TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) AZMEY MATARIEH...................................................................... DIRECTOR	1.00 ................. 55.00	X		0	594,554	26,216
(2) CRAIG LAMP...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(3) JOHN CHAPMAN...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(4) JOSE TORRES...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(5) JOY JENSEN...................................................................... DIRECTOR (NONVOTING)	1.00 ................. 0.00	X		0	10,754	267
(6) KAREN LAMBERT...................................................................... DIRECTOR	1.00 ................. 55.00	X		0	1,432,738	64,475
(7) KENNETH KOEHLER...................................................................... ASSISTANT TREASURER, DIRECTOR	1.00 ................. 0.00	X	X	0	0	0
(8) LAWRENCE KOSINSKI MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(9) LINDA DEERING DEAN...................................................................... PRESIDENT, DIRECTOR	55.00 ................. 1.00	X	X	1,428,091	0	28,744
(10) LINDA WALLACE...................................................................... ASSISTANT SECRETARY, DIRECTOR	1.00 ................. 0.00	X	X	0	0	0
(11) MICHAEL KENYON...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(12) MICHAEL SEIGLE MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(13) NICOLE PAULK...................................................................... DIRECTOR	1.00 ................. 55.00	X		0	388,883	55,637
(14) PATRICK CRAWFORD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(15) RACHEL BAER MD...................................................................... DIRECTOR	1.00 ................. 55.00	X		0	373,862	53,813
(16) RAVI DAMARAJU MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(17) REV DR NATHANIEL EDMOND...................................................................... VICE CHAIRPERSON, DIRECTOR	1.00 ................. 1.00	X	X	0	4,000	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) K RICHARD JAKLE........................................................................ DIRECTOR	1.00 .......................1.00	X				0	78,966	0
(19) SCOTT RICHMOND........................................................................ DIRECTOR	1.00 .......................0.00	X				0	0	0
(20) SHARON JAKLE........................................................................ DIRECTOR	1.00 .......................0.00	X				0	0	0
(21) STAN NABRINSKY........................................................................ DIRECTOR	1.00 .......................0.00	X				0	0	0
(22) SUSAN CAMPBELL........................................................................ DIRECTOR	1.00 .......................55.00	X				0	2,064,210	83,508
(23) TRACY ELLIS........................................................................ DIRECTOR	1.00 .......................0.00	X				0	0	0
(24) WILLIAM HOFFER........................................................................ CHAIRPERSON, DIRECTOR	1.00 .......................0.00	X	X			0	0	0
(25) WILLIAM P SANTULLI........................................................................ DIRECTOR	1.00 .......................55.00	X				0	3,965,389	50,170
(26) BRUCE HYMAN........................................................................ VP, MEDICAL MANAGEMENT	55.00 .......................0.00		X			495,417	0	44,097
(27) CHERI GOLL........................................................................ VP, CHIEF NURSING EXECUTIVE	55.00 .......................0.00		X			286,668	0	48,171
(28) DAMON HAVILL........................................................................ VP, STRATEGIC PLAN & BUS DEV	1.00 .......................55.00		X			0	336,429	49,551
(29) DOMINIC J NAKIS........................................................................ TREASURER	1.00 .......................55.00		X			0	2,635,976	53,865
(30) EARL J BARNES II........................................................................ SECRETARY	1.00 .......................55.00		X			0	1,960,426	152,541
(31) FREDERICK RAJAN........................................................................ VP, MISSION & SPIRITUAL CARE	1.00 .......................55.00		X			0	120,625	86,516
(32) JAMES DOHENY........................................................................ ASSISTANT TREASURER	1.00 .......................55.00		X			0	518,656	53,917
(33) JO AMICK........................................................................ VP, DEVELOPMENT	1.00 .......................55.00		X			0	193,372	23,721
(34) KATE KOVICH........................................................................ VP, PATIENT SAFETY	1.00 .......................55.00		X			0	275,872	40,189
(35) KEVIN FITCH........................................................................ VP, FINANCE	55.00 .......................0.00		X			274,862	0	43,271
(36) MARY KANE........................................................................ VP, NURSING INFORMATICS	1.00 .......................55.00		X			0	408,180	33,591
(37) MARY MARTINI........................................................................ VP, OPERATIONS	55.00 .......................0.00		X			268,249	0	43,129
(38) MELISSA O'NEIL........................................................................ VP, HUMAN RESOURCES	1.00 .......................55.00		X			0	269,884	32,992
(39) MICHAEL KERNS........................................................................ SECRETARY	1.00 .......................55.00		X			0	420,969	60,895
(40) PEG STONE........................................................................ VP, PROFESSIONAL ARRANGEMENTS	1.00 .......................55.00		X			0	264,688	24,989
(41) JOAN KANUTE........................................................................ DIRECTORE SERVICE EXCELLENCE	55.00 .......................0.00			X		177,273	0	25,301
(42) KARA AALFS........................................................................ DIRECTOR DV SERVICES	55.00 .......................0.00			X		201,048	0	13,560
(43) MICHAEL ROSENBERG........................................................................ DIRECTOR CLINICAL DECISION	55.00 .......................0.00			X		317,701	0	23,034
(44) PATRICK UPLEGGER........................................................................ DIRECTOR PHARMACY	55.00 .......................0.00			X		202,789	0	29,294
(45) PAUL DRAHOS........................................................................ PHARMACY MANAGER	55.00 .......................0.00			X		175,818	0	26,297
(46) GAIL D HASBROUCK........................................................................ FORMER SECRETARY	0.00 .......................4.00				X	0	430,963	46
(47) TRENT GORDON........................................................................ FORMER OFFICER	0.00 .......................55.00				X	0	233,700	55,342

(A) Name and business address	(B) Description of services	(C) Compensation
SUPERIOR HEALTH LINENS LLC 5005 S PACKARD AVENUE CUDAHY,WI53110	LAUNDRY SERVICES	882,591
ARAMARK HEALTHCARE SUPPORT SERVICES LLC 25271 NETWORK PLACE CHICAGO,IL606731252	HOSPITAL SERVICES	832,397
MANEVAL CONSTRUCTION CO INC 28090 W CONCRETE DR INGLESIDE,IL60041	CONSTRUCTION	567,425
COSTELLO MCMAHON BURKE 150 N UPPOER WACKER DR 3050 CHICAGO,IL60606	LEGAL SERVICES	300,000
SWANSON MARTIN & BELL LLC 330 N WABASH SUITE 3300 CHICAGO,IL60611	LEGAL SERVICES	272,572
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 55

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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

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

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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.)..

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

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) 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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). 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

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) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization ADVOCATE SHERMAN HOSPITAL

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization ADVOCATE SHERMAN HOSPITAL		Employer identification number 36-2167920

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization ADVOCATE SHERMAN HOSPITAL			Employer identification number 36-2167920
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

41,152

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

41,152

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, 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:	SUPPLEMENTAL LOBBYING INFORMATION ADVOCATE SHERMAN HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. THESE ORGANIZATIONS, AS PART OF THEIR MISSIONS, ADVOCATE IN THE GENERAL ASSEMBLY AND IN CONGRESS ON LEGAL AND POLICY ISSUES THAT AFFECT HEALTHCARE INCLUDING QUALITY, AFFORDABILITY, PATIENT ACCESS, AND ACCREDITATION. A PORTION OF THE ANNUAL MEMBERSHIP DUES PAID TO THIS ORGANIZATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE HOSPITAL ALSO REIMBURSES ASSOCIATES FOR DUES AND EDUCATIONAL EXPENSES PAID TO VARIOUS PROFESSIONAL AND MEMBERSHIP ORGANIZATIONS. ADVOCATE SHERMAN HOSPITAL ENDEAVORS TO IDENTIFY THE PORTION OF THESE DUES OR FEES ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Return Reference

Explanation

PART II-B, LINE 1:

SUPPLEMENTAL LOBBYING INFORMATION ADVOCATE SHERMAN HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. THESE ORGANIZATIONS, AS PART OF THEIR MISSIONS, ADVOCATE IN THE GENERAL ASSEMBLY AND IN CONGRESS ON LEGAL AND POLICY ISSUES THAT AFFECT HEALTHCARE INCLUDING QUALITY, AFFORDABILITY, PATIENT ACCESS, AND ACCREDITATION. A PORTION OF THE ANNUAL MEMBERSHIP DUES PAID TO THIS ORGANIZATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE HOSPITAL ALSO REIMBURSES ASSOCIATES FOR DUES AND EDUCATIONAL EXPENSES PAID TO VARIOUS PROFESSIONAL AND MEMBERSHIP ORGANIZATIONS. ADVOCATE SHERMAN HOSPITAL ENDEAVORS TO IDENTIFY THE PORTION OF THESE DUES OR FEES ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

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

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" on 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 .....	28,475,147		28,475,147
b	Buildings ....	250,124,808	58,856,810	191,267,998
c	Leasehold improvements	5,084,048	2,083,492	3,000,556
d	Equipment ....	89,160,691	50,099,131	39,061,560
e	Other .....	5,558,133		5,558,133
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				267,363,394

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
I/C NOTES PAYABLES-SHERMAN	231,412,826
BLUE CROSS TAKEBACKS	29,172,860
OTHER THIRD PARTY PAYABLE	3,000,000
BLUE CROSS DUE-CURRENT YEAR	1,036,000
MEDICARE RAC RESERVE	1,200,000
THIRD PARTY PAYOR TRANSFERS	823,568
IBNR PROV INS LOSS	40,000
ACCRUED INSURANCE AND CLAIMS COST	36,000
REMEDIATION COST ACCRUAL	8,411
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	266,729,665
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) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	6,103,934	5,696	6,098,238	1.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	55,951,298	43,200,748	12,750,550	2.960 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	62,055,232	43,206,444	18,848,788	4.380 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,304,779	0	1,304,779	0.300 %
f	Health professions education (from Worksheet 5) . . .	2,672,253	0	2,672,253	0.620 %
g	Subsidized health services (from Worksheet 6) . . . .	275,468	240,338	35,130	0.010 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	80,335	0	80,335	0.020 %
j	Total. Other Benefits . .	4,332,835	240,338	4,092,497	0.950 %
k	Total. Add lines 7d and 7j .	66,388,067	43,446,782	22,941,285	5.330 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

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

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

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

20,443,653

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. ......

105,011

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

Section B. Medicare

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

121,555,615

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

131,032,337

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

-9,476,722

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 ALGONQUIN ROAD SURGERY CENTER LLC	ANCILLARY SURGERY CENTER	26.000 %	0 %	49.000 %
22 ARSC RE HOLDINGS LLC	REAL ESTATE LEASING	50.000 %	0 %	0 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?1Name, 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)
1	ADVOCATE SHERMAN HOSPITAL 1425 N RANDALL ROAD ELGIN,IL601232300 HTTP://WWW.ADVOCATEHEALTH.COM/HOPE/ 0005884	X	X	X

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	ADVOCATE SHERMAN HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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?........................

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): HTTP://WWW.ADVOCATEHEALTH.COM/CHNAREPORTS

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTP://WWW.ADVOCATEHEALTH.COM/CHNAREPORTS

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ADVOCATE SHERMAN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 600.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.ADVOCATEHEALTH.COM/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.ADVOCATEHEALTH.COM/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.ADVOCATEHEALTH.COM/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ADVOCATE SHERMAN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	ADVOCATE SHERMAN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 4

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)


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):

Yes

Community Health Needs Assessment

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?........................

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

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

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

6 a

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

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

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

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

Hospital facility’s website (list url):

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Indicate the tax year the hospital facility last adopted an implementation strategy: 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)


Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of % and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Explained the method for applying for financial assistance?...................

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections


Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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


Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 3J: N/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 5: IN 2014-2016, ADVOCATE SHERMAN HOSPITAL (ADVOCATE SHERMAN) COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) BY WORKING COLLABORATIVELY WITH TWO PUBLIC HEALTH DEPARTMENTS-THE MCHENRY COUNTY DEPARTMENT OF HEALTH AND THE KANE COUNTY HEALTH DEPARTMENT. BOTH HEALTH DEPARTMENTS ENGAGED A COMMUNITY COLLABORATIVE COMPRISED OF CROSS SECTOR COMMUNITY ORGANIZATIONS TO FACILITATE THE DEVELOPMENT AND IMPLEMENTATION OF A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT, USING THE MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS STRATEGY ENABLED THE HOSPITAL TO PARTICIPATE IN DATA COLLECTION THAT COVERED ALL OF THE HOSPITAL'S PRIMARY SERVICE AREA (PSA) AND THE MAJORITY OF THE SECONDARY SERVICE AREA (SSA). FOR PURPOSES OF ADVOCATE SHERMAN'S CHNA, COMMUNITY WAS DEFINED AS THE FOLLOWING MUNICIPALITIES LOCATED IN KANE AND MCHENRY COUNTIES: ALGONQUIN, CARPENTERSVILLE, DUNDEE, ELGIN, GILBERTS, HUNTLEY, LAKE IN THE HILLS AND SOUTH ELGIN. THE MCHENRY COUNTY SURVEY, CONSISTED OF THREE COMPONENTS-A COMMUNITY SURVEY, KEY INFORMANT INTERVIEWS OF COMMUNITY LEADERS AND A COMMUNITY ANALYSIS USING SECONDARY DATA SOURCES. THE 2015 KANE COUNTY COMMUNITY HEALTH ASSESSMENT WAS USED FOR THE 2014-2016 CHNA. THE ASSESSMENT INCLUDED THREE COMPONENTS-A COMMUNITY SURVEY, KEY INFORMANT FOCUS GROUPS AND SECONDARY DATA ANALYSIS CONSISTING OF PUBLIC HEALTH, VITAL STATISTICS AND OTHER DATA. IN PREPARATION FOR THE SELECTION OF PRIORITIES, ADVOCATE SHERMAN COMMUNITY HEALTH STAFF PRESENTED DEMOGRAPHIC, ECONOMIC, EDUCATION, EMPLOYMENT AND HEALTH DATA TO THE HOSPITAL COMMUNITY HEALTH COUNCIL OVER A PERIOD OF SEVERAL MEETINGS. THE DATA PRESENTED WAS DRAWN FROM THE TWO COUNTY HEALTH DEPARTMENT SURVEYS AS WELL AS FROM THE HEALTHY COMMUNITIES INDEX (HCI), A DATA REPOSITORY PURCHASED BY ADVOCATE HEALTH CARE. THE COMMUNITY HEALTH COUNCIL IS AN ADVISORY COMMITTEE TO THE HOSPITAL WHOSE PURPOSE IS TO ASSIST IN THE SELECTION OF HEALTH PRIORITIES AND ADVISE AND MONITOR THE IMPLEMENTATION OF COMMUNITY HEALTH INTERVENTIONS TO ADDRESS THE HEALTH ISSUES IN THE COMMUNITY. IN ALIGNMENT WITH ADVOCATE HEALTH CARE'S STANDARDIZED APPROACH, ADVOCATE SHERMAN CONVENED ITS COMMUNITY HEALTH COUNCIL EVERY THREE MONTHS, FROM APRIL THROUGH SEPTEMBER 2016, TO REVIEW THE RESULTS OF THE CHNA. THIS COMMUNITY HEALTH COUNCIL WAS CHAIRED BY A REPRESENTATIVE OF THE COMMUNITY WHO ALSO SERVES AS A MEMBER OF THE HOSPITAL'S BOARD OF DIRECTORS. ADDITIONAL HOSPITAL STAFF AND COMMUNITY REPRESENTATIVES WERE ADDED TO THE COMMUNITY HEALTH COUNCIL REPRESENTING A VARIETY OF EXPERTISE AREAS, INCLUDING ELECTED OFFICIALS, AREA BUSINESSES, SCHOOL DISTRICTS, OTHER HEALTH CARE PROVIDERS AND THE FAITH COMMUNITY. THE AFFIDAVITS OF THESE REPRESENTATIVES AND THE NAMES OF THE ORGANIZATIONS THEY REPRESENT ARE PROVIDED BELOW. INDIVIDUALS REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS ARE ALSO INDICATED BELOW.ADVOCATE SHERMAN HOSPITAL COMMUNITY HEALTH COUNCIL MEMBERSMEMBERS FROM THE COMMUNITY- AMERICAN CANCER SOCIETY, HOSPITALS SYSTEMS MANAGER- CITY OF ELGIN, MAYOR- ELGIN COMMUNITY MEMBER; ADVOCATE SHERMAN BOARD MEMBER- GREATER ELGIN FAMILY CARE CENTER, CHIEF OPERATING OFFICER (MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS)- KANE COUNTY HEALTH DEPARTMENT, EXECUTIVE DIRECTOR- MCHENRY COUNTY HEALTH DEPARTMENT, ADMINISTRATIVE MANAGER- SECOND BAPTIST CHURCH OF ELGIN, PASTOR; ADVOCATE SHERMAN BOARD CHAIR AND COMMUNITY HEALTH COUNCIL CHAIR- UNITED WAY, PRESIDENT/CEO (MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS)ADVOCATE STAFF MEMBERS- ADVOCATE HEALTH CARE, COMMUNITY HEALTH DIRECTOR, NORTH ILLINOIS REGION- ADVOCATE SHERMAN, ADMINISTRATIVE DIRECTOR, POPULATION HEALTH AND SERVICE EXCELLENCE- ADVOCATE SHERMAN, MANAGER, COMMUNITY OUTREACH- ADVOCATE SHERMAN, MANAGER, STRATEGIC PLANNING- ADVOCATE SHERMAN, PHYSICIAN, FAMILY PRACTICE- ADVOCATE SHERMAN, MANAGER, PERFORMANCE EXCELLENCE AND CULTURAL SERVICESADVOCATE SHERMAN ALSO CONSULTED WITH SEVERAL ADDITIONAL PARTNER ORGANIZATIONS REGARDING THE HOSPITAL CHNA. THESE INCLUDED GREATER ELGIN FAMILY CARE CENTER (GEFCC), VNA HEALTH CARE, AUNT MARTHA'S HEALTH AND WELLNESS, KANE COUNTY SUBSTANCE ABUSE COALITION, MCHENRY COUNTY SUBSTANCE ABUSE COALITION AND THE MENTAL HEALTH 708 INC BOARD. EACH OF THESE ORGANIZATIONS HAVE A FOCUS ON MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.ADVOCATE SHERMAN'S 2014-2016 AND PREVIOUS 2011-2013 CHNA REPORTS AND IMPLEMENTATION PLANS ARE POSTED ON ADVOCATE'S WEBSITE AND INCLUDE A LINK TO A FORM AND AN EMAIL FOR THE COMMUNITY TO USE IN PROVIDING FEEDBACK IN COMPLIANCE WITH THE AFFORDABLE CARE ACT. ANY QUESTIONS SUBMITTED WILL BE ADDRESSED WITHIN THIRTY DAYS. AS OF DECEMBER 31, 2018, NO FEEDBACK OR COMMENTS WERE RECEIVED FROM THE COMMUNITY.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 6A: - RELATED? ADVOCATE GOOD SHEPHERD HOSPITAL- UNRELATED? CENTEGRA HEALTH SYSTEMS, MCHENRY, IL PRESENCE ST. JOSEPH'S HOSPITAL, ELGIN, ILPRESENCE MERCY MEDICAL CENTER, AURORA, ILNORTHWESTERN DELNOR COMMUNITY HOSPITAL, GENEVA, IL RUSH-COPLEY MEDICAL CENTER, AURORA, IL
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 6B: - FAMILY ALLIANCE, INC., CRYSTAL LAKE, IL - MCHENRY COUNTY COLLEGE, CRYSTAL LAKE, IL- MCHENRY COUNTY COMMUNITY FOUNDATION, WOODSTOCK, IL- MCHENRY COUNTY DEPARTMENT OF HEALTH, WOODSTOCK, IL- MCHENRY COUNTY MENTAL HEALTH BOARD, CRYSTAL LAKE, IL- MCHENRY COUNTY REGIONAL OFFICE OF EDUCATION, WOODSTOCK, IL- PIONEER CENTER, MCHENRY, IL- SENIOR SERVICES ASSOCIATION, INC., WOODSTOCK, IL- UNITED WAY OF GREATER MCHENRY COUNTY, MCHENRY, IL- KANE COUNTY HEALTH DEPARTMENT, AURORA, IL- INC BOARD NFP (COMMUNITY MENTAL HEALTH FUNDING ALLIANCE), AURORA, IL
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 7D: THE HOSPITAL ISSUED AN ANNOUNCEMENT AND A BRIEF SUMMARY OF THE CHNA RESULTS TO ADVOCATE SHERMAN EMPLOYEES, WHICH ALSO INCLUDED A LINK TO THE FULL REPORT. COMMUNITY HEALTH STAFF HAVE PRESENTED THE CHNA RESULTS TO THE ADVOCATE SHERMAN EXECUTIVE AND SENIOR LEADERSHIP TEAMS AS WELL.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 11: 2014-2016 CHNA NEEDS SELECTED TO ADDRESSIN 2016, ADVOCATE SHERMAN CONDUCTED A COMPREHENSIVE CHNA WHICH INCLUDED THE SELECTION OF HEALTH PRIORITIES THROUGH A CONSENSUS PRIORITIZATION PROCESS BY THE COMMUNITY HEALTH COUNCIL. THE COMMUNITY HEALTH COUNCIL RECOMMENDED, AND THE HOSPITAL GOVERNING COUNCIL APPROVED, TWO HEALTH AREAS FOR PRIORITY ACTION: 1) DIABETES/KIDNEY DISEASE; AND 2) OBESITY/NUTRITION/PHYSICAL ACTIVITY.DIABETES/KIDNEY DISEASETHE GOAL OF THE DIABETES INTERVENTIONS ARE TO REDUCE THE LONG-TERM COMPLICATIONS RELATED TO DIABETES AND KIDNEY DISEASE FOR RESIDENTS LIVING IN CARPENTERSVILLE AND ELGIN, THROUGH THREE SPECIFIC STRATEGIES. THESE COMMUNITIES WERE SELECTED FOR INTERVENTION AS THEY HAD HIGH SOCIONEEDS INDEX RANKINGS IN THE HEALTHY COMMUNITIES INSTITUTE DATABASE AND ALSO WERE IDENTIFIED AS HAVING A HIGHER PREVELENCE OF DIABETES AND KIDNEY DISEASE. THE SOCIONEEDS INDEX SCORES RANKING CORRELATES DEMOGRAPHIC DETERMINANTS AND POOR HEALTH OUTCOMES.THE FIRST STRATEGY IS TO INCREASE THE PERCENTAGE OF ADULTS WHO ARE SCREENED TO IDENTIFY PRE-DIABETES AND DIABETES, AND REFERRED FOR FOLLOW-UP TO A PRIMARY CARE PROVIDER (PCP). AS PART OF THE DIABETES PROGRAM FOR THE LATINO COMMUNITY, ADVOCATE SHERMAN IMPLEMENTED BLOOD GLUCOSE SCREENINGS IN ELGIN AND CARPENTERSVILLE LATINO COMMUNITIES. SCREENING LOCATIONS INCLUDED THE ELGIN MALL FLEA MARKET, SEVERAL ELGIN LAUNDRY MATS, THE CARPENTERSVILLE FISH FOOD PANTRY AND AT THE GRAND VICTORIA CASINO FOR THEIR EMPLOYEES. IN 2018, THE PROGRAM SCREENED 370 PATIENTS. EIGHTY-SIX PERCENT OF INDIVIDUALS SCREENED HAD A NORMAL BLOOD GLUCOSE LEVEL, EIGHT PERCENT PRESENTED WITH PRE-DIABETES GLUCOSE LEVELS AND SIX PERCENT PRESENTED WITH GLUCOSE LEVELS THAT MAY INDICATE DIABETES. THIRTY PEOPLE (100 PERCENT) OF THOSE SCREENED AS BEING PRE-DIABETIC OR DIABETIC WERE REFERRED TO A PCP IN THE COMMUNITY. IN ADDITION, THERE WERE 167 PHYSICIAN REFERRALS MADE FOR DIABETES FOLLOW-UP APPOINTMENTS AT THE ADVOCATE SHERMAN DIABETES CENTER. ALL OF THE PREVIOUSLY MENTIONED RESULTS HAVE INCREASED OVER THE LAST TWO YEARS. THE SECOND DIABETES STRATEGY IMPLEMENTED IS THE STANFORD MODEL DIABETES SELF-MANAGEMENT PROGRAM (DSMP). THE PROGRAM IS BEING IMPLEMENTED IN ELGIN IN CONJUNCTION WITH THE EXISTING DIABETES PROGRAM FOR THE LATINO COMMUNITY. IN 2018, ONE ADDITIONAL INDIVIDUAL COMPLETED THE ENGLISH DSMP INSTRUCTOR TRAINING, ADDING TO THE EXISTING TWO SPANISH-SPEAKING DSMP INSTRUCTORS THAT WERE TRAINED IN 2017. TWO SIX-WEEK SESSIONS WERE HELD IN 2018, BOTH IN SPANISH, AT THE YWCA AND CENTRO DE INFORMACION. ONE ADDITIONAL SIX-WEEK SESSION WAS OFFERED AT THE GAIL BORDEN LIBRARY, BUT WAS CANCELLED DUE TO LOW ENROLLMENT. FROM THESE CLASSES, THERE WERE A TOTAL OF 44 PARTICIPANTS WHO STARTED THE SIX-WEEK DSMP SELF-MANAGEMENT PROGRAM WITH A TOTAL OF 32 PARTICIPANTS COMPLETING THE PROGRAM, WHICH IS A 72 PERCENT COMPLETION RATE. IT WAS ALSO DETERMINED IN 2018 THAT SEVERAL OF THE IMPACT INDICATORS WOULD BE CHANGED TO BETTER ALIGN WITH THE REPORTING STRUCTURE FOR THE DSMP CLASS. THE CHANGES MADE WERE TO MEASURE THE PRE- AND POST-CLASS RESPONSES FOR RATING OVERALL HEALTH, CONFIDENCE LEVELS IN CHOOSING APPROPRIATE FOODS TO EAT WHEN HUNGRY AND IN INCREASING EXERCISE MINUTES PER WEEK. THE THIRD STRATEGY IDENTIFIED FOR DIABETES IS TO INCREASE THE ACCESS POINTS TO FRESH PRODUCE FOR RESIDENTS LIVING WITHIN CARPENTERSVILLE AND ELGIN. IN 2018, ADVOCATE SHERMAN DEVELOPED A PROCESS TO PROVIDE EXCESS PRODUCE FROM THE ON-SITE COMMUNITY GARDEN TO HOSPITAL DIABETES CENTER PATIENTS WHO ARE IDENTIFIED AS FOOD INSECURE BASED ON THE HUNGER VITAL SIGN SCREENING TOOL. DISTRIBUTION OF FRESH PRODUCE FROM THE GARDEN TO DIABETES CENTER PATIENTS BEGAN IN MARCH 2018. ADDITIONALLY, THE HOSPITAL INITATED A NEW PARTNERSHIP WITH THE LOCAL COMMUNITY COLLEGE-ELGIN COMMUNITY COLLEGE (ECC) STUDENT FOOD PANTRY. ECC STUDENTS WERE ASSIGNED GARDEN PLOTS AT THE ONSITE ADVOCATE SHERMAN COMMUNITY GARDEN AND THE PRODUCE HARVESTED WAS PROVIDED TO THE ECC STUDENT FOOD PANTRY. IN THE 2018 GARDEN SEASON, 376 POUNDS OF PRODUCE WAS PROVIDED TO PATIENTS IN THE DIABETES CENTER AND THE ECC STUDENT FOOD PANTRY. ANOTHER PROGRAM AT ADVOCATE SHERMAN THAT PROVIDES CARE TO PATIENTS WITH CHRONIC CONDITIONS, INCLUDING DIABETES, WITHIN THE COMMUNITY IS THE MOBILE INTEGRATED HEALTH (MIH) PROGRAM. THE PROGRAM GOAL IS TO IMPROVE CARE COORDINATION AND REDUCE READMISSIONS OF PATIENTS WITH CHRONIC CONDITIONS AS THEY TRANSITION FROM THE HOSPITAL TO HOME. THE MIH PARTNERSHIP BETWEEN A PHYSICIAN AND AN ON-STAFF PARAMEDIC ALLOWS OUTREACH TO PATIENTS IN THEIR HOMES WHEN THEY ARE UNABLE TO MAKE A SCHEDULED CLINIC VISIT OR WHEN SYMPTOMS ARISE THAT WOULD BENEFIT FROM AN IN-PERSON HOME ASSESSMENT. IN 2018, THE MIH PROGRAM ADDED A SECOND PART-TIME PARAMEDIC, DUE TO INCREASED VOLUMES. ADDITIONALLY IN 2018, THE STATE OF ILLINOIS APPROVED THE ADDITION OF PROVIDING INTRAVENOUS MEDICATIONS FOR HEART FAILURE PATIENTS THAT HAVE FLUID RETENTION. ANOTHER ADDITION WAS THE ABILITY TO SEE CANCER CARE PATIENTS FOR SYMPTOM MANAGEMENT. IN 2018, THERE WERE 196 PATIENTS ENROLLED IN THE MIH PROGRAM-60 WITH HEART FAILURE, 69 WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), 46 WITH DIABETES, SIX WITH ASTHMA, FIVE POST-MYOCARDIAL INFARCTION (MI), FIVE WITH PNEUMONIA AND FIVE RECEIVING CANCER CARE. OF THE 196 PATIENTS ENROLLED IN THE MIH PROGRAM, ONLY EIGHT PATIENTS (FOUR PERCENT) WERE READMITTED TO THE HOSPITAL WITHIN 30 DAYS.OBESITY/NUTRITION/PHYSICAL ACTIVITYTHE GOAL OF THE OBESITY INTERVENTIONS IS TO REDUCE THE PREVALENCE OF SERVICE AREA RESIDENTS WHO ARE OBESE BY ONE PERCENT BY 2020. THE FIRST STRATEGY IS TO IMPLEMENT WALKING CAMPAIGNS IN TARGETED ELGIN NEIGHBORHOODS. IN ORDER TO INCREASE PHYSICAL ACTIVITY IN LOW-INCOME COMMUNITIES IN ELGIN, ADVOCATE SHERMAN IS WORKING COLLABORATIVELY WITH ACTIVATE ELGIN, A COMMUNITY-WIDE INITIATIVE FOR ELGIN RESIDENTS TO PROMOTE PHYSICAL ACTIVITY. ADVOCATE SHERMAN WILL IMPLEMENT THE LET'S MOVE! WALKING INITIATIVE IN COORDINATION WITH ACTIVATE ELGIN. THE CITY OF ELGIN CONDUCTED A SIDEWALK GAP AND TRANSIT STOP STUDY IN 2014. THIS STUDY EXAMINED PEDESTRIAN ACCESSIBILITY AND WALKABILITY THROUGHOUT THE CITY OF ELGIN. COMMUNITY HEALTH STAFF REVIEWED THE STUDY TO IDENTIFY TARGET COMMUNITIES WITHIN ELGIN FOR THE WALKING INITIATIVE. ACTIVATE ELGIN COORDINATES A WALKING INITIATIVE CALLED WALK WITH THE MAYOR, WHERE THE MAYOR WALKS WITH RESIDENTS IN NEIGHBORHOODS TO INCREASE PHYSICAL ACTIVITY AND DECREASE OBESITY RATES. IN 2018, ADVOCATE SHERMAN SERVED AS A SPONSOR WITH THE KANE COUNTY HEALTH DEPARTMENT FOR CENTURY OAKS ELEMENTARY SCHOOL'S ANNUAL WALK TO SCHOOL DAY, WHERE OVER 200 STUDENTS PARTICIPATED. THE SECOND OBESITY STRATEGY IS TO IMPROVE PARENTS AND CHILDCARE PROVIDERS' KNOWLEDGE AND SKILLS IN NUTRITION AND PHYSICAL EDUCATION PRACTICES THROUGH THE GO NUTRITION AND PHYSICAL ACTIVITY SELF-ASSESSMENT FOR CHILD CARE (GO NAP SACC) PROGRAM. GO NAP SACC IS AN EVIDENCE-BASED EARLY INTERVENTION PROGRAM TARGETING INFANTS THROUGH PRE-KINDERGARTEN CHILDREN AND AIMS TO ADVANCE THE CHILDCARE ENVIRONMENT BY IMPROVING NUTRITION, PHYSICAL ACTIVITY AND POLICIES IN THE CHILD CARE CENTER. IN 2018, ADVOCATE AURORA HEALTH CARE LED THE LAUNCH OF A MULTI-STAKEHOLDER CHICAGOLAND COALITION TO RAISE FUNDS TO BRING THE WEB-BASED GO NAP SACC PROGRAM TO THE STATE OF ILLINOIS. THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) SECURED A TWO-YEAR GRANT FROM THE NEMOURS FOUNDATION TO SUPPORT THE ANNUAL GO NAP SACC SUBSCRIPTION AND THE GO NAP SACC ILLINOIS COLLABORATIVE LAUNCHED THE ONLINE SYSTEM IN 2018. NOW ALL CHILD CARE CENTERS ARE BEING TRANSITIONED INTO THE WEB-BASED GO NAP SACC PLATFORM. THE STATE COLLABORATIVE REMAINS ACTIVE AND ADVOCATE SHERMAN IS PARTICIPATING IN QUARTERLY PHONE CALLS. COLLABORATIVE MEMBER ORGANIZATIONS HAVE BEGUN TO ELECTRONICALLY SHARE RESOURCES. IN 2018, THE UNIVERSITY OF NORTH CAROLINA PROVIDED ON-LINE TRAINING OF GO NAP SACC TO THE ADVOCATE SHERMAN COMMUNITY HEALTH STAFF, RESULTING IN GO NAP SACC TECHNICAL ASSISTANT CONSULTANT CERTIFICATION. ADVOCATE SHERMAN LEADS THE GO NAP SACC ASSESSMENT PROCESS WITH CHILDCARE CENTERS IN ELGIN. THE HOSPITAL HAS PARTNERED WITH TWO OTHER HOSPITALS-ADVOCATE GOOD SHEPHERD AND ADVOCATE CONDELL-TO MAKE THIS PROGRAM A REGIONAL INITIATIVE. IN 2018, ADVOCATE SHERMAN HELD FOUR PLANNING MEETINGS WITH THE TWO RIVERS HEAD START AGENCY WHILE CONTINUING ITS PARTNERSHIP WITH ELGIN PARTNERSHIP FOR EARLY LEARNING (EPEL). HOSPITAL COMMUNITY HEALTH STAFF ALSO DEVELOPED A NAP SACC INFORMATION GUIDE AND PROMOTIONAL MATERIALS FOR RECRUITING CHILDCARE CENTERS IN THE COMMUNITY. THREE CHILD CARE CENTERS IN ELGIN AND CARPENTERSVILLE COMPLETED THE GO NAP SACC ASSESSMENTS IN 2018. AT THE END OF 2018, ALL THREE CENTERS WERE ACTIVELY DEVELOPING THEIR ACTION PLANS TO FOCUS ON CHANGES IN NUTRITION AND PHYSICAL ACTIVITY PRACTICES AND POLICIES, IMPACTING A TOTAL OF 212 CHILDREN ENROLLED IN THESE FOUR CENTERS.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 13B: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 13BN/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 13H: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 13HOTHER FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS INCLUDE: DECEASED PATIENTS WITH NO ESTATE; HOMELESS PATIENTS, OR PATIENTS WHO RECEIVE CARE IN A HOMELESS CLINIC; PATIENTS WITH RELIGIOUS AFFILATION WITH A VOW OF POVERTY, PATIENTS WHO QUALIFY FOR A STATE DEPARTMENT OF HUMAN SERVICES (DHS) ASSISTANCE PROGRAM, BUT HAVE NO MEDICAL COVERAGE (E.G., ILLINOIS AMI/GA, FOOD STAMP, PRESCRIPTION, WOMEN, FREE LUNCH AND BREAKFAST PROGRAM, TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF), INFANTS AND CHILDREN (WIC), MEDICAID ELIGIBLE PATIENTS BUT NOT ON THE DATE OF SERVICE, WHY WAIT AND WISE WOMEN PROGRAMS; COUNTY HEALTH CLINIC PATIENTS; LEGAL ASSSISTANCE FOUNDATION OF ILLINOIS REFERRALS; INDIVIDUALS WITH A VALID ADDRESS AT LOW-INCOME/SUSIDIZED HOUSING; QUALIFIED INDIVIDUALS OF LOW INCOME HOME ENERGY ASSISTANCE PROGRAM, INCARCERATED INDIVIIDUALS; INCOMPETENT INDIVIDUALS WITH COMPROMISED DIAGNOSES (E.G., PSYCHIATRIC); INDIVIDUALS MEETING DEFINED CREDIT REPORTING (OR OTHER EXTERNAL REPORTING) RESULT THRESHOLDS; PATIENTS WITH PRIOR HISTORY OF INABILITY TO MAKE PAYMENTS; PATIENTS WITH COURT FILED OR APPROVED BANKRUPTCY DETERMINATIONS.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 15E: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 15EN/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 16J: PART V, SECTION C- DESCRIPTION FOR PART V, SEC B, LINES 16A, 16B, AND 16CHTTP://WWW.ADVOCATEHEALTH.COM/FINANCIALASSISTANCEPART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 16JADVOCATE SHERMAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY. MEANS OF COMMUNICATION INCLUDE:1. THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HOSPITAL SERVICES INCLUDES A STATEMENT THAT FINANCIAL COUNSELING, INCLUDING FINANCIAL ASSISTANCE CONSIDERATION, IS AVAILABLE UPON REQUEST.2. SIGNAGE IS CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO HOSPITAL RESGISTRATION AREAS (I.E., PATIENT ACCESS, EMERGENCY DEPARTMENT).3. BROCHURES ARE PLACED IN HOSPITAL RESGISTRATION AREAS (I.E., PATIENT ACCESS, EMERGENCY DEPARTMENT) AND INCLUDE GUIDANCE ON HOW A PATIENTS MAY APPLY FOR MEDICARE, MEDICAID, ALL KIDS, FAMILY CARE ETC., AND THE HOSPTIAL'S FINANCIAL ASSISTANCE PROGRAM. A HOSPITAL CONTACT AND TELEPHONE NUMBER FOR FINANCIAL ASSISTANCE IS INCLUDED. 4. A HANDOUT SUMMARIZING ADVOCATE'S FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION ARE GIVEN TO ALL UNINSURED PATIENTS WHO RECEIVE MEDICALLY NECESSARY HOSPITAL SERVICES AT THE EARLIEST PRACTICAL TIME OF SERVICE.5. ADVOCATE'S WEBSITE PROMINENTLY NOTES THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLAINATION OF THE APPLICATION PROCESS, A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, AND THE FINANCIAL ASSISTANCE APPLICATION.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 18E: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 18EN/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 19E: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 19EADVOCATE SHERMAN DOES NOT PERFORM ACTIONS SUCH AS THOSE LISTED IN LINES 19A-D UNTIL REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE A PATIENT'S FAP ELIGIBILITY.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 20E: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 20EADVOCATE MAKES REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY UNDER ITS FAP, INCLUDING SENDING A SERIES OF LETTERS AND ATTEMPTING TO WORK WITH THE PATIENT THROUGH THE FINANCIAL COUNSELING PROCESS AND/OR PHONE CALLS. ALL CORRESPONDENCE ASKS THE PATIENT TO NOTIFY THE HOSPITAL IF HE/SHE IS EXPERIENCING "DIFFICULTY IN PAYING YOUR BILL". ADVOCATE ALSO USES EARLY OUT AND PRECOLLECTION VENDORS TO ASSIST IN OBTAINING PAYMENTS OR COLLECTING FINANCIAL ASSISTANCE ELIGIBILITY INFORMATION. THESE VENDORS HAVE THE FOLLOWING LANGUAGE IN THEIR CONTRACT: "VENDOR WILL COMMUNICATE THE ADVOCATE HEALTH CARE POLICY AND GUIDELINE TO ANY PATIENT EXPRESSING A DIFFICULTY IN PAYING THEIR BILL AND, "VENDOR WILL MAIL THE ADVOCATE HEALTH CARE FINANCIAL ASSISTANCE APPLICATION TO ANY PATIENTS EXPRESSING A DIFFICULTY IN PAYING THEIR BILL". ADVOCATE'S BAD DEBT AGENCY CONTRACTS HAVE THE FOLLOWING LANGUAGE: "AGENCY SHALL EVALUATE EACH PATIENT WHOSE ACCOUNT IS REFERRED TO AGENCY, WHERE THE PATIENT EXPRESSES DIFFICULTY OR INABILITY TO PAY THEIR BILL, FOR ELIGIBILITY UNDER ADVOCATE'S FINANCIAL ASSISTANCE POLICY." VENDOR AND AGENCY CONTRACTS ARE STANDARD ACROSS ADVOCATE'S SYSTEM.
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 21C: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 21CN/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 21D: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 21DN/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 23: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 23N/A
ADVOCATE SHERMAN HOSPITAL	PART V, SECTION B, LINE 24: PART V, SECTION C - DESCRIPTION FOR PART V, SEC B, LINE 24N/A
PART V, SECTION B, LINE 11 - CONTINUED	THE FINAL STRATEGY DEVELOPED TO ADDRESS OBESITY IS TO IDENTIFY INDIVIDUALS LIVING WITHIN ELGIN AND CARPENTERSVILLE WHO ARE FOOD INSECURE (FI) AND REFER THEM TO COMMUNITY RESOURCES. THE HUNGER VITAL SIGN FI SCREENING TOOL RAPIDLY IDENTIFIES HOUSEHOLDS AT RISK FOR FOOD INSECURITY, ENABLING PROVIDERS TO TARGET SERVICES THAT AMELIORATE THE ASSOCIATED HEALTH AND DEVELOPMENTAL CONSEQUENCES. IN MARCH 2018, SCREENING BEGAN FOR PATIENTS IN THE HOSPITAL DIABETES CENTER AS WELL AS PATIENTS ENROLLED IN THE MOBILE INTEGRATED HEALTH PROGRAM. DURING 2018, THERE WERE 174 INDIVIDUALS SCREENED, OF WHICH 26 PERCENT SCREENED AS BEING FOOD INSECURE. PATIENTS WHO ARE IDENTIFIED AS FOOD INSECURE ARE BEING EDUCATED REGARDING COMMUNITY RESOURCES AND REFERRED OR LINKED DIRECTLY TO COMMUNITY SUPPORT ORGANIZATIONS AND PROGRAMS. ADVOCATE SHERMAN DEVELOPED A FOOD AND NUTRITION RESOURCE GUIDE FOR CARPENTERSVILLE AND ELGIN, CONTAINING AREA COMMUNITY FOOD RESOURCES. GUIDES WERE PUBLISHED IN BOTH ENGLISH AND SPANISH AND ARE UPDATED ANNUALLY. THE GUIDE ALSO INCLUDES FARMERS MARKETS. ADDITIONALLY, AS MENTIONED EARLIER, A PROCESS WAS DEVELOPED TO PROVIDE EXCESS PRODUCE FROM THE ON-SITE ADVOCATE SHERMAN COMMUNITY GARDEN TO PATIENTS BEING SEEN IN THE DIABETES CENTER WHO ARE DETERMINED TO BE FOOD INSECURE.PRIORITIES NOT SELECTED FOR NEW PROGRAMMINGTHERE WERE ADDITIONAL HEALTH ISSUES REVIEWED AS PART OF THE CHNA PROCESS THAT WERE ALSO DETERMINED TO BE HEALTH NEEDS WITHIN THE ADVOCATE SHERMAN SERVICE AREA. HOWEVER, THESE ISSUES WERE NOT SELECTED AS PRIORITIES FOR THE 2017-2019 IMPLEMENTATION PLAN. HEART DISEASE AND STROKETHE CHNA RESULTS INDICATED A DECLINE IN DEATH RATES DUE TO HEART DISEASE AND STROKE AS WELL AS POSITIVE PERFORMANCE AGAINST THE HEALTHY PEOPLE 2020 TARGETS, DEMONSTRATING THAT PROGRESS IS BEING MADE TO DECREASE HEART DISEASE AND STROKE RATES. ADDITIONALLY, ADVOCATE SHERMAN IS A MEMBER OF THE ADVOCATE HEART INSTITUTE, WHICH COMBINES ADVANCED DIAGNOSTICS AND TREATMENT WITH STATE-OF-THE-ART TECHNOLOGY TO PROVIDE PATIENTS WITH THE BEST POSSIBLE OUTCOMES. THE HEART INSTITUTE INITIATES A VARIETY OF ANNUAL HEART DISEASE PREVENTION AND TREATMENT PROGRAMS TO DECREASE CARDIOVASCULAR DISEASE. TAKING THIS INFORMATION INTO CONSIDERATION, THE COMMUNITY HEALTH COUNCIL VOTED TO PRIORITIZE OBESITY BECAUSE OF ITS UNDERLYING RELATIONSHIP TO HEART DISEASE.HEART DISEASE AND STROKE ARE INCLUDED AS TWO OF THE CHRONIC HEALTH CONDITIONS THAT ARE INCLUDED IN THE SCOPE OF THE ADVOCATE SHERMAN MIH PROGRAM. MENTAL HEALTHADVOCATE SHERMAN CURRENTLY WORKS CLOSELY WITH THE ECKER CENTER FOR MENTAL HEALTH, A NON-PROFIT OUTPATIENT MENTAL HEALTH AGENCY WITH OFFICES IN ELGIN, ST. CHARLES AND STREAMWOOD. THE ECKER CENTER WORKS IN PARTNERSHIP WITH THE ADVOCATE SHERMAN EMERGENCY DEPARTMENT STAFF. LOCATED ONSITE AT THE HOSPITAL, ECKER CENTER STAFF RECEIVE REFERRALS FOR PATIENTS WHO NEED FURTHER MENTAL HEALTH SUPPORT AFTER BEING SEEN IN THE EMERGENCY ROOM. IN ADDITION, THE HOSPITAL WORKS WITH A WIDE ARRAY OF OTHER MENTAL HEALTH PROVIDERS IN THE PRIMARY SERVICE AREA TO ENSURE A CONTINUUM OF CARE FOR PATIENTS. THE DIRECTOR OF COMMUNITY HEALTH SITS ON THE KANE COUNTY BEHAVIORAL HEALTH COUNCIL, A COALITION OF MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT PROVIDERS WORKING TO IMPROVE THE CONTINUUM OF CARE FOR KANE COUNTY RESIDENTS. IN 2017, THE BEHAVIORAL HEALTH COUNCIL WORKED TOGETHER TO DEVELOP A BEHAVIORAL HEALTH PROVIDER WEBSITE AND DIRECTORY: WWW.WESUPPORTMENTALHEALTH.ORG. BECAUSE OF THIS ONGOING ACTIVITY, THE COMMUNITY HEALTH COUNCIL DECIDED TO FOCUS ON OTHER HEALTH ISSUES FOR 2017-2019.SUBSTANCE ABUSEA GREAT DEAL OF WORK IS CURRENTLY BEING DONE TO ADDRESS SUBSTANCE ABUSE WITHIN BOTH KANE AND MCHENRY COUNTIES THROUGH COALITIONS AND ACTION TEAMS ADDRESSING THE USE OF OPIOIDS. THE DIRECTOR OF COMMUNITY HEALTH SITS ON THE MCHENRY COUNTY SUBSTANCE ABUSE COALITION AND THE KANE COUNTY BEHAVIORAL HEALTH COUNCIL. IN 2018, PLANNING BEGAN TO FORM A KANE COUNTY OPIOID TASK FORCE THROUGH THE KANE COUNTY HEALTH DEPARTMENT. THE DIRECTOR OF COMMUNITY HEALTH PARTICIPATED IN THESE PLANNING MEETINGS. SINCE ADVOCATE SHERMAN IS ALREADY INVOLVED IN THESE COALITIONS, THE COMMUNITY HEALTH COUNCIL DECIDED TO FOCUS ON OTHER PRIORITIES.

Schedule H (Form 990) 2018

Page 9

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?16
Name and address		Type of Facility (describe)
1	1 - SHERMAN MOB 1435 N RANDALL RD ELGIN,IL60120	PATIENT CARE - IN PATIENT
2	2 - AMG 1140 N MCLEAN BLVD STE E F ELGIN,IL60120	PATIENT CARE - OUT PATIENT
3	3 - SHERMAN IMMEDIATE CARE 2320 ROYAL BLVD ELGIN,IL60120	PATIENT CARE - OUT PATIENT
4	4 - SHERMAN IMMEDIATE CARE - ALGONQUIN 600 RANDALL RD STE 210 230 ALGONQUIN,IL60102	PATIENT CARE - OUT PATIENT
5	5 - SHERMAN IMMEDIATE CARE - SOUTH ELGIN 2000 MCDONALD RD SOUTH ELGIN,IL60177	PATIENT CARE - OUT PATIENT
6	6 - THE CENTRE OF ELGIN 100 SYMPHONY WAY ELGIN,IL60120	PATIENT CARE - OUT PATIENT
7	7 - SHERMAN IMMEDIATE CARE - BARTLETT 1052-54 NORWOOD LN BARTLETT,IL60103	PATIENT CARE - OUT PATIENT
8	8 - SHERMAN WEST COURT - 826 PROSPECT 826 PROSPECT BLVD ELGIN,IL60120	PATIENT CARE - OUT PATIENT
9	9 - THE CENTRE OF ELGIN - FLETCHER 745 FLETCHER DR ELGIN,IL60120	PATIENT CARE - OUT PATIENT
10	10 - THE CENTRE OF ELGIN - PENNY 201 PENNY AVE STE 100 EAST DUNDEE,IL60118	PATIENT CARE - OUT PATIENT
11	11 - SHERMAN IMMEDIATE CARE - HAMPSHIRE 1000 S STATE ST HAMPSHIRE,IL60140	PATIENT CARE - OUT PATIENT
12	12 - SHERMAN IMMEDIATE CARE - BARTLETT 864 STERNS RD STE 103 BARTLETT,IL60103	PATIENT CARE - OUT PATIENT
13	13 - SHERMAN IMMEDIATE CARE - CRYSTAL LAKE 741 MCHENRY AVE CRYSTAL LAKE,IL60014	PATIENT CARE - OUT PATIENT
14	14 - SHERMAN MOB - CRYSTAL LAKE 4900 S ROUTE 31 CRYSTAL LAKE,IL60014	PATIENT CARE - OUT PATIENT
15	15 - SHERMAN MOB - ELGIN CHICAGO 999-1019 E CHICAGO ST ELGIN,IL60120	PATIENT CARE - OUT PATIENT
16	16 - SHERMAN IMMEDIATE CARE - STREAMWOOD 550 S BLVD STREAMWOOD,IL60107	PATIENT CARE - OUT PATIENT

Schedule H (Form 990) 2018

Page 10

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:	THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 IS BASED ON THE RATIO OF PATIENT CARE COST TO CHARGES. THE UNREIMBURSED COST OF BAD DEBT WAS CALCULATED BY APPLYING THE ORGANIZATION'S COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) TO THE ORGANIZATION'S BAD DEBT PROVISION PER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS RECEIVED.ADVOCATE MAKES EVERY EFFORT TO IDENTIFY THOSE PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BY STRICTLY ADHERING TO ITS FINANCIAL ASSISTANCE POLICY. WE BELIEVE THAT ADVOCATE HAS A POPULATION OF PATIENTS WHO ARE UNINSURED OR UNDERINSURED BUT WHO DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) WHICH COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY, WAS BASED UPON SELF PAY PATIENT ACCOUNTS WHICH HAD AMOUNTS WRITTEN OFF TO BAD DEBTS. OUR METHOD WAS TO BEGIN WITH THE SELF-PAY PORTION OF BAD DEBT EXPENSE PROVISION. THE SELF PAY PORTION EXCLUDES THOSE PATIENTS WHO HAD CHARITY APPLICATIONS PENDING AT THE TIME OF SERVICE. THIS COST WAS THEN REDUCED BY CHARGES IDENTIFIED AS TRUE BAD DEBT EXPENSE, INCLUDING COPAYS FOR PATIENTS WHO QUALIFIED FOR LESS THAN 100% FINANCIAL ASSISTANCE. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE REMAINING CHARGES, TO DETERMINE THE VALUE (AT COST) OF PATIENT ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT. WE BELIEVE THIS PROCESS IS A REASONABLE BASIS FOR OUR ESTIMATE. AS WE ARE ONLY CONSIDERING SELF-PAY ACCOUNTS WRITTEN OFF TO BAD DEBT FOR THIS ESTIMATE, THIS ESTIMATE DOES NOT INCLUDE THE IMMEDIATE 30% DISCOUNT TO CHARGES WHICH IS APPLIED TO ALL SELF-PAY PATIENTS. IT ALSO DOES NOT INCLUDE ACCOUNT BALANCES OR CO-PAYS OF NON-SELF PAY ACCOUNTS WHICH ARE WRITTEN OFF TO BAD DEBT WHEN THE PATIENT HAS NO OTHER FINANCIAL RESOURCES TO PAY THESE AMOUNTS AND THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE.BAD DEBT AMOUNTS HAVE BEEN EXCLUDED FROM OTHER COMMUNITY BENEFIT AMOUNTS REPORTED THROUGHOUT SCHEDULE H.
PART I, LINE 7G:	PART VI, LINE 1 - DESCRIPTION FOR PART I, LINE 7A COST-TO-CHARGE RATIO, DERIVED FROM SCHEDULE H INSTRUCTIONS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7A. SCHEDULE H INSTRUCTIONS WORKSHEET 3, UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS, WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINE 7B. A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE TABLE FOR PART I, LINES 7E, 7F, 7G, AND 7I.SCHEDULE H, PART VI, LINE 1 - 7EADVOCATE SHERMAN HOSPITAL PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES TO THE COMMUNITIES IN WHICH IT SERVES. ADVOCATE SHERMAN HOSPITAL PROVIDES LANGUAGE SERVICES TO ALL THOSE IN NEED IN ORDER TO PROVIDE BETTER ACCESS TO CARE FOR ALL COMMUNITY MEMBERS. IN ADDITION, OTHER PROGRAMS ARE CARRIED OUT WITH THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH, ACCESS TO HEALTH SERVICES AND GENERAL HEALTH KNOWLEDGE. THESE SERVICES DO NOT GENERATE PATIENT BILLS, HOWEVER, CERTAIN PROGRAMS OR SERVICES MAY HAVE NOMINAL FEES. PART VI, LINE 1 - DESCRIPTION FOR PART I, LINE 7GADVOCATE SHERMAN HOSPITAL PROVIDES SUBSIDIZED HEALTH SERVICES TO THE COMMUNITY. THESE SERVICES ARE PROVIDED DESPITE CREATING A FINANCIAL LOSS FOR ADVOCATE SHERMAN HOSPITAL. THESE SERVICES ARE PROVIDED BECAUSE THEY MEET AN IDENTIFIED COMMUNITY NEED. IF ADVOCATE SHERMAN HOSPITAL DID NOT PROVIDE THE CLINICAL SERVICE, IT IS REASONABLE TO CONCLUDE THAT THESE SERVICES WOULD NOT BE AVAILABLE TO THE COMMUNITY. PART VI, LINE 1 - DESCRIPTION FOR PART I, LINE 7HADVOCATE SHERMAN HOSPITAL CONDUCTS NUMEROUS RESEARCH ACTIVITIES FOR THE ADVANCEMENT OF MEDICAL AND HEALTH CARE SERVICES. HOWEVER, THE UNREIMBURSED COST OF SUCH RESEARCH ACTIVITIES IS NOT READILY DETERMINABLE AND NO AMOUNT IS BEING REPORTED FOR PURPOSES OF THE 2018 FORM 990, SCHEDULE H.
PART I, LN 7 COL(F):	PART VI, LINE 1 - DESCRIPTION FOR PART III, LINES 2, 3, AND 4 THE FOOTNOTES TO ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES' AUDITED FINANCIAL STATEMENTS DO NOT SPECIFICALLY ADDRESS BAD DEBT EXPENSE; RATHER, THE FOOTNOTE DESCRIBES ADVOCATE'S PATIENT ACCOUNTS RECEIVABLE POLICY AND THE PERCENTAGE OF ACCOUNTS RECEIVABLE THAT THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERS (SEE PAGES 10-11 OF THE AUDITED FINANCIAL STATEMENTS). FOR 2018, FOR ADVOCATE SHERMAN HOSPITAL, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERED 35.77% OF NET PATIENT ACCOUNTS RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. ADVOCATE SHERMAN HOSPITAL EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYER CLASS, HISTORICAL COLLECTION EXPERIENCE, AND TRENDS IN HEALTH CARE INSURANCE PROGRAMS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE.
PART II, COMMUNITY BUILDING ACTIVITIES:	PART VI, LINE 5. PROMOTION OF COMMUNITY HEALTH.ENVIRONMENTAL IMPROVEMENTS ADVOCATE HEALTH CARE IS COMMITTED TO GREENING HEALTH CARE BECAUSE IT IS DEEPLY CONNECTED TO OUR CORE MISSION - HEALTH AND HEALING. WE UNDERSTAND THAT THE HEALTH OF THE ENVIRONMENT AND THE HEALTH OF THE PATIENTS AND COMMUNITIES WE SERVE IS INEXTRICABLY LINKED - AND THAT A HEALTHY PLANET SUPPORTS HEALTHY PEOPLE. REDUCING WASTE, CONSERVING ENERGY AND WATER, MINIMIZING USE OF TOXIC CHEMICALS, AND CONSTRUCTING ECO-FRIENDLY BUILDINGS FOR TODAY AND TOMORROW - ALL OF THESE EFFORTS HAVE A DIRECT BENEFIT ON THE HEALTH OF LOCAL COMMUNITIES VIA CLEANER COMMUNITIES, HEALTHIER AIR QUALITY, REDUCED GREEN HOUSE GASES, AND PRESERVATION OF NATURAL RESOURCES. AS WE WORK TO REDUCE THE ENVIRONMENTAL AND HEALTH IMPACT OF HEALTH CARE, OUR ENVIRONMENTAL STEWARDSHIP PRACTICES HELP EASE THE BURDEN OF HEALTH CARE COSTS BOTH DIRECTLY (LOWER ENERGY COSTS) AND INDIRECTLY (LOWER ENVIRONMENTALLY-RELATED DISEASE BURDEN). 1. MENTORING AND EDUCATIONAS WE WORK TO SERVE THE HEALTH NEEDS OF TODAY'S PATIENTS AND FAMILIES WITHOUT COMPROMISING THE NEEDS OF FUTURE GENERATIONS, ADVOCATE HAS COMMITTED RESOURCES TO SHARING LESSONS LEARNED AND BEST PRACTICES WITH OTHER HOSPITALS AND HEALTH SYSTEMS, BOTH LOCALLY AND NATIONALLY, AND WE DO SO IN A VARIETY OF WAYS. ADVOCATE HEALTH CARE WAS ONE OF 12 FOUNDING AND SPONSORING HEALTH SYSTEMS OF THE NATIONAL HEALTHIER HOSPITALS INITIATIVE, WHICH HAS NOW BECOME A PERMANENT PROGRAM OF PRACTICE GREENHEALTH. THE HEALTHIER HOSPITALS PROGRAM ENGAGES OVER 1,300 HOSPITALS IN SIX KEY CATEGORIES OF HEALTH CARE SUSTAINABILITY: ENGAGED LEADERSHIP, HEALTHIER FOODS, LESS WASTE, LEANER ENERGY, SAFER CHEMICALS, AND SMARTER PURCHASING. ENROLLED HOSPITALS HAVE ACCOMPLISHED REDUCTIONS IN MEAT PURCHASING, INCREASED PURCHASING OF LOCAL AND SUSTAINABLE FOOD, REDUCED EXPOSURE TO TOXIC CHEMICALS THROUGH GREEN CLEANING PROGRAMS AND CONVERSION OF MEDICAL PRODUCTS FREE FROM PVC AND DEHP AND DECREASED ENERGY AND WASTE. ADVOCATE IS PROUD TO JOURNEY WITH THIS GROWING MASS OF HOSPITALS THROUGH ITS OWN INVOLVEMENT AND LEADERSHIP IN THE HEALTHIER HOSPITALS CHALLENGES. ADVOCATE CONTINUES ITS LEADERSHIP, ADVOCACY AND MENTORING ROLE NATIONALLY THROUGH PARTICIPATION IN SEVERAL HEALTHCARE SUSTAINABILITY LEADERSHIP GROUPS AND ADVISORY BOARDS, ADDRESSING ANTIBIOTIC OVERUSE IN AGRICULTURE, SAFER CHEMICALS IN FURNISHING AND MEDICAL PRODUCTS, CLIMATE CHANGE, PLASTICS RECYCLING, AND ENVIRONMENTALLY-PREFERABLE PURCHASING:" PRACTICE GREENHEALTH MARKET TRANSFORMATION GROUP - LESS MEAT, BETTER MEAT" PRACTICE GREENHEALTH MARKET TRANSFORMATION GROUP - SAFER CHEMICALS" HEALTH CARE CLIMATE COUNCIL " HEALTHCARE PLASTICS RECYCLING COALITION - HEALTHCARE FACILITY ADVISORY BOARD" VIZIENT ENVIRONMENTAL ADVISORY COUNCIL " SIGNATORY OF THE CHEMICAL FOOTPRINT PROJECTADVOCATE ALSO COMMONLY PROVIDES MENTORING TO HEALTH CARE COMMUNITY ON SUSTAINABILITY BEST PRACTICES THROUGH PRESENTATIONS AND WEBINARS, AS WELL AS TO INDIVIDUAL HEALTH CARE INSTITUTIONS ON A CASE-BY-CASE BASIS.2. ADVOCATE HEALTH CARE SYSTEM - 2018 ENVIRONMENTAL INITIATIVES:" REDUCED CUMULATIVE (ELEVEN HOSPITALS) HOSPITAL ENERGY CONSUMPTION BY 0.5 PERCENT IN TWELVE MONTHS ENDING 11/30/18. OUR 2018 ENERGY REDUCTIONS SAVED ADVOCATE $490,000 IN ENERGY COSTS" AVOIDED 2,811 MTCO2E OF GREENHOUSE GASES (EQUIVALENT TO 6.8 MILLION MILES OF DRIVING) THROUGH ECO-FRIENDLY MANAGEMENT OF ANESTHETIC GASES." RECYCLED 2,760 TONS OF WASTE FROM HOSPITAL OPERATIONS." RECYCLED 74 PERCENT, OR 1,370 TONS, OF CONSTRUCTION AND DEMOLITION DEBRIS." SAVED 56 TONS OF WASTE FROM LANDFILL AND SAVED OVER $2 MILLION VIA OUR SURGICAL AND MEDICAL DEVICE REPROCESSING PROGRAMS." CONTINUED OUR DONATION PROGRAM WITH PROJECT C.U.R.E., A NON-PROFIT ORGANIZATION THAT WILL RESPONSIBLY REDISTRIBUTE DONATED MEDICAL SUPPLIES AND EQUIPMENT TO UNDER-RESOURCED AREAS AROUND THE GLOBE, FOR ALL ADVOCATE HEALTH CARE FACILITIES. ADVOCATE DONATED A TOTAL OF 91 PALLETS OF MISCELLANEOUS MEDICAL SUPPLIES AND 13PIECES OF MEDICAL EQUIPMENT TO PROJECT CURE IN 2018, ALL OF WHICH MAY HAVE OTHERWISE BEEN LANDFILLED." PURCHASED 7,134 FEWER REAMS OF PAPER IN 2018 VERSUS 2017 EVEN THOUGH PATIENT VOLUMES ROSE - TRANSLATING INTO AN OVER 3% YEAR-OVER-YEAR REDUCTION IN PAPER USAGE." SPENT 78% OF ADVOCATE'S EXPENSES IN SELECT CLEANING PRODUCT CATEGORIES (WINDOW, FLOOR, CARPET, BATHROOM, AND GENERAL-PURPOSE CLEANERS) ON THIRD-PARTY CERTIFIED "GREEN" CLEANERS." INCREASED THE PURCHASE OF HEALTHIER HOSPITALS-APPROVED FURNITURE, MADE WITHOUT SELECT CHEMICALS OF CONCERN, INCLUDING PERFLUORINATED COMPOUNDS, PVC (VINYL), FORMALDEHYDE, FLAME RETARDANTS (WHERE CODE PERMISSIBLE) AND ANTIMICROBIALS, TO 78% OF TOTAL PURCHASES." PURCHASED 24% OF TOTAL MEAT PRODUCTS FROM LIVESTOCK AND POULTRY RAISED WITHOUT THE ROUTINE USE OF ANTIBIOTICS, SUPPORTING THE JUDICIOUS AND RESPONSIBLE USE OF ANTIBIOTICS IN AGRICULTURE WHICH CAN HELP SLOW THE EMERGENCE OF ANTIBIOTIC-RESISTANT BACTERIA." PLEASE SEE ADVOCATE HEALTH CARE'S PUBLICLY-FACING SUSTAINABILITY & WELLNESS WEBSITE FOR MORE INFORMATION.HOSPITAL-BASED ENVIRONMENTAL IMPROVEMENTS IN 2018ADVOCATE SHERMAN HOSPITAL" DIVERTED OVER 481,000 POUNDS OF OPERATING WASTE FROM THE LANDFILL THROUGH ITS VARIOUS RECYCLING PROGRAMS. " AVOIDED 10,000 POUNDS OF MEDICAL AND SOLID WASTE THROUGH ITS MEDICAL AND SURGICAL DEVICE REPROCESSING PROGRAMS. " 71% OF FURNITURE PURCHASES WERE FREE OF FIVE KEY CHEMICALS OF CONCERN." IN 2018, SHERMAN DONATED 5 PALLETS OF VARIOUS MEDICAL SUPPLIES TO PROJECT CURE FOR USE IN RESOURCE-LIMITED AREAS AROUND THE WORLD. " THROUGH THE GENEROSITY OF THE COMMUNITY GARDENERS, THE SHERMAN NATURAL PRAIRIE AND COMMUNITY GARDEN DONATED FRESH PRODUCE TO FOOD FOR GREATER ELGIN IN 2018." SHERMAN HOSPITAL HAS A GEOTHERMAL LAKE THAT HELPS HEAT AND COOL THE HOSPITAL, REDUCING ENERGY AND WATER NEEDS AS WELL AS RELATED GREENHOUSE GAS EMISSIONS
PART III, LINE 2:	ADVOCATE MAKES EVERY EFFORT TO IDENTIFY THOSE PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BY STRICTLY ADHERING TO ITS FINANCIAL ASSISTANCE POLICY. WE BELIEVE THAT ADVOCATE HAS A POPULATION OF PATIENTS WHO ARE UNINSURED OR UNDERINSURED BUT WHO DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) WHICH COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY, WAS BASED UPON SELF PAY PATIENT ACCOUNTS WHICH HAD AMOUNTS WRITTEN OFF TO BAD DEBTS. OUR METHOD WAS TO BEGIN WITH THE SELF-PAY PORTION OF BAD DEBT EXPENSE PROVISION. THE SELF PAY PORTION EXCLUDES THOSE PATIENTS WHO HAD CHARITY APPLICATIONS PENDING AT THE TIME OF SERVICE. THIS COST WAS THEN REDUCED BY CHARGES IDENTIFIED AS TRUE BAD DEBT EXPENSE, INCLUDING COPAYS FOR PATIENTS WHO QUALIFIED FOR LESS THAN 100% FINANCIAL ASSISTANCE. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE REMAINING CHARGES, TO DETERMINE THE VALUE (AT COST) OF PATIENT ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT. WE BELIEVE THIS PROCESS IS A REASONABLE BASIS FOR OUR ESTIMATE. AS WE ARE ONLY CONSIDERING SELF-PAY ACCOUNTS WRITTEN OFF TO BAD DEBT FOR THIS ESTIMATE, THIS ESTIMATE DOES NOT INCLUDE THE IMMEDIATE 30% DISCOUNT TO CHARGES WHICH IS APPLIED TO ALL SELF-PAY PATIENTS. IT ALSO DOES NOT INCLUDE ACCOUNT BALANCES OR CO-PAYS OF NON-SELF PAY ACCOUNTS WHICH ARE WRITTEN OFF TO BAD DEBT WHEN THE PATIENT HAS NO OTHER FINANCIAL RESOURCES TO PAY THESE AMOUNTS AND THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE.BAD DEBT AMOUNTS HAVE BEEN EXCLUDED FROM OTHER COMMUNITY BENEFIT AMOUNTS REPORTED THROUGHOUT SCHEDULE H.
PART III, LINE 4:	PART VI, LINE 1 - DESCRIPTION FOR PART III, LINES 2, 3, AND 4 THE FOOTNOTES TO ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES' AUDITED FINANCIAL STATEMENTS DO NOT SPECIFICALLY ADDRESS BAD DEBT EXPENSE; RATHER, THE FOOTNOTE DESCRIBES ADVOCATE'S PATIENT ACCOUNTS RECEIVABLE POLICY AND THE PERCENTAGE OF ACCOUNTS RECEIVABLE THAT THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERS (SEE PAGES 10-11 OF THE AUDITED FINANCIAL STATEMENTS). FOR 2018, FOR ADVOCATE SHERMAN HOSPITAL, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS COVERED 35.77% OF NET PATIENT ACCOUNTS RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. ADVOCATE SHERMAN HOSPITAL EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYER CLASS, HISTORICAL COLLECTION EXPERIENCE, AND TRENDS IN HEALTH CARE INSURANCE PROGRAMS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE.
PART III, LINE 8:	PART VI, LINE 1 - DESCRIPTION FOR PART III, LINE 8THE SHORTFALL OF $9,476,722 ON PART III, LINE 7 IS THE UNREIMBURSED COST OF PROVIDING SERVICES FOR MEDICARE PATIENTS AND SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE PROVIDING THESE SERVICES WITHOUT REIMBURSEMENT LESSENS THE BURDENS OF GOVERNMENT OR OTHER CHARITIES THAT WOULD OTHERWISE BE NEEDED TO SERVE THE COMMUNITY.FOR ADVOCATE SHERMAN'S OPERATIONS, THE UNREIMBURSED COST OF MEDICARE WAS CALCULATED BY APPLYING THE ORGANIZATION'S COST TO CHARGE RATIO FROM THE MEDICARE COST REPORTS (CMS 2252-96 WORKSHEET C, PART 1, PPS INPATIENT RATIOS) AND FOR NON-HOSPITAL OPERATIONS THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES TO THE ORGANIZATION'S MEDICARE, LESS ANY PATIENT OR THIRD PARTY PAYOR PAYMENTS AND/OR CONTRIBUTIONS RECEIVED THAT WERE DESIGNATED FOR THE PAYMENT OF MEDICARE PATIENT BILLS.
PART III, LINE 9B:	PART VI, LINE 1 - DESCRIPTION FOR PART III, LINE 9BADVOCATE SHERMAN HOSPITAL MAINTAINS BOTH WRITTEN FINANCIAL ASSISTANCE AND BAD DEBT/COLLECTION POLICIES. THE BAD DEBT/COLLECTION POLICY DOES NOT APPLY TO THOSE PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE; THEREFORE SUCH PATIENTS ARE NOT SUBJECT TO COLLECTION PRACTICES.
PART VI, LINE 2:	PART VI, LINE 2. NEEDS ASSESSMENT.N/A
PART VI, LINE 3:	ADVOCATE SHERMAN HOSPITAL ASSISTS PATIENTS WITH ENROLLMENT IN GOVERNMENT-SUPPORTED PROGRAMS FOR WHICH THEY ARE ELIGIBLE AND IN SECURING REIMBURSEMENT FROM AVAILABLE THIRD PARTY RESOURCES. FINANCIAL COUNSELING IS PROVIDED TO HELP PATIENTS IDENTIFY AND OBTAIN PAYMENT FROM THIRD PARTIES, INCLUDING ILLINOIS MEDICAID, ILLINOIS CRIME VICTIMS FUND, ETC., AS WELL AS TO DETERMINE ELIGIBILITY UNDER ADVOCATE SHERMAN HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ADVOCATE UTILIZES A FINANCIAL SCREENING SOFTWARE PROGRAM TO HELP IDENTIFY PUBLIC ASSISTANCE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE OR ADVOCATE'S FINANCIAL ASSISTANCE AT THE TIME OF REGISTRATION OR AS SOON AS PRACTICABLE THEREAFTER. IN ADDITION, HEALTHADVISOR, ADVOCATE'S EDUCATION REGISTRATION AND PHYSICIAN REFERRAL TELEPHONE CENTER, SERVES AS A COMMUNITY RESOURCE PROVIDING REFERRALS TO GOVERNMENT-FUNDED AND OTHER PROGRAMS VIA TELEPHONE FROM 7 A.M. TO 7 P.M., MONDAY THROUGH FRIDAY AND SATURDAYS 9 A.M. TO 2 P.M. ADVOCATE SHERMAN HOSPITAL ASSISTS PATIENTS WITH APPLYING FOR ADVOCATE'S OWN FINANCIAL ASSISTANCE SERVICES, IF PATIENTS ARE NOT ELIGIBLE FOR GOVERNMENT-SUPPORTED PROGRAMS. ADVOCATE SHERMAN HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY. MEANS OF COMMUNICATION INCLUDE:1. THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HOSPITAL SERVICES INCLUDES A STATEMENT THAT FINANCIAL COUNSELING, INCLUDING FINANCIAL ASSISTANCE CONSIDERATION, IS AVAILABLE UPON REQUEST.2. SIGNS ARE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS.3. BROCHURES ARE PLACED IN HOSPITAL PATIENT ACCESS, REGISTRATION, EMERGENCY DEPARTMENT, CASHIER, AND BUSINESS OFFICE LOCATIONS, AND WILL INCLUDE GUIDANCE ON HOW A PATIENT MAY APPLY FOR MEDICARE, MEDICAID, ALL KIDS, FAMILY CARE ETC., AND THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. A HOSPITAL CONTACT AND TELEPHONE NUMBER FOR FINANCIAL ASSISTANCE IS INCLUDED.4. A HANDOUT SUMMARIZING ADVOCATE'S FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION IS GIVEN TO UNINSURED PATIENTS WHO RECEIVE MEDICALLY NECESSARY HOSPITAL SERVICES AT THE EARLIEST PRACTICAL TIME OF SERVICE.5. ADVOCATE'S WEBSITE POSTS NOTICE IN A PROMINENT PLACE THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLANATION OF THE FINANCIAL ASSISTANCE APPLICATION PROCESS, AND ENABLE PRINTING OF THE FINANCIAL ASSISTANCE APPLICATION.6. HOSPITAL BILLS TO UNINSURED PATIENTS INCLUDE A REQUEST THAT THE PATIENT INFORM THE HOSPITAL OF ANY AVAILABLE HEALTH INSURANCE COVERAGE, AND INCLUDE A SUMMARY OF ADVOCATE'S FINANCIAL ASSISTANCE POLICY, A FINANCIAL ASSISTANCE APPLICATION, AND A TELEPHONE NUMBER TO REQUEST FINANCIAL ASSISTANCE.
PART VI, LINE 4:	ADVOCATE SHERMAN DEFINES COMMUNITY AS THE HOSPITAL PRIMARY SERVICE AREA (PSA), WHICH INCLUDES COMMUNITIES IN MCHENRY COUNTY AND KANE COUNTY, ILLINOIS. AS OF 2016, THE POPULATION OF THE PSA WAS 295,699. GENERALLY, 80 PERCENT OF ALL PATIENTS SERVED BY THE HOSPITAL RESIDE IN THE PSA. THE THREE LARGEST ZIP CODE COMMUNITIES WITHIN THE PSA ARE ELGIN (60120) WITH A POPULATION OF 52,703; ELGIN (60123) WITH A POPULATION OF 47,644; AND CARPENTERSVILLE (60110) WITH A POPULATION OF 39,541. THE MEDIAN AGE FOR THE PSA IS 37.49 YEARS OLD. IN THE PSA, 27 PERCENT OF THE RESIDENTS ARE AGE 17 AND YOUNGER AND EIGHT PERCENT ARE AGE 70 AND OLDER. FIFTY PERCENT OF THE PSA RESIDENTS ARE MALE AND 50 PERCENT ARE FEMALE. SEVENTY-SEVEN PERCENT OF THE PSA POPULATION IS WHITE, SIX PERCENT ASIAN, FOUR PERCENT AFRICAN AMERICAN, THREE PERCENT TWO OR MORE RACES, NINE PERCENT SOME OTHER RACE AND LESS THAN ONE PERCENT AMERICAN INDIAN OR ALASKA NATIVE. TWENTY-NINE PERCENT OF THE PSA POPULATION IS OF HISPANIC ETHNICITY. THE LARGEST HISPANIC POPULATION IN THE PSA IS IN ELGIN (60120) AT 54 PERCENT AND CARPENTERSVILLE (60110) AT 50 PERCENT. TWENTY-NINE PERCENT OF THE PSA POPULATION (AGE 5 AND OLDER) SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, INCLUDING SPANISH, INDO-EUROPEAN LANGUAGES, ASIAN/PACIFIC ISLAND AND OTHER LANGUAGES. A TOTAL OF 72 PERCENT OF PSA HOUSEHOLDS SPEAK ONLY ENGLISH AT HOME. WHEN COMPARED TO OTHER COMMUNITIES IN THE PSA, THE ZIP CODES IN THE PSA WITH THE HIGHEST PERCENTAGE OF THE POPULATION SPEAKING SPANISH AT HOME ARE ELGIN (60120) AT 49 PERCENT AND CARPENTERSVILLE (60110) AT 41 PERCENT.THE ADVOCATE SHERMAN PSA HAS AN OVERALL MEDIAN HOUSEHOLD INCOME OF $79,805. IN THE PSA, SIX PERCENT OF FAMILIES ARE LIVING BELOW 100 PERCENT OF THE FEDERAL POVERTY LEVEL, WHICH IS $24,300 FOR A FAMILY OF FOUR. IN 2015, THE PERCENTAGE OF ADULTS WITH HEALTH INSURANCE IN KANE COUNTY INCREASED TO 87 PERCENT, UP FROM 80 PERCENT IN 2011. THE RATE FOR MCHENRY COUNTY WAS 87 PERCENT IN 2011 AND INCREASED TO 93 PERCENT IN 2015. BOTH RATES ARE STILL BELOW THE HEALTHY PEOPLE 2020 NATIONAL HEALTH TARGET OF 100 PERCENT OF PEOPLE WITH HEALTH INSURANCE. TWELVE PERCENT OF THE PSA POPULATION ARE MEDICARE RECIPIENTS AND FIVE PERCENT OF RESIDENTS AGE 65 AND OLDER ARE LIVING BELOW 100 PERCENT OF THE FEDERAL POVERTY LEVEL. FIFTEEN PERCENT OF THE PSA POPULATION HAS MEDICAID INSURANCE WHICH EQUALS APPROXIMATELY 43,381 MEDICAID ENROLLEES.; . THE PSA COMMUNITIES WITH THE HIGHEST MEDICAID ENROLLMENT ARE ELGIN (60123) WITH 31 PERCENT AND CARPENTERSVILLE WITH 29 PERCENT. AS OF 2016, FIVE PERCENT OF THE PSA POPULATION IS UNINSURED. THE COMMUNITY IN THE PSA WITH THE HIGHEST PERCENTAGE OF UNINSURED RESIDENTS IS ELGIN-BOTH ZIP CODES 60120 (FIVE PERCENT) AND 60123 (FIVE PERCENT).THERE ARE SOME COMMUNITIES IN THE HOSPITAL'S SERVICE AREA WHICH ARE ALSO SERVED BY ADVOCATE GOOD SHEPHERD. ADDITIONALLY, THERE ARE FIVE OTHER HOSPITALS WITH INTERSECTING SERVICE AREAS, INCLUDING CENTEGRA HEALTH SYSTEM, MCHENRY; NORTHWESTERN DELNOR COMMUNITY HOSPITAL, GENEVA; PRESENCE ST. JOSEPH HOSPITAL, ELGIN; PRESENCE MERCY MEDICAL CENTER, AURORA; AND RUSH-COPLEY MEDICAL CENTER, AURORA. WITHIN KANE COUNTY, THERE ARE THREE DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA). SEVEN CENSUS TRACTS ARE DESIGNATED AS THE INNER-CITY AURORA SERVICE AREA MUA; ONE CENSUS TRACT IS DESIGNATED AS THE KANE SERVICE AREA MUA; AND ONE CENSUS TRACT IS DESIGNATED THE CENTRAL CARPENTERSVILLE SERVICE AREA MUA. WITHIN MCHENRY COUNTY, THERE IS ONE MEDICALLY UNDERSERVED POPULATION (MUP). THE CENSUS TRACTS OF 8702, 8709.02 AND 8715 WITHIN WOODSTOCK ARE DESIGNATED AS A MUP.
PART VI, LINE 5:	THE ADVOCATE SHERMAN BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY LEADERS AND PHYSICIANS. BOARD MEMBERS SUPPORT HOSPITAL LEADERSHIP IN THEIR PURSUIT OF THE HOSPITAL'S GOALS, REPRESENT THE COMMUNITY'S INTEREST TO THE HOSPITAL AND SERVE AS AMBASSADORS IN THE COMMUNITY. EIGHTY-THREE PERCENT OF THE CURRENT BOARD MEMBERS REPRESENT THE COMMUNITY, INCLUDING THE FAITH COMMUNITY. IN ADDITION, THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS AND SPECIALTIES.ADVOCATE SHERMAN ALSO DONATES STAFF TIME AND EXPERTISE TO SEVERAL LOCAL COUNCILS, BOARDS, COALITIONS AND COMMITTEES. THE ALIGNMENT COLLABORATIVE FOR EDUCATION (ACE) IS A COLLECTIVE IMPACT ORGANIZATION WHOSE MISSION IS TO ALIGN COMMUNITY RESOURCES IN SUPPORT OF PUBLIC-SCHOOL STRATEGIES TO RAISE STUDENT ACHIEVEMENT, IMPROVE THE HEALTH AND HAPPINESS OF CHILDREN, CREATE RESPONSIBLE, PRODUCTIVE AND CONTRIBUTING MEMBERS OF SOCIETY AND ADVANCE THE ECONOMIC AND SOCIAL WELL-BEING OF COMMUNITIES SERVED BY DISTRICT U-46. THE ACE GOVERNING BOARD IS CHAIRED BY THE PRESIDENT OF ADVOCATE SHERMAN AND FOCUSES ON THE MISSION OF THE ORGANIZATION. THE ACE OPERATING BOARD IS CHAIRED BY THE ADVOCATE SHERMAN VICE PRESIDENT OF OPERATIONS AND CO-CHAIRED BY THE ASSISTANT SUPERINTENDENT OF EDUCATION SUPPORT PROGRAMS AND ALIGNMENT FOR DISTRICT U-46. ALIGNMENT TEAMS (A-TEAMS) WERE CREATED TO FIND SOLUTIONS TO NEEDS IDENTIFIED BY THE PUBLIC SCHOOLS. THE DIRECTOR OF COMMUNITY HEALTH IS A MEMBER OF THE TRAUMA-INFORMED CARE A-TEAM.THE HOSPITAL'S EXECUTIVE DIRECTOR OF SERVICE EXCELLENCE AND POPULATION HEALTH SERVES ON THE VNA HEALTH CARE BOARD OF DIRECTORS-A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). THE DIRECTOR OF COMMUNITY HEALTH SERVES ON THE KANE COUNTY BEHAVIORAL HEALTH COUNCIL-A COMMITTEE OF MENTAL HEALTH, SUBSTANCE ABUSE TREATMENT AND MEDICAL PROVIDERS AND THE KANE COUNTY HEALTH DEPARTMENT- FOCUSED ON IMPROVING THE BEHAVIORAL HEALTH SERVICES IN KANE COUNTY. THE MANAGER OF COMMUNITY OUTREACH SERVES ON BOTH THE KANE COUNTY HEALTH DEPARTMENT EXECUTIVE COMMITTEE AND MCHENRY COUNTY HEALTH DEPARTMENT CORE TEAM, WHICH OVERSEES THE IMPLEMENTATION OF STRATEGIES TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM BOTH THE KANE AND MCHENRY COUNTY COMMUNITY HEALTH ASSESSMENTS. THE MANAGER OF COMMUNITY OUTREACH ALSO SERVES ON THE ACTIVATE ELGIN COALITION, WHICH FOCUSES ON DECREASING CHILDHOOD OBESITY RATES AND INCREASING PHYSICAL ACTIVITY IN THE ELGIN AREA, AND ON THE COALITION FOR A SAFE AND HEALTHY ELGIN (CSHE), WHICH FOCUSES ON ISSUES OF YOUTH COMMUNITY VIOLENCE AND SUBSTANCE USE. IN JANUARY 2018, ADVOCATE SHERMAN IMPLEMENTED A NEW ACCESS TO CARE PROGRAM TO LINK PATIENTS TO A PRIMARY CARE PROVIDER. THE HOSPITAL ADDED A FULL-TIME COMMUNITY HEALTH WORKER (CHW) IN THE EMERGENCY DEPARTMENT TO MEET WITH PATIENTS COMING IN FOR CARE FOR LOW-ACUITY REASONS. THE CHW MEETS THESE PATIENTS AND THEIR FAMILIES TO HELP EDUCATE THEM ON OTHER OPTIONS FOR CARE, SUCH AS THE ADVOCATE IMMEDIATE CARE CENTERS, WALGREENS CLINICS AND OTHER RETAIL-BASED CLINICS. THE CHW ALSO EDUCATES PATIENTS ON THEIR INSURANCE ENROLLMENT AND, IF THEY DO NOT HAVE A MEDICAL HOME, LINKS THEM TO A PCP OR FQHC FOR ONGOING CARE. IN 2018, THE CHW SAW 1,313 PATIENTS IN THE ADVOCATE SHERMAN ED. A TOTAL OF 524 PATIENTS (40 PERCENT) SCREENED POSITIVE FOR FOOD INSECURITY AND RECEIVED INFORMATION ABOUT COMMUNITY FOOD RESOURCES, AND 437 APPOINTMENTS WERE SCHEDULED WITH A PRIMARY CARE PROVIDER. ADVOCATE SHERMAN, IN PARTNERSHIP WITH GEFCC, A FQHC, HAS PUT TOGETHER A MULTI-YEAR, MULTI-DISCIPLINARY APPROACH TO EDUCATE THE COMMUNITY ON COLON CANCER PREVENTION AND SCREENING, HELPING THE NATIONAL COLORECTAL CANCER ROUNDTABLE (NCCRT) ACHIEVE ITS GOAL OF 80 PERCENT BY 2020. THE GRANT FUNDS MADE IT POSSIBLE TO PROVIDE COLON CANCER PREVENTION EDUCATION, FREE FIT (FECAL IMMUNOCHEMICAL TEST) KITS FOR SCREENING AND COLONOSCOPIES TO THE MOST VULNERABLE, UNINSURED PATIENTS OF THE GEFCC. GEFCC PROVIDES SERVICES FOR THE GREATER ELGIN AND NORTHERN KANE COUNTY COMMUNITY. TO DATE, 174 FREE FIT SCREENINGS HAVE BEEN PROVIDED AND ONE COLONOSCOPY WAS COMPLETED IN 2018; ONE ADDITIONAL COLONOSCOPY WAS SCHEDULED, HOWEVER, THE PATIENT WAS ADMITTED AND HAD THE COLONOSCOPY DONE DURING THE ADMISSION. ADVOCATE SHERMAN ROUTINELY MAKES CASH AND IN-KIND DONATIONS TO COMMUNITY PARTNERS, SUCH AS THE ELGIN YWCA, AREA FQHC'S AND OTHER SOCIAL SERVICE ORGANIZATIONS TO FURTHER THE HEALTH OF THE COMMUNITY, INCLUDING THE DONATION OF MEDICAL SUPPLIES.
PART VI, LINE 6:	PART VI. SUPPLEMENTAL INFORMATION6. 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.ALTHOUGH ADVOCATE HEALTH CARE (ILLINOIS) AND AURORA HEALTH CARE (WISCONSIN) MERGED IN 2018 TO BECOME ADVOCATE AURORA HEALTH AND WORK CONTINUES TO ALIGN THE COMMUNITY STRATEGY OF BOTH PREDECESSOR ORGANIZATIONS, ADVOCATE HEALTH CARE (ADVOCATE), IN SERVICE OF ITS MISSION, CONTINUES TO SUPPORT SYSTEM-WIDE PROGRAMS THAT ADDRESS THE HEALTH NEEDS OF PATIENTS, FAMILIES AND THE COMMUNITIES IT SERVES. ADVOCATE'S BOARD, LEADERSHIP AND TEAM MEMBERS (STAFF/EMPLOYEES) ARE COMMITTED TO POSITIVELY AFFECTING THE HEALTH STATUS AND QUALITY OF LIFE OF INDIVIDUALS AND POPULATIONS IN COMMUNITIES SERVED BY ADVOCATE THROUGH PROGRAMS AND PRACTICES THAT REFLECT THIS MISSION. THE ORGANIZATION CONTINUES TO DEVELOP AND SUPPORT INITIATIVES THAT ENHANCE ACCESS TO HEALTH AND WELLNESS SERVICES. AS SUCH, SYSTEM LEADERSHIP DIRECTS AND SUPPORTS THE HOSPITALS IN THEIR EFFORTS TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS.IN 2016, ADVOCATE CREATED A COMMUNITY HEALTH DEPARTMENT THAT IS LED BY A SYSTEM EXECUTIVE AND STAFFED WITH PUBLIC/COMMUNITY HEALTH SPECIALISTS TO EXECUTE COMMUNITY NEEDS ASSESSMENTS, EVIDENCE-BASED PROGRAM DEVELOPMENT AND COLLABORATIVE PARTNERSHIPS WITHIN THE COMMUNITIES SERVED BY ADVOCATE. PRIOR TO THIS TIME, THE COMMUNITY FACING FUNCTION WAS LED BY A TEAM OF SYSTEM-LEVEL INDIVIDUALS WHOSE JOB RESPONSIBILITIES INCLUDED VARIOUS COMMUNITY ROLES MORE CLOSELY ALIGNED WITH COMMUNITY RELATIONS. DURING THE INITIAL 2011-2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CYCLE, THE SYSTEM LEADERS PROVIDED OVERSIGHT AND SUPPORT TO THE HOSPITALS FOR DEVELOPING THEIR CHNAS AND SUBSEQUENT PROGRAMMING. IN 2016, ADVOCATE'S NEW COMMUNITY HEALTH TEAM CONDUCTED THEIR HOSPITAL'S COMPREHENSIVE CHNAS (2014-2016) AND POSTED GOVERNANCE-APPROVED CHNA REPORTS AND CHNA IMPLEMENTATION PLANS ON ADVOCATE'S WEBPAGE IN COMPLIANCE WITH THE AFFORDABLE CARE ACT.AT THE DIRECTION OF THE SYSTEM LEVEL, COMMUNITY HEALTH DEPARTMENT LEADERSHIP ALSO MET MONTHLY IN LATE 2016 THROUGH FIRST QUARTER 2017 TO SIGNIFICANTLY REVISE ADVOCATE HEALTH CARE'S COMMUNITY BENEFITS PLAN. THE PLANS GOALS AND OBJECTIVES WERE CRAFTED AND EXPANDED TO BUILD ON RECENT LEARNINGS AND INCREASED FOCUS ON COMMUNITY HEALTH. THE PLAN'S BROAD GOALS AND OBJECTIVES WERE DESIGNED TO STRUCTURE SYSTEM-WIDE COMMUNITY BENEFITS ACTIVITIES WITHIN A STRATEGIC FRAMEWORK. INCLUDED IN THE COMMUNITY BENEFITS PLAN ARE GOALS FOCUSED ON SYSTEM-WIDE EFFORTS TO ADDRESS THE BROADER ISSUES OF DISPARITY AND ACCESS, AND TO ALIGN HOSPITAL COMMUNITY HEALTH PLANS WITH SYSTEM STRATEGY AS COMMUNITY HEALTH PLANS AND IMPLEMENTATION STRATEGIES EVOLVE. ADVOCATE'S COMMUNITY BENEFITS PLAN ALSO SETS THE COURSE FOR STRENGTHENING EXISTING PARTNERSHIPS AND BUILDING NEW ONES TO LEVERAGE AND MAXIMIZE THE IMPACT OF ADVOCATE'S PROGRAMS IN ITS SERVICE AREAS. ADVOCATE'S COMMUNITY BENEFITS PLAN GOALS AND SPECIFIC EXAMPLES OF PROGRAMS AND SERVICES THAT ARE DIRECTED AND MANAGED AT THE SYSTEM LEVEL ARE PROVIDED BELOW.GOAL A: OPTIMIZE ADVOCATE'S CAPACITY TO MANAGE AN EFFECTIVE COMMUNITY HEALTH STRATEGY BY IMPLEMENTING REGULAR COMMUNITY HEALTH ASSESSMENTS (CHNAS) AND USING DATA FROM THESE ASSESSMENTS TO GUIDE PROGRAM DEVELOPMENT.DURING 2016, ALL ELEVEN ADVOCATE HEALTH CARE HOSPITALS COMPLETED COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS IN COLLABORATION WITH HEALTH DEPARTMENTS, OTHER HOSPITALS, AND COMMUNITY ORGANIZATIONS. ADVOCATE CHILDREN'S HOSPITAL, WITH INTEGRATED SITES AT BOTH ADVOCATE LUTHERAN GENERAL HOSPITAL (ADVOCATE LUTHERAN GENERAL) AND ADVOCATE CHRIST MEDICAL CENTER (ADVOCATE CHRIST), CONTRIBUTED TO ASSESSMENTS AT THOSE TWO HOSPITALS. ALL THE ADVOCATE HOSPITAL ASSESSMENTS ARE AVAILABLE THROUGH THE ADVOCATE WEBSITE AT: HTTP://WWW.ADVOCATEHEALTH.COM/CHNAREPORTSAS A FIRST STEP TOWARD DEVELOPING A 2017-2019 IMPLEMENTATION PLAN, THE SYSTEM DIRECTED THE HOSPITAL COMMUNITY HEALTH LEADERS AND STAFF TO IDENTIFY THE STRENGTHS AND OPPORTUNITIES FOR IMPROVEMENT WITHIN THE JUST COMPLETED CYCLE (2014-2016), AS WELL AS IDEAS FOR NEW DATA SOURCES, AND NEEDS FOR PROFESSIONAL DEVELOPMENT RELATED TO THE OVERALL CHNA PROCESS. A NUMBER OF STRENGTHS WERE IDENTIFIED INCLUDING DEVELOPMENT OF LOCAL COMMUNITY HEALTH COUNCILS (CHC), INVOLVEMENT OF HOSPITAL GOVERNING COUNCIL MEMBERS IN THE CHCS, PARTNERSHIPS WITH HEALTH DEPARTMENTS, DATA FROM CONDUENT-HEALTHY COMMUNITIES INSTITUTE, ESPECIALLY THE ZIP CODE LEVEL HOSPITALIZATION AND EMERGENCY ROOM UTILIZATION DATA, AND THE SHARING OF TEMPLATES AND APPROACHES ACROSS HOSPITAL SITES. ADDITIONAL PROFESSIONAL DEVELOPMENT REGARDING DATA RETRIEVAL, ANALYSIS AND SUMMARIZATION, AS WELL AS PROGRAM DEVELOPMENT, WERE IDENTIFIED. A PROFESSIONAL DEVELOPMENT PLAN WAS IMPLEMENTED FOR ALL INTERNAL COMMUNITY HEALTH STAFF IN 2017. CHNA DATA TRAINING WAS CONDUCTED USING THE HEALTHY COMMUNITIES INSTITUTE (HCI) PLATFORM WITH THE TEAM RECEIVING TRAINING REGARDING RUNNING VARIOUS TYPES OF REPORTS AND CROSS COMPARING DATA IN HCI. UPDATE PRESENTATIONS WERE HELD AT SELECTED MONTHLY STAFF MEETINGS REGARDING NEW CAPACITIES OF THE HCI PLATFORM FOR REPORTS AND DATA PRESENTATION. ADDITIONALLY, ALL STAFF PROVIDED INPUT REGARDING TRAINING NEEDS RESULTING IN THE ESTABLISHMENT OF A SET OF MINIMUM STANDARD DATA REQUIREMENTS ADVOCATE IS NOW USING FOR THE NEXT CHNA CYCLE. COMMUNITY HEALTH STAFF PULLED DATA AS PART OF LEARNING EXERCISES AND SHARED FINDINGS FROM THEIR UNIQUE SERVICE AREAS WITH PEERS IN A PEER REVIEW MODEL. IN 2018, TRAINING FOCUSED ON DATA ANALYSIS, DATA INTERPRETATION AND PROGRAM DEVELOPMENT AND EVALUATION. GOAL B: UNDERTAKE OR SUPPORT INITIATIVES THAT ENHANCE ACCESS TO HEALTH CARE, PREVENTION AND WELLNESS SERVICES ACROSS THE LIFESPAN AND WITHIN THE DIVERSE COMMUNITIES ADVOCATE SERVES.CHARITY CARE. AS A NON-PROFIT HEALTH CARE SYSTEM, ADVOCATE PROVIDES CHARITY AND FINANCIAL ASSISTANCE TO PATIENTS IN NEED. ALTHOUGH ADVOCATE'S SYSTEM-WIDE CHARITY CARE POLICY IS VERY GENEROUS, ADVOCATE CONTINUES TO REVIEW AND REFINE ITS POLICY IN AN ONGOING EFFORT TO ENSURE THAT FINANCIAL ASSISTANCE IS AVAILABLE TO THOSE IN NEED IN A TIMELY MANNER. WHILE EACH HOSPITAL HAS A CHARITY CARE COUNCIL TO REVIEW APPLICATIONS AND DETERMINE ELIGIBILITY, SYSTEM FINANCE LEADERS ARE RESPONSIBLE FOR ONGOING POLICY REVIEW AND REFINEMENTS TO ASSURE THAT ADVOCATE CONTINUES TO PROVIDE FINANCIAL ASSISTANCE TO INDIVIDUALS WHO NEED HELP, WHEN THEY NEED IT. FEDERALLY QUALIFIED HEALTH CENTERS (FQHC). IN ADDITION, ADVOCATE'S SYSTEM LEADERS ENCOURAGE AND SUPPORT ITS HOSPITALS' INITIATIVES TO PARTNER WITH FQHC'S, PUBLIC HEALTH DEPARTMENTS AND COMMUNITY CLINICS IN ORDER TO ASSIST THE UNINSURED IN FINDING INSURANCE COVERAGE AND MEDICAL SERVICES. FOR EXAMPLE, ADVOCATE SOUTH SUBURBAN HOSPITAL (ADVOCATE SOUTH SUBURBAN) HAS A PARTNERSHIP WITH AUNT MARTHA'S YOUTH SERVICE CENTER, AN FQHC, TO IMPROVE ACCESS TO PRIMARY CARE SERVICES FOR UNINSURED AND UNDERINSURED INDIVIDUALS IN ITS SERVICE AREA. ADVOCATE BROMENN MEDICAL CENTER (ADVOCATE BROMENN) MAINTAINS A COMMUNITY HEALTH CLINIC IN COLLABORATION WITH OSF ST. JOSEPH'S HOSPITAL, WHEREBY ADVOCATE BROMENN IS RESPONSIBLE FOR A PORTION OF THE HOSPITAL CARE FOR THE CLINIC PATIENTS' HOSPITAL CARE THROUGHOUT THE YEAR. ADVOCATE BROMENN IS ALSO THE SOLE PROVIDER OF THE CLINIC'S INFORMATION TECHNOLOGY (IT) SUPPORT AND PROVIDES THE SPACE OCCUPIED BY THE CLINIC. IN ADDITION, ADVOCATE BROMENN, THROUGH AN INFORMAL REFERRAL AGREEMENT IN PLACE SINCE 2010, COLLABORATES WITH CHESTNUT HEALTH SYSTEMS. CHESTNUT HEALTH SYSTEMS OWNS AND OPERATES AN FQHC IN BLOOMINGTON AND PATIENTS ARE SOMETIMES REFERRED TO ADVOCATE BROMENN FOR SERVICES. WORKING WITH OTHER AREA HOSPITALS, ADVOCATE GOOD SAMARITAN HOSPITAL (ADVOCATE GOOD SAMARITAN) PROVIDES SUPPORT THROUGH THE DUPAGE HEALTH COALITION TO SUSTAIN THE ACCESS DUPAGE COMMUNITY PROGRAM - A COMMUNITY COLLABORATION DESIGNED TO PROVIDE LOW-COST PRIMARY MEDICAL CARE SERVICES TO THE LOW-INCOME, MEDICALLY UNINSURED RESIDENTS OF DUPAGE COUNTY. IN ADDITION, THE HOSPITAL PARTNERS WITH THE DUPAGE COUNTY HEALTH DEPARTMENT'S ENGAGE DUPAGE INITIATIVE FOR INDIGENT PATIENT FINANCIAL ELIGIBILITY IN THE EMERGENCY ROOM AND TO ASSIST WITH OUTPLACEMENT SERVICES FOR THOSE PATIENTS WHO COULD BENEFIT FROM TREATMENT PROGRAMS, PLACEMENT WITH A PRIMARY CARE PROVIDER (PCP), DENTAL CARE, ETC.ADVOCATE ALSO WORKS TO IMPROVE THE PROVISION OF SERVICES TO INDIVIDUALS AND FAMILIES WHO ARE COVERED BY MEDICARE AND MEDICAID AND SEEK SERVICES FROM ADVOCATE'S OVER 400 SITES OF CARE. ADVOCATE COLLABORATES WITH VARIOUS COMMUNITY-BASED ORGANIZATIONS (CBO'S) AND FQHC'S IN INNOVATIVE WAYS TO ESTABLISH PRIMARY CARE RELATIONSHIPS FOR MEDICAID AND UNINSURED PATIENTS.
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDADVOCATE CARE ORGANIZATION (ACO). AS ONE OF THE LARGEST PROVIDERS OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID PATIENTS IN CHICAGO AND THE SURROUNDING SUBURBS, ADVOCATE'S MEDICAID ACCOUNTABLE CARE ORGANIZATION (ACO), ALSO KNOWN AS THE ADVOCATE ACCOUNTABLE CARE ENTITY (ACE), TRANSITIONED TO MERIDIAN FAMILY HEALTH PLAN (FHP) OF ILLINOIS AS PART OF AN INTEGRATED CARE MODEL ON APRIL 1, 2016. THE ADVOCATE/MERIDIAN FHP PARTNERSHIP AND COLLABORATION WAS DRIVEN LARGELY BY CHANGES TO THE MEDICAID PROGRAM IN ILLINOIS AND WAS DESIGNED TO ENSURE CURRENT MEDICAID MEMBERS CONTINUE TO RECEIVE HIGH-QUALITY AND WELL-COORDINATED CARE DELIVERED IN AN APPROPRIATE SETTING. ADVOCATE HAS A STRONG HISTORY OF PROVIDING HIGH QUALITY CARE FOR THE MEDICAID POPULATION WITHIN OUR NETWORK WITH KEY FOCUS AREAS, INCLUDING IMPROVED CARE COORDINATION, ACCESS AND QUALITY PERFORMANCE. ADVOCATE HAS AND WILL CONTINUE TO APPLY ITS ACHIEVEMENTS AND LESSONS LEARNED FROM ITS MEDICARE AND COMMERCIAL ACOS TO THE ADVOCATE/MERIDIAN FHP PARTNERSHIP.COMMUNITY HEALTH WORKERS (CHWS). IN 2016, ADVOCATE EMBARKED ON A QUALITY IMPROVEMENT PROJECT TO ENGAGE AND EDUCATE MEDICAID BENEFICIARIES SEEN IN THE ADVOCATE CHRIST EMERGENCY DEPARTMENT ON APPROPRIATE LEVEL OF CARE OPTIONS AVAILABLE TO THEM USING COMMUNITY HEALTH WORKERS. THE MAIN OBJECTIVES OF THE PRIMARY CARE CONNECTIONS INTERVENTION WERE: 1) TO EDUCATE AND SCHEDULE LOW ACUITY PATIENTS WHO VISIT THE ADVOCATE CHRIST EMERGENCY DEPARTMENT REGARDING ALTERNATIVE CARE OPTIONS AVAILABLE TO THEM WITHIN THEIR COMMUNITIES; AND 2) EDUCATE AND SCHEDULE LOW ACUITY MEDICAID PATIENTS FOR FOLLOW-UP APPOINTMENTS WITH THEIR ADVOCATE PRIMARY CARE PHYSICIAN (PCP) OR AN FQHC WHEN THE BENEFICIARY DOES NOT HAVE AN ESTABLISHED PRIMARY CARE MEDICAL HOME.FQHC'S AND COMMUNITY-BASED RESOURCES PROVIDE SERVICES FOR MEDICAID BENEFICIARIES WITH SPECIFIC SOCIAL DETERMINANTS OF HEALTH BARRIERS TO CARE, INCLUDING HOUSING INSECURITY, UTILITY NEEDS AND INTERPERSONAL VIOLENCE, WHICH ARE IMPORTANT TO ADDRESS FOR IMPROVING OUTCOMES FOR VULNERABLE POPULATIONS. IN 2018, THE PROGRAM WAS EXPANDED TO THREE ADDITIONAL ILLINOIS HOSPITALS-ADVOCATE TRINITY HOSPITAL (ADVOCATE TRINITY), ADVOCATE CONDELL MEDICAL CENTER (ADVOCATE CONDELL) AND ADVOCATE SHERMAN HOSPITAL (ADVOCATE SHERMAN). AS OF DEC. 2018, MORE THAN 20,560 PATIENTS WERE ENGAGED, OF WHICH 30% (OVER 6,100 PATIENTS) WERE SCHEDULED FOR A FOLLOW-UP APPOINTMENT WITH AN ADVOCATE PCP OR FQHC. AS A RESULT, 98% OF THESE PATIENTS WHO WERE ENGAGED WITH THE PRIMARY CARE CONNECTION INTERVENTION DID NOT RETURN TO THE EMERGENCY ROOM FOR A LOW ACUITY VISIT.ADVOCATE CONTINUES TO PURSUE QUALITY AND UTILIZATION IMPROVEMENT ACTIVITIES LIKE THE PRIMARY CARE CONNECTIONS INTERVENTION TO ACTIVELY MANAGE AND ENGAGE THE ADVOCATE/MERIDIAN FHP MEMBERS IN ORDER TO ACHIEVE THE QUADRUPLE AIM OF IMPROVED PHYSICIAN AND PATIENT EXPERIENCE, BETTER PATIENT OUTCOMES, AND REDUCTIONS IN THE TOTAL COSTS OF CARE.LANGUAGE SERVICES. ADVOCATE IS ALSO COMMITTED TO PROVIDING ITS PATIENTS AND FAMILIES WITH LANGUAGE AND OTHER CULTURALLY APPROPRIATE SERVICES TO IMPROVE ACCESS TO CARE. A SYSTEM-LEVEL DIRECTOR HAS OVERSIGHT OF LANGUAGE SERVICES THROUGHOUT ADVOCATE. ADVOCATE'S PATIENT ACCESS DEPARTMENT MONITORS AND REFINES ASSOCIATE SCRIPTING TO ENSURE THAT LANGUAGE NEED IS CORRECTLY IDENTIFIED DURING THE REGISTRATION PROCESS. THIS ASSISTS WITH CORRECTLY ROUNDING ON PATIENTS AND ENSURING INTERPRETERS ARE AVAILABLE WHEN NEEDED. IN 2018, ADVOCATE PROVIDED INTERPRETING SERVICES FOR OVER 250,000 PATIENT/FAMILY MEMBER/COMPANION ENCOUNTERS-UP FROM 220,000 ENCOUNTERS THE PREVIOUS YEAR. AS THE NEED FOR THESE SERVICES INCREASES, ADVOCATE CONTINUES TO ANTICIPATE AND IMPLEMENT CHANGES TO MEET THE UNIQUE INTERPRETATION NEEDS OF PATIENTS. ONE SUCH CHANGE, WHICH CONTINUES TO INCREASE THE VOLUME OF INTERPRETER SERVICES EACH YEAR, IS THE USE OF VIDEO REMOTE INTERPRETING (VRI). SIMILAR TO SKYPE TECHNOLOGY, WHEN A TEAM MEMBER (EMPLOYEE/STAFF) CLICKS OR TOUCHES THE SCREEN FOR A NEEDED LANGUAGE, AN INTERPRETER APPEARS ON THE COMPUTER OR IPAD SCREEN TO INTERPRET IN ONE OF 32 AVAILABLE LANGUAGES. IN ADDITION TO VRI, OVER 200 LANGUAGES ARE OFFERED VIA TELEPHONIC INTERPRETING. WHEN TELEPHONIC OR VRI ARE NOT APPROPRIATE FOR THE PATIENT ENCOUNTER, ONSITE AGENCY INTERPRETERS ARE PROVIDED. FIVE (5) ADVOCATE HOSPITALS EMPLOY SPANISH AND POLISH INTERPRETERS DUE TO THE HIGH VOLUME OF PATIENTS SPEAKING THESE LANGUAGES. ADVOCATE TYPICALLY ACCESSES OVER 150 DIFFERENT LANGUAGES PER YEAR TO MEET PATIENTS' NEEDS.IN 2018, A NEW FORM WAS ADDED TO CARE CONNECTION FOR THE NURSING ADMISSION PROCESS. THERE IS ALSO A FORM FOR LANGUAGE SERVICES TO INPUT ANY CHANGES NEEDED-CALLED AN AD HOC FORM. THE FORM SUPPORTS THE NURSE IN IDENTIFYING LANGUAGE ASSISTANCE NEEDS OF THE PATIENT AND FAMILY MEMBERS/COMPANION. VITAL DOCUMENTS CONTINUE TO BE TRANSLATED. SIGNAGE IS POSTED INDICATING THAT INTERPRETING SERVICES ARE AVAILABLE. SEVERAL HOSPITALS CONTINUE TO HAVE PATIENT WHITE BOARDS TRANSLATED INTO SPANISH AND POLISH WITH ENGLISH SUBTITLES SO THAT PATIENTS ARE AWARE OF THEIR PLAN FOR THE DAY IN THEIR LANGUAGE.TO EVALUATE HOW WELL THE SITES ARE DOING WITH PROVIDING INTERPRETING SERVICES, A RESPONSE TO THE STATEMENT, "IF ENGLISH IS NOT YOUR PRIMARY LANGUAGE, THE DEGREE TO WHICH YOUR COMMUNICATION NEEDS WERE MET," IS REQUESTED ON NON-ENGLISH PRESS GANEY SURVEYS. THE PATIENT IS ASKED TO RATE THE SERVICES RECEIVED BETWEEN 1 AND 5, WITH 5 BEING THE HIGHEST SCORE. CURRENTLY THREE HOSPITALS-ADVOCATE CHRIST, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (ADVOCATE ILLINOIS MASONIC) AND ADVOCATE LUTHERAN GENERAL-PARTICIPATE. THE AVERAGE SCORE FOR 2018 REMAINED AT 89% FAVORABLE. GIVEN THE LOW RATE OF RETURN, THIS NUMBER IS NOT CONSIDERED TO BE STATISTICALLY SIGNIFICANT.THE READMISSION RATE OF NON-ENGLISH SPEAKING PATIENTS IS ALSO TRACKED AND COMPARED TO THE READMISSION RATE OF ENGLISH-SPEAKING PATIENTS. THE NON-ENGLISH READMISSION RATE CONTINUES TO BE CLOSE TO THE ENGLISH-SPEAKING PATIENT READMISSION RATE.ONE QUALITY AUDIT WAS CONDUCTED IN 2018 THAT FOCUSED ON THE KNOWLEDGE OF CLINICAL CARE PROVIDERS. THE OVERALL RESULT WAS "COMPETENT." RESULTS WERE CONVEYED AND CORRECTIVE ACTION PLANS COMPLETED AT TWO SITES. LANGUAGE SERVICES CONTINUES TO PARTICIPATE IN PATIENT SAFETY HUDDLES AND REPORTS THE NUMBER OF INDIVIDUALS NEEDING INTERPRETING SERVICES AS WELL AS LANGUAGE SERVICES EVENTS. PATIENT SAFETY EVENTS ARE ALSO REPORTED AT THE SYSTEM SAFETY HUDDLE. THIS ASSISTS WITH IDENTIFYING LANGUAGE SERVICE ISSUES THAT MAY BE OCCURRING ACROSS THE SYSTEM.PARISH NURSE MINISTRY. ADVOCATE FULLY FUNDS THREE FAITH COMMUNITY NURSE POSITIONS SERVING THREE CONGREGATIONS IN LOW-INCOME, HIGH NEED COMMUNITIES. THESE FAITH COMMUNITY NURSES PROVIDE HEALTH EDUCATION, WELLNESS PROMOTION, NAVIGATION AND CARE MANAGEMENT, HEALTH SCREENINGS, ADVOCACY AND SPIRITUAL SUPPORT TO THE MEMBERS OF THEIR CONGREGATIONS AND TO THE WIDER COMMUNITIES THAT THEY SERVE. MANY OF THE PEOPLE SERVED ARE HOMELESS, MARGINALIZED OR CHRONICALLY ILL INDIVIDUALS. IN ADDITION, ADVOCATE SUPPORTS A FAITH COMMUNITY NURSE SUPPORT NETWORK OF 37 NURSES THAT SERVE CONGREGATIONS ACROSS THE CHICAGOLAND REGION. ADVOCATE ALSO FUNDS SYSTEM LEVEL PROGRAMS AND ACTIVITIES FOCUSED ON POSITIVELY AFFECTING THE HEALTH STATUS AND QUALITY OF LIFE OF INDIVIDUALS AND POPULATIONS IN COMMUNITIES SERVED BY ADVOCATE. TWO EXAMPLES OF SUCH PROGRAMS FOLLOW.ADVOCATE BETHANY COMMUNITY HEALTH FUND (BETHANY FUND). ESTABLISHED IN 2006 BY ADVOCATE HEALTH CARE AS PART OF AN ONGOING COMMITMENT TO HELP BUILD, PROMOTE AND SUSTAIN HEALTHY COMMUNITIES ON CHICAGO'S WEST SIDE, THE BETHANY FUND SUPPORTS NONPROFIT ORGANIZATIONS THAT ARE IN THE COMMUNITIES HISTORICALLY SERVED BY ADVOCATE BETHANY HOSPITAL (NOW RML CHICAGO)-AUSTIN, GARFIELD PARK, HUMBOLDT PARK AND NORTH LAWNDALE. THE FUND DOES THIS THROUGH PROGRAM GRANTS, ORGANIZATIONAL CAPACITY BUILDING EVENTS AND PARTNERSHIPS TO BUILD ON THE ASSETS OF THESE VULNERABLE COMMUNITIES. IN 2018, THE BETHANY FUND AWARDED $815,000 IN PROGRAM GRANTS ADDRESSING ITS PRIORITY AREAS OF DIABETES, SCHOOL DROPOUT PREVENTION, VIOLENCE PREVENTION AND WORKFORCE DEVELOPMENT.CENTER FOR FAITH AND COMMUNITY HEALTH TRANSFORMATION. THE CENTER FOR FAITH AND COMMUNITY HEALTH TRANSFORMATION WORKS TO ADVANCE HEALTH EQUITY BY PARTNERING WITH FAITH-BASED AND COMMUNITY ORGANIZATIONS TO BUILD COMMUNITY, NURTURE LEADERS AND CONNECT THE UNIQUE SPIRIT POWER OF FAITH COMMUNITIES TO PROMOTE SOCIAL JUSTICE AND ABUNDANT LIFE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES. THE CENTER IS A PARTNERSHIP BETWEEN ADVOCATE AND THE OFFICE FOR COMMUNITY ENGAGEMENT AND NEIGHBORHOOD HEALTH PARTNERSHIPS AT THE UNIVERSITY OF ILLINOIS AT CHICAGO. CURRENTLY, THE CENTER IS CONVENING A TRAUMA INFORMED CONGREGATIONS NETWORK TO SUPPORT THE CAPACITY OF FAITH COMMUNITIES TO PREVENT TRAUMA
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDAND TO BE PLACES OF HEALING FOR THOSE WHO HAVE EXPERIENCED ADVERSITY IN CHILDHOOD OR THROUGHOUT THEIR LIVES.THE CENTER ALSO CONVENES THE COURAGE TO LOVE COLLABORATIVE (CTLC), A PARTNERSHIP COMMITTED TO REDUCING PRE-TERM BIRTH AND INFANT MORTALITY IN THE VULNERABLE AUBURN GRESHAM NEIGHBORHOOD OF CHICAGO. THE COURAGE TO LOVE APPROACH IS ROOTED IN A REPORT BY THE COMMISSION ON INFANT MORTALITY OF THE HEALTH POLICY INSTITUTE OF THE JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES THAT MAINTAINS THAT SOCIAL COHESION IS THE NECESSARY STRATEGY FOR IMPROVING BIRTH OUTCOMES. THE CTLC HAS INTERVIEWED OR GATHERED INPUT FROM ALMOST 150 COMMUNITY RESIDENTS DOCUMENTING THEIR EXPERIENCES OF STRESS, AND OF LOVE AND CARE IN THEIR COMMUNITIES. ECONOMIC PRESSURES AND COMMUNITY VIOLENCE WERE IDENTIFIED AS MOST STRESSFUL, AND FAMILY, CHURCH AND NEIGHBORS EMERGED AS THE CORE DRIVERS OF SOCIAL CONNECTION. THE COLLABORATIVE CONTINUES TO WORK WITH TEAMS OF COMMUNITY MEMBERS TO DESIGN AN APPROACH TO EXPAND EXISTING NETWORKS OF SOCIAL CONNECTION TO PROVIDE INTENTIONAL SUPPORT FOR PARENTS AND FAMILIES.GOAL C. NOT USEDGOAL D. EXAMINE AND ADDRESS IN PARTNERSHIP WITH OTHERS THE ROOT CAUSES OF HEALTH INEQUITIES IN ADVOCATE COMMUNITIES INCLUDING, BUT NOT LIMITED TO, UNEMPLOYMENT, LACK OF EDUCATION, POVERTY, ENVIRONMENTAL INJUSTICE AND RACISM.SOCIONEEDS INDEX. IN PREPARATION FOR THE 2014-2016 CHNA, ADVOCATE PURCHASED ACCESS TO A TOOL THAT COULD BE USED BY ALL OF ITS HOSPITALS TO IDENTIFY PRIORITY OPPORTUNITIES TO IMPACT THE SOCIAL DETERMINANTS OF HEALTH IN THE COMMUNITIES SERVED BY ADVOCATE. INCLUDED IN THIS TOOL, DEVELOPED BY THE HEALTHY COMMUNITIES INSTITUTE, IS THE SOCIONEEDS INDEX. THE SOCIONEEDS INDEX IS A MEASURE OF SOCIOECONOMIC NEED THAT IS CORRELATED WITH POOR HEALTH OUTCOMES. INDICATORS FOR THE INDEX ARE WEIGHTED TO MAXIMIZE THE CORRELATION OF THE INDEX WITH PREMATURE DEATH RATES AND PREVENTABLE HOSPITALIZATION RATES. THIS INDEX COMBINES MULTIPLE SOCIOECONOMIC INDICATORS INTO A SINGLE COMPOSITE VALUE. AS A SINGLE INDICATOR, THE INDEX CAN SERVE AS A CONCISE WAY TO EXPLAIN WHICH AREAS ARE OF HIGHEST NEED. A MAP WAS THEN PREPARED FOR EACH HOSPITAL SERVICE AREA ENABLING THE COMMUNITY HEALTH COUNCILS TO FOCUS PRIORITY SETTING AND PROGRAM PLANNING ON COMMUNITIES AT HIGHER LEVELS OF SOCIOECONOMIC NEED. THE INDEX IS ALSO BEING USED FOR THE 2017-2019 CHNA PROCESS.ALLIANCE FOR HEALTH EQUITY (FORMERLY KNOWN AS THE HEALTH IMPACT COLLABORATIVE OF COOK COUNTY). IN 2015, COMMUNITY HEALTH LEADERS FROM ADVOCATE, PRESENCE HEALTH, THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHA), THE CHICAGO DEPARTMENT OF HEALTH (CDPH) AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH (CCDPH) CAME TOGETHER TO FORM THE HEALTH IMPACT COLLABORATIVE OF COOK COUNTY (HICCC). EVENTUALLY THIS COLLABORATIVE INCLUDED 26 HOSPITALS, INCLUDING FIVE FROM ADVOCATE, SEVEN HEALTH DEPARTMENTS AND NEARLY 100 COMMUNITY ORGANIZATIONS FROM ACROSS CHICAGO AND COOK COUNTY. THE PURPOSE OF HICCC WAS TO CREATE A MORE EFFECTIVE WAY TO ASSESS HEALTH NEEDS ACROSS CHICAGO AND COOK COUNTY AND THEN IMPLEMENT A SHARED ACTION PLAN TO MAXIMIZE HEALTH EQUITY AND WELLNESS. DURING 2016, THE COLLABORATIVE COMPLETED THREE COMPREHENSIVE ASSESSMENTS - ONE EACH FOR THE NORTH, CENTRAL AND SOUTH REGIONS OF COOK COUNTY, INCLUDING CHICAGO. SEE: HTTP://HEALTHIMPACTCC.ORG/REPORTS2016/ THROUGH COLLABORATIVE PRIORITIZATION PROCESSES INVOLVING ALL HOSPITAL AND HEALTH DEPARTMENT MEMBERS OF THE COLLABORATIVE, AS WELL AS STAKEHOLDER ADVISORY GROUPS COMPRISED OF COMMUNITY REPRESENTATIVES, HICCC IDENTIFIED FOUR OVERARCHING FOCUS AREAS INCLUDING:" IMPROVING SOCIAL, ECONOMIC, AND STRUCTURAL DETERMINANTS OF HEALTH WHILE REDUCING SOCIAL AND ECONOMIC INEQUALITIES;" IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE;" PREVENTING AND REDUCING CHRONIC DISEASE, WITH A FOCUS ON RISK FACTORS-NUTRITION, PHYSICAL ACTIVITY AND TOBACCO; AND" INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.ALL OF THE HOSPITALS IN THE COLLABORATIVE AGREED TO INCLUDE THE FIRST FOCUS AREA-IMPROVING SOCIAL, ECONOMIC, AND STRUCTURAL DETERMINANTS OF HEALTH-AS A PRIORITY AREA FOR THEIR CHNA AND IMPLEMENTATION PLAN. OF THE FIVE ADVOCATE HOSPITALS IN COOK COUNTY, ADVOCATE ILLINOIS MASONIC AND ADVOCATE TRINITY CHOSE WORKFORCE DEVELOPMENT, ADVOCATE CHRIST SELECTED VIOLENCE PREVENTION, ADVOCATE SOUTH SUBURBAN CHOSE HOUSING AND ADVOCATE LUTHERAN GENERAL SELECTED YOUTH EMPLOYMENT. ACTION TEAMS BEGAN MEETING IN 2017 AND CONTINUED TO MEET THROUGHOUT 2018. WORK TO DEVELOP COMMUNITY HEALTH IMPROVEMENT PLANS FOCUSED ON ALIGNED ACTIONS AND DATA COLLECTION CONTINUES.IN LATE 2017, HICCC MERGED WITH THE HEALTHY CHICAGO HOSPITALS COLLABORATIVE TO CREATE THE ALLIANCE FOR HEALTH EQUITY. THE ALLIANCE FOR HEALTH EQUITY IS A PARTNERSHIP BETWEEN THE ILLINOIS PUBLIC HEALTH INSTITUTE, HOSPITALS, HEALTH DEPARTMENTS AND COMMUNITY ORGANIZATIONS ACROSS CHICAGO AND COOK COUNTY. ADVOCATE, AS A FOUNDING MEMBER OF THE PREDECESSOR HICCC, CONTINUES TO BE ACTIVELY INVOLVED IN LEADERSHIP OF THE ALLIANCE FOR HEALTH EQUITY PARTNERSHIP, SERVING ON THE STEERING COMMITTEE. ADVOCATE'S HOSPITALS AS WELL AS THE OTHER MEMBER HOSPITALS PROVIDE THE MONETARY SUPPORT FOR THE COLLABORATIVE'S WORK AND SUPPORT THE COST OF STAFF AND OVERSIGHT PROVIDED BY THE ILLINOIS PUBLIC HEALTH INSTITUTE.THIS INITIATIVE IS ONE OF THE LARGEST COLLABORATIVE HOSPITAL-COMMUNITY PARTNERSHIPS IN THE COUNTRY WITH THE CURRENT INVOLVEMENT OF OVER 30 NONPROFIT AND PUBLIC HOSPITALS, SEVEN LOCAL HEALTH DEPARTMENTS, AND REPRESENTATIVES OF MORE THAN 100 COMMUNITY ORGANIZATIONS SERVING ON ACTION TEAMS. PARTNERS ARE COMING TOGETHER WITH THE GOAL OF WORKING ON STRATEGIES TO ADDRESS THE PRESSING ISSUES IN OUR COMMUNITIES TO ACHIEVE GREATER COLLECTIVE IMPACT.ORGANIZATIONS WHOSE REPRESENTATIVES SERVE ON THE ALLIANCE'S STEERING COMMITTEE INCLUDE: ADVOCATE, LOYOLA UNIVERSITY HEALTH SYSTEM, LURIE CHILDREN'S HOSPITAL, NORTHWESTERN MEMORIAL HOSPITAL, NORWEGIAN AMERICAN HOSPITAL, PRESENCE HEALTH, RUSH, SINAI HEALTH SYSTEM, SWEDISH COVENANT, UNIVERSITY OF CHICAGO MEDICINE. HEALTH CARE ANCHOR NETWORK. IN DECEMBER 2016, ADVOCATE JOINED LEADERS FROM HEALTH SYSTEMS IN WASHINGTON, DC, TO EXPLORE WHAT IT WOULD MEAN TO HARNESS THEIR SHARED ECONOMIC AND INTELLECTUAL POWER TO TRULY BENEFIT THEIR COMMUNITIES. "THE DISCUSSION CENTERED ON IDENTIFYING HOW ALL OF THESE ECONOMIC ASSETS (THE COMBINED PURCHASES OF $65 BILLION IN PURCHASED GOODS AND SERVICES, 1.4 MILLION EMPLOYEES AND $200 BILLION IN INVESTMENT AND ENDOWMENT PORTFOLIOS), COMBINED WITH CIVIC LEADERSHIP COULD BE DEPLOYED TO CREATE INCLUSIVE, EQUITABLE, HEALTHY AND ENVIRONMENTALLY SUSTAINABLE COMMUNITIES." (ADVANCING THE ANCHOR MISSION OF HEALTHCARE, DEMOCRACY COLLABORATIVE, 2017)ADVOCATE OFFICIALLY JOINED THE HEALTH CARE ANCHOR NETWORK IN 2016 AS A FOUNDING PARTNER AND HAS CONTINUED TO PROVIDE MONETARY SUPPORT, LEADERSHIP AND ACTIVE ENGAGEMENT TO THE NETWORK. IN 2018, ADVOCATE STAFF ATTENDED TWO IN PERSON MEETINGS HELD IN SAN FRANCISCO, CALIFORNIA AND RICHMOND, VIRGINIA AND PARTICIPATED AS ACTIVE MEMBERS OF WORKGROUPS ADDRESSING NETWORK PROJECTS. BY THE END OF 2018, THE NETWORK HAD A MEMBERSHIP OF NEARLY 40 NATIONAL HEALTH SYSTEMS. THE WORK OF THE NETWORK IS SUPPORTED BY HEALTH SYSTEM DOLLARS AND FUNDING FROM THE ROBERT WOOD JOHNSON FOUNDATION. FACILITATION AND BACKBONE SUPPORT ARE PROVIDED BY THE DEMOCRACY COLLABORATIVE, WASHINGTON, DC. THE HEALTH CARE ANCHOR NETWORK AIMS TO ADDRESS UPSTREAM SOCIAL DETERMINANTS OF HEALTH IN COMMUNITIES THROUGH LOCAL HIRING, LOCAL PURCHASING AND LOCAL INVESTMENT.CHICAGO ANCHORS FOR A STRONG ECONOMY (CASE). ADVOCATE IS ONE OF 16 ANCHOR INSTITUTIONS COMPRISING CASE. THE CENTRAL WORK OF THE COLLABORATIVE IS FOSTERING STRATEGIC RELATIONSHIPS BETWEEN ANCHOR INSTITUTIONS AND SMALL BUSINESSES THAT CAN SUPPLY THE NEEDS OF THESE INSTITUTIONS IN AN EFFORT TO BUILD ECONOMIC VITALITY ACROSS CHICAGO'S NEIGHBORHOODS. HTTP://WWW.CHICAGOANCHORS.COM/. CASE IS FOCUSING ON FOUR MAJOR AREAS:" INCREASING LOCAL SPENDING BY PARTNERING WITH ANCHOR INSTITUTIONS TO INFUSE NEW REVENUE INTO THE REGIONAL ECONOMY; " FACILITATING NEW CONTRACTS BETWEEN LOCAL BUSINESSES AND ANCHOR INSTITUTIONS; " GROWING THE NETWORK BETWEEN SMALL BUSINESSES AND ANCHOR INSTITUTIONS; AND " FACILITATING TRAINING TO BUILD CAPACITY AMONG SMALL BUSINESSES IN CHICAGO COMMUNITIESTHE HEALTHCARE INSTITUTIONS IN CASE ARE FOCUSING ON SUPPLY CHAIN INITIATIVES ENGAGING LOCAL SUPPLIERS AND POSSIBLE DEVELOPMENT OF NEW SMALL BUSINESSES IN UNDERSERVED COMMUNITIES THAT CAN SUPPLY HEALTH CARE PRODUCT NEEDS. RESULTS FOR THE OVERALL GROUP OF ANCHOR INSTITUTIONS INCLUDE 476 BUSINESSES ASSISTED RESULTING IN NEW CONTRACTS BETWEEN SMALL BUSINESSES AND ANCHORS; 230 JOBS RETAINED; $58.9 MILLION IN REVENUE COMMITTED; AND 57 CONTRACTS SIGNED WITH SMALL BUSINESSES THROUGH MULTIYEAR ANCHOR CONTRACTS.
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDADVOCATE IS ALSO WORKING TO STRENGTHEN CORPORATE OPTIONS THROUGH HUMAN RESOURCE, SUPPLY CHAIN, ENVIRONMENTAL STEWARDSHIP AND INVESTMENT POLICIES TO IMPACT THE SOCIAL DETERMINANTS OF HEALTH IN THE COMMUNITIES SERVED BY ADVOCATE. SEVERAL EXAMPLES OF THE ORGANIZATION'S WORK IN THESE AREAS FOLLOW.ENVIRONMENTAL STEWARDSHIP. ADVOCATE BELIEVES THAT ENVIRONMENTAL HEALTH DEEPLY IMPACTS PERSONAL HEALTH AND THE HEALTH OF COMMUNITIES. GROUNDED IN OUR FAITH BELIEFS THAT GUIDE OUR HEALTH MINISTRY, WE ARE CALLED TO CARE FOR THE EARTH AND WORK DILIGENTLY TO MINIMIZE OUR ENVIRONMENTAL IMPACT AND CONTRIBUTE POSITIVELY TO EFFORTS THAT PRESERVE HEALTHY ENVIRONMENTS FOR GENERATIONS TO COME.ADVOCATE IS INVOLVED AS A LEADER IN THE HEALTH CARE SUSTAINABILITY ARENA AS AN ACTIVE MEMBER OF PRACTICE GREENHEALTH, HEALTH CARE CLIMATE COUNCIL, HEALTHCARE PLASTICS RECYCLING COALITION (HEALTH FACILITY ADVISORY BOARD) AND THE MIDWEST BUSINESS GROUP ON HEALTH, AS WELL AS HEALTH CARE ANCHORS (FOCUSED ON ENVIRONMENTAL STEWARDSHIP, SUSTAINABILITY, EQUITABLE PROCUREMENT AND WORK FORCE DEVELOPMENT). IN 2010, ADVOCATE BECAME A FOUNDING SPONSOR OF THE HEALTHIER HOSPITALS INITIATIVE, A THREE-YEAR NATIONAL CAMPAIGN TO IMPLEMENT BEST PRACTICES FOCUSED ON IMPROVING SUSTAINABILITY IN THE HEALTH CARE SECTOR. HEALTHIER HOSPITALS IS NOW A PERMANENT PROGRAM OF PRACTICE GREENHEALTH. THE PROGRAM ENGAGES OVER 1,300 HOSPITALS IN CHALLENGES IN SIX CATEGORIES: ENGAGED LEADERSHIP, HEALTHIER FOODS, LESS WASTE, LEANER ENERGY, SAFER CHEMICALS AND SMARTER PURCHASING.IN 2008, ADVOCATE EMBARKED ON A JOURNEY TO REDUCE ITS CARBON FOOTPRINT AND TO BECOME AS EFFICIENT AS POSSIBLE. BY 2015, ADVOCATE HAD REDUCED ENERGY CONSUMPTION BY 23% FROM THE 2008 BASELINE. BY THE END OF 2018, ADVOCATE ACHIEVED AN ADDITIONAL 4.5% REDUCTION FROM ITS NEW 2015 BASELINE. PROJECT C.U.R.E. (COMMISSION ON URGENT RELIEF AND EQUIPMENT). ADVOCATE IS AN OFFICIAL DONATION PARTNER OF PROJECT C.U.R.E., THE WORLD'S LEADING MEDICAL SUPPLY DISTRIBUTION ORGANIZATION BENEFITING RESOURCE-LIMITED AREAS ACROSS THE GLOBE. SURPLUS MEDICAL SUPPLIES AND DECOMMISSIONED EQUIPMENT ARE DONATED TO PROJECT C.U.R.E. AND MANY ADVOCATE TEAM MEMBERS ALSO VOLUNTEER TIME AT ITS WAREHOUSE-SORTING AND PACKAGING SUPPLIES FOR DISTRIBUTION OVERSEAS. IN 2018, ADVOCATE DONATED A TOTAL OF 91 PALLETS OF MISCELLANEOUS MEDICAL SUPPLIES AND 13 PIECES OF MEDICAL EQUIPMENT TO PROJECT CURE.STAKEHOLDER HEALTH. ADVOCATE IS A FOUNDING MEMBER AND INVESTING PARTNER OF STAKEHOLDER HEALTH, FORMERLY KNOWN AS HEALTH SYSTEMS LEARNING GROUP. MEMBERS OF ADVOCATE STAFF SERVE ON THE ADVISORY COUNCIL AND HAVE BEEN ACTIVELY INVOLVED IN OFFERING THOUGHT LEADERSHIP AS WELL AS CONTRIBUTING TO THE WRITING OF TWO SEMINAL DOCUMENTS-A 2013 HEALTH SYSTEMS LEARNING GROUP MONOGRAPH HTTPS://STAKEHOLDERHEALTH.ORG/PDF/ AND A 2016 BOOK, STAKEHOLDER HEALTH: INSIGHTS FROM NEW SYSTEMS OF HEALTH HTTPS://STAKEHOLDERHEALTH.ORG/STAKEHOLDER-HEALTH-CHAPTER-1/. THE LATTER PUBLICATION, DEVELOPED AND PUBLISHED WITH THE SUPPORT OF THE ROBERT WOOD JOHNSON FOUNDATION, IS A RICH AND DETAILED REVIEW OF SOME OF THE BEST PRACTICES IN THE AREAS OF COMMUNITY HEALTH IMPROVEMENT, AND CLINICAL AND COMMUNITY PARTNERSHIPS. THE FIRST RELEASE OF THE BOOK OCCURRED AT AN EVENT AT CHICAGO THEOLOGICAL SEMINARY AND WAS PLANNED AND EXECUTED BY ADVOCATE STAFF AND STAFF OF THE CENTER FOR FAITH AND COMMUNITY HEALTH TRANSFORMATION. STAKEHOLDER HEALTH ASPIRES TO IDENTIFY AND ACTIVATE A MENU OF PROVEN COMMUNITY HEALTH PRACTICES AND PARTNERSHIPS THAT WORK FROM THE TOP OF THE MISSION STATEMENT TO THE BOTTOM LINE. ADVOCATE AURORA HEALTH CONTINUES TO BE AN ACTIVE MEMBER AND LEADER OF STAKEHOLDER HEALTH.SUSTAINABLE BUILDING. SUSTAINABILITY, SAFETY AND EFFICIENCY ARE CORE ELEMENTS OF ALL ADVOCATE CONSTRUCTION PROJECTS. IN 2018, 74% OR 1,370 TONS OF ADVOCATE CONSTRUCTION WASTE WAS RECYCLED. ADVOCATE IS PURSUING LEADERSHIP IN ENERGY AND ENVIRONMENTAL DESIGN (LEED) CERTIFICATION ON ALL NEW MAJOR BUILDINGS AND HAS DEVELOPED A NEW TOOL, THE HEALTHY SPACES ROADMAP, TO ENSURE SUSTAINABILITY IN ALL RENOVATIONS AND PROJECTS THROUGHOUT ADVOCATE. AS REPORTED FOR 2017, ADVOCATE CHRIST'S EAST TOWER WAS LEED GOLD HEALTHCARE CERTIFIED. IN 2018, HOWEVER, TWO MORE HOSPITALS-ADVOCATE GOOD SAMARITAN FOR ITS WEST TOWER AND ADVOCATE GOOD SHEPHERD FOR ITS MODERNIZATION PROJECT-ACHIEVED LEED FOR HEALTHCARE-SILVER CERTIFICATION IN 2018. SUSTAINABLE WORK SPACES. BEING GREEN AT WORK IS EASIER WHEN THE WORK ENVIRONMENT IS CONDUCIVE TO SUSTAINABLE PRACTICES. AT ADVOCATE, INDOOR AIR QUALITY IS INCREASED AND EXPOSURE TO TOXIC CHEMICALS DECREASED THROUGH ENVIRONMENTALLY-PREFERABLE PURCHASING, INCLUDING FURNITURE, CLEANING PRODUCTS AND MEDICAL SUPPLIES. ADVOCATE'S TEAM MEMBERS ARE EMPOWERED TO CREATE SUSTAINABLE WORK SPACES THROUGH THE GREEN ADVOCATE AND SUSTAINABLE WORK SPACE CERTIFICATION PROGRAMS. ALL TEAM MEMBERS AND VOLUNTEERS ARE ENCOURAGED TO REDUCE WASTE, RECYCLE AND UTILIZE ELECTRICITY EFFECTIVELY. BEING GREEN IS A TEAM EFFORT AND MANY METRICS ARE TRACKED AND REPORTED AT ADVOCATE SITES.BETHANY COMMUNITY HEALTH FUND ("BETHANY FUND"). AS INTRODUCED EARLIER, THE BETHANY FUND ADDRESSES THE UNIQUE HEALTH NEEDS OF FOUR TARGETED UNDERSERVED COMMUNITIES ON CHICAGO'S WEST SIDE [AUSTIN, GARFIELD PARK, HUMBOLDT PARK AND NORTH LAWNDALE] BY AWARDING GRANTS TO PROGRAMS THAT PROMOTE HEALTH AND WELLNESS AND REDUCE HEALTH DISPARITIES AND THEIR DETERMINANTS. PRIORITY AREAS INCLUDE DIABETES, SCHOOL DROPOUT PREVENTION, WORKFORCE DEVELOPMENT, AND VIOLENCE PREVENTION. SINCE THE BOARD WAS ESTABLISHED IN 2007, THE BETHANY FUND HAS AWARDED OVER $9 MILLION THROUGH 381 GRANTS TO SUPPORT ORGANIZATIONS IN ITS FUND COMMUNITIES. IN 2018, THE FUND AWARDED $815,000 TO GRANTEES. THE ADVOCATE BETHANY FUND HAS SUPPORTED A WIDE VARIETY OF PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, INCLUDING THE FOLLOWING EXAMPLES OF PROGRAMS FUNDED DURING 2018: NEW MOMS (AUSTIN), FOR THEIR WORKFORCE DEVELOPMENT PROGRAM THAT WORKS WITH YOUNG MOMS EXPERIENCING POVERTY AND UTILIZES CANDLE MAKING TO TEACH JOB-READINESS SKILLS; FREE SPIRIT MEDIA (NORTH LAWNDALE) FOR THEIR INDUSTRY AND CAREER PATHWAYS PROGRAM WHICH SERVES YOUTH AND YOUNG ADULTS SEEKING TO BREAK INTO CHICAGO'S ROBUST FILM AND MEDIA INDUSTRIES; MARILLAC ST. VINCENT FAMILY SERVICES (GARFIELD PARK) TO SUPPORT PROJECT HOPE, A PROGRAM FOR PREGNANT AND PARENTING TEENS AND YOUNG ADULTS; AND GREATER WEST TOWN COMMUNITY DEVELOPMENT PROJECT (HUMBOLDT PARK), TO ENRICH THEIR EXISTING VOCATIONAL TRAINING PROGRAM. IN ADDITION TO ITS GRANT MAKING ROLE, THE ADVOCATE BETHANY FUND INVESTS SUBSTANTIAL STAFF TIME AND FINANCIAL RESOURCES IN ORGANIZATIONAL CAPACITY BUILDING. THE ORGANIZATIONS FUNDED ARE PHYSICALLY LOCATED IN ONE OR MORE OF THE PRIORITY WEST-SIDE COMMUNITIES. EACH YEAR, THE FUND SUPPORTS CAPACITY-BUILDING IDEAS DETERMINED FROM RECOMMENDATIONS FROM ITS GRANTEE ORGANIZATIONS AND ITS BOARD MEMBERS (SOME OF WHOM ARE LEADERS AT GRANTEE ORGANIZATIONS). THE FUND HAS OFFERED OVER 80 FORMAL CAPACITY BUILDING/PROFESSIONAL DEVELOPMENT SESSIONS THAT HAVE ENGAGED MORE THAN 1,150 STAFF FROM GRANTEE AND COMMUNITY-BASED ORGANIZATIONS. GOAL E: LEVERAGE RESOURCES AND MAXIMIZE COMMUNITY ENGAGEMENT BY BUILDING AND STRENGTHENING COMMUNITY PARTNERSHIPS WITH HEALTH DEPARTMENTS AND OTHER DIVERSE COMMUNITY ORGANIZATIONS.A KEY OBJECTIVE UNDER THIS GOAL IS ALIGNING INITIATIVES WITH LOCAL HEALTH DEPARTMENTS AND THEIR COMMUNITY HEALTH PRIORITIES. ALL ADVOCATE HOSPITALS COLLABORATED WITH THEIR RESPECTIVE HEALTH DEPARTMENTS DURING THE 2014-2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CYCLE. ONE OF THE PRIMARY VALUES OF ADVOCATE'S COMMUNITY HEALTH DEPARTMENT IS COLLABORATION WITH PARTNERS, PREFERABLY THROUGH A COLLECTIVE IMPACT MODEL. ONE OF THE PRINCIPAL PARTNERS IN PROVIDING FOR COMMUNITY NEEDS IS THE LOCAL HEALTH DEPARTMENT. WHILE AT THE DIRECTION OF THE SYSTEM, ALL HOSPITALS ACTIVELY PARTICIPATED IN COLLABORATIVE ASSESSMENTS AND HEALTH IMPROVEMENT PLANNING WITH THEIR LOCAL HEALTH DEPARTMENTS FOR THE 2014-2016 CHNA PROCESS AND ARE DOING SO AGAIN FOR THE 2017-2019 PROCESS. THERE IS ONE NOTABLE COLLABORATION IN PARTICULAR IN WHICH ADVOCATE SYSTEM LEVEL LEADERSHIP PLAYED A VITAL ROLE. ALLIANCE FOR HEALTH EQUITY (FORMERLY THE HEALTH IMPACT COLLABORATIVE OF COOK COUNTY [HICCC]. AS INTRODUCED EARLIER, ADVOCATE HEALTH CARE, PRESENCE HEALTH AND THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) WERE THE THREE FOUNDING ORGANIZATIONS OF THE HEALTH IMPACT COLLABORATIVE OF COOK COUNTY. THESE ORGANIZATIONS INVITED HEALTH DEPARTMENTS AND ALL COOK COUNTY NONPROFIT HOSPITALS TO JOIN THEM IN CREATING ONE OF THE LARGEST CHNA AND COMMUNITY HEALTH IMPROVEMENT COLLABORATIVES IN THE COUNTRY. IPHI SERVES AS THE BACKBONE ORGANIZATION FOR THE COLLABORATIVE AND THE HOSPITALS PROVIDE FUNDING FOR THE SHARED ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLANNING FACILITATION WORK. IN ADDITION TO 27
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDNONPROFIT AND PUBLIC HOSPITALS, SEVEN LOCAL HEALTH DEPARTMENTS AND MORE THAN 100 COMMUNITY ORGANIZATIONS PARTICIPATED IN THE ASSESSMENT AND ACTION TEAMS.DURING 2015 AND 2016, IPHI, THE PARTICIPATING HOSPITALS AND HEALTH DEPARTMENTS WORKED TOGETHER TO DESIGN A SHARED LEADERSHIP MODEL AND COLLABORATIVE INFRASTRUCTURE TO SUPPORT COMMUNITY-ENGAGED PLANNING PARTNERSHIPS AND STRATEGIC ALIGNMENT OF IMPLEMENTATION PLANS, WHICH WILL FACILITATE MORE EFFECTIVE AND SUSTAINABLE COMMUNITY HEALTH IMPROVEMENT IN THE FUTURE. SURVEYS WERE DISTRIBUTED THROUGHOUT COOK COUNTY WITH A FOCUS ON UNDERSERVED COMMUNITIES. OVER 5,000 SURVEYS WERE COMPLETED PROVIDING A GOOD PICTURE OF THE HEALTH NEEDS OF THE COUNTY. PRIMARY DATA ALSO INCLUDED MULTIPLE FOCUS GROUPS AND HOSPITAL UTILIZATION DATA. A DATA TEAM ANALYZED MULTIPLE SECONDARY DATA SOURCES AS WELL. THIS COLLABORATIVE WORK RESULTED IN THREE REGIONAL CHNA REPORTS.AS A RESULT OF THE ASSESSMENT WORK, ALL PARTNERS DETERMINED FOUR FOCUS AREAS FOR IMPLEMENTATION. ACTION TEAMS HAVE BEEN FORMED AND COMMUNITY HEALTH IMPROVEMENT PLANS ARE BEING DEVELOPED WITH A FOCUS ON ALIGNED ACTIONS AND DATA COLLECTION. IN LATE 2017 AND FOLLOWING HICCC'S MERGER WITH THE HEALTH CHICAGO HOSPITALS COLLABORATE TO CREATE THE ALLIANCE FOR HEALTH EQUITY (AFHE), ADVOCATE HAS CONTINUED TO BE AN ACTIVE MEMBER INVOLVED IN LEADERSHIP AND SERVING ON THE AFHE STEERING COMMITTEE. ANOTHER OBJECTIVE TO STRENGTHEN COMMUNITY PARTNERSHIPS IS FOR ADVOCATE TO EXPLORE NON-TRADITIONAL RELATIONSHIPS, SUCH AS WITH SCHOOL DISTRICTS, EMPLOYMENT AGENCIES, HOUSING GROUPS, FOOD PANTRIES, SHELTERS, ETC. WHILE THERE ARE MANY EXISTING ADVOCATE COMMUNITY PARTNERSHIPS MENTIONED THROUGHOUT THIS DOCUMENT AND EVEN SOME THAT RESULTED FROM OR BEGAN PRIOR TO ADVOCATE'S 2011-2013 CHNA PROCESS, THIS OBJECTIVE IS FOCUSED PRIMARILY ON THE INNOVATIVE NON-TRADITIONAL PARTNERSHIPS THAT HAVE BEGUN AS A RESULT OF THE 2014-2016 CHNA.ADDRESSING FOOD INSECURITY. ONE SUCH EXAMPLE OF A NON-TRADITIONAL COMMUNITY PARTNERSHIP IS ADVOCATE GOOD SAMARITAN'S PARTNERSHIP WITH LOCAL FOOD PANTRIES AND THE UNIVERSITY OF ILLINOIS EXTENSION TO DEVELOP A PROGRAM THAT OFFERS HEALTHY FRESH FOOD, NUTRITION AND COOKING CLASSES TO CLIENTS OF THE FOOD PANTRIES. ANOTHER EXAMPLE IS ADVOCATE GOOD SHEPHERD'S WORK WITH VARIOUS COMMUNITY-BASED ORGANIZATIONS AND LOCAL MUNICIPAL ENTITIES THAT SERVE SENIORS TO IMPLEMENT FOOD SECURITY SCREENING FOR SENIORS. A SCREENING TOOL AND COMPREHENSIVE RESOURCE GUIDE HAVE BEEN DEVELOPED FOR SENIORS THAT SCREEN AS FOOD INSECURE. ADVOCATE GOOD SHEPHERD AND SEVERAL OTHER ADVOCATE HOSPITALS ARE GROWING VEGETABLES ON THEIR CAMPUSES OR IN THE COMMUNITY. ADVOCATE GOOD SHEPHERD HAS PARTNERED WITH A LOCAL NON-PROFIT ORGANIZATION, SMARTFARM, WHOSE MISSION IS TO BE AN EDUCATIONAL RESOURCE ON SUSTAINABLE GARDENING AND HEALTHY EATING. SMART FARM MANAGES THE ON-SITE GARDEN ON OVER 10 ACRES OF LAND OWNED BY ADVOCATE AND THE HARVESTED FRESH VEGETABLES ARE DONATED TO LOCAL FOOD PANTRIES. SIMILAR PARTNERSHIPS EXIST AT ADVOCATE SHERMAN AND ADVOCATE BROMENN. IN 2018, ADVOCATE ILLINOIS MASONIC ESTABLISHED A HOSPITAL-BASED FOOD PANTRY TO ADDRESS THE NEEDS OF FOOD INSECURE ONCOLOGY PATIENTS. IN PARTNERSHIP WITH THE LAKEVIEW FOOD PANTRY, THE MEDICAL CENTER PROVIDES DRY GOOD FOOD BAGS, RE-USABLE WHEELIE GROCERY BAGS AND GIFT CARDS TO LOW-INCOME AND FOOD INSECURE PATIENTS. TWO HOSPITALS, ADVOCATE SOUTH SUBURBAN AND ADVOCATE TRINITY HAVE PARTNERED WITH ADVOCATE'S PRODUCE VENDOR, CRISTINA FOODS, TO HOST THREE PUBLIC FARMERS MARKETS WHERE FRESH PRODUCE WAS PROVIDED TO PATIENTS, SURROUNDING COMMUNITIES AND ADVOCATE TEAM MEMBERS, WITH LEFTOVER FOOD DONATED TO LOCAL FOOD PANTRIES IN 2018.ADVOCATE WORKFORCE INITIATIVE (AWI). IN 2015, JPMORGAN CHASE MADE A GENEROUS DONATION TO THE ADVOCATE CHARITABLE FOUNDATION, THE CHARITABLE ARM OF ADVOCATE, TO DEVELOP THE HEALTHCARE WORKFORCE COLLABORATIVE, A CREATIVE AND MODERN SOLUTION TO THE CITY'S TALENT SHORTAGE AND ECONOMIC DISPARITIES. LED BY ADVOCATE, THIS HEALTH CARE SECTOR SKILLS-BASED TRAINING INITIATIVE CONNECTS CHICAGOLAND'S UNDEREMPLOYED AND UNEMPLOYED RESIDENTS WITH HIGH-QUALITY, IN-DEMAND JOBS IN THE RAPIDLY GROWING HEALTH CARE INDUSTRY. UNEMPLOYMENT RATES ARE AS HIGH AS 31.9% IN SOME NEIGHBORHOODS IN THE METROPOLITAN AREA AS COMPARED TO CHICAGO'S OVERALL UNEMPLOYMENT RATE OF 8.2%. ILLINOIS HAS THE NATION'S HIGHEST UNEMPLOYMENT RATE AMONG AFRICAN-AMERICANS. THE UNEMPLOYMENT RATE OF AFRICAN-AMERICANS AND HISPANICS IN CHICAGO IS THREE TIMES THAT OF THEIR WHITE COUNTERPARTS. THE HEALTH CARE SECTOR IS EXPECTED TO GENERATE 14,000 NEW WELL-PAYING MIDDLE-SKILL JOBS ANNUALLY IN THE CHICAGO REGION THROUGH 2019, BUT LACKS THE SKILLED TALENT NEEDED TO FILL THESE ROLES. ADVOCATE ALSO HELPED LAUNCH THE CHICAGOLAND HEALTHCARE WORKFORCE COLLABORATIVE (CHWC). THE CHWC IS A CONSORTIUM OF LEADING HEALTHCARE EMPLOYERS AND INDUSTRY PARTNERS THAT BELIEVE IN THE NECESSITY OF A STRONG AND DIVERSE LOCAL HEALTHCARE WORKFORCE. BY LEVERAGING RESOURCES AND BEST PRACTICES, THE COLLABORATIVE AIMS TO SUPPORT AN INCLUSIVE HEALTHCARE WORKFORCE, PROVIDE ACCESSIBILITY FOR THE UNEMPLOYED AND UNDEREMPLOYED POPULATIONS, AND DEVELOP INNOVATIVE RESPONSES TO THE EVOLVING NEEDS OF THE HEALTHCARE INDUSTRY. THIS IS ACHIEVED BY IDENTIFYING AND IMPLEMENTING IMPACTFUL, DATA-DRIVEN AND ACTION-ORIENTED SOLUTIONS, WITH A SPECIFIC FOCUS ON POPULATIONS THAT ARE UNDERREPRESENTED IN THE HEALTH CARE WORKFORCE.THIS WORKFORCE DEVELOPMENT PROGRAM:" ALIGNS TRAINING CURRICULUM TO CURRENT AND EMERGING JOB NEEDS;" CONNECTS JOB SEEKERS TO EMPLOYMENT OPPORTUNITIES WITHIN ADVOCATE;" INCREASES DIVERSITY WITHIN THE HEALTHCARE SECTOR;" PROVIDES CAREER PATHWAYS TO ADVANCED TRAINING OR CAREER OPPORTUNITIES IN HEALTHCARE;" SUPPORTS ECONOMIC DEVELOPMENT IN VULNERABLE COMMUNITIES;" ESTABLISHES BEST PRACTICES, CREATING A REGIONAL/NATIONAL MODEL; AND" PROVIDES SUPPORTIVE SERVICES TO REMOVE BARRIERS TO EMPLOYMENT.TO ENSURE THE INITIATIVE IS BROAD-REACHING AND COMPREHENSIVE, ADVOCATE HAS ESTABLISHED STRATEGIC ALLIANCES WITH THE CITY COLLEGES OF CHICAGO, PRAIRIE STATE COLLEGE, CHICAGO STATE UNIVERSITY, UNIVERSITY OF CHICAGO (URBAN LABS) AND OTHER COMMUNITY-BASED ORGANIZATIONS, SUCH AS PHALANX FAMILY SERVICES, JEWISH VOCATION SERVICES, INSTITUTO DEL PROGRESO LATINO, POLISH AMERICAN ASSOCIATION, NATIONAL LATINO EDUCATION INSTITUTE, KINZIE INDUSTRIAL DEVELOPMENT CORPORATION AND CHICAGO CENTER FOR ARTS AND TECHNOLOGY, TO RECRUIT, TRAIN AND SUPPORT POTENTIAL CANDIDATES. AFTER SUCCESSFUL COMPLETION OF THE TRAINING AND LICENSING EXAM, ALL PARTICIPANTS ARE GUARANTEED AN INTERVIEW WITH ADVOCATE AND RECEIVE JOB PLACEMENT ASSISTANCE. SINCE INCEPTION, THE INITIATIVE HAS TRAINED MORE THAN 800 PARTICIPANTS AND HAS OVER AN 80% GRADUATION RATE. NEARLY 300 GRADUATES FROM THE INITIATIVE ARE NOW EMPLOYED IN THE HEALTH CARE INDUSTRY WITH ABOUT 162 STILL ENROLLED PENDING NEW EMPLOYMENT OPPORTUNITIES. OF THOSE EMPLOYED, 98% HAVE MAINTAINED EMPLOYMENT FOR AT LEAST 90 DAYS. ADVOCATE HAS ALSO LAUNCHED AN INCUMBENT WORKER STRATEGY FOR FRONTLINE TEAM MEMBERS, THE NAVIGATE PROGRAM. NAVIGATE AIMS TO CREATE A MORE INCLUSIVE WORKFORCE, ONE THAT PROVIDES TEAM MEMBERS WITH OPPORTUNITIES TO DEVELOP NEW SKILLS, DETERMINE A CAREER PATHWAY AND CONNECT WITH TOOLS AND RESOURCES. ADVOCATE IS INVESTED IN TEAM MEMBERS' SUCCESS THROUGH LEVERAGING THESE TYPES OF PROGRAMS TO ENSURE ADVOCATE IS A GREAT PLACE FOR TEAM MEMBERS WORK, PATIENTS TO HEAL AND PHYSICIANS TO PRACTICE. THE PROGRAM WAS INITIATED AT ADVOCATE TRINITY IN 2016 AND AS OF YEAR-END 2018, HAS EXPANDED TO ADVOCATE ILLINOIS MASONIC, ADVOCATE CHRIST AND ADVOCATE MEDICAL GROUP, WITH PLANS TO ACTIVATE AT ADVOCATE SOUTH SUBURBAN IN 2019. THE PROGRAM HAS ENROLLED AND SUPPORTED 182 INCUMBENT WORKERS, GUIDED MORE THAN 100 TO IDENTIFY A CAREER PATHWAY AND HAS NEARLY AN 80% GRADUATION RATE. OF THOSE THAT HAVE MOVED INTO AN ADVANCED CAREER PATHWAY, THE AVERAGE WAGE INCREASE IS 24%. VOLUNTEERS FROM THE COMMUNITY. ANOTHER ASPECT OF COMMUNITY ENGAGEMENT IS PROVIDING COMMUNITY MEMBERS WITH AN OPPORTUNITY TO DONATE THEIR TIME SERVING THROUGH A MYRIAD OF VOLUNTEER SERVICE OPPORTUNITIES. EACH YEAR, VOLUNTEERS FROM THE COMMUNITY SHARE THEIR TIME AND TALENTS THROUGH SERVICE AT ADVOCATE'S HOSPITALS, ADVOCATE MEDICAL GROUP AND ADVOCATE AT HOME, AND IN THEIR OWN WAY, FURTHER ADVOCATE'S COMMITMENT TO PROVIDING EXCELLENT HEALTH CARE. IN 2018, ADVOCATE STAFF MANAGED 5,018 ACTIVE COMMUNITY VOLUNTEERS THAT ENGAGED PATIENTS, FAMILIES AND STAFF IN A VARIETY OF ACTIVITIES, SOME OF WHICH WERE: PROVIDING INFORMATION DESK SERVICES TO VISITORS; CLERICAL SUPPORT TO STAFF; SERVING CUSTOMERS IN HOSPITAL GIFT AND RESALE SHOPS; OFFERING COMPASSIONATE CONCERN TO PATIENTS AND THEIR LOVED ONES IN MULTIPLE HOSPITAL AREAS SUCH AS THE EMERGENCY DEPARTMENT, INTENSIVE CARE UNIT, SURGERY WAITING ROOM,
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDPOST-ANESTHESIA CARE AND NURSERY INTENSIVE CARE UNITS; ASSISTING WITH COMMUNITY HEALTH SCREENINGS AND BLOOD DRIVE EVENTS; PROVIDING CHEERFUL SERVICE TO PATIENTS BY DELIVERING FLOWERS, MAIL AND NEWSPAPERS; AND PROVIDING SUPPORT SERVICES IN THE HOSPITAL THAT HAVE LIBRARIES AND/OR WELLNESS CENTERS. ADVOCATE TEAM MEMBERS VOLUNTEERING IN THE COMMUNITY. ADVOCATE'S SYSTEM LEADERSHIP ALSO ENCOURAGES AND PROVIDES OPPORTUNITIES FOR TEAM MEMBERS AND PHYSICIANS TO DONATE TO, VOLUNTEER AT AND HELP RAISE FUNDS FOR COMMUNITY INITIATIVES. IN 2018, ADVOCATE PROMOTED AND SUPPORTED ASSOCIATE, PHYSICIAN AND HOSPITAL PARTICIPATION IN WALKS, RUNS AND RACES, INCLUDING DEVELOPING OFFICIAL ADVOCATE TEAMS FOR THE AMERICAN HEART ASSOCIATION (HEAR WALK), AMERICAN CANCER SOCIETY (MAKING STRIDES AGAINST BREAST CANCER EVENTS AND HEAD FOR THE CURE 5K), ALZHEIMER'S ASSOCIATION (WALK TO END ALZHEIMER'S) AND MARCH OF DIMES (MARCH FOR BABIES). IN 2018, 5,583 ADVOCATE TEAM MEMBERS WALKED IN THESE FUNDRAISERS AND $633,792 IN CHARITABLE CONTRIBUTIONS WAS RAISED TO SUPPORT THESE NONPROFIT PARTNER ORGANIZATIONS THROUGH SUCH EFFORTS. ADVOCATE ALSO HAD THE HONOR OF BEING DESIGNATED THE #1 HEART WALK FUNDRAISING HEALTH CARE COMPANY IN THE NATION BY THE AMERICAN HEART ASSOCIATION IN 2018. IN ADDITION, ADVOCATE'S TEAM MEMBERS AND PHYSICIANS GENEROUSLY SUPPORT MULTIPLE LOCAL COMMUNITY ORGANIZATIONS, PROGRAMS AND INITIATIVES, INCLUDING SOME OF ADVOCATE'S OWN SYSTEM-WIDE AND HOSPITAL-BASED COMMUNITY HEALTH PROGRAMS. IN 2018, ADVOCATE TEAM MEMBERS CONTRIBUTED MORE THAN $2.1 MILLION THROUGH THE ADVOCATE AURORA GIVING CAMPAIGN. IN ADDITION, SYSTEM LEVEL LEADERS ARE SUPPORTIVE OF TEAM MEMBERS VOLUNTEERING DURING WORKTIME ON NONPROFIT COMMUNITY BOARDS, COMMITTEES, COUNCILS, TASK FORCES AND COALITIONS, USING THEIR TALENTS TO SUPPORT A VARIETY OF COMMUNITY-BASED ORGANIZATIONS. GOAL F: PROMOTE ACCOUNTABILITY FOR SYSTEM AND SITE ALIGNMENT BY INCREASING PROGRAM COORDINATION AND DEVELOPING STRONG GOVERNANCE RELATIONSHIPS.KEY TO DEVELOPING STRONG GOVERNANCE RELATIONSHIPS WAS ESTABLISHING SYSTEM BOARD ENGAGEMENT IN SUPPORT OF ADVOCATE'S COMMUNITY HEALTH VISION. AS THE FUNCTION ACCOUNTABLE FOR ADVOCATE'S SYSTEM-WIDE CHNA PROCESS AND BOTH CHNA AND STATE COMMUNITY BENEFITS REGULATORY REPORTING IN ILLINOIS, THE COMMUNITY HEALTH DEPARTMENT PROVIDES PROGRESS UPDATES AT LEAST ANNUALLY TO HOSPITAL AND SYSTEM LEADERSHIP. WHEREAS PRIOR TO THE APRIL 2018MERGER, THE MISSION AND SPIRITUAL CARE COMMITTEE OF THE BOARD OF DIRECTORS WAS RESPONSIBLE FOR THE ADOPTION OF COMMUNITY HEALTH STRATEGY, POST-MERGER THE ADVOCATE HEALTH CARE NETWORK BOARD IS NOW CHARGED WITH THIS RESPONSIBILITY. AS INDICATED EARLIER, ADVOCATE HEALTH CARE ESTABLISHED A COMMUNITY HEALTH DEPARTMENT IN LATE 2015 AND THE DEPARTMENT WAS FULLY STAFFED AND OPERATING BY JANUARY 2016. THE DEPARTMENT'S FIRST ORDER OF BUSINESS WAS TO DEVELOP A MISSION, VALUES AND VISION (MVV) TO GUIDE ITS ACTIONS. THE DEPARTMENT'S MISSION IS "TO TRANSFORM THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE BY PROMOTING PREVENTION AND ENSURING HEALTH EQUITY, THROUGH COLLABORATIVE PARTNERSHIPS AND EVIDENCE-BASED PRACTICES." THE DEPARTMENT'S VALUES ENCOMPASS BEING "ACCOUNTABLE, COLLABORATIVE, EQUITABLE, INCLUSIVE, RESILIENT, SUSTAINABLE, TRANSFORMATIVE AND TRANSPARENT." THROUGH THESE ATTRIBUTES, THE VISION - "TO WORK COLLABORATIVELY TO TRANSFORM OUR ENVIRONMENT INTO COMMUNITIES WHERE HEALTH SERVICES ARE ACCESSIBLE AND INTEGRATED; PEOPLE ARE SUPPORTED; HEALTH EQUITY IS ACHIEVED AND RESULTS ARE MEASURABLE" - WILL BE ACHIEVED. DURING 2016 AND TO SUPPORT ADVOCATE HOSPITALS' PLANS TO IMPLEMENT PROGRAM STRATEGIES AS OUTLINED IN THEIR CHNA REPORTS DURING 2017, SITE-SPECIFIC COMMUNITY HEALTH DEPARTMENT BUDGETS WERE PUT IN PLACE AT ALL ADVOCATE HOSPITALS BY THE SYSTEM VICE PRESIDENT OF COMMUNITY HEALTH AND FAITH OUTREACH. HOSPITAL COMMUNITY HEALTH BUDGETS, INCLUDING ONGOING PROGRAM IMPLEMENTATION COSTS, STAFF SALARIES, ANNUAL CONTRACTED DATA ACCESS COSTS TO THE CONDUENT-HEALTHY COMMUNITIES INSTITUTE'S CHNA TOOL, FEE TO PARTICIPATE IN THE ALLIANCE FOR HEALTH EQUITY (AHFE) AND FOR ANNUAL SUPPORT FOR AND USE OF THE LYON SOFTWARE CBISA (COMMUNITY BENEFITS INVENTORY OF SOCIAL RESPONSIBILITY) REPORTING TOOL WERE INCLUDED IN THE 2017 AND 2018 BUDGET CYCLE IN PREPARATION FOR YEAR 2019. SYSTEM LEVEL MONITORING OF BUDGETS SUPPORTS APPROPRIATE FUNDING TO SUSTAIN EXISTING AND IMPLEMENT NEW PROGRAMS THAT TARGET SELECTED COMMUNITY HEALTH PRIORITIES. HOSPITAL GOVERNING COUNCILS. ALSO KEY TO PROMOTING ACCOUNTABILITY FOR COMMUNITY HEALTH THROUGHOUT ADVOCATE WAS A SYSTEM LEVEL IMPLEMENTED PROCESS FOR ESTABLISHING HOSPITAL-BASED GOVERNANCE OVERSIGHT FOR EACH HOSPITAL'S CHNA PROCESS, INCLUDING REVIEW AND APPROVAL OF THE HOSPITAL CHNA REPORT AND HIGH LEVEL STRATEGIES TO ADDRESS KEY SELECTED NEEDS THAT RESULTED FROM THE PRIORITY-SETTING PROCESS. TO THAT END, THE SYSTEM EXPANDED THE ROLE OF THE HOSPITAL GOVERNING COUNCILS TO INCLUDE OVERSIGHT OF THE CHNA PROCESS AND APPROVAL OF THE HOSPITAL CHNA REPORTS AND IMPLEMENTATION STRATEGIES. THIS HAS RESULTED IN COMMUNITY HEALTH BEING STRONGLY INTEGRATED INTO ADVOCATE GOVERNANCE STRUCTURES. COMMUNITY HEALTH COUNCILS COMPRISED OF COMMUNITY EXPERTS AND HOSPITAL LEADERS HAVE BEEN DEVELOPED AT EACH HOSPITAL. THESE COUNCILS ARE CO-LED BY THE HOSPITAL COMMUNITY HEALTH LEADER AND A HOSPITAL GOVERNING COUNCIL MEMBER. A MINIMUM OF 50% OF THE COUNCIL MEMBERS FOR THE 2016 CHNA REPORT CYCLE WERE COMMUNITY REPRESENTATIVES WITH A FOCUS ON PEOPLE WHO REPRESENTED UNDERSERVED AND VULNERABLE POPULATIONS. THE COUNCILS MET AT LEAST FOUR TIMES DURING THE YEAR. HOSPITAL COMMUNITY HEALTH STAFF ANALYZED AND PRESENTED PRIMARY AND SECONDARY COMMUNITY HEALTH DATA TO THE HOSPITALS' COMMUNITY HEALTH COUNCILS. THE COUNCIL MEMBERS IDENTIFIED THE HOSPITAL SERVICE AREAS' SIGNIFICANT HEALTH NEEDS, SUBSEQUENTLY EMPLOYING A CONSENSUS BASED PRIORITY-SETTING PROCESS TO DETERMINE THE NEEDS UPON WHICH TO FOCUS. AS PART OF THE PRIORITIZATION PROCESS, THE COUNCILS SCANNED HOSPITAL AND COMMUNITY CHALLENGES AND ASSETS, AS WELL AS POTENTIAL PARTNERSHIPS WITH OTHER ORGANIZATIONS THAT MIGHT RESULT IN A LARGER HEALTH IMPROVEMENT IMPACT.CHNA DATA ASSESSMENT RESULTS AND RECOMMENDATIONS FOR HEALTH IMPROVEMENT PRIORITIES WERE PRESENTED TO THE FULL HOSPITAL GOVERNING COUNCILS FOR ENDORSEMENT. ONCE THE HEALTH IMPROVEMENT PRIORITIES AND STRATEGIES WERE APPROVED BY THE HOSPITAL GOVERNING COUNCILS, THE RESULTS WERE PRESENTED TO THE MISSION AND SPIRITUAL CARE COMMITTEE OF THE ADVOCATE HEALTH CARE BOARD OF DIRECTORS, CHARGED WITH SYSTEM OVERSIGHT OF COMMUNITY HEALTH PLANNING AT THAT TIME, FOR FINAL APPROVAL. AS INDICATED EARLIER, AS A RESULT OF THE MERGER, THIS RESPONSIBILITY MOVED TO THE ADVOCATE HEALTH CARE NETWORK BOARD IN 2018. SERVICE LINE AND POPULATION HEALTH ENGAGEMENT. TO SUPPORT FURTHER ALIGNMENT WITHIN ADVOCATE, THE SYSTEM COMMUNITY HEALTH DEPARTMENT HAS ALSO WORKED TO ENGAGE SYSTEM DEFINED CLINICAL SERVICE LINES IN EXPANDING THEIR FOCUS ON COMMUNITY HEALTH. ADVOCATE IS VIEWED AS A LEADER IN THE POPULATION HEALTH MANAGEMENT ARENA. AN EARLY ADOPTER OF MANAGING CARE ACROSS POPULATIONS, ADVOCATE HAS SIGNIFICANT SUCCESS IMPROVING HEALTH OUTCOMES WHILE DECREASING OR MAINTAINING COST OF CARE DELIVERY. ADVOCATE'S COMMUNITY HEALTH DEPARTMENT HAS INTENTIONALLY ALIGNED WITH ADVOCATE POPULATION HEALTH LEADERS AND ADVOCATE SERVICE LINES. THIS ALIGNMENT ASSURES THAT MEMBERS OF THE COMMUNITIES ADVOCATE SERVES AND OUR PATIENTS RECEIVE COMMUNITY-BASED INTERVENTIONS, AS WELL AS EDUCATION AND PROGRAMMING THAT ALIGNS WITH THEIR HEALTH NEEDS. THE FOLLOWING ARE EXAMPLES OF EDUCATION AND PROGRAMMING ALIGNED WITH POPULATION HEALTH AND SERVICE LINE DEVELOPMENT THAT REFLECT THIS INTEGRATED APPROACH. BEHAVIORAL HEALTH. BEHAVIORAL HEALTH COUNCIL INTEGRATION STRATEGIES HAVE INCLUDED COMMUNITY HEALTH STAFF OFFERING MENTAL HEALTH FIRST AID TO TARGETED COMMUNITY MEMBERS FOR THE PURPOSE OF REDUCING STIGMA, AND TRAINING COMMUNITY MEMBERS TO RECOGNIZE MENTAL HEALTH ISSUES AND UNDERSTAND APPROPRIATE INTERVENTIONS. IN 2018, OVER 1,047 COMMUNITY MEMBERS WERE TRAINED IN THE EIGHT-HOUR EVIDENCE-BASED PROGRAM. ADDITIONALLY, ALL HOSPITALS PARTICIPATE IN LOCAL BEHAVIORAL HEALTH AND SUBSTANCE ABUSE COLLABORATIVES.ADVOCATE PHYSICIAN PARTNERS (APP). ADVOCATE POPULATION HEALTH LEADERS AND ADVOCATE COMMUNITY HEALTH LEADERS ARE PARTNERING TO DEVELOP NEW APPROACHES TO PATIENT SCREENING AND RESOURCING FOR SOCIAL DETERMINANTS OF HEALTH. GOAL G: PROMOTE THE TRAINING OF FUTURE HEALTH PROFESSIONALS. TO FURTHER THE TRADITION OF PROVIDING MEDICAL EDUCATION TO UNDERGRADUATE AND GRADUATE MEDICAL STUDENTS AND NURSING STUDENTS, ADVOCATE'S SYSTEM LEVEL CLINICAL EDUCATION DEPARTMENT HAS DEVELOPED LONG-TERM ACADEMIC AFFILIATIONS WITH ALL MAJOR UNIVERSITIES IN THE CHICAGO METROPOLITAN AREA FOR THE
PART VI, LINE 6:	6. AFFILIATED HEALTH CARE SYSTEM- CONTINUEDEDUCATION AND TRAINING OF STUDENTS IN UNDERGRADUATE MEDICAL EDUCATION (UME), GRADUATE MEDICAL EDUCATION (GME), NURSING UNDERGRADUATE AND GRADUATE EDUCATION, AND IN NUMEROUS OTHER ALLIED HEALTH PROFESSIONAL FIELDS. ADVOCATE MEDICAL EDUCATION DEPARTMENT'S MISSION IS TO TRAIN THE NEXT GENERATION OF PHYSICIANS THROUGH UNDERGRADUATE (UME) AND GRADUATE MEDICAL EDUCATION (GME), AND TO CONTINUE THE DEVELOPMENT OF ADVOCATE PHYSICIANS THROUGH CONTINUING MEDICAL EDUCATION (CME). AS ONE OF THE LARGEST PROVIDERS OF PRIMARY MEDICAL EDUCATION IN ILLINOIS, THERE WERE 2,270 MEDICAL STUDENT ROTATIONS COMPLETED AND 580 RESIDENTS AND FELLOWS WHO RECEIVED HANDS-ON TRAINING IN 2018 AT ADVOCATE'S FOUR ACADEMIC MEDICAL CENTERS, INCLUDING ADVOCATE BROMENN, ADVOCATE CHRIST, ADVOCATE ILLINOIS MASONIC AND ADVOCATE LUTHERAN GENERAL. POST-GRADUATE MEDICAL EDUCATION (CME). ADVOCATE HEALTH CARE IS ACCREDITED BY ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME) TO PROVIDE CONTINUING MEDICAL EDUCATION (CME) FOR PHYSICIANS. ADVOCATE'S CME PROGRAM PROVIDES PROFESSIONAL DEVELOPMENT THROUGH YEAR-ROUND SCHEDULING AND PLANNING OF ACCREDITED COURSES, SEMINARS AND MEETINGS FOR ADVOCATE AND NON-ADVOCATE PHYSICIANS AND HEALTH CARE PROFESSIONALS IN THE REGION. ADVOCATE'S MEDICAL STAFF SHARE THEIR EXPERTISE THROUGH GRAND ROUNDS, MORTALITY AND MORBIDITY CONFERENCES, AND JOURNAL CLUBS-AS WELL AS SINGLE ACTIVITIES ADDRESSING A VARIETY OF CLINICAL AND RESEARCH TOPICS. IN 2018, ADVOCATE HOSTED 2,879 CME EVENTS TOTALING 3,942 CME CREDIT HOURS TO 54,277 PARTICIPANTS-OF WHICH 41,642 WERE PHYSICIANS. THIS IS A SIGNIFICANT INCREASE AS COMPARED TO THE 2,581 EVENTS, 2513 CREDIT HOURS AND 48,592 PARTICIPANTS (PHYSICIAN AND NON-PHYSICIAN) IN 2017.NURSING EDUCATION. UNDERGRADUATE AND GRADUATE (APN/NP/MANAGEMENT) NURSING EDUCATION OCCURS AT TEN ADVOCATE HOSPITALS AND AT MANY ADVOCATE MEDICAL GROUP SITES. NOTABLY, EIGHT ADVOCATE HOSPITALS HAVE EARNED MAGNET RECOGNITION FROM THE AMERICAN NURSE CREDENTIALING CENTER (ANCC), INCLUDING ADVOCATE BROMENN, ADVOCATE CHRIST, ADVOCATE CONDELL, ADVOCATE GOOD SAMARITAN, ADVOCATE GOOD SHEPHERD, ADVOCATE ILLINOIS MASONIC, ADVOCATE LUTHERAN GENERAL AND ADVOCATE SHERMAN. MAGNET STATUS REPRESENTS HOSPITAL-WIDE TEAMWORK AND DEDICATION TO CREATING A POSITIVE ENVIRONMENT, WHICH HELPS ATTRACT THE BEST PHYSICIANS AND NURSES, RESULTING IN BETTER OVERALL PATIENT CARE. EMERGENCY MEDICAL TECHNICIAN (EMT) EDUCATION. ADVOCATE ALSO TAKES A LEADERSHIP ROLE IN THE TRAINING OF EMTS TO TAKE THEIR PLACE IN PROVIDING CARE IN THE COMMUNITY. A MAJORITY OF ADVOCATE'S HOSPITALS PROVIDE EMT EDUCATION FROM BASIC THROUGH PARAMEDIC LEVEL. IN FACT, SEVERAL ADVOCATE HOSPITALS SERVE AS THE LEAD HOSPITAL IN THEIR COUNTIES/SERVICE AREAS, PROVIDING EDUCATION, STANDARDIZATION OF PROTOCOLS OF CARE AMONG ALL HOSPITALS (NON-ADVOCATE INCLUDED) AND EMS RESPONDERS, AND DIRECTION OF COUNTY-WIDE EMERGENCY MEDICAL SERVICES IN RESPONSE TO COMMUNITY-BASED, MASS INJURY/CASUALTY DISASTERS. ALLIED HEALTH EDUCATION. ADVOCATE IS COMMITTED TO TEACHING STUDENTS IN A BROAD RANGE OF SPECIALTIES. THESE STUDENTS COME FROM LOCAL UNIVERSITIES AND COLLEGES WITH WHOM ADVOCATE HAS CONTRACTED TO PROVIDE THESE SERVICES. STUDENTS ARE PROVIDED A CLINICAL ENVIRONMENT IN WHICH TO LEARN IN OVER TWENTY HEALTH CARE DISCIPLINES/FIELDS, INCLUDING, BUT NOT LIMITED TO: PHARMACEUTICAL; CARDIO DIAGNOSTICS; CARDIAC REHABILITATION; RADIOLOGY, NUCLEAR MEDICINE, MRI AND X-RAY; RADIATION THERAPY; EXERCISE PHYSIOLOGY; PHYSICAL, OCCUPATIONAL, SPEECH AND RECREATIONAL THERAPY; PSYCHIATRY; BEHAVIORAL HEALTH; RESPIRATORY; AUDIOLOGY; PATHOLOGY; PODIATRY; PHLEBOTOMY; NUTRITION/DIETARY; AND DENTISTRY (DENTISTRY IS ONLY AVAILABLE THROUGH ADVOCATE ILLINOIS MASONIC). CLINICAL PASTORAL EDUCATION. ADVOCATE'S SPIRITUAL LEADERS OVERSEE A NATIONALLY ACCREDITED CLINICAL PASTORAL EDUCATION (CPE) PROGRAM WITH OVERSIGHT BY THE SYSTEM DIRECTOR OF CLINICAL PASTORAL EDUCATION. SUPERVISING OVER 200 STUDENT UNITS EACH YEAR, THE PROGRAM IS ONE OF THE LARGEST IN THE COUNTRY, PROVIDING OPPORTUNITIES FOR SEMINARY STUDENTS AND LOCAL HEALTH LEADERS TO GROW AND DEVELOP SPIRITUAL CARE MINISTRY SKILLS. OTHER EDUCATION. MULTIPLE ADVOCATE SYSTEM AND HOSPITAL DEPARTMENTS ALSO PROVIDE LEARNING ENVIRONMENTS FOR UNDERGRADUATE AND GRADUATE STUDENTS IN PUBLIC HEALTH, HEALTH ADMINISTRATION AND HEALTH INFORMATION MANAGEMENT. IN ADDITION, SEVERAL ADVOCATE HOSPITALS PROVIDE EXPERIENTIAL LEARNING TO AREA HIGH SCHOOL STUDENTS THAT ARE ON AN EDUCATIONAL TRACK TO A HEALTH CARE CAREER. THESE STUDENTS RECEIVE CREDIT TOWARDS GRADUATION IN ADDITION TO HELPING THEM DECIDE WHICH AREA OF HEALTH CARE THEY WISH TO PURSUE. FOR EXAMPLE, IN ORDER TO GIVE CHICAGO SOUTHSIDE STUDENTS BETTER JOB OPPORTUNITIES, ADVOCATE TRINITY WORKS WITH STUDENTS FROM CHICAGO VOCATIONAL CAREER ACADEMY, AND SOUTH SHORE AND JULIAN HIGH SCHOOLS, ROTATING STUDENTS IN THE HOSPITAL'S UNITS TO LEARN MARKETABLE JOB SKILLS.CONCLUSIONADVOCATE'S LEADERSHIP RECOGNIZES THAT COMMUNITY HEALTH AND COMMUNITY BENEFIT ARE BY DESIGN AN ELEMENT WITHIN ITS STRUCTURE AND ITS STRATEGIC DIRECTION. ADVOCATE HEALTH CARE, THEREFORE, IS COMMITTED TO CONTINUING ITS SUPPORT OF SYSTEM AND SITE PROGRAMS AND ACTIVITIES THAT SUPPORT ADVOCATE'S MISSION TO SERVE THE HEALTH NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A WHOLISTIC PHILOSOPHY ROOTED IN THE FUNDAMENTAL UNDERSTANDING OF HUMAN BEINGS AS CREATED IN THE IMAGE OF GOD.
PART VI, LINE 7, REPORTS FILED WITH STATES	IL

Schedule H (Form 990) 2018

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
ADVOCATE SHERMAN HOSPITAL

Employer identification number
36-2167920

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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" on 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 noncash assistance	(h) Purpose of grant or assistance
(1) ALIGNMENT COLLABORATIVE FOR EDUCATION 1750 GRANDSTAND PLACE SUITE 5 ELGIN,IL60123	47-4377813	501(C)(3)	8,500				COMMUNITY SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

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) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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

Schedule I (Form 990) 2018

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2018

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 on 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 on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1AZMEY MATARIEH DIRECTOR	(i) (ii)	0 ------------- 500,000	0 ------------- 95,855	0 ------------- -1,301	0 ------------- 22,417	0 ------------- 3,799	0 ------------- 620,770	0 ------------- 0
2KAREN LAMBERT DIRECTOR	(i) (ii)	0 ------------- 590,226	0 ------------- 564,123	0 ------------- 278,389	0 ------------- 25,167	0 ------------- 39,308	0 ------------- 1,497,213	0 ------------- 0
3LINDA DEERING DEAN PRESIDENT, DIRECTOR	(i) (ii)	493,422 ------------- 0	647,381 ------------- 0	287,288 ------------- 0	22,417 ------------- 0	6,327 ------------- 0	1,456,835 ------------- 0	0 ------------- 0
4NICOLE PAULK DIRECTOR	(i) (ii)	0 ------------- 315,132	0 ------------- 64,542	0 ------------- 9,209	0 ------------- 22,417	0 ------------- 33,220	0 ------------- 444,520	0 ------------- 0
5RACHEL BAER MD DIRECTOR	(i) (ii)	0 ------------- 361,315	0 ------------- 20,830	0 ------------- -8,283	0 ------------- 22,417	0 ------------- 31,396	0 ------------- 427,675	0 ------------- 0
6SUSAN CAMPBELL DIRECTOR	(i) (ii)	0 ------------- 202,493	0 ------------- 803,366	0 ------------- 1,058,351	0 ------------- 67,400	0 ------------- 16,108	0 ------------- 2,147,718	0 ------------- 0
7WILLIAM P SANTULLI DIRECTOR	(i) (ii)	0 ------------- 1,073,245	0 ------------- 2,114,312	0 ------------- 777,832	0 ------------- 25,167	0 ------------- 25,003	0 ------------- 4,015,559	0 ------------- 0
8BRUCE HYMAN VP, MEDICAL MANAGEMENT	(i) (ii)	374,786 ------------- 0	93,792 ------------- 0	26,839 ------------- 0	25,167 ------------- 0	18,930 ------------- 0	539,514 ------------- 0	0 ------------- 0
9CHERI GOLL VP, CHIEF NURSING EXECUTIVE	(i) (ii)	238,749 ------------- 0	42,822 ------------- 0	5,097 ------------- 0	22,044 ------------- 0	26,127 ------------- 0	334,839 ------------- 0	0 ------------- 0
10DAMON HAVILL VP, STRATEGIC PLAN & BUS DEV	(i) (ii)	0 ------------- 266,727	0 ------------- 55,777	0 ------------- 13,925	0 ------------- 25,167	0 ------------- 24,384	0 ------------- 385,980	0 ------------- 0
11DOMINIC J NAKIS TREASURER	(i) (ii)	0 ------------- 786,099	0 ------------- 1,330,444	0 ------------- 519,433	0 ------------- 25,167	0 ------------- 28,698	0 ------------- 2,689,841	0 ------------- 0
12EARL J BARNES II SECRETARY	(i) (ii)	0 ------------- 222,375	0 ------------- 921,732	0 ------------- 816,319	0 ------------- 116,930	0 ------------- 35,611	0 ------------- 2,112,967	0 ------------- 0
13FREDERICK RAJAN VP, MISSION & SPIRITUAL CARE	(i) (ii)	0 ------------- 95,466	0 ------------- 17,969	0 ------------- 7,190	0 ------------- 13,321	0 ------------- 73,195	0 ------------- 207,141	0 ------------- 0
14JAMES DOHENY ASSISTANT TREASURER	(i) (ii)	0 ------------- 376,465	0 ------------- 105,297	0 ------------- 36,894	0 ------------- 25,167	0 ------------- 28,750	0 ------------- 572,573	0 ------------- 0
15JO AMICK VP, DEVELOPMENT	(i) (ii)	0 ------------- 173,803	0 ------------- 17,477	0 ------------- 2,092	0 ------------- 17,432	0 ------------- 6,289	0 ------------- 217,093	0 ------------- 0
16KATE KOVICH VP, PATIENT SAFETY	(i) (ii)	0 ------------- 221,001	0 ------------- 39,940	0 ------------- 14,931	0 ------------- 24,479	0 ------------- 15,710	0 ------------- 316,061	0 ------------- 0
17KEVIN FITCH VP, FINANCE	(i) (ii)	228,212 ------------- 0	39,464 ------------- 0	7,186 ------------- 0	23,885 ------------- 0	19,386 ------------- 0	318,133 ------------- 0	0 ------------- 0
18MARY KANE VP, NURSING INFORMATICS	(i) (ii)	0 ------------- 332,225	0 ------------- 61,777	0 ------------- 14,178	0 ------------- 11,203	0 ------------- 22,388	0 ------------- 441,771	0 ------------- 0
19MARY MARTINI VP, OPERATIONS	(i) (ii)	231,137 ------------- 0	37,511 ------------- 0	-399 ------------- 0	22,283 ------------- 0	20,846 ------------- 0	311,378 ------------- 0	0 ------------- 0
20MELISSA O'NEIL VP, HUMAN RESOURCES	(i) (ii)	0 ------------- 213,400	0 ------------- 45,550	0 ------------- 10,934	0 ------------- 23,469	0 ------------- 9,523	0 ------------- 302,876	0 ------------- 0
21MICHAEL KERNS SECRETARY	(i) (ii)	0 ------------- 324,582	0 ------------- 70,419	0 ------------- 25,968	0 ------------- 25,167	0 ------------- 35,728	0 ------------- 481,864	0 ------------- 0
22PEG STONE VP, PROFESSIONAL ARRANGEMENTS	(i) (ii)	0 ------------- 206,890	0 ------------- 37,770	0 ------------- 20,028	0 ------------- 16,433	0 ------------- 8,556	0 ------------- 289,677	0 ------------- 0
23JOAN KANUTE DIRECTORE SERVICE EXCELLENCE	(i) (ii)	157,653 ------------- 0	17,542 ------------- 0	2,078 ------------- 0	13,726 ------------- 0	11,575 ------------- 0	202,574 ------------- 0	0 ------------- 0
24KARA AALFS DIRECTOR DV SERVICES	(i) (ii)	180,218 ------------- 0	18,685 ------------- 0	2,145 ------------- 0	12,514 ------------- 0	1,046 ------------- 0	214,608 ------------- 0	0 ------------- 0
25MICHAEL ROSENBERG DIRECTOR CLINICAL DECISION	(i) (ii)	312,000 ------------- 0	0 ------------- 0	5,701 ------------- 0	22,417 ------------- 0	617 ------------- 0	340,735 ------------- 0	0 ------------- 0
26PATRICK UPLEGGER DIRECTOR PHARMACY	(i) (ii)	179,713 ------------- 0	23,482 ------------- 0	-406 ------------- 0	16,259 ------------- 0	13,035 ------------- 0	232,083 ------------- 0	0 ------------- 0
27PAUL DRAHOS PHARMACY MANAGER	(i) (ii)	162,395 ------------- 0	13,807 ------------- 0	-384 ------------- 0	13,609 ------------- 0	12,688 ------------- 0	202,115 ------------- 0	0 ------------- 0
28GAIL D HASBROUCK FORMER SECRETARY	(i) (ii)	0 ------------- 0	0 ------------- 420,963	0 ------------- 10,000	0 ------------- 0	0 ------------- 46	0 ------------- 431,009	0 ------------- 0
29TRENT GORDON FORMER OFFICER	(i) (ii)	0 ------------- 203,110	0 ------------- 33,769	0 ------------- -3,179	0 ------------- 21,296	0 ------------- 34,046	0 ------------- 289,042	0 ------------- 0

Schedule J (Form 990) 2018

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
SCHEDULE J, PART I, LINE 1A	FREDERICK E. RAJAN RECEIVED A HOUSING ALLOWANCE IN THE AMOUNT OF $60,000.
SCHEDULE J, PART I, LINE 4A	EARL J. BARNES II, FORMER ASSISTANT SECRETARY, RECEIVED A SERVERANCE PAYMENT IN THE AMOUNT OF $116,346 AND A LUMP SUM SEVERANCE PAYMENT OF $507,308. SUSAN CAMPBELL, FORMER DIRECTOR, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $95,192 AND A LUMP SUM SEVERANCE PAYMENT OF $273,658. JOY M. JENSEN, FORMER DIRECTOR, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $10,976. THESE PAYMENTS HAVE ALL BEEN REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III).
SCHEDULE J, PART I, LINE 4B	ADVOCATE PROVIDES A TARGET REPLACEMENT SENIOR EXECUTIVE RETIREMENT PLAN. THE CONTRIBUTIONS TO THIS PLAN ARE VESTED AND TAXABLE AFTER FIVE YEARS OF SERVICE. THE FOLLOWING EMPLOYEES ARE VESTED IN THE PLAN AND THEREFORE THE CONTRIBUTIONS ARE REPORTED AS COMPENSATION ON THE W-2: EARL J. BARNES II $161,281, SUSAN CAMPBELL 524,114, LINDA J. DEERING DEAN $159,139, KAREN A. LAMBERT $152,769, DOMINIC NAKIS $281,176, AND WILLIAM P. SANTULLI $417,996. THE FOLLOWING EMPLOYEES HAVE NOT YET VESTED AND THEREFORE THE CONTRIBUTIONS ARE REPORTED AS DEFERRED COMPENSATION: EARL J. BARNES II $108,830 AND SUSAN CAMPBELL, $36,733.
SCHEDULE J, PART I, LINE 7	INCENTIVE PAYMENTS ARE BASED UPON A FORMULA. THE AMOUNTS ARE CALCULATED AFTER CERTAIN PERFORMANCE AND OPERATING GOALS ARE ACHIEVED. THE COMPENSATION COMMITTEE CAN EXERCISE DISCRETION OVER WHETHER INCENTIVE COMPENSATION IS PAID OUT ANNUALLY.

Schedule J (Form 990) 2018

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2018

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) KELLY DEERING	FAMILY MEMBER - LINDA DEERING	68,860	EMPLOYMENT		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Return Reference	Explanation
FORM 990, PART III, LINE 4C - CONTINUED	AS INDICATED EARLIER IN THIS DOCUMENT IN PART III, LINE 4A, ADVOCATE SHERMAN OFFERS A VERY GENEROUS CHARITY CARE PROGRAM. OTHER PROGRAMS AND SERVICES EXIST, HOWEVER, THAT HAVE BEEN DEVELOPED BASED ON KNOWLEDGE OF NEEDS SPECIFIC TO THE COMMUNITY THAT ADVOCATE SHERMAN SERVES. BREAST CANCER PREVENTION FOCUSED ON LOW-INCOME HISPANIC WOMEN TO DECREASE THE ELEVATED INCIDENCE OF BREAST CANCER IN ELGIN'S LOW-INCOME HISPANIC FEMALE POPULATION, THE HOSPITAL HAS PARTNERED WITH THE WOMEN'S ORGANIZATION FOR WELLNESS (WOW) TO PROVIDE BREAST CANCER SCREENINGS, PREVENTION EDUCATION AND OUTREACH. THE HOSPITAL'S AUXILIARY HAS BEEN PROVIDