TO ALL PERSONS RECEIVING HOSPITAL CARE THAT IT IDENTIFIES AS UNINSURED PATIENTS AT THE TIME OF IN-PERSON REGISTRATION, ADMISSION, OR SUCH LATER TIME THAT THE PATIENT IS FIRST IDENTIFIED AS AN UNINSURED PATIENT. FOR PATIENTS PRESENTING IN THE EMERGENCY DEPARTMENT, ALL PRESENCE HEALTH HOSPITALS PROVIDE SUCH FINANCIAL ASSISTANCE MATERIALS AT SUCH TIME AND IN SUCH MANNER AS IS CONSISTENT WITH THEIR OBLIGATIONS UNDER EMTALA TO ACCESS FOR AND STABILIZE ANY PATIENT WITH AN EMERGENCY MEDICAL CONDITION BEFORE MAKING INQUIRY OF THE PATIENT'S ABILITY TO PAY. 3. BROCHURES. BROCHURES, INFORMATION SHEETS AND SIMILAR FORMS OF WRITTEN COMMUNICATION REGARDING THE HOSPITAL'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY ARE MAINTAINED IN APPROPRIATE AREAS OF THE HOSPITAL (E.G. EMERGENCY DEPARTMENT, ORGANIZED REGISTRATION AREAS, THE BUSINESS OFFICE). THESE COMMUNICATIONS STATE IN MULTIPLE LANGUAGES THAT THE HOSPITAL OFFERS FINANCIAL ASSISTANCE/CHARITY CARE DISCOUNTS AND DESCRIBES HOW TO OBTAIN MORE INFORMATION. 4. WEBSITE. COMPREHENSIVE INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAMS - INCLUDING ELIGIBILITY CRITERIA, APPLICATION DETAILS, AND CONTACT INFORMATION - IS ALSO AVAILABLE ON OUR CONSUMER WEB SITE(HTTP://PRESENCEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE) 5. BILLING NOTICES. EACH PRESENCE HEALTH HOSPITAL INCLUDES A NOTE ON OR WITH THE HOSPITAL BILL AND/OR STATEMENT REGARDING THE HOSPITAL'S FINANCIAL ASSISTANCE/CHARITY CARE PROGRAM AND HOW THE PATIENT MAY APPLY FOR CONSIDERATION UNDER THIS PROGRAM. 6. FINANCIAL COUNSELORS. EACH PRESENCE HEALTH HOSPITAL HAS ONE OR MORE FINANCIAL COUNSELORS WHOSE CONTACT INFORMATION IS LISTED OR PROVIDED WITH OTHER INFORMATION CONCERNING THE FINANCIAL ASSISTANCE/CHARITY CARE DISCOUNT PROGRAM. THESE COUNSELORS ARE AVAILABLE TO DISCUSS ELIGIBILITY AND OTHER QUESTIONS CONCERNING THE PROGRAM, AND PROVIDE aSSISTANCE WITH APPLICATIONS. THEY ARE ALSO AVAILABLE TO MEET WITH PATIENTS DURING THEIR STAY IF THEY HAVE QUESTIONS ABOUT THEIR ABILITY TO PAY FOR SERVICES AND OUR FINANCIAL ASSISTANCE PROGRAMS. 7. NOTIFICATION OF DETERMINATION. WHEN A PRESENCE HEALTH HOSPITAL MAKES A DETERMINATION THAT A PATIENT'S BILL IS DISCOUNTED OR ADJUSTED BASED ON A DETERMINATION OF FINANCIAL NEED, THE HOSPITAL NOTIFIES THE PATIENT OF SUCH ELIGIBILITY DETERMINATION AND THAT THERE IS NO FURTHER COLLECTION ACTION TAKEN ON THE DISCOUNTED PORTION OF THE PATIENT'S BILL.
PART VI, 4 - COMMUNITY INFORMATION PRESENCE HEALTH PROVIDES SERVICES AT 150 SITES, INCLUDING TWELVE ACUTE CARE HOSPITALS WITH A TOTAL OF 2,997 STAFFED BEDS AND OVER 90 PRIMARY AND SPECIALTY CARE CLINIC. THESE MINISTRIES OFFER A BROAD RANGE OF SERVICES FROM HIGHLY SPECIALIZED TERTIARY SERVICES TO AN EXTENDED NETWORK OF PRIMARY AND AMBULATORY CARE. PRESENCE HEALTH HAS IDENTIFIED A SEPARATE SERVICE AREA FOR EACH OF ITS ACUTE CARE HOSPITALS UTILIZING A CONSISTENT METHODOLOGY AND REFLECTING A COMBINATION OF GEOGRAPHIC LOCATION AND MARKET SHARE CRITERIA. THE TOTAL SERVICE AREA OF EACH MINISTRY REPRESENTS APPROXIMATELY 80% TO 90% OF THE TOTAL INPATIENT DISCHARGES FROM THAT FACILITY. THE PRIMARY SERVICE AREA (THE "PRIMARY SERVICE AREA") OF EACH FACILITY REPRESENTS APPROXIMATELY 65 TO 75% OF SUCH DISCHARGES AND THE SECONDARY SERVICE AREA (THE "SECONDARY SERVICE AREA") OF EACH FACILITY REPRESENTS APPROXIMATELY 15 TO 25% OF SUCH DISCHARGES. THE PRIMARY SERVICE AREAS AND SECONDARY SERVICE AREAS HAVE BEEN DETERMINED BY UTILIZING A PATIENT ORIGIN ANALYSIS TO IDENTIFY THOSE ZIP CODES THAT REPRESENT INPATIENT DISCHARGES. THESE ZIP CODES ARE THEN MAPPED TO IDENTIFY GEOGRAPHIC COVERAGE OF THE PRIMARY SERVICE AREAS AND SECONDARY SERVICE AREAS. MANY OF THE PRESENCE HEALTH HOSPITAL MINISTRIES FACILITIES ARE LOCATED IN POPULATION GROWTH AREAS. BASED UPON POPULATION ESTIMATES AND PROJECTIONS OBTAINED FROM CLARITAS, INC., THE POPULATION OF THE OUR HOSPITALS' COMBINED SERVICE AREA IS EXPECTED TO GROW AT A RATE OF 1.9% ANNUALLY BETWEEN 2012 AND 2017, COMPARED WITH A GROWTH RATE OF 1.3% AND 1.6% PER YEAR IN THE CHICAGO MSA AND IN ILLINOIS, RESPECTIVELY. OF PRESENCE'S TOTAL SERVICE AREA POPULATION, 10.7% IS OVER THE AGE OF 65, COMPARED TO 11.1% AND 12.3% IN THE CHICAGO MSA AND IN ILLINOIS, RESPECTIVELY. THE PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER CHNA SERVICE AREA INCLUDES THE ZIP CODES 60630, 60634, 60639, AND 60641, WHICH CORRESPOND TO THE CHICAGO COMMUNITY AREAS OF JEFFERSON PARK, DUNNING, MONTCLARE, BELMONT CRAGIN, HERMOSA AND PORTAGE PARK. THE TOTAL POPULATION OF ZIP CODES 60630, 60634, 60639, AND 60641 IN 2010 WAS 248,683, MAKING UP THE SERVICE AREA OF POLRMC. PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER HAS BEEN PROVIDING HEALTH CARE TO RESIDENTS OF CHICAGO'S NORTHWEST SIDE SINCE 1955. POLRMC SPECIALIZES IN PROVIDING ITS NEIGHBORS WITH COMPREHENSIVE MEDICAL AND SURGICAL SERVICES PLUS SPECIALIZED SERVICES THAT MEET THE DIVERSE HEALTH CARE NEEDS OF THE COMMUNITY. ACCORDING TO A 2012 MARKET SHARE ANALYSIS, TEN (10) OTHER HOSPITALS SERVE THE POLRMC SERVICE AREA COMMUNITIES.
DEMOGRAPHICS IN THE PAST TEN YEARS, POPULATION CHANGE WAS MODEST IN THE POLRMC SERVICE AREA COMMUNITIES, WITH DECREASES IN THE 1 TO 2% RANGE FOR JEFFERSON PARK, DUNNING, BELMONT CRAGIN AND PORTAGE PARK, AND 7% FOR HERMOSA. THE MONTCLARE POPULATION INCREASED BY 6%. IN CONTRAST, THE POPULATION OF CHICAGO DECREASED BY 7%, AND THE ILLINOIS AND U.S. POPULATIONS SAW INCREASES OF 3% AND 10%, RESPECTIVELY. ROUGHLY A QUARTER OF THE POPULATION IS UNDER 20 YEARS OF AGE IN THE POLRMC SERVICE AREA, THE ONE EXCEPTION BEING ZIP CODE 60639 AT 34%. THESE PERCENTAGES ARE SIMILAR TO THOSE FOR COOK COUNTY, CHICAGO, ILLINOIS AND THE U.S. TWO OF THE ZIP CODES HAD LESS THAN 10% OF THEIR POPULATION OVER 65 (60639 AND 60641). ZIP CODES 60630 AND 60634 HAVE PROPORTIONS OF SENIOR POPULATIONS THAT ARE QUITE SIMILAR TO THE PERCENTAGES IN COOK COUNTY, ILLINOIS AND THE UNITED STATES, WHICH RANGE FROM 10 TO 13%. THE ZIP CODES 60630 (JEFFERSON PARK), 60634 (DUNNING AND MONTCLARE) AND 60641 (PORTAGE PARK) EXPERIENCED SLIGHT DECREASES IN THE PROPORTION OF PEOPLE OVER 65 FROM 2000 TO 2010. THE PROPORTION OF HISPANIC/LATINOS INCREASED IN EACH OF THE COMMUNITIES IN THE POLRMC SERVICE AREA. THE COMMUNITIES HAVE HISPANIC/LATINO POPULATIONS THAT RANGED FROM ABOUT 20% IN JEFFERSON PARK TO ALMOST 90% IN HERMOSA. THE LARGEST INCREASE IN THE HISPANIC/LATINO POPULATION WAS IN JEFFERSON PARK, NEARLY DOUBLING FROM 2000 TO 2010. THE CAUCASIAN POPULATION DECREASED IN ALL THE COMMUNITIES IN THE SERVICE AREA WHILE THE ASIAN POPULATION REMAINED BELOW 10% FOR ALL OF THE COMMUNITIES, THE LARGEST PROPORTION BEING 9% IN JEFFERSON PARK. THE SERVICE AREA HAS A CONSIDERABLE PERCENTAGE OF LIMITED ENGLISH SPEAKING POPULATION WITH THE MOST COMMON LANGUAGE BEING SPANISH, WITH RATES OVER 30% IN BELMONT CRAGIN AND HERMOSA. POLISH WAS THE SECOND MOST COMMON LANGUAGE SPOKEN WITH DUNNING THE LEADER AT 16% FOLLOWED BY JEFFERSON PARK AND PORTAGE PARK.
SOCIOECONOMICS THE MEDIAN HOUSEHOLD INCOME IN DUNNING ($61,584) AND JEFFERSON PARK ($60,592) EXCEEDED THE U.S. MEDIAN. MONTCLARE'S MEDIAN HOUSEHOLD INCOME WAS VERY NEAR THAT FOR CHICAGO WHILE BELMONT CRAGIN AND HERMOSA FELL SLIGHTLY BELOW THAT AT A LITTLE OVER $42,000. BELMONT CRAGIN AND HERMOSA HAD 19% OF THEIR POPULATION LIVING BELOW THE POVERTY LINE, A PERCENTAGE JUST BELOW THE CHICAGO RATE BUT 6 PERCENTAGE POINTS ABOVE THE ILLINOIS RATE. BELMONT CRAGIN AT 26% AND HERMOSA AT 27% HAD RATES OF CHILDREN LIVING IN POVERTY THAT WERE ABOVE THE COOK COUNTY PERCENTAGE AND TWICE THE COUNTY HEALTH RANKING (CHR)'S BENCHMARK. THE OTHER COMMUNITIES HAD RATES RANGING FROM 21% TO 5%, ALL BELOW THE COOK COUNTY RATE OF 22%. OVER HALF THE POPULATION IN BELMONT CRAGIN AND HERMOSA LIVES BELOW 200% OF THE FEDERAL POVERTY LEVEL. PORTAGE PARK AND MONTCLARE HAVE ABOUT A THIRD OF THEIR POPULATION BELOW 200% OF THE FEDERAL POVERTY LEVEL, A NUMBER NEAR THE COOK COUNTY, ILLINOIS AND U.S. RATES. THE RATES IN DUNNING AND JEFFERSON PARK WERE NEAR 20%. FOUR OF THE SERVICE AREA COMMUNITIES, BELMONT CRAGIN, MONTCLARE, PORTAGE PARK AND HERMOSA, HAD 70% OR MORE STUDENTS ELIGIBLE FOR FREE AND REDUCED LUNCH. ALL BUT ONE OF THE HIGH SCHOOLS IN THE SERVICE AREA HAD GRADUATION RATES THAT EXCEEDED THE CHICAGO RATE (73.8%). SIX OF THE SEVEN COMMUNITIES HAD RATES OF RESIDENTS WITHOUT HIGH SCHOOL DIPLOMAS THAT EXCEEDED THE 15% RATE IN THE U.S. FOUR OF THE SIX COMMUNITIES HAD DOUBLE DIGIT UNEMPLOYMENT RATES RANGING FROM 12.9% IN HERMOSA TO 10.8% IN PORTAGE PARK AND MONTCLARE. THESE RATES ARE ALL SIMILAR TO THE CHICAGO AND COOK COUNTY RATES, BUT ABOVE THAT FOR THE U.S. JEFFERSON PARK AND DUNNING HAD RATES THAT WERE SIMILAR TO THE ILLINOIS RATE OF 8.6%.
ACCESS TO CARE THE RATE OF UNINSURED FOR CHICAGO IS NEARLY 20%, CONSIDERABLY ABOVE THE CHR BENCHMARK AND THE ILLINOIS RATE OF 13.1%. EACH OF THE ZIP CODES IN THE SERVICE AREA HAD RATES OF MEDICAID ENROLLEES THAT WERE HIGHER THAN THE STATE RATE. ZIP CODE 60639 HAD THE HIGHEST RATE AT 41% WHILE 19% IN ZIP CODE 60630 WAS THE LOWEST. OF ALMOST 1,300 REQUESTS FOR INTERPRETERS IN THE ER, 80% WERE FOR SPANISH AND POLISH, HOWEVER REQUESTS FOR 28 DIFFERENT LANGUAGES WERE RECEIVED. BELMONT CRAGIN, HERMOSA AND MONTCLARE ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS FOR PRIMARY CARE. BELMONT CRAGIN, HERMOSA, MONTCLARE, PORTAGE PARK AND DUNNING ALL HAVE SHORTAGES OF MENTAL HEALTH PROVIDERS. A FULL COMMUNITY HEALTH PROFILE OF DEMOGRAPHIC AND OTHER HEALTH INDICATORS CAN BE FOUND OF PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER AT WWW.PRESENCEHEALTH.ORG/COMMUNITY.
