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 10-01-2014 , and ending 09-30-2015
BCheck if applicable:
CName of organization
SWEDISH COVENANT HOSPITAL
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
5145 N CALIFORNIA AVE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL60625
D Employer identification number

36-2179813
E Telephone number

G Gross receipts $ 291,222,358
F Name and address of principal officer:
THOMAS J GARVEY
5145 N CALIFORNIA AVE
CHICAGO,IL60625
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.swedishcovenant.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1907
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Providing excellent healthcare services for our culturally diverse communities for over 120 years.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 24
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 2,233
6 Total number of volunteers (estimate if necessary) ............. 6 162
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,813,093
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 501,774 324,033
9 Program service revenue (Part VIII, line 2g) ......... 241,686,328 259,348,588
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 9,162,954 5,408,516
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 19,166,926 26,141,221
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 270,517,982 291,222,358
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 962,433 954,750
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) 119,059,824 119,276,648
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).... 133,132,311 138,848,247
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 253,154,568 259,079,645
19 Revenue less expenses. Subtract line 18 from line 12....... 17,363,414 32,142,713
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 442,054,712 446,778,668
21 Total liabilities (Part X, line 26)............. 272,555,069 277,220,750
22 Net assets or fund balances. Subtract line 21 from line 20..... 169,499,643 169,557,918
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: Our Mission is to provide a continuum of excellent healthcare services. Rooted in The Evangelical Covenant Church, the hospital is dedicated to serving the physical, spiritual and psychological needs of our culturally diverse communities.
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 $ 225,291,205 including grants of $ 954,750 ) (Revenue $ 284,158,235 )
Since 1886, Swedish Covenant Hospital (SCH) has been dedicated to providing community benefit healthcare services and healthcare education. As part of its mission as a not-for-profit, church-based community hospital, Swedish Covenant has served as an educational center, health rehabilitation center, illness prevention center, social support services center, and community center. Swedish Covenant Hospital serves as a solid community structure through employment of over 1,797 individuals.Recognizing its mission to the community, Swedish Covenant Hospital offers the following quality medical healthcare services regardless of race, creed, sex, national origin, handicap, age or ability to pay:General Medicine, Surgery, ICUSwedish Covenant Hospital continually offers the latest technology to meet the vast needs of the community. During the fiscal year, SCH serviced 13,570 inpatients and more than 273,000 outpatients at a total cost of $212,631,515.Physical Medicine/Rehab ServicesSCH is dedicated to providing a comprehensive Rehab Unit that combines the disciplines of physical therapy, speech therapy, occupational therapy and social work to help patients regain their strength and skills. The Rehab unit features a special room that simulates a home environment so patients can practice with home-like carpeting, furniture and fixtures while supervised by nurses. During the fiscal year, 214,981 inpatient and outpatient treatments for rehab, speech and occupational therapy were provided for a total cost of $4,643,987.Cardiac Care and RehabThe Cardiac Rehabilitation program offered by Swedish Covenant Hospital has improved the lives of many individuals with such innovative programs as "Coronary Heart Disease Reversal." SCH also offers a state-of-the-art Cardiac Catheterization Lab, and other diagnostic and preventive programs. During the fiscal year, SCH provided 30,558 treatments and 1,751 procedures by the Cardiac Rehab program and Cardiac Catheterization Lab, respectively, for a total cost of $7,072,750.In addition to the program services listed above, Swedish Covenant Hospital also offers the following services to the community:Health Screening, Health Promotions, Education, PreventionSCH offers year-round health screenings to members of the community. Blood pressure screening events are provided in collaboration with the hospital's Stroke Education Coordinator.Each year free or reduced-cost cancer screenings are offered to the community. These included prostate, skin, cervical and breast screenings. Additionally, dozens of programs led by oncologists and dietitians from the hospital address topics of cancer prevention, treatment, nutrition, fitness and other healthy lifestyle recommendations.The hospital also has an in-house smoking cessation program, which offers customized treatment plans and ongoing group support.During the fiscal year Swedish Covenant Hospital served a total of 15,631 persons through participation in health promotions, education, and prevention for a total cost of $340,353.Community Wellness and Prevention programs continue to serve the community with 225 events held at the Hospital or in the community through collaboration with community partners. These events include health fairs, screenings, daytime and evening lectures, seminars, classes, Speakers' Bureau presentations, children's events and other health related activities. Throughout the year the Hospital collaborated with dozens of community organizations to provide wellness and prevention programs.Swedish Covenant Hospital publishes periodic health and wellness information which is distributed through mailings and web-based programs to 985,265 households throughout the surrounding community for a cost of $54,015.During the fiscal year, Swedish Covenant Hospital also offered transportation services to 3,269 members of the community at a net cost of $136,426.Interpreter ServicesSwedish Covenant Hospital provides in-house interpreters for patients who speak Korean, Spanish, and Russian, the primary non-English languages in the community. In FY 2015, the interpreters participated in a total of 1,983 sessions. Additionally, SCH uses professional telephone interpretive assistance and had a total of 167,070 telephonic interpretation minutes in 74 languages. For deaf or hearing impaired patients who request sign language interpreters, the Hospital provides interpreters through CAIRS and Chicago Hearing Society. SCH incurred a total cost of $412,159 for interpreter services serving a total of 41,690 persons.Medical Education ProgramSwedish Covenant Hospital is an independent teaching hospital, with residency programs in family medicine, osteopathic internal medicine, and podiatric surgery. Swedish Covenant Hospital also has fellowship programs in Critical Care Medicine and Pulmonary Critical Care Medicine.Swedish Covenant Hospital utilizes board-certified physicians who are employed by Swedish Covenant Management Services, a wholly-owned subsidiary of Swedish Covenant Hospital to provide teaching, training and supervision of the residents in Swedish Covenant Hospital's Family Medicine (12 residents), Internal Medicine (24 residents), Podiatric Surgery (6 residents) residency programs as well as the Critical Care (2 fellows) and Pulmonary Critical Care Fellowships (3 fellows). As part of Swedish Covenant Hospital's teaching affiliation agreement with Midwestern University Chicago College of Osteopathic Medicine (MWU/CCOM), Swedish Covenant Hospital is a training site for residents in emergency medicine and critical care.Swedish Covenant Hospital has an affiliation agreement with Rush University which allows for the Hospital to be a training site for their OB/GYN residents.In addition to the above, during the fiscal year ended September 30, 2015, Swedish Covenant Hospital voluntarily provided $6,521,194 at cost in charity care/uninsured discounts and provided $21,774,724 at cost in unreimbursed Medicaid services.
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 expensesMediumBullet225,291,205
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
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 attachment
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.. Click to see attachment
21
Yes
 
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........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
278
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
1
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,233
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
24
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTHOMAS GARVEY

5145 N CALIFORNIA AVE
CHICAGO,IL60625 (773) 878-8200
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) CHARLES L ADAIR........................................................................
DIRECTOR
1.00
.......................1.00
X           0 0 0
(2) KURT D ANDERSON........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(3) LYLE BANKS........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(4) MICHAEL BAUGHMAN........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(5) RONALD D CURRAN MD........................................................................
DIRECTOR
1.00
.......................40.00
X           34,167 788,742 30,201
(6) VINCENT DIBENEDETTO........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(7) H CLARK FEDERER MD........................................................................
DIRECTOR
1.00
.......................40.00
X           0 340,685 27,136
(8) MAUREEN T GIRARD........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(9) W J WESLEY KEE........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(10) DAVID J KOO........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(11) BRUCE MCNULTY MD........................................................................
DIRECTOR
7.50
.......................1.00
X           25,000 0 0
(12) REV MARK A NILSON........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(13) CHRISTOPHER J OLSON........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(14) BEA REYNA-HICKEY........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(15) CHRIS SULLIVAN........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(16) JEFFREY M TILKIN MD........................................................................
DIRECTOR
1.00
.......................  
X           13,933 0 0
(17) LAWRENCE P ANDERSON........................................................................
DIRECTOR
1.00
.......................42.00
X           0 591,281 27,429
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) DAVID A DWIGHT........................................................................
DIRECTOR
1.00
.......................42.00
X           0 657,813 38,110
(19) ARMINIO SURUCCI MD........................................................................
DIRECTOR
1.00
.......................  
X           0 0 0
(20) REV GARY B WALTER........................................................................
DIRECTOR
1.00
.......................40.00
X           0 151,200 113,208
(21) THOMAS M PYRA........................................................................
CHAIRMAN
1.00
.......................  
X   X       0 0 0
(22) JUDITH A PINS........................................................................
VICE CHAIR
1.00
.......................  
X   X       15,131 0 0
(23) DAVID R PUTMAN........................................................................
SECRETARY
1.00
.......................1.00
X   X       0 0 0
(24) MARK NEWTON........................................................................
PRESIDENT & CEO
40.00
.......................3.00
X   X       0 962,414 19,750
(25) THOMAS J GARVEY........................................................................
SENIOR VP & CFO
40.00
.......................3.00
    X       416,644 0 58,790
(26) JUDITH A BORENSTEIN........................................................................
GENERAL COUNSEL
40.00
.......................3.00
      X     360,816 0 35,282
(27) ANTHONY GUACCIO........................................................................
SENIOR VP & COO
40.00
.......................1.00
      X     488,047 0 67,219
(28) DEREK J KELLY MD........................................................................
VP & CHIEF MEDICAL OFFICER
40.00
.......................  
      X     382,949 0 18,206
(29) MARY SHEHAN RN........................................................................
SENIOR VP, CNO
40.00
.......................  
      X     303,657 0 8,561
(30) KATHRYN DONOFRIO RN........................................................................
SENIOR VP, CNO
40.00
.......................  
      X     166,449 0 19,562
(31) KAREN M SHEEHAN........................................................................
SENIOR VP & CIO
40.00
.......................  
        X   279,180 0 25,460
(32) JANIS A RUEPING........................................................................
VP QUALITY IMPVMT/RISK MGM
40.00
.......................1.00
        X   255,137 0 41,230
(33) MICHAEL FEINZIMER........................................................................
PHYSICIAN
40.00
.......................  
        X   221,180 0 1,716
(34) JONATHAN LIND........................................................................
VP OPERATIONS
40.00
.......................  
        X   213,456 0 24,561
(35) PATRICIA KING........................................................................
ASSOCIATE GENERAL COUNSEL
40.00
.......................  
        X   208,049 0 22,477
(36) TONY VANCAUWELAERTMD........................................................................
FORMER DIRECTOR,PHYSICIAN
0.00
.......................40.00
          X 0 303,331 15,326
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,383,795 3,795,466 594,224
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet80
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
MIDWESTERN UNIVERSITY

555 31ST STREET
DOWNERS GROVE,IL60515
HEALTH CARE 937,798
ANDERSON MIKOS ARCHITECTS LTD

17W110 2ND ST SUITE 200
OAKBROOK TERRACE,IL60181
ARCHITECT SERVICES 867,782
NEPHRON DIALYSIS CTR LTD

5140 N CALIFORNIA AVE STE 510
CHICAGO,IL60625
HEALTH CARE 659,095
PEDIATRIC FACULTY FOUNDATION LURIE CHILD

225 E CHICAGO AVE BOX 152
CHICAGO,IL60611
HEALTH CARE 614,395
QUEST DIAGNOSTICS

12989 COLLECTION CENTER DR
CHICAGO,IL60693
HEALTH CARE 581,376
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet23
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 263,806
f All other contributions, gifts, grants, and
similar amounts not included above
1f
60,227
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 324,033
 Program Service RevenueAmt Business Code
2a HEALTH CARE SERVICES 900099 257,010,935 257,010,935    
b LABORATORY SERVICES 621500 2,337,653   2,337,653  
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 259,348,588
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet -247,024     -247,024
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 6,299,289  
b Less: rental expenses 0  
c Rental income or (loss) 6,299,289  
d Net rental income or (loss).......MediumBullet 6,299,289 6,299,289    
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 5,655,540  
b Less: cost or other basis and sales expenses 0  
c Gain or (loss) 5,655,540  
d Net gain or (loss)..........MediumBullet 5,655,540     5,655,540
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      
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        
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        
Miscellaneous Revenue Business Code
11a CHRPP REBATE 900099 9,357,953 9,357,953    
b CHILD CARE CENTER 624410 1,021,511 546,071 475,440  
c PARKING GARAGE FEES 812930 956,284 956,284    
d All other revenue .... 8,506,184 8,506,184    
e Total. Add lines 11a–11d ...... MediumBullet 19,841,932
12 Total revenue. See Instructions......MediumBullet 291,222,358 284,158,235 2,813,093 5,408,516
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 .... 954,750 954,750
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 2,223,449 921,164 1,302,285  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 219,719 116,185 103,534  
7 Other salaries and wages .... 95,937,640 87,416,942 8,520,698  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,819,457 1,635,874 183,583  
9 Other employee benefits ....... 12,012,708 10,847,278 1,165,430  
10 Payroll taxes ........... 7,063,675 6,304,296 759,379  
11 Fees for services (non-employees):        
a Management ...... 3,028,219   3,028,219  
b Legal ......... 227,431   227,431  
c Accounting ........... 116,100   116,100  
d Lobbying ........... 217,500   217,500  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 27,262,034 23,569,990 3,692,044  
12 Advertising and promotion .... 819,213 396,149 423,064  
13 Office expenses ....... 630,880 540,475 90,405  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 4,437,343 4,106,915 330,428  
17 Travel ............ 375,252 252,392 122,860  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 8,786,442   8,786,442  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 19,234,511 17,868,788 1,365,723  
23 Insurance .............. 10,021,090 9,009,962 1,011,128  
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 OTHER OPERATING SUPPLIE 40,726,756 40,616,396 110,360  
b IDPA TAX 12,709,392 12,709,392    
c EQUIPMENT REPAIR & MAIN 6,328,127 6,236,554 91,573  
d PROPERTY & SALES TAX 2,197,841 265,911 1,931,930  
e All other expenses 1,730,116 1,521,792 208,324  
25 Total functional expenses. Add lines 1 through 24e 259,079,645 225,291,205 33,788,440 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).        
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 .............   1 288,035
2 Savings and temporary cash investments .........   2 11,897,913
3 Pledges and grants receivable, net ........... 993,799 3 543,629
4 Accounts receivable, net ............. 26,652,044 4 30,947,891
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,303,416 8 3,784,892
9 Prepaid expenses and deferred charges .......... 4,752,038 9 4,446,796
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 475,095,084
b Less: accumulated depreciation ..... 10b 288,103,678 193,551,595 10c 186,991,406
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ..... 139,816,422 12 133,415,456
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 1,667,943 14 592,357
15 Other assets. See Part IV, line 11 ........... 70,317,455 15 73,870,293
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 442,054,712 16 446,778,668
Liabilities 17 Accounts payable and accrued expenses ......... 32,222,328 17 39,720,768
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 171,843,930 20 167,269,819
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 68,488,811 25 70,230,163
26 Total liabilities. Add lines 17 through 25......... 272,555,069 26 277,220,750
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 .............. 168,467,998 27 168,484,197
28 Temporarily restricted net assets ........... 1,031,645 28 1,073,721
29 Permanently restricted net assets ...........   29  
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 ........... 169,499,643 33 169,557,918
34 Total liabilities and net assets/fund balances ........ 442,054,712 34 446,778,668
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
291,222,358
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
259,079,645
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
32,142,713
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
169,499,643
5
Net unrealized gains (losses) on investments ...............
5
-13,467,349
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
-18,617,089
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
169,557,918
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
146,885
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
217,500
j
Total. Add lines 1c through 1i ...............................
364,385
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: In the course of regular business activities, the hospital or its lobbyist perform some lobbying activities on matters of interest to itself and its patients.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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 .... 21,383,248 20,747,291 20,575,237 19,626,213 18,814,654
b Contributions ........ 2,587,312 2,850,273 1,532,811 8,677,201 1,270,179
c Net investment earnings, gains, and losses -164,316 477,914 115,000 127,001 20,979
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
1,746,011 2,692,230 1,475,757 7,855,178 479,599
f Administrative expenses ....          
g End of year balance ...... 22,060,233 21,383,248 20,747,291 20,575,237 19,626,213
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet17.840 %
b
Permanent endowment SchDMd Bullet82.160 %
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)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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 .................   7,960,138 7,960,138
b Buildings ................   206,553,629 91,342,827 115,210,802
c Leasehold improvements ............   550,932 550,932 0
d Equipment ................   230,437,044 176,237,060 54,199,984
e Other .................   29,593,341 19,972,859 9,620,482
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 186,991,406
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    
(3)Other
(A) CMB BOND & EQUITY FUND - FMV
124,066,502 F

(B) US BANK
9,346,348 F

(C) MERRILL LYNCH - FMV
2,606 F






Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 133,415,456
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) OTHER INVESTMENTS 879,216
(2) CAPTIVE RECOVERIES A/R 1,628,937
(3) CHRPP RECOVERIES A/R 6,178,000
(4) DUE FROM AFFILIATES 55,641,103
(5) ASSETS WHOSE USE IS LIMITED 3,624,951
(6) ALL OTHER CURRENT ASSETS 536,226
(7) ACA 400 2,319,613
(8) PA TAX ASSESSMENT 1,946,891
(9) STOP LOSS REIMBURSEMENTS 570,947
(10) TRANSITIONAL CARE PAYMENT 544,409
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 73,870,293
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  
ACCRUED LONG TERM MALPRACTICE LIABILITY 18,913,658
FAIR VALUE OF INTEREST RATE SWAPS 18,295,741
ASSET RETIREMENT OBLIGATION 1,705,061
DUE TO THIRD PARTY PAYERS 17,840,703
NMTC DEBT ISSUE 13,475,000




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 70,230,163
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
Part V, Line 4: The earnings are to be used for education, charity care, and other hospital programs. Swedish Covenant Hospital is the related beneficiary of the endowment funds held by Swedish Covenant Hospital Foundation.
Part X, Line 2: The Hospital is a not-for-profit organization under the laws of Illinois. The Internal Revenue Service has determined that the Hospital is a not-for-profit organization described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, the Hospital has not provided for income taxes in the accompanying financial statements. The Hospital and its not-for-profit subsidiaries each file Form 990 (Return of Organization Exempt from Income Tax), and the for-profit subsidiary files Form 1120 (U.S. Corporation Income Tax Return) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business income (UBI). UBI is reported on Internal Revenue Service Form 990-T, as appropriate. The benefit of a tax position is recognized in the financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the tax position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits reflected as a liability for unrecognized tax benefits in the accompanying consolidated statements of financial position along with any associated interest and penalties that would be payable to the taxing authorities upon examination. At September 30, 2015 and 2014, there were no unrecognized tax benefits identified or recorded as liabilities. The Forms 990, Forms 990-T and Forms 1120 filed by the Hospital are subject to examination for up to three years from the extended due date of each return. These returns are no longer subject to examination for tax years ended before September 30, 2012.
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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
 
No
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) ..
    6,637,718   6,637,718 2.580 %
b Medicaid (from Worksheet 3,
column a) ....
    78,527,966 79,476,079 -948,113 0 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    85,165,684 79,476,079 5,689,605 2.580 %
Other Benefits
    932,512   932,512 0.360 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    3,868,421 2,970,648 897,773 0.350 %
g Subsidized health services
(from Worksheet 6) ..
    1,034,560   1,034,560 0.400 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    954,750   954,750 0.370 %
j Total. Other Benefits ..     6,790,243 2,970,648 3,819,595 1.480 %
k Total. Add lines 7d and 7j .     91,955,927 82,446,727 9,509,200 4.060 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     34,476   34,476 0.010 %
8 Workforce development            
9 Other            
10 Total     34,476   34,476 0.010 %
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
8,312,952
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
 
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
83,497,445
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
79,409,573
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
4,087,872
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 %
11 CHICAGO CK ENTERPRISES LLC
 
OUTPATIENT MEDICAL SERVICES 5.300 % 0 % 94.700 %
22 CK PROPERTY DEVELOPMENT LLC
 
PROPERTY MANAGMENT SERVICES 36.800 % 0 % 63.200 %
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 SWEDISH COVENANT HOSPITAL
5145 N CALIFORNIA AVENUE
CHICAGO,IL60625
www.swedishcovenant.org
00002717
X X   X     X   I/P & OP HOSPITAL SERVICES, SKILLED NURSING FACILITY  
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)
SWEDISH COVENANT HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
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 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): www.schosp.org
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)

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

SWEDISH COVENANT HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   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
SWEDISH COVENANT HOSPITAL Part V, Section B, Line 5: The Community Health Needs Assessment was produced in cooperation with the Metropolitan Chicago Healthcare Council (MCHC). The project also received input from several Community Health Needs Assessment Focus Groups, which were comprised of representatives of the partnering organizations as well as other citizens chosen for their relevant experience and interests. The sample design used for this effort consisted of a random sample of 515 individuals age 18 and older in the Swedish Covenant Hospital Service Area. Once the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the Swedish Covenant Hospital Service Area as a whole. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC). For statistical purposes, the maximum rate of error associated with a sample size of 515 respondents is 4.4% at the 95 percent level of confidence.The sample design and the quality control procedures used in the data collection ensure that the sample is representative. Thus, the findings may be generalized to the total population of community members in the defined area with a high degree of confidence.As part of the Community Health Needs Assessment, seven focus groups were held among key informants in the community on June 21-22 and July 11-12, 2012, each focusing on needs within different geographies or among certain populations. These key informant focus groups allowed for input from persons with special knowledge of or expertise in public health, as well as others who represent the interests of key cultural groups represented in communities served by Swedish Covenant Hospital. In all, 50 key informants participated, including physicians, other health professionals, social service providers, business leaders, minority organizations and other community leaders.Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Specific names/titles of those participating are available upon request.
SWEDISH COVENANT HOSPITAL Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the CHNA process, Swedish Covenant Hospital determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. The hospital focused on 7 of the 14 identified needs. Listed below are the seven needs which are being addressed and how they being addressed:1. Access to health servicesSCH continues to identify improper utilization of the Emergency Department and direct patients to Erie Foster Avenue Health Center for follow up care or to establish future medical home. Hospital employees served as Certified Application Counselors to assist consumers with enrollment on the health insurance marketplace. These employees also helped eligible individuals enroll in Medicaid and Medicare throughout the year. The hospital also opened an on-site marketplace assistance center in partnership with ACA Enroll, which was open five days per week during open enrollment. As part of the hospital's Care Transitions Program, recently discharged patients are called to assess educational and social support needs. Patients identified as at risk for readmission receive a home visit by a Wellness Coach, who performs medication reconciliation, education and assistance in scheduling physician appointments and needed transportation. 2. Heart disease and strokeAs part of the hospital's Primary Stroke Center certification, SCH's Stroke Education Coordinator provides blood pressure screenings throughout the community along with education related to warning signs/risk factors for heart disease and stroke. At blood pressure screenings, participants with abnormally high levels are referred for follow-up with their physician or a community health clinic. Discharge Navigators play a leading role in patient follow up and support. Discharge Navigators call patients who were at high risk for readmission, with the majority of these patients receiving multiple calls. The navigator may help to explain medications, assist with getting physician appointments or arrange services such as oxygen delivery, meals on wheels, and home health providers. Patients at risk for re-admission are visited at home by a Wellness Coach to review prescribed medications and provide disease specific education. If appropriate, 90-day home telemonitoring is also available for patients at risk for readmission.3. Nutrition, physical activity and weightThe hospital provides community education regarding healthy eating and fitness. More than 40 programs in FY15 featured nutrition, cooking, diabetes prevention or fitness. Partners included Whole Foods Market, Mariano's, Oak Street Health, The Breakers and Peterson Garden Project. A key partner in this priority is Galter LifeCenter, the certified medical fitness facility on campus (and the only certified medical fitness facility in Chicago), which offers a number of programs in collaboration with SCH, including Fundamental Fitness and Total Control.4. Mental health and mental disordersThe hospital continues to seek ways to provide appropriate resources for mentally ill individuals and to decrease improper use of Emergency Department (ED) services. The hospital maintains an active partnership with Lutheran Social Services of Illinois (LSSI) Project IMPACT on site in the ED. In 2015, 3,657 patients were seen by Project Impact in SCH's ED; 630 patients lacked health insurance. Initiating treatment and intensive case management for uninsured patients in acute crisis holds promise for reducing the number in need of state hospitalization and repeat ED visits. Project IMPACT maintains a Certified Addictions Counselor (CAC) as part of the care team in the hospital's ED. In May 2015 LSSI expanded services on the hospital campus by opening the Welcoming Center in the Foster Medical Pavilion. The Welcoming Center is a behavioral health program that provides open-access to treatment for individuals struggling with emotional stress, mental health symptoms, and substance abuse, no appointments necessary. The center is a safe alternative to seeking care in the emergency room and uses a warm, compassionate environment that is more like a living room than an office. 5. Cancer Swedish Covenant Hospital has a cancer affiliation with Rush University Medical Center. This affiliation results in service and treatment enhancements including: increased access to care, enhanced surgical services, radiation therapy, imaging and specialty care; new research opportunities; increased opportunities for medical students; and lifestyle enhancement for cancer patients through the use of the Galter LifeCenter. The hospital's Integrated Cancer Care Program (ICCP) augments standard cancer care with psychosocial support, nutrition counseling and supplementation, exercise programming, rehabilitation, palliative care planning; as well as complementary treatments. The hospital is committed to serve the uninsured and underinsured in our local service area. The SCH Community Breast Health Program serves approximately 4,000 underserved, low-income women each year. 6. Maternal, infant and child healthIn FY15, SCH opened the Outpatient Breastfeeding Clinic. It is housed on campus in the Women's Health Center. It is the only clinic of its kind in the city of Chicago. Women receive hands-on professional breastfeeding support that is billed directly to insurance, including Medicaid. Before our clinic opened, women's options for breastfeeding support were limited to a few suburban clinics, or private home visit lactation consultants who require payment of $200-250 up front. Our service allows women to take advantage of the insurance provisions of the ACA, which cover multiple visits for lactation support without cost-sharing by the patient. The hospital continues to educate physicians and the community about the importance of fetal development during final weeks of pregnancy to minimize Early Elective Delivery. 7. Respiratory diseasesIn FY15, the hospital's new Heart & Lung Center, which centralizes the outpatient cardiology and respiratory services, began to see patients. The Center expands the hospital's ability to provide Pulmonary Function Testing and adds services including Pulmonary Stress Testing using a metabolic cart, and body Plethysmography, which enables physicians to detect certain pulmonary conditions that conventional testing cannot. Use of the new metabolic cart has been extremely successful to wean ventilator patients in the intensive care units. The Respiratory Department participates in health fairs and screenings throughout the year, providing community members with 1-1 free respiratory screenings utilizing spirometry. Each appointment lasts approximately 10 minutes and results are provided to the patient who in turn is instructed to give to their physicians. In FY16, the department will begin providing free inhaler evaluations and demonstrations, in an effort to combat COPD readmissions. All individuals attending a consultation will be given a spacer (if needed) along with individualized instruction. These demonstrations will also be available in Spanish. Listed below are the health priorities not chosen for action and the reasons as to why they were not selected:Injury & Violence Prevention: Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action. Chronic Kidney Disease: SCH regularly partners with organizations including the National Kidney Foundation to provide free screenings to the ethnicities most vulnerable to this disease. SCH feels that efforts outlined herein to improve access to health services will also have a positive impact on chronic kidney disease and that a separate set of specific initiatives was not necessary.Family Planning: The partnership with Erie Family Health will positively impact outreach regarding family planning education. Erie and other community organizations have infrastructure and programs in place to better meet this need. Infectious Diseases: Advisory committee members felt that more pressing health needs existed. Limited resources and lower priority excluded this as an area chosen for action.Sexually Transmitted Diseases: SCH believes that this priority area falls more within the purview of the county health department and other community organizations. Limited resources excluded this as an area chosen for action. Substance Abuse: Other community organizations have infrastructure and programs in place to better meet this need. Limited resources excluded this as an area chosen for action. HIV: SCH believes this area falls more within the purview of the county health department and other community organizations. Limited resources excluded this as an area chosen for action.
Part V, Section B, Line 16 Financial Assistance Policy Website Availability
SWEDISH COVENANT HOSPITAL Part V, Section B, line 16a website: www.swedishcovenant.org
SWEDISH COVENANT HOSPITAL Part V, Section B, line 16b website: www.swedishcovenant.org
SWEDISH COVENANT HOSPITAL Part V, Section B, line 16c website: www.swedishcovenant.org
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?2
Name and address Type of Facility (describe)
1 LIFE CENTER ON THE GREEN INC
5157 N FRANCISCO AVENUE
CHICAGO,IL60625
PHYSICAL REHABILITATION SERVICES
2 SWEDISH COVENANT HOME HEALTH CARE
6141 N CICERO AVENUE
CHICAGO,IL60646
HOME HEALTH CARE SERVICES
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 7: Each net community benefit expense is divided by total hospital expenses (excluding bad debt expense) to determine the percent of community benefits provided for fiscal year 2015. Costing Methodology - For all community benefits, we utilize the cost to charge ratio to calculate the benefit. The net operating costs are calculated by taking the total operating costs less the following: the PA tax and the non-patient care activity costs. The net gross charges are calculated as follows: gross charges less charges for community benefits. Net operating costs divided by net gross charges provides the cost to charge ratio.Part I - Line 7d - column dFor Schedule H, line 7b, column (c) the $78,527,966 in the Community Benefit Expense includes the provider assessment tax of $12,709,392. Had the provider tax been excluded, the total Community Benefit expense would have been $65,818,574. On Schedule H, line 7b, column (d), the direct offsetting revenue of $79,476,079 includes the provider tax revenue of $35,432,229 million. Had the public aid provider revenue been excluded from Schedule H, the direct offsetting revenue would have been $44,043,850. Using an adjusted total community benefit expense of $65,818,574 noted above, minus an adjusted direct offsetting revenue amount of $44,043,850, also noted above, the resulting community benefit dollar amount on Schedule H, line 7b, column (e) would have been $21,774,724. On Schedule H, line 7b, column (f) percentage of total expense would have increased from 0% to 8.46%.The PA tax benefit is not reimbursement for direct patient care and therefore we believe it should be excluded from the Schedule H calculations.
Part II, Community Building Activities: Members of Swedish Covenant Hospital staff work with other organizations and participate in many activities to advocate for health improvement in our community. These include:Involvement with the Association for Community Safety Net Hospitals, participation in the Medicaid Rate Reform Tag Group, community meetings, chambers of commerce, education, and seeking of resources with regard to the planning and development of the Emergency Department Renovation Project on the hospital campus to enhance emergency health care services in the community. During the 2015 fiscal year, Swedish Covenant Hospital joined with other area hospitals to develop the Healthy Chicago Hospital Collaborative. The Healthy Chicago Hospital Collaborative is a collaboration of Chicago-based hospitals that strives to promote a collective impact on health outcomes in the city of Chicago through an environment that fosters learning, sharing of resources, data and best practices. Members of the Swedish Covenant Hospital Staff have also worked to establish an affiliation with Rush University Medical Center to allow our emergency room physicians to communicate with Rush University Medical Center neurologists using robotic equipment which enables the Rush neurologists to remotely examine Swedish Covenant emergency department patients for signs of a stroke. This resource can improve patient outcomes by early and accurate diagnosis of stroke.
Part III, Line 2: The costing methodology is applying the cost-to-charge ratio of 20% to total bad debt expense.
Part III, Line 3: There are no bad debt amounts included in community benefits.
Part III, Line 4: This statement is extracted from the SCH consolidated financial statements. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for uncollectible accounts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (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 Hospital records a significant provision for uncollectible accounts 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 discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is written off against the allowance for uncollectible accounts in the period they are determined uncollectible.
Part III, Line 8: The hospital has used the standard single apportionment step down cost allocation methodology for the allocation of allowable costs (as defined by the Medicare principles of reimbursement) to the revenue cost centers. Allowable allocated costs are divided by the revenues in each ancillary department and by the days in each nursing unit to determine the appropriate ratios and cost per diems to be applied to the related Medicare ancillary charges and nursing unit days to determine the cost of Medicare services.
Part III, Line 9b: Charity Care Patients:If a patient has been determined to meet Hospital Charity Care Guidelines no collection agencies, lien attachments or attempts to possess real or personal property will be made.During the fiscal year 2014, the organization policy of using the Federal Poverty Guidelines to determine eligibility for providing free care to low income individuals was amended from 200% to 300% of the family income limit.The organization has a policy of Presumptive Charity Care for health care services provided to uninsured patients who are presumed eligible for charity care based on criteria demonstrating financial need.Effective January 1, 2014, the regulations adopted by the Illinois Attorney General (77 Ill. Admin. Code Part 4500, Hospital Financial Assistance under the Fair Patient Billing Act), require that a presumptive charity determination take place as soon as possible after the receipt of health care services from the hospital and prior to the issuance of any bill for those health care services by the hospital. According to the regulations, a patient's financial need must be determined by use of presumptive charity criteria (which may be accomplished through software/screening) without further scrutiny by the hospital.Financial Assistance:Patients with a self-pay balance and without the resources to pay their obligations will be assessed for financial assistance by the Credit Services Department. The assessment involves an evaluation for eligibility for all appropriate levels of assistance, including governmental or partial reductions or complete charity care.
Part VI, Line 2: Needs AssessmentIn the spring of 2012, Swedish Covenant Hospital (SCH) embarked on a comprehensive Community health Needs Assessment (CHNA) process to identify and address the key issues for our community.Swedish Covenant Hospital is a comprehensive health care facility providing health and wellness services to Chicago's North and Northwest side communities. This 323-bed hospital is one of the few independent, nonprofit hospitals in the area. Its 600 physicians and 2,200 employees remain focused on the hospital's mission of providing compassionate, high quality care in a healing environment. An established teaching hospital, Swedish Covenant Hospital offers a range of medical programs, including the latest cardiac, cancer, orthopedic, surgical, women's health, back health and emergency services.To address concerns about healthcare access, SCH created a partnership with Erie Family Health Center. In July 2013, Erie opened the Erie Foster Avenue Health Center on the hospital's campus. Erie Foster Avenue Health Center is a Federally Qualified Health Center which provides care to patients who come through the emergency department at SCH and might not have a medical home. Swedish Covenant Hospital (SCH) maintains a department dedicated to addressing its outreach objectives of serving the entire community, not only those who come through its doors. Building on a long tradition of service, the Community Relations Department utilizes hospital strengths alongside those of other well-established community partners. This strategy allows SCH to better understand and reach the most vulnerable sectors of the community, while meeting pressing healthcare needs. The goal is to improve the community's health status by empowering citizens to make healthy lifestyle choices. The Community Benefit Plan (Community Health Needs Assessment Implementation Strategy) identifies seven priority health issues to be addressed for providing community benefit. The implementation strategy is intended to exist over a three year time period, after which a new needs assessment and benefit plan will be developed. The following is a list of the seven priorities of the Community Benefit Plan, out of 14 community needs identified, to be addressed on an ongoing basis and reported on annually through FY16. 1. Access to health services 2. Heart disease and stroke 3. Nutrition, physical activity and weight4. Mental health and mental disorders5. Cancer6. Maternal infant and child health7. Respiratory diseases
Part VI, Line 3: Patient Education of eligibility for AssistanceCharity or discounted care is available for medically necessary services as defined by Medicare, to patients who meet the financial and documentation criteria defined below. Each situation is reviewed on an individual case-by-case basis. While not absolutely essential, the need for potential charity or discounted care should be established in advance of admission or rendering of service, or shortly thereafter.Notices in English, Greek, Korean, Russian, Spanish and Urdu about the availability of Charity or Discounted Care are posted in the Emergency Room registration area, and the inpatient and outpatient registration areas. The information is also contained in the Patient Handbook, given to all patients upon inpatient admission. Patients and families are encouraged to speak to a financial counselor for more information and assistance. The Guidelines, along with the financial questionnaire, are posted in English, Greek, Korean, Russian, Spanish and Urdu on the hospital's website.In order to be eligible for charity or discounted care, the patient must be willing to provide verification of income by filling out the Patient Financial Statement. The patient is responsible to voluntarily submit any and all documentation in order to be eligible to receive this discount. During the registration and information gathering process, the financial counselors determine if the patient qualifies for medical assistance from other existing financial resources such as Medicare, Medicaid, Kid Care, Family Care or other state or federal programs. If the patient refuses to apply for existing financial resources or to provide information necessary to the application process, charity or discounted care cannot be granted. If the application for existing financial resources is denied, or has been previously denied, consideration for charity or discounted care will then be given.Once the Financial Assistance Application form is received, Credit Services Department determines the eligibility for charity or discount care. SCH suspends the collection process while the Financial Assistance Application is being reviewed. The only criteria considered for Financial Assistance is income and family size. Income is evaluated against the matrix of Federal Poverty Guidelines to determine whether full or partial discount can be approved. Documentation of income is submitted in the form of paycheck stubs, income tax returns, Social Security checks, and other documents that are indicative of income. If the information submitted is not perceived to be accurate or reliable, SCH reserves the right to request additional documentation to substantiate income or family size.The insured patient with a large balance due to deductibles and/or co-payments may be eligible for charity or discounted care. In order to qualify, the patient must complete the Patient Financial Statement and return it to the financial counselors for evaluation and recommendation.If a patient has been determined to meet the Hospital Charity Care Guidelines, no referral to collection agencies, legal actions, lien attachments or attempts to possess real or personal property is pursued.No legal action is taken against uninsured patients for the first one hundred twenty (120) days after discharge.Illinois residents who have a family income that is no more than 600% of the Federal Poverty Guidelines (as determined each year), and who do not have any health insurance (or coverage under workers' compensation, accident liability insurance, or other third party liability) as documented through SCH's insurance verification procedures, receive a discount in accordance with the Hospital Uninsured Patient Discount Act (210 ILCS 89/) (the Act).
Part VI, Line 4: Community InformationSCH's community, as defined for the purposes of the hospital's 2012 Community Health Needs Assessment, included each of the residential ZIP Codes that comprise the hospital's Primary Service Area (PSA) and Secondary Service Area (SSA), including: 60613, 60618, 60625, 60626, 60630, 60640, 60641, 60645, 60646, 60659, 60660 and 60712. This encompasses approximately a 5 mile radius surrounding the hospital and was determined because the majority of SCH's patients originate from this area. The population of the hospital's service area is estimated at 631,311 people. It is predominantly non-Hispanic White (63.66%), but also has substantial Hispanic (28.75%) and Asian (10.87%) populations. As throughout the state and nation, our population is aging, with 10.94% currently age 65 and older. This is projected to increase in coming years, as is the need for services to meet the health needs of this older population. Median household income is below the state average at $48,386, and 12.37% of the families in our population remain below the poverty level. The hospital serves a very diverse multicultural community, with the Albany Park neighborhood serving as a key entry point for many new immigrants. To better address the needs of our highly diverse community, the hospital works regularly with dozens of community stakeholders including local ethnic groups, legislators, and community and business organizations, including: the Albany Park Community Center, Centro Romero, Polish American Association, Erie Family Health, Heartland Health, Chicago Department of Public Health, Korean American Community Services, Asian Human Services, Cambodian Association, North River Commission and the Albany Park Chamber of Commerce. These organizations serve as a link between the hospital and the many surrounding niche communities, and the hospital's Community and Government Relations teams communicate regularly online and in-person to propose solutions to issues including Access to Care and health reform. The Spanish and Korean languages represent the majority of interpretative assistance requested at the hospital. To meet this need on an inpatient and outpatient basis, the hospital employs full time Spanish and Korean interpreters. The Korean interpreter also serves as Korean Community Relations Manager, facilitating deeper, ongoing communication between the hospital and its local Korean community partners and physicians. In addition, the hospital uses a telephonic interpretative service to meet interpretative needs in other languages, as well as for Korean and Spanish interpretation when the interpreters are not present.To better serve the Korean community, the hospital partners each year with Korean American Community Services (KACS), the Korean Medical Society and the Korean Nurses Association to host an annual Korean Health Fair at the hospital. This is an annual event, targeting the uninsured and underinsured working population. Nearly 200 Koreans residing in the greater Chicago area attend this event to receive free or reduced cost screenings and services. KACS coordinates the event collaboratively with the hospital's Korean Community Relations Manager.In FY2015, Swedish Covenant Hospital delivered 225 community programs to more than 15,000 individuals in partnership with nearly 100 community organizations, legislators, chambers of commerce, local businesses and schools. Topics included nutrition, fitness, stroke awareness, heart health, cancer prevention, joint health, pregnancy, diabetes education, women's health and pediatrics. Ongoing partnerships exist between many organizations but highlights include Oak Street Health (monthly wellness talks), Peterson Garden Project (on-campus community garden and monthly wellness talks at Fearless Food Kitchen), Budlong Elementary School (healthy nutrition for kids; laboratory tours; career chats), American Cancer Society (cancer screening events), 47th Ward Alderman Ameya Pawar (Annual Wellness Fair and senior activities), Whole Foods Market Sauganash (healthy eating and lifestyle choices), Marianos (community events), The Breakers (health events for seniors), Purple Asparagus (Delicious Nutritious Adventures at Budlong School), Centro Romero (health fair and ACA collaboration), Vietnamese Association of IL (breast cancer awareness and mammography), Casa Ecuatoriana (wellness info and mammography), Korean American Community Services (annual Korean Health Fair at SCH), Indo-American Center (community health talks), and Sulzer Regional Library (health fair).
Part VI, Line 5: In keeping with the Hospital's mission to provide a continuum of excellent healthcare services, any surplus funds are invested in capital improvements related to patient care or in community benefit programs.The hospital extends medical staff privileges to all qualified physicians in the communities it serves, in accordance with our medical staff development process. The hospital has an active Board of Directors who meet every two months. In addition to reviewing the hospital's financial results, they discuss the hospital's plans and programs in support of our efforts to enhance the health care environment for the entire community we service. The hospital operates the "HouseCalls" program to provide medical care to the homebound.The Hospital helps community members gain access to health care services by assisting low income families in applying for the Illinois Department of Public Aid's KidCare and FamilyCare programs.
Part VI, Line 7, Reports Filed With States IL
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SWEDISH COVENANT HOSPITAL
 
Employer identification number
36-2179813
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) ERIE FAMILY HEALTH CENTER
1701 W SUPERIOR ST 3RD FLOOR
CHICAGO,IL60622
36-3088628   945,000       To help defray the costs of uncompensated care to lower income and medically underserved patients at the Health Center.






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, Line 2: The mission of Swedish Covenant Hospital is to provide excellent healthcare services for our culturally diverse community. In pursuit of this mission, the hospital will fund or otherwise sponsor programs which advance our mission. If a grant is approved by the Board of Directors, yearly progress reports will be required, with a final report required at the conclusion of the project. An annual audit may be requested, if appropriate.
Schedule I (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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
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
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1RONALD D CURRAN MDDIRECTOR (i)
(ii)
34,167
...............................
742,050
0
...............................
0
0
...............................
46,692
0
...............................
11,631
0
...............................
18,570
34,167
...............................
818,943
0
...............................
0
2H CLARK FEDERER MDDIRECTOR (i)
(ii)
0
...............................
318,358
0
...............................
0
0
...............................
22,327
0
...............................
7,212
0
...............................
19,924
0
...............................
367,821
0
...............................
0
3LAWRENCE P ANDERSONDIRECTOR (i)
(ii)
0
...............................
396,339
0
...............................
84,558
0
...............................
110,384
0
...............................
7,800
0
...............................
29,412
0
...............................
628,493
0
...............................
0
4DAVID A DWIGHTDIRECTOR (i)
(ii)
0
...............................
499,292
0
...............................
0
0
...............................
158,521
0
...............................
7,800
0
...............................
30,956
0
...............................
696,569
0
...............................
27,119
5REV GARY B WALTERDIRECTOR (i)
(ii)
0
...............................
151,200
0
...............................
0
0
...............................
0
0
...............................
27,400
0
...............................
85,808
0
...............................
264,408
0
...............................
0
6MARK NEWTONPRESIDENT & CEO (i)
(ii)
0
...............................
602,447
0
...............................
176,806
0
...............................
183,161
0
...............................
7,800
0
...............................
12,596
0
...............................
982,810
0
...............................
0
7THOMAS J GARVEYSENIOR VP & CFO (i)
(ii)
320,150
...............................
0
63,682
...............................
0
32,812
...............................
0
42,104
...............................
0
16,687
...............................
0
475,435
...............................
0
0
...............................
0
8JUDITH A BORENSTEINGENERAL COUNSEL (i)
(ii)
226,209
...............................
0
36,294
...............................
0
98,313
...............................
0
24,134
...............................
0
11,148
...............................
0
396,098
...............................
0
46,764
...............................
0
9ANTHONY GUACCIOSENIOR VP & COO (i)
(ii)
353,411
...............................
0
70,687
...............................
0
63,949
...............................
0
45,095
...............................
0
22,124
...............................
0
555,266
...............................
0
17,403
...............................
0
10DEREK J KELLY MDVP & CHIEF MEDICAL OFFICER (i)
(ii)
302,860
...............................
0
42,039
...............................
0
38,050
...............................
0
0
...............................
0
18,206
...............................
0
401,155
...............................
0
11,681
...............................
0
11MARY SHEHAN RNSENIOR VP, CNO (i)
(ii)
216,472
...............................
0
43,793
...............................
0
43,392
...............................
0
7,755
...............................
0
806
...............................
0
312,218
...............................
0
8,822
...............................
0
12KATHRYN DONOFRIO RNSENIOR VP, CNO (i)
(ii)
139,130
...............................
0
6,090
...............................
0
21,229
...............................
0
5,105
...............................
0
14,457
...............................
0
186,011
...............................
0
0
...............................
0
13KAREN M SHEEHANSENIOR VP & CIO (i)
(ii)
200,394
...............................
0
30,865
...............................
0
47,921
...............................
0
7,627
...............................
0
17,833
...............................
0
304,640
...............................
0
8,409
...............................
0
14JANIS A RUEPINGVP QUALITY IMPVMT/RISK MGM (i)
(ii)
166,012
...............................
0
25,623
...............................
0
63,502
...............................
0
21,265
...............................
0
19,965
...............................
0
296,367
...............................
0
42,398
...............................
0
15MICHAEL FEINZIMERPHYSICIAN (i)
(ii)
221,180
...............................
0
0
...............................
0
0
...............................
0
0
...............................
0
1,716
...............................
0
222,896
...............................
0
0
...............................
0
16JONATHAN LINDVP OPERATIONS (i)
(ii)
161,446
...............................
0
24,238
...............................
0
27,772
...............................
0
5,730
...............................
0
18,830
...............................
0
238,016
...............................
0
9,908
...............................
0
17PATRICIA KINGASSOCIATE GENERAL COUNSEL (i)
(ii)
186,281
...............................
0
8,303
...............................
0
13,465
...............................
0
6,457
...............................
0
16,020
...............................
0
230,526
...............................
0
0
...............................
0
18TONY VANCAUWELAERTMDFORMER DIRECTOR,PHYSICIAN (i)
(ii)
0
...............................
285,831
0
...............................
0
0
...............................
17,500
0
...............................
7,650
0
...............................
7,676
0
...............................
318,657
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
Part I, Line 1a As part of their compensation package, vice presidents of the organization are offered a $900 reimbursement for membership dues to the health club of their choice. This benefit is treated as taxable compensation.
Part I, Line 3 The Hospital and Covenant Ministries of Benevolence follow the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation for the CEO and other officers and executive leaders of the corporation. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the compensation committee and full board meetings where executive compensation is considered.
Part I, Line 4b Executive Benefit Plan Covenant Ministries of Benevolence (CMB) provides certain supplemental retirement benefits to its officers and key employees. These benefits are provided through a nonqualified deferred compensation plan, under which a portion of the benefits being earned are subject to a substantial risk of forfeiture. The supplemental retirement benefits are structured to provide a retention incentive that has been determined by the Compensation Committee of CMB's Board to be of substantial value to the organization. The Committee approves all retirement benefits, together with all other forms of compensation and benefits for these and other executives, in a manner intended to qualify for the rebuttable presumption of reasonableness under the intermediate sanctions rules of federal income tax law. The following individuals participated in the Executive Benefit Plan: Lawrence Anderson - $64,289 David Dwight - $64,365 Mark Newton - $76,024 Judith Borenstein - $26,856 Thomas Garvey - $45,391 Anthony Guaccio - $41,534 Derek Kelley - $38,083 Mary Shehan - $27,227 Karen Sheehan - $23,779 Janis Rueping - $19,439 Jonathan Lind - $17,541
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
SWEDISH COVENANT HOSPITAL
 
Employer identification number
36-2179813
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Illinois Finance Authority
 
86-1091967 45200FEW5 04-08-2008 60,000,000 2008A IFA Revenue Bonds - Cap Adds & Ref of 01/16/98 & 07/22/99 issues.   X   X   X
B Illinois Finance Authority
 
86-1091967 45200FR35 02-02-2010 99,390,260 2010A IFA Revenue Bonds - Ref of 11/17/03 & 06/17/08 issues.   X   X   X
C Illinois Finance Authority
 
86-1091967   11-03-2010 20,000,000 2010C IFA Revenue Bonds - Cap Adds   X   X   X
D Illinois Finance Authority
 
86-1091967   06-28-2011 20,000,000 2011A IFA Revenue Bonds - Cap Adds & Construction   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 8,536,000 7,120,000 5,406,203 11,320,000
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 60,846,284 99,390,260 20,001,820 20,098,509
4 Gross proceeds in reserve funds . . . . . . . . . . . . 11 9,932,548 450,693 15,509
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 837,840 1,982,568    
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 7,508,444   19,002,109 10,110,526
11 Other spent proceeds . . . . . . . . . . . . . . 52,500,000 88,150,000 999,711 10,004,191
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2009 2014 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X     X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X     X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 1.500 % 1.500 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . . 1.500 % 1.500 %    
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X X  
b Exception to rebate? . . . . . . . . X     X   X   X
c No rebate due? . . . . . . . .   X X   X     X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X     X   X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K Supplental Information Form 990 - Schedule K - Part I - Line B - Column f The original 8038 filing for the 2010A bonds listed the issue date of the 2008B refunded bond incorrectly as April 8, 2008. The correct issue date of the 2008B refunded bond is June 17, 2008.
Part IV, Line 2c, columns B & C The rebate computations were performed on August 04, 2015.
Form 990 - Schedule K - Part II - Line 3 The total amount of proceeds of the bond issues entered on Part II Line 3 include the investment earnings.
Part II, Line 4, columns A,C and D The amounts shown here consist solely of sinking fund deposits.
Part II, Line 4, column B The amount shown here consists of $9,346,348 in a reasonably required reserve or replacement fund and $586,200 of sinking fund deposits.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Brooke Newton Family member of Mark Newton (CEO of Swedish Covenant Hospital) 60,622 Wages paid as an employee of Swedish Covenant Hospital   No
(2) Emily Flatley Family member of Mark Newton (CEO of Swedish Covenant Hospital) 40,105 Wages paid as an employee of Swedish Covenant Hospital.   No
(3) Elizabeth Pyra Family member of Thomas M. Pyra (Member of the Board of Directors) 60,309 Wages paid as an employee of Swedish Covenant Hospital   No
(4) Anne Pyra Family member of Thomas M. Pyra (Member of the Board of Directors) 55,876 Wages paid as an employee of Swedish Covenant Hospital   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
Return Reference Explanation
Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a business relationship with each other by virtue of sitting on related Swedish Covenant Hospital entity boards. Kurt D. Anderson, Director, and Lawrence P. Anderson, Director, have a family relationship.
Form 990, Part VI, Section A, line 6 The sole member is Covenant Ministries of Benevolence (CMB).
Form 990, Part VI, Section A, line 7a The member elects the Board of Directors.
Form 990, Part VI, Section A, line 7b S 3.1 of the Bylaws grant reserved powers to the member, such as approval of amendments to the Bylaws of the corporation, approval of certain acquisitions, dispositions and financing, and the power to elect or remove the members of the Board of Directors of the Corporation.
Form 990, Part VI, Section B, line 11 The draft Form 990 was reviewed by multiple levels of management and by the CFO of Swedish Covenant Hospital. In addition, Swedish Covenant Hospital's external public accounting firm reviews the return prior to filing. After filing, the Form 990 is provided to the Board of Directors and key provisions are discussed.
Form 990, Part VI, Section B, line 12c Swedish Covenant Hospital has an Administrative Policy on conflict of interest, identifying the parameters of a conflict of interest and the requirement to disclose any such conflict of interest. Each September, the policy is distributed to the board members, key employees, directors and officers. They are asked to sign acknowledging receipt of policy and to disclose if they have any conflicts of interest. If someone is absent from the meeting or fails to return the acknowledgement, there is a follow-up with the individual until the signed acknowledgement is provided. If a person becomes an interested person he or she may be considered in determining whether a quorum is present. The interested person may make a short statement relating to the transaction or arrangement in question, but shall not vote on the motion addressing the actual or potential conflict.
Form 990, Part VI, Section B, line 15 The Hospital and Covenant Ministries of Benevolence follow the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation for the CEO and other officers and executive leaders of the corporation. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the compensation committee and full board meetings where executive compensation is considered. The Governance Committee of Swedish Covenant Hospital has established the executive compensation program to enable the Organization to recruit, motivate and retain highly qualified executives to successfully carry out its Mission Statement and Core Values. The program also serves to align the interests of our executive officers with those of our community by placing a reasonable portion of compensation at risk through performance goals that, if achieved, are expected to increase the aggregate health level of the communities we serve and contribute to the long-term success of the Organization. Additionally, the executive compensation program will enable the Organization to reward performance that emphasizes teamwork and close collaboration among executive officers, supports Organizational excellence by leveraging enterprise-wide capabilities, drives efficiencies and integrates care and services for the benefit of our communities. The program will also assist the Organization in rewarding the achievement of specific annual, long-term and strategic goals, and align executive officers' interests with those of the communities we serve by rewarding performance that meets or exceeds established goals, with the ultimate objective of increasing community health. The overall executive compensation program aligns short- and long-term performance with the goals of the Organization and ensures cost-effective and efficient use of capital resources by offering the appropriate amounts and mix of compensation. Base Salary represents a fixed compensation component set at a level commensurate with the roles and responsibilities if each individual executive position to attract, motivate and retain top executive talent. The Annual Incentive Plan is a variable short-term performance-based compensation component with target award amounts set by the Governance Committee for each eligible executive position. Payouts reflect the degree to which the Organization and the individual executives have performed against predetermined 12-month metrics. Resulting total cash compensation levels may be below or above target amounts based on the Organization's performance against its short-term goals. Goals are sometimes set at a "stretch" level such that target performance may result in above-median levels of compensation. The Annual Incentive plan is intended to align the executive compensation program with the Organization's business strategy, and strengthen the relationship between pay and performance. The Long-Term Incentive Plan is a variable three-year performance-based compensation component with target award amounts set by the Governance Committee for each eligible executive position. Payouts reflect the degree to which the Organization and the individual executives have performed against predetermined 12-, 24- and 36-month metrics. Resulting total cash levels may be below or above target amounts based on the Organization's performance against its long-term goals. Goals are sometimes set at a "stretch" level such that target performance may result in above-median levels of compensation. The Long-Term Incentive Plan is intended to align the executive compensation program with the Organization's business strategy, strengthen the relationship between pay and performance, reinforce the link between the interests of executives and the long-range vision of the Board of Directors and promote the retention of executive talent. Qualified and non-qualified retirement benefit plans are provided by the Organization to help meet the executives' pre- and post-retirement financial needs, serve as a backstop for our performance-based programs and promote the retention of executive talent. The Board of Directors and the Governance Committee are comprised of voluntary citizens of the community who perform their duties without compensation for hours devoted to Board work. The Governance Committee includes an executive from the Covenant Ministries of Benevolence, the controlling member of Swedish Covenant Hospital. A majority of voting members of the Governance Committee are independent, and the Committee is responsible for the development of the philosophy, policy and objectives that guide the Organization's executive pay programs as well as establishing our performance standards and determining the compensation of our senior executives. The Governance Committee retains Pearl Meyer as their independent compensation consultant to assist the Committee in the continued development and evaluation of the Organization's compensation policies and practices and the Committee's determination of compensation. The Governance Committee has the sole authority to retain and terminate the independent compensation consultant and to review and approve the consultant's fees and other retention terms. The Governance Committee has the authority to approve new executive compensation plans and material amendments to existing executive compensation plans. The Governance Committee provides the Board with reports on its actions and decisions following every Governance Committee meeting. Management provides data, analysis and recommendations for the Governance Committee's consideration regarding the Organization's executive compensation programs and policies and assists the Governance Committee in carrying out its responsibilities. Management also provides information to the Governance Committee's independent compensation consultant in connection with the consultant's role in advising the Governance Committee. The CEO typically attends the Committee meetings. The Governance Committee also meets regularly in executive session outside the presence of management. While the Governance Committee considers the recommendations of the CEO and the input received from its independent compensation consultant, most compensation decisions for the Organization's executives are made by management within their prescribed parameters dictated by the Governance Committee. The Governance Committee retains its independent compensation consultant to conduct a comprehensive review of the total compensation provided to the Organization's executives relative to competitive and comparable market practices, ensure that the Organization's compensation programs provide total compensation opportunities that are reasonable for purposes of Intermediate Sanctions (IRC Section 4958), assess the competitiveness of the Organization's compensation programs with respect to healthcare industry peer organizations, assist the Governance Committee with its charter review, review annual disclosures and the compensation of "disqualified individuals" whose compensation is subject to a reasonableness review under IRC Section 4958, provide an opinion letter to the Governance Committee regarding the reasonableness of the compensation of the Organization's executives and other "disqualified persons and help to create a rebuttable presumption of reasonableness with regard to executive compensation.
Form 990, Part VI, Section C, line 18 A copy of the organization's Form 990 is available upon request by contacting the Swedish Covenant Hospital administration department at 773/878-8200.
Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available upon request, for the same period of disclosure as set forth in IRC Section 6104(d), by contacting the Swedish Covenant Hospital administration department at 773/878-8200.
FORM 990,PART VIII,LINES 7A - 7C Publicly traded securities held in an investment pool and allocated by Covenant Ministries of Benevolence on a percentage basis.
Form 990, Part IX, line 11g CONSULTING FEES: Program service expenses 427,287. Management and general expenses 904,319. Fundraising expenses 0. Total expenses 1,331,606. PHYSICIANS FEES: Program service expenses 3,853,321. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,853,321. OUTSIDE PROFESSIONAL FEES: Program service expenses 2,732,112. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,732,112. AGENCY FEES: Program service expenses 1,397,256. Management and general expenses 42,026. Fundraising expenses 0. Total expenses 1,439,282. COLLECTION EXPENSE: Program service expenses 95,104. Management and general expenses 1,204,786. Fundraising expenses 0. Total expenses 1,299,890. PURCHASED SERVICES: Program service expenses 15,064,910. Management and general expenses 1,540,913. Fundraising expenses 0. Total expenses 16,605,823.
Form 990, Part XI, line 9: Net assets released from restriction 8,426. equity transfer to Covenant Ministries of Benevolence Net restricted funds transfers from Swedish Covenant Hospital Foundation 1,480,721. Equity transfer to Swedish Covenant Management Services Inc. -20,000,000. Other changes in restricted funds -106,236.
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
SWEDISH COVENANT HOSPITAL
 
Employer identification number

36-2179813
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) Evangelical Covenant Church (ECC)
8303 W Higgins Road

Chicago,IL60631
36-2167730
Church IL 501(c)(3) Line 1 N/A
 
No
(2) Covenant Ministries of Benevolence (CMB)
5145 N California Avenue

Chicago,ID60625
36-3486813
Management/Support Services IL 501(c)(3) Line 11a, I Evangelical Covenant Church (ECC)
 
 
No
(3) Swedish Covenant Faculty Group (SCFG)
5145 N California Avenue

Chicago,IL60625
36-3686216
Patient Treatment/Education IL 501(c)(3) Line 11a, I Swedish Covenant Hospital (SCH)
 
Yes
 
(4) Swedish Covenant Hospital Foundation (SCHF)
5145 N California Avenue

Chicago,IL60625
20-5055155
Support of Swedish Covenant Hospital IL 501(c)(3) Line 7 Swedish Covenant Hospital (SCH)
 
Yes
 
(5) SC Insurance Company
6970 E Chauncey Lane Suite 100

Phoenix,AZ85054
27-3312053
Insurance AZ 501(c)(3) Line 11a, I Swedish Covenant Hospital (SCH)
 
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) Covenant Village of PortlandLP

420 NE Mason St
Portland,OR97211
36-4356838
Assisted Living Community OR 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) Covenant International Insurance Company Ltd

Crawford House 50 Cedar Avenue
Hamilton    
BD
Insurance BD N/A
C         No
(2) Covenant Trust Company

8303 W Higgins Road 6th Floor
Chicago,IL60631
36-3583163
Financial Services IL N/A
C         No
(3) Swedish Covenant Management Services Inc (SCMS)

5145 N California Avenue
Chicago,IL60625
36-4073303
Physician Practice Management IL Swedish Covenant Hospital
 
C -12,204,003 16,100,389 100.000 % Yes  
(4) Swedish Covenant Managed Health Care Alliance (SCMCA)

2740 W Foster Suite 409
Chicago,IL60625
36-4118659
Physician - Hospital Organization IL N/A
C         No
(5) St Francis Health Care Ltd

2740 W Foster Avenue Suite 002
Chicago,IL60625
36-3208131
Independent Group of Physicians IL N/A
C       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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
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) Swedish Covenant Hospital Foundation

M 626,919 Cash Value
(2) Swedish Covenant Hospital Foundation

S 1,480,071 Cash Value
(3) Swedish Covenant Management Services Inc

R 38,445,949 Cash Value
(4) SC Insurance Company

M 6,913,020 Cash Value
(5) SC Insurance Company

L 240,000 Cash Value

Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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