PART VI, 5 - PROMOTION OF COMMUNITY HEALTH PRESENCE HEALTH HOSPITALS ARE FAITH-BASED MINISTRIES THAT PROVIDE SERVICES CONSISTENT WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES. PRESENCE HEALTH HOSPITALS ENHANCE THE PUBLIC HEALTH OF OUR COMMUNITIES BY: 1. ENSURING OUR MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS. 2. ENSURING ALL OF OUR HOSPITALS ARE ACCREDITED AND IN GOOD STANDING WITH THE JOINT COMMISSION ACCREDITATION OF HEALTHCARE ORGANIZATIONS. 3. ENSURING OUR BOARD OF DIRECTORS IS DIVERSE AND ABLE TO PROVIDE EXPERTISE, AND INCLUDES INDEPENDENT MEMBERS OF THE COMMUNITIES WE SERVE. OUR BOARD MEMBERS MUST FOLLOW A CONFLICT OF INTEREST POLICY. 4. REINVESTING SURPLUS FUNDS INTO THE ORGANIZATION TO IMPROVE PATIENT CARE THOUGH NEW PROGRAMS AND TECHNOLOGY. 5. PROVIDING FINANCIAL ASSISTANCE, SLIDING SCALE DISCOUNTS AND HAVING COLLECTION PRACTICES THAT ARE IN COMPLIANCE WITH STATE AND FEDERAL GUIDELINES. IN ADDITION, WE FOLLOW THE FINANCIAL ASSISTANCE AND CHARITY GUIDELINES OF THE CATHOLIC HEALTH ASSOCIATION. 6. PARTICIPATING IN ALL GOVERNMENT SPONSORED HEALTH CARE PROGRAMS, MEDICARE, MEDICAID, CHAMPUS, TRICARE, SCHIP AND OTHERS. 7. PROVIDING EMERGENCY ROOM SERVICES IN ALL OF OUR COMMUNITIES AND PROVIDE TRAINING TO LOCAL FIRE DEPARTMENTS AND AMBULANCES. OUR EMERGENCY ROOM PARTICIPATES WITH LOCAL POLICE AND FIRE DEPARTMENTS IN DISASTER DRILLS. 8. STAFFING BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS IN OUR EMERGENCY ROOM AND URGENT CARE SERVICES. WE TREAT PATIENTS ACCORDING TO EMTALA GUIDELINES AND SERVE ALL PATIENTS REGARDLESS OF ABILITY TO PAY. IN ADDITION, WE ARE COMMITTED TO DETERMINING THE NEEDS OF OUR COMMUNITIES AND CREATING WAYS TO MEET THOSE NEEDS. THE OBLIGATION TO REACH OUT TO THOSE IN NEED AND IMPROVE HEALTH FLOWS DIRECTLY FROM OUR CATHOLIC IDENTITY AND THE HERITAGE OF OUR FOUNDING CONGREGATIONS. THE Polrmc SENIOR LEADERSHIP TEAM AND THE GOVERNING BOARD HAVE A STRONG COMMITMENT TO COMMUNITY HEALTH INITIATIVES. COMMUNITY INITIATIVES AND ACTIVITIES HAVE ON GOING MONITORING AND EVALUATION FOR PROGRAM EFFECTIVENESS. THE FOLLOWING PROGRAMS ARE EXISTING COMMUNITY BENEFIT PROGRAMS Polrmc SPONSORS IN THE COMMUNITY.
WALKING CLUB AT PORTAGE PARK PROGRAM DESCRIPTION THIS FREE PROGRAM WAS DEVELOPED BY THE PHYSICAL THERAPY DEPARTMENT TO PROMOTE PHYSICAL ACTIVITY, FITNESS AND MOBILITY TO COMMUNITY MEMBERS. ONCE A WEEK A PHYSICAL THERAPIST MEETS A SMALL GROUP IN A LOCAL PARK TO PROVIDE EDUCATION AND ENCOURAGE WALKING. OUTCOMES ARE MEASURED BY MONITORING IF THERE IS AN INCREASE IN EACH PARTICIPANT'S ENDURANCE LEVEL. MANY MEMBERS OF THE POLRMC HEALTH TEAM SUCH AS DIETICIANS, OCCUPATIONAL THERAPISTS, AND NURSES PROVIDED EDUCATION TO THE GROUP. COMMUNITY MEMBERS LEARNED ZUMBA, NUTRITION, YOGA, AND EVEN DID WATER EXERCISES IN THE PORTAGE PARK POOL. THE GROUP MET FOR 17 WEEKS FOR 1-2 HOURS EACH WEEK. HEALTH INFORMATION HANDOUTS, COOKBOOKS, AND WATER BOTTLES WERE PROVIDED TO THOSE ATTENDING. TO FURTHER PROMOTE WALKING, A POLRMC PHYSICIAN SPONSORED THE GROUP AND PAID ADMISSION FEES TO THE POLRMC FALL INTO FITNESS WALK/RUN HELD EACH SEPTEMBER.
LET'S MOVE OUR NUMBERS PROGRAM DESCRIPTION THE LET'S MOVE OUR NUMBERS PROGRAM PROVIDES COMMUNITY EDUCATION AND SCREENING PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS BOTH IN THE COMMUNITY AND MAIN HOSPITAL LOCATION. COMPONENTS OF THE PROGRAM INCLUDE: BLOOD PRESSURE, BLOOD GLUCOSE, BLOOD LIPID PANEL, BODY MASS INDEX (BMI) AND/OR BODY FAT ANALYSIS. HEALTH EDUCATION TOPICS ON CHRONIC DISEASE INCLUDE OBESITY, HYPERTENSION, HEART DISEASE, STROKE, DIABETES, AND CANCER.
PART VI, 6 - AFFILIATED HEALTH CARE SYSTEM THE PROVENA HEALTH AND RESURRECTION HEALTH CARE SYSTEMS CAME TOGETHER ON NOVEMBER 1, 2011 TO FORM A NEW HEALTH SYSTEM, PRESENCE HEALTH, CREATING A COMPREHENSIVE FAMILY OF NOT-FOR-PROFIT HEALTH CARE SERVICES AND THE SINGLE LARGEST CATHOLIC HEALTH SYSTEM IN ILLINOIS. THE NAME PRESENCE HEALTH EMBODIES THE ACT OF BEING PRESENT IN EVERY MOMENT WE SHARE WITH THOSE WE SERVE AND IS THE CORNERSTONE OF A PATIENT, RESIDENT AND FAMILY-CENTERED CARE ENVIRONMENT. "PRESENCE" HEALTH EMBODIES THE WAY WE CHOOSE TO BE PRESENT IN OUR COMMUNITIES, AS WELL AS WITH ONE ANOTHER AND THOSE WE SERVE. PRESENCE HEALTH IS SPONSORED BY FIVE CONGREGATIONS OF CATHOLIC RELIGIOUS WOMEN: THE FRANCISCAN SISTERS OF THE SACRED HEART, THE SERVANTS OF THE HOLY HEART OF MARY, THE SISTERS OF THE HOLY FAMILY OF NAZARETH, SISTERS OF MERCY OF THE AMERICAS AND THE SISTERS OF THE RESURRECTION. AS WAS THE CASE FROM OUR VERY BEGINNINGS, PRESENCE HEALTH IS CALLED TO BE MUCH MORE THAN JUST A PROVIDER OF HEALTH SERVICES. PRESENCE HEALTH HAS INSTILLED WITHIN ALL OF ITS MINISTRIES THAT ARE COMMITTED TO RESPONDING TO THE NEEDS OF THOSE WE ARE PRIVILEGED TO SERVE; DELIVERING HIGH QUALITY CARE THAT IS ACCESSIBLE TO ALL. IT IS THIS CULTURE OF CARING AND GIVING THAT DRIVES OUR DILIGENT EFFORTS TO ENSURE WE RETURN THE OPTIMAL VALUE OF OUR CHARITABLE ASSETS TO OUR LOCAL COMMUNITIES. AS A NOT-FOR-PROFIT HEALTH SYSTEM, PRESENCE HEALTH INVESTS A SIGNIFICANT PORTION OF ITS OPERATING CAPITAL INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE VULNERABLE POPULATIONS, SUCH AS THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS, AND PROMOTE HEALTH EDUCATION AND PROMOTION OUTREACH AND INITIATIVES. IN FISCAL YEAR 2014, THIS INCLUDED $180 MILLION IN COMMUNITY BENEFIT ACTIVITIES. PRESENCE HEALTH TAKES A SYSTEMS APPROACH TO ITS COMMUNITY BENEFIT EFFORTS, AND THEREFORE ENSURES ITS MEMBER HOSPITALS AND OTHER ENTITIES AND AFFILIATES ARE HELPING TO PROMOTE AND ADDRESS THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE. FOR MORE INFORMATION ON PRESENCE HEALTH, VISIT WWW.PRESENCEHEALTH.ORG.
PART VI, 7 - STATE FILING OF COMMUNITY BENEFIT REPORT PRESENCE HEALTH FILES ITS ANNUAL COMMUNITY BENEFIT REPORT IN ILLINOIS.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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
 
 
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
 
 
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
1Patrick QuinnAssistant Treasurer (i)
(ii)
0
...............................
239,708
0
...............................
0
0
...............................
30,943
0
...............................
23,958
0
...............................
24,645
0
...............................
319,254
0
...............................
18,512
2Julie RoknichAssistant Secretary (i)
(ii)
0
...............................
196,072
0
...............................
0
0
...............................
0
0
...............................
7,126
0
...............................
20,909
0
...............................
224,107
0
...............................
0
3Jeannie C FreySecretary (i)
(ii)
0
...............................
474,603
0
...............................
0
0
...............................
63,709
0
...............................
104,089
0
...............................
28,515
0
...............................
670,916
0
...............................
43,893
4Paul SkiemSYSTEM SR VICE PRESIDENT (i)
(ii)
0
...............................
228,187
0
...............................
0
0
...............................
311,655
0
...............................
318,392
0
...............................
8,906
0
...............................
867,140
0
...............................
100,029
5John BairdRGN PRESIDENT & CEO-NWC (i)
(ii)
0
...............................
470,078
0
...............................
0
0
...............................
61,641
0
...............................
99,029
0
...............................
22,272
0
...............................
653,020
0
...............................
43,258
6Anthony J FilerTreasurer (i)
(ii)
0
...............................
682,424
0
...............................
0
0
...............................
123,757
0
...............................
149,460
0
...............................
39,419
0
...............................
995,060
0
...............................
78,612
7David DiLoreto MDSYS CH MEDICAL & QUAL OFF (i)
(ii)
0
...............................
558,119
0
...............................
0
0
...............................
52,873
0
...............................
125,008
0
...............................
26,695
0
...............................
762,695
0
...............................
43,084
8Dennis FitzmauriceVICE PRESIDENT (i)
(ii)
237,457
...............................
0
0
...............................
0
20,212
...............................
0
15,186
...............................
0
2,123
...............................
0
274,978
...............................
0
20,208
...............................
0
9ROSEMARIE WADESTAFF NURSE I WKND S (i)
(ii)
201,084
...............................
0
0
...............................
0
0
...............................
0
4,165
...............................
0
26,354
...............................
0
231,603
...............................
0
0
...............................
0
10DIANE ORTOLANODIR REHAB SERVICES (i)
(ii)
148,249
...............................
0
0
...............................
0
0
...............................
0
8,637
...............................
0
431
...............................
0
157,317
...............................
0
0
...............................
0
11EUNICE BAISTAFF NURSE I (i)
(ii)
147,887
...............................
0
0
...............................
0
0
...............................
0
6,306
...............................
0
28,854
...............................
0
183,047
...............................
0
0
...............................
0
12ELIZABETH PANKAUVP PATIENT CARE SVS & CNO (i)
(ii)
147,018
...............................
0
0
...............................
0
0
...............................
0
8,793
...............................
0
254
...............................
0
156,065
...............................
0
0
...............................
0
13MARGARET MCDERMOTTREG/ADMINISTRATOR (i)
(ii)
142,400
...............................
0
0
...............................
0
0
...............................
0
8,928
...............................
0
0
...............................
0
151,328
...............................
0
56,302
...............................
0
14EMERITA BURGESSDIR NURSING (i)
(ii)
137,736
...............................
0
0
...............................
0
0
...............................
0
6,834
...............................
0
15,106
...............................
0
159,676
...............................
0
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
DETERMINATION OF COMPENSATION OF ORGANIZATION'S CEO/EXECUTIVE DIRECTOR SCEDULE J, PART I, LINE 3 COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION'S SOLE MEMBER, PRESENCE RHC CORPORATION (PRHCC) AND PRHCC'S SOLE MEMBER, THE SYSTEM PARENT CORPORATION. SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF THE SYSTEM PARENT CORPORATION, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. THE PARENT CORPORATION USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE BOARD.
SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A PRESENCE HAS THREE SEVERANCE PLANS DEPENDING UPON LEVEL. THESE PLANS ALLOW INDIVIDUALS WHOSE JOBS HAVE BEEN ELIMINATED AND WHO HAVE NOT BEEN ABLE TO FIND A SIMILAR POSITION WITHIN THE SYSTEM TIME TO TRANSITION. THE NUMBER OF WEEKS OF WAGE CONTINUATION ARE BASED UPON LENGTH OF SERVICE. THE PLANS ARE NOT FUNDED. THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR YEAR 2014: Paul Skiem $183,394 THE CORPORATION ALSO ACCRUED DEFERRED SEVERANCE FOR THE FOLLOWING INDIVIDUALS, WHICH WILL VEST IN A LATER YEAR: Paul Skiem $296,304
PAYMENTS FROM A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, QUESTION 4B IN ORDER TO ENHANCE THE ABILITY OF PRESENCE HEALTH TO ATTRACT AND RETAIN QUALIFIED MANAGEMENT PERSONNEL BY PROVIDING ELIGIBLE EXECUTIVES WITH ADDITIONAL RETIREMENT BENEFITS ON A DEFERRED BASIS, PRESENCE HEALTH NETWORK MAINTAINS AN UNFUNDED SUPPLEMENTAL RETIREMENT PLAN (THE "PLAN") FOR A SELECT GROUP OF MANAGEMENT, WHICH IS INTENDED TO COMPLY WITH SECTION 457(F), AND SECTION 409A OF THE INTERNAL REVENUECODE. UNDER THE PLAN, PRESENCE HEALTH NETWORK CREDITS TO SUCH ELIGIBLE EXECUTIVE'S RETIREMENT ACCOUNT AN AMOUNT BASED ON A PERCENTAGE OF SALARY. EARNINGS AND/OR LOSSES ON INVESTMENTS ARE CREDITED AT A RATE EQUAL TO THE RATE OF RETURN OVER THE SAME PERIOD ON INVESTMENT OPTIONS SELECTED BY THE ELIGIBLE EXECUTIVE. ELIGIBLE EXECUTIVES ARE ENTITLED TO RECEIVE BENEFITS ON THE EARLIEST OF (I) JANUARY 1 OF THE THIRD CALENDAR YEAR BEGINNING AFTER THE YEAR IN WHICH SUCH CONTRIBUTION IS CREDITED, (II) ATTAINING AGE 62, OR (III) ATTAINING THE AGE OF 60 IF THE ELIGIBLE EXECUTIVE HAS COMPLETED TEN (10) YEARS OF SERVICE. THE FOLLOWING LISTED INDIVIDUALS BECAME VESTED IN SUPPLEMENTAL RETIREMENT BENEFITS UNDER THE SERP, AND THEREFORE HAD BENEFITS INCLUDED IN THEIR TAXABLE INCOME: Dennis FITZMAURICE $20,212 John Baird $51,861 DAVID DILORETO $43,093 PAUL SKIEM $123,372 JEANNIE FREY $53,929 ANTHONY FILER $92,113 PATRICK QUINN $22,168 ALSO IN RESPONSE TO QUESTION 4B, THE FOLLOWING LISTED INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S SECTION 457(F) PLAN AND EARNED UNVESTED BENEFITS DURING 2014 WHICH ARE REPORTED IN COLUMN (C): John Baird $86,029 DAVID DILORETO $112,008 PAUL SKIEM $ 8,990 JEANNIE FREY $88,489 ANTHONY FILER $146,460 PATRICK QUINN $23,958
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE N
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet Attach to Form 990 or 990-EZ.
bulletInformation about Schedule N (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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number
36-2644178
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.Click to see list of attachments
1(a)Description of asset(s)
distributed or transaction
expenses paid
(b)Date of
distribution
(c)Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d)Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity




















Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2014)

Schedule N (Form 990 or 990-EZ) (2014)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III . . . . . . . . . . .
3
 
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .
4a
 
 
b
If "Yes," did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
 
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .
5
 
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .
6a
 
 
b
If "Yes" to line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
 
 
c
If "Yes" to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" to line 6b, explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
REAL STATE 12-31-2014 3,500,000 APPRAISAL COMMUNITY FIRST HEALTHCARE OF ILLIN
5645 W ADDISON
CHICAGO,IL60634
N/A
PERSONAL PROPERTY AND INTANGIBLES 12-31-2014 6,500,000 APPRAISAL COMMUNITY FIRST HEALTHCARE OF ILLIN
5645 W ADDISON
CHICAGO,IL60634
N/A














Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
Schedule N(Form 990 or 990-EZ) (2014)

Schedule N (Form 990 or 990-EZ) (2014)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
SALE OF POLRMC'S ASSETS FORM 990, SCHEDULE N, PART II ON DECEMBER 31, 2014 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER ("POLRMC") AND ITS ULTIMATE PARENT ENTITY, PRESENCE HEALTH NETWORK ("PHN"), CLOSED ON THE SALE OF SUBSTANTIALLY ALL THE ASSETS OF POLRMC TO COMMUNITY FIRST HEALTHCARE OF ILLINOIS, INC. AS POLRMC AND PHN ARE BOTH TAX-EXEMPT UNDER IRC SECTION 501(C)(3) AND SUBSTANTIALLY ALL OF THE ASSETS ARE RELATED-USE ASSETS, THIS SALE WAS NOT SUBJECT TO FEDERAL OR STATE INCOME TAX. THE ASSET PURCHASE AGREEMENT AND RELATED CLOSING DOCUMENTS DICTATED THAT THE SALE WAS LEGALLY EFFECTIVE ON JANUARY 1, 2015, THE DAY AFTER CLOSING. HOWEVER, POLRMC'S BOOKS AND RECORDS REFLECT THE SALE AS OF DECEMBER 31, 2014, THE DATE THE SALE WAS FINALIZED, AND THEREFORE POLRMC IS COMPLETING THIS SCHEDULE N TO FORM 990 IN ORDER TO REPORT CONSISTENTLY WITH ITS BOOKS AND RECORDS AS REFLECTED IN ITS AUDITED FINANCIAL STATEMENTS. IN ORDER TO ACCURATELY REPORT THIS SALE FOR TAX PURPOSES, POLRMC WILL FILE FORM 8594, ASSET ACQUISITION STATEMENT UNDER SECTION 1060, WITH ITS 2015 RETURN. FORM 990, SCHEDULE N, PART II, LINE 2E Two of POLRMC's key employees became employees of the purchaser, Dennis Fitzmaurice and Elizabeth Pankau.
Schedule N (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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
Return Reference Explanation
GROUP EXEMPTION FORM 990, BOX H (C) PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER IS PART OF THE OFFICIAL CATHOLIC DIRECTORY GROUP EXEMPTION. IT ALSO HAS ITS OWN INDEPENDENT EXEMPTION RULING.
SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1 PRESENCE OUR LADY OF THE RESURRECTION PROVIDES COMPASSIONATE MEDICAL AND NURSING CARE AS WELL AS ADVANCED DIAGNOSTIC AND TREATMENT SERVICES THAT PROMOTE PATIENTS' WELL-BEING. THE HOSPITAL FEATURES A 269-LICENSED BED MAIN BUILDING WITH A NEARBY PROFESSIONAL OFFICE BUILDING, A CONVENIENT RADIOLOGY CENTER AND AN EXTENSIVE OUTPATIENT SERVICES CENTER.
MISSION STATEMENT FORM 990, PART III, QUESTION 1 THE CORPORATION IS PART OF THE PRESENCE HEALTH SYSTEM AND ACTS IN ACCORDANCE WITH THE PRESENCE HEALTH MISSION, WHICH IS AS FOLLOWS: INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST AND AS PART OF PRESENCE HEALTH, A CATHOLIC HEALTH SYSTEM, PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER PROVIDES HEALTHCARE SERVICES IN A COMPASSIONATE, HOLISTIC MANNER IN THE SPIRIT OF HEALING AND HOPE. FORM 990, PART III, LINE 4A PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER SPECIALIZES IN PROVIDING ITS NEIGHBORS WITH COMPREHENSIVE MEDICAL AND SURGICAL SERVICES PLUS SPECIALIZED SERVICES THAT MEET THE DIVERSE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL FEATURES A 264-LICENSED BED MAIN BUILDING WITH A NEARBY PROFESSIONAL OFFICE BUILDING, A CONVENIENT RADIOLOGY CENTER AND AN EXTENSIVE OUTPATIENT SERVICES CENTER. THE HOSPITAL PROVIDED PATIENT CARE OF 32,556 ACUTE PATIENT DAYS AND HAD 6,604 ACUTE DISCHARGES. SKILLED NURSING PATIENT DAYS WERE 12,886 AND DISCHARGES WERE 955. THERE WERE 43,277 EMERGENCY ROOM VISITS, 3,063 SURGERIES AND 101,157 OUTPATIENT REGISTRATIONS.
COMPENSATION AND FORM W-3 TRANSMITTAL OF WAGES AND TAX STATEMENT FORM 990, PART I, QUESTION 5, AND PART V, QUESTION 2 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER (THE "CORPORATION") REPORTS 0 EMPLOYEES ON FORM 990, PART I, QUESTION 5 AND FORM 990, PART V,QUESTION 2A AS IT IS NOT REQUIRED TO FILE FORM W-3, TRANSMITTAL OF WAGESAND TAX STATEMENT. THE CORPORATION'S COMPENSATION IS PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES THE FORMS W-2 AND W-3, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC.
FORM 1096 TRANSMITTAL OF U.S. INFORMATION RETURNS FORM 990, PART V, QUESTION 1A PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER (THE "CORPORATION") REPORTS 0 ON FORM 990, PART V, QUESTION 1A AS IT IS NOT REQUIRED TO FILE FORM 1096, TRANSMITTAL OF U.S. INFORMATION RETURNS. ALL OF THE CORPORATION'S ACCOUNTS PAYABLE REPORTABLE ON FORM 1096 ARE PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES ALL FORMS 1099, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC.
MEMBERS OF SHAREHOLDERS FORM 990, PART VI, QUESTION 6 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER HAS ONE MEMBER, PRESENCE RHC CORPORATION.
PERSONS WITH AUTHORITY TO ELECT MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, QUESTION 7A THE CORPORATION'S SOLE MEMBER, PRESENCE RHC CORPORATION, HAS THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY, OTHER THAN EX-OFFICIO DIRECTORS.
DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS FORM 990, PART VI, QUESTION 7B PRESENCE RHC CORPORATION (THE "MEMBER"), THROUGH ITS BOARD OF DIRECTORS, HAS CERTAIN RESERVE POWERS WITH RESPECT TO THE FOLLOWING. GENERAL POWERS AND RESPONSIBILITIES: THE MEMBER SHALL PROVIDE OVERSIGHT AND SUPPORT FOR THE ACTIVITIES OF THE CORPORATION, FOR THE PURPOSE OF ASSURING THAT ALL ACTIONS OF THE CORPORATION ARE CONSISTENT WITH THE MISSION AND VALUES OF THE SYSTEM; THE PURPOSES OF THE CORPORATION; THE ETHICAL AND RELIGIOUS DIRECTIVES; THE PRESENCE HEALTH SYSTEM STRATEGIC PLAN; AND BEST PRACTICES. MEMBER RESERVED POWERS: IN FURTHERANCE OF THE EXERCISE OF ITS GENERAL POWERS AND RESPONSIBILITIES, THE MEMBER SHALL HAVE THE SOLE POWER TO TAKE THE ACTIONS SPECIFIED BELOW WITH RESPECT TO THE FOLLOWING MATTERS, SUBJECT TO ANY NOTICES OR FURTHER APPROVALS REQUIRED BY APPLICABLE CIVIL OR CANON LAW, OR THE MEMBER'S BYLAWS: A) BYLAWS. AMEND OR REPEAL THE BYLAWS OF THE CORPORATION. B) OFFICERS AND DIRECTORS. APPOINT AND REMOVE ALL OFFICERS OF THECORPORATION AND ALL DIRECTORS OF THE CORPORATION, OTHER THAN ANYEX-OFFICIO DIRECTORS. C) BUDGETS. APPROVE CAPITAL AND OPERATING BUDGETS, AND LONG-TERM CAPITAL EQUIPMENT PLANS FOR THE CORPORATION. D) UNBUDGETED EXPENDITURES. APPROVE UNBUDGETED EXPENDITURES IN EXCESS OFTHE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. E) DEBT, SALE, LEASE AND OTHER REAL PROPERTY TRANSACTIONS. APPROVE ANY BORROWING OR SIGNIFICANT INCURRENCE OF DEBT BY THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME, OR ANY SALE,PURCHASE, ALIENATION, EXCHANGE, SIGNIFICANT LEASES (OTHER THAN IN THEORDINARY COURSE) OR ENCUMBRANCES OF THE CORPORATION'S REAL PROPERTY,EXCEPT THOSE MADE PURSUANT TO APPROVED BUDGETS. F) REAL ESTATE DOCUMENTS, EQUIPMENT LEASES. APPROVE EXECUTION OF ANYDEEDS, MORTGAGES, BONDS, OR MAJOR EQUIPMENT LEASES, EXCEPT THOSE ENTEREDINTO PURSUANT TO APPROVED BUDGETS. G) SIGNIFICANT UNBUDGETED TRANSACTIONS. APPROVE ANY OTHER SIGNIFICANT AND UNBUDGETED SALE, PURCHASE, EXCHANGE, LEASE (OTHER THAN IN THE ORDINARY COURSE) TRANSFER, LITIGATION OR LEGAL SETTLEMENT, BENEFITS PACKAGES, ENCUMBRANCE OR OTHER DISPOSITION OR OTHER SIGNIFICANT TRANSACTION INVOLVING THE NON-REAL-ESTATE ASSETS OF THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME-TO-TIME. H) MATERIAL CHANGES IN SERVICES. APPROVE MATERIAL CHANGES IN THE KIND OF SERVICES RENDERED, SUCH AS THE ADDITION OR DISCONTINUATION OF ANY MAJOR SERVICE LINE (E.G., OBSTETRICS) OR CHANGE IN THE FUNDAMENTAL NATURE OFSERVICES PROVIDED BY THE CORPORATION (E.G., A CHANGE REQUIRING ADIFFERENT KIND OF LICENSE). I) STRATEGIC PLAN. APPROVE STRATEGIC PLANS FOR THE CORPORATION CONSISTENT WITH AND IN FURTHERANCE OF SYSTEM MISSION AND VALUES, AND RESPONSIVE TO THE NEEDS OF THE COMMUNITIES SERVED BY THE CORPORATION AND SUPPORT THE ABILITY OF THE CORPORATION AND ITS AFFILIATES TO PROVIDE HIGH-QUALITYCARE AND SERVICES. J) MANAGEMENT CONTRACTS. APPROVE ANY CONTRACT FOR THE MANAGEMENT OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION OR ANY HEALTH CARE FACILITIES OWNED BY THE CORPORATION. K) BUSINESS NAME, LOGO. APPROVE ANY SELECTION OR MODIFICATION OF THE BUSINESS NAME OR LOGO OF THE CORPORATION OR ANY PROGRAM OR DIVISION OF THE CORPORATION, OR THE USE OF ANY CORPORATE OR BUSINESS NAME OF THE CORPORATION BY AN ENTITY OTHER THAN THE MEMBER OR AN AFFILIATE. L) ADMINISTRATIVE SERVICES. PROVIDE OR ASSURE THE PROVISION OF APPROPRIATE INSURANCE COVERAGE, STANDARDIZED EMPLOYEE BENEFITS, INFORMATION SYSTEMS AND TECHNOLOGY, FINANCIAL MANAGEMENT SERVICES, LEGAL, MARKETING, RISK MANAGEMENT AND OTHER ADMINISTRATIVE SERVICES NECESSARY TO SUPPORT THE CORPORATION'S OPERATIONS. M) SIGNIFICANT JOINT VENTURES. APPROVE THE ESTABLISHMENT, TERMINATION, OR SALE OF ANY SIGNIFICANT JOINT VENTURE RELATIONSHIP BY THE CORPORATION. N) UNRELATED BUSINESS ACTIVITY. APPROVE THE ACQUISITION OR DEVELOPMENT OF ANY BUSINESS OR ACTIVITY UNRELATED TO THE PROVISION OF HEALTH CARE SERVICES. O) NEW AFFILIATES. APPROVE THE CREATION OF ANY NEW AFFILIATE TO BE OWNED OR CONTROLLED BY THE CORPORATION. P) CONTRIBUTIONS TO MEMBER. DIRECT AND APPROVE ANY CONTRIBUTIONS, DONATIONS OR OTHER ASSET TRANSFERS WITHOUT CONSIDERATION TO THE MEMBER OR ANY AFFILIATE, IN FURTHERANCE OF THE MISSION AND VALUES. Q) CONTRIBUTION ACCEPTANCE. APPROVE ACCEPTANCE OF A CONTRIBUTION THAT IMPOSES A MATERIAL OBLIGATION ON THE CORPORATION, IF APPROVED BY THE CORPORATION'S APPLICABLE FOUNDATION OR FUNDRAISING AFFILIATE AS CONSISTENT WITH THE CORPORATION'S AND SYSTEM'S MISSION AND GOALS. R) BANKING. DEFINE THE CRITERIA FOR THE SELECTION OF BANKS AND OTHER FINANCIAL DEPOSITORIES TO BE USED BY THE CORPORATION, AND AUTHORIZE THE PROCESS BY WHICH SIGNATORIES ON ALL BANK AND SIMILAR ACCOUNTS OF THE CORPORATION ARE APPROVED. S) AUDITORS. SELECT INDEPENDENT AUDITORS FOR THE CORPORATION, IN CONNECTION WITH THE CONSOLIDATED AUDIT OF ALL SYSTEM ENTITIES. T) REGISTERED AGENT. APPROVE OR CHANGE THE CORPORATION'S REGISTERED AGENT OR REGISTERED OFFICE, AS APPROPRIATE FROM TIME TO TIME. U) TAX-EXEMPTION. APPROVE ANY VOLUNTARY CHANGE TO THE CORPORATION'S STATUS OF AN ORGANIZATION EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED FROM TIME-TO-TIME. APPROVAL AND RECOMMENDATION POWERS: TO BE EFFECTIVE, THE ACTIONS SET FORTH BELOW MUST BE APPROVED BY BOTH THE CORPORATION'S BOARD OF DIRECTORS AND THE MEMBER. SUCH ACTIONS MAY BE INITIATED EITHER BY THE MEMBER OR THE CORPORATION'S BOARD. A) ADOPTION, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION. B) ADOPTION OF ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION.
FORM 990 REVIEW PROCESS FORM 990, PART VI, QUESTION 11B The Corporation provides a complete copy of its Form 990 to all members of the governing boards of its ultimate parent corporations, Presence Health Network and Presence RHC Corporation, for review prior to filing with the IRS. The board of directors of the Corporation and other subsidiary organizations within the Presence Health system are internal limited fiduciary boards which do not receive a completed copy of the Form 990 prior to filing. As a result, the Corporation answers "no," to Form 990, Part VI, line 11a.
PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF PRESENCE HEALTH NETWORK AND ALL OF ITS AFFILIATED MINISTRIES (COLLECTIVELY "PRESENCE HEALTH") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY DIRECTOR, TRUSTEE, OFFICER, CORPORATE MEMBER APPOINTEE, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SENIOR LEADERS, AND OTHERS IN ARECENT POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PRESENCE HEALTH ("INTERESTED PERSONS"), AND CLARIFY THE STANDARDS OF CONDUCT, DUTIES AND OBLIGATIONS OF INTERESTED PERSONS IN THE CONTEXT OF POTENTIAL CONFLICTS OF INTEREST BY PROVIDING A METHOD FOR DISCLOSING AND RESOLVING SUCH POTENTIAL CONFLICTS. NO PRESENCE HEALTH ENTITY WILL ENGAGE IN ANY CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS DISINTERESTED MEMBERS OF THE APPLICABLE BOARD OF DIRECTORS OR OTHER GOVERNING BODY DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF PRESENCE HEALTH HAVE BEEN IMPLEMENTED. TO FACILITATE THIS POLICY, ALL INTERESTED PERSONS HAVE A CONTINUING OBLIGATION TO PROMPTLY DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE. ALL DISCLOSURES MUST BE PROVIDED TO THE SYSTEM COMPLIANCE OFFICER AND GENERAL COUNSEL IN A WRITTEN DESCRIPTION OF THE MATERIAL FACTS. DISCLOSURE SHALL BE ON A CONFLICTS OF INTEREST QUESTIONNAIRE OR SIMILAR FORMAT AS DESCRIBED IN THE CONFLICTS OF INTEREST POLICY. ALL INTERESTED PERSONS SHALL ALSO COMPLETE A QUESTIONNAIRE BASED ON THE ASSUMPTION OF THE BOARD (OR OTHER RELEVANT) POSITION, AND THEREAFTER ON AT LEAST AN ANNUAL BASIS OR WHEN AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT ARISES. AT ANY TIME THAT AN ACTUAL, APPARENT OR A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE CORPORATION'S BOARD OF DIRECTORS, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A DISCLOSURE STATEMENT BY AN INTERESTED PERSON, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE SUBJECT INTERESTED PERSON, THE CORPORATION'S BOARD OR APPLICABLE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, ONLY DISINTERESTED DIRECTORS/COMMITTEE MEMBERS VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT IS FOUND TO EXIST THE INTERESTED PERSON WILL GENERALLY BE REQUIRED TO RECUSE HIM OR HERSELF DURING ANY MEETING IN WHICH THE BOARD OF DIRECTORS OR APPLICABLE COMMITTEE CONDUCTS THE EVALUATION OF THE SUBJECT TRANSACTION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. TO ENSURE THAT THE PRESENCE HEALTH OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS EXEMPT STATUS, TRANSACTIONS INVOLVING INTERESTED PERSONS ARE ONLY APPROVED IF, AFTER EXERCISING REASONABLE DUE DILIGENCE, THE BOARD DETERMINES THEY ARE FAIR AND REASONABLE, TAKING INTO ACCOUNT FACTORS SUCH AS WHETHER PRESENCE HEALTH COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT. HOWEVER, LENDING MONEY OR GUARANTYING AN OBLIGATION OF A DIRECTOR, OFFICER, OR EMPLOYEE OF PRESENCE HEALTH (EXCLUSIVE OF CUSTOMARY INSURANCE COVERAGE FOR ACTS DONE IN CONNECTION WITH SUCH INDIVIDUAL'S SERVICE TO OR EMPLOYMENT BY PRESENCE HEALTH) IS STRICTLY PROHIBITED.
COMPENSATION AND APPROVAL PROCESS FOR OFFICERS AND KEY EMPLOYEES FORM 990 PART VI, QUESTIONS 15A AND 15B, AND PART V, QUESTION 2A COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION'S SOLE MEMBER, PRESENCE RHC CORPORATION (PRHCC) AND PRHCC'S SOLE MEMBER,PRESENCE HEALTH NETWORK, THE SYSTEM PARENT CORPORATION. SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF THE SYSTEM PARENT CORPORATION, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. THE SYSTEM PARENT CORPORATION USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE SYSTEM PARENT'S HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION AND APPROVES ALL COMPONENTS OF EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE SYSTEM PARENT'S BOARD. THE CORPORATION ANSWERS "NO" TO FORM 990. PART VI, QUESTION 15A AND 15B AS ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION, PRESENCE RESURRECTION MEDICAL CENTER, THE SYSTEM'S STATUTORY EMPLOYER.
DOCUMENT AVAILABILITY FORM 990, PART VI, QUESTION 19 THE CORPORATION'S ARTICLES OF INCORPORATION ARE ON FILE WITH THE STATE OF ILLINOIS. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE CORPORATION, TOGETHER WITH ITS AFFILIATES, ARE AVAILABLE FROM THE NATIONAL DISSEMINATION AGENT AS REQUIRED BY PRESENCE HEALTH SYSTEM'S BOND DOCUMENTS. CONFLICTS OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE PUBLIC, HOWEVER A SUMMARY OF THE CURRENT POLICY IS ANNUALLY INCLUDED IN SCHEDULE O OF THE CORPORATION'S FORM 990.
STATUTORY EMPLOYER FORM 990, PART VII, SECTIONS A & B PRESENCE RESURRECTION MEDICAL CENTER ("PRMC") (FEIN 36-3330926) ACTS AS THE PAYROLL AGENT FOR THE CORPORATION. CASH IS SWEPT FROM THE CORPORATION ON A DAILY BASIS TO PRMC AND PRMC ISSUES ALL PAYROLL AND ACCOUNTS PAYABLE CHECKS ON BEHALF OF AND AS PAYROLL AGENT FOR THE CORPORATION AND THE APPROPRIATE ACCOUNTING ENTRIES ARE RECORDED. INSURANCE EXPENSE FORM 990,PART IX, LINE 23 INSURANCE EXPENSE WAS ($1,909,951) DUE TO A REDUCTION IN EXPENSE BOOKED FOLLOWING A REVISED ACTUARIAL EVALUATION OF SELF-INSURANCE.
AUDITED FINANCIAL STATEMENTS FORM 990, PART XII, LINE 2B AN INDEPENDENT ACCOUNTANT ANNUALLY AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF PRESENCE HEALTH NETWORK AND ITS AFFILIATES. THE AUDIT OPINION IS ISSUED ON THE CONSOLIDATED FINANCIAL STATEMENTS AND EACH AFFILIATE IS NOT SEPARATELY AUDITED.
FORM 990 PART IX LINE 11G DESCRIPTION:THIRD PARTY LAB & PHARMACY SVC TOTAL FEES:5599016
FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED PHYSICIAN SERVICES TOTAL FEES:4176981
FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED NURSING SERVICES TOTAL FEES:1139963
FORM 990 PART IX LINE 11G DESCRIPTION:BIOMEDICAL EQUIPMENT MAINT TOTAL FEES:1246350
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:2750432
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


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
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
Presence Our Lady of the Resurrection Medical
Center
Employer identification number

36-2644178
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) Presence Health Network
200 South Wacker

Chicago,IL60606
36-1649520
Parent Corp IL 501(C)(3) 11C III-FI na
 
 
No
(2) Medicare Value Partners
100 North River Road

Des Plaines,IL60016
36-3495969
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(3) Presence Holy Family Medical Center
100 North River Road

Des Plaines,IL60016
36-2439318
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(4) Mount Loretto Nursing Home Inc
302 Swart Hill Road

Amsterdam,NY12010
14-1363014
Health Care NY 501(C)(3) 3 RM New York
 
Yes
 
(5) Presence Care Home
18927 Hickory Creek Drive 300

Mokena,IL60448
46-0483587
Health Care IL 501(C)(3) 9 PLC
 
Yes
 
(6) Presence PRV Health
1000 REMINGTON BLVD SUITE 100

BOLINGBROOK,IL60440
36-3366652
Mgmt Support IL 501(C)(3) 11C III-FI PHN
 
 
No
(7) Presence Home Care
18927 Hickory Creek Drive 300

Mokena,IL60448
46-0483581
Health Care IL 501(C)(3) 9 PLC
 
Yes
 
(8) Presence Hospitals PRV
1000 REMINGTON BLVD SUITE 100

BOLINGBROOK,IL60440
36-4195126
Health Care IL 501(C)(3) 3 PPRVH
 
Yes
 
(9) Laverna Terrace Housing Corporation
18927 Hickory Creek Drive 300

Mokena,IL60448
36-3438977
Senior Living IL 501(C)(3) 9 PPRVH
 
Yes
 
(10) Provena Self-Insurance Trust
1000 REMINGTON BLVD SUITE 100

BOLINGBROOK,IL60440
36-2987310
Insurance IL 501(C)(3) 11C III-FI na
 
 
No
(11) Presence Life Connections
18927 Hickory Creek Drive 300

Mokena,IL60448
37-1127787
Health Care IL 501(C)(3) 7 PPRVH
 
Yes
 
(12) Presence Behavioral Health
1820 South 25th Avenue

Broadview,IL60155
36-2709982
Health Care IL 501(C)(3) 3 PHS
 
Yes
 
(13) Presence Ambulatory Services
100 North River Road

Des Plaines,IL60016
36-4286236
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(14) Presence Health Fdn Board of Trustees
200 S Wacker

Chicago,IL60606
36-3330929
Fundraising IL 501(C)(3) 7 PRHCC
 
Yes
 
(15) Presence RHC Corporation
200 S Wacker

Chicago,IL60606
36-2235165
Mgmt Support IL 501(C)(3) 11C III-FI PHN
 
 
No
(16) Presence Home Care Services
5747 West Dempster

Morton Grove,IL60053
36-2893936
Home Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(17) Presence Resurrection Medical Center
7435 West Talcott Avenue

Chicago,IL60631
36-3330926
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(18) Resurrection Nursing Home Inc
90 North Main Street

Castleton,NY12033
14-1348691
Health Care NY 501(C)(3) 3 RM New York
 
Yes
 
(19) Presence RHC Senior Services
100 North River Road

Des Plaines,IL60016
23-7061646
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(20) Presence Healthcare Services
100 North River Road

Des Plaines,IL60016
36-3330928
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(21) Presence Saint Francis Hospital
355 Ridge Avenue

Evanston,IL60202
36-2167800
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(22) St Francis Hospital Aux of Evanston
355 Ridge Avenue

Evanston,IL60202
36-6143349
Fundraising IL 501(C)(3) 7 PSFH
 
Yes
 
(23) Presence St Mary and Elizabeth Med Cntr
2233 West Division Street

Chicago,IL60622
36-2171079
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(24) Presence Saint Joseph Hospital Chicago
2900 North Lake Shore Drive

Chicago,IL60657
36-3200170
Health Care IL 501(C)(3) 3 PRHCC
 
Yes
 
(25) Presence Nazarethville
300 North River Road

Des Plaines,IL60016
36-2801392
Health Care IL 501(C)(3) 9 PRHC Snr Srv
 
Yes
 
(26) Arthur Merkle - Clara Knipprath Nursing
1190 E 2900 N Road

Clifton,IL60927
36-2841358
Health Care IL 501(C)(3) 9 PLC
 
Yes
 
(27) Rainbow Hospice and Palliative Care
1550 Bishop Court

Mount Prospect,IL60056
36-3296367
Health Care IL 501(C)(3) 9 PHCS
 
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) BEL HARLEM SURG CTR

3101 North Harlem
Chicago,IL60634
41-2237162
Medical Service IL na
 
                 
(2) RH SLEEP CTR - NW

665 W N AVE
Lombard,IL60148
26-1519627
Medical Service IL na
 
                 
(3) RH SLEEP CTR - EVAN

665 W N AVE
Lombard,IL60148
26-1519556
Medical Service IL na
 
                 
(4) RH SLEEP CTR - LP

665 W N AVE
Lombard,IL60148
26-1519667
Medical Service IL na
 
                 
(5) RH SLEEP CTR - RF

665 W N AVE
Lombard,IL60148
26-2189763
Medical Service IL na
 
                 
(6) ALVERNO CLINIC LAB

2434 Interstate Pl Dr
Hammond,IN46324
20-3240648
Medical Service IN N/A
                 
(7) PROF CLINIC LAB LLC

113 E 4TH ST
MICHIGAN CITY,IN46360
30-0711211
MEDICAL SERVICE IN N/A
                 
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) Presence Properties Inc

100 North River Road
Des Plaines,IL60016
36-3520630
Medical IL PV
 
C Corp       Yes  
(2) Presence Service Corporation

2380 E Dempster Street
Des Plaines,IL60016
36-4314354
Medical IL PHPRV
 
C Corp       Yes  
(3) Presence Ventures Inc

100 North River Road
Des Plaines,IL60016
37-1168085
Medical IL PPRVH
 
C Corp       Yes  
(4) Resurrection Medical Center Auxiliary

7435 West Talcott Avenue
Chicago,IL60631
36-6109825
Fundraising IL PR Med Ctr
 
C Corp       Yes  
(5) Resurrection Ministries of New York

90 North Main Street
Castleton,NY12033
14-1720818
Parent Corp NY PRHCC
 
C Corp       Yes  
(6) Presence Health Care Preferred

100 North River Road
Des Plaines,IL60016
36-3974620
MGD Care Contract IL PRHCC
 
C Corp       Yes  
(7) L GILBRAITH INSURANCE SPC LTD

68 W BAY ROAD PO BOX 1109
GRAND CAYMAN    
CJ
000000000
INSURANCE CJ PRHCC
 
FOREIGN COMPANY       Yes  
(8) PROVENA HEALTH ASSURANCE SPC

23 LIME TREE BAY AVE PO BOX 1051
GRAND CAYMAN    
CJ
98-0420054
INSURANCE CJ PPRVH
 
FOREIGN COMPANY       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
 
No
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
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
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
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) PRESENCE HEALTH FOUNDATION BOARD OF TRUSTEES

c 299,370 CASH
(2) PRESENCE RESURRECTION MEDICAL CENTER

p 102,149,077 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
Reimbursements for Shared Services Presence Resurrection Medical Center (FEIN: 36-3330926) pays all of the compensation and accounts payable for all entities under the Presence Health System that were historically part of the Resurrection Health Care System ("Legacy Resurrection Entities"). Cash is deposited into an account by all Legacy Resurrection Entities and swept on a monthly basis to reimburse Presence Resurrection Medical Center for these expenses at cost. The amounts reported on Part V of Schedule R reflect the total cash transfers to/from Presence Resurrection Medical Center.
Schedule R (Form 990) 2014
Additional Data


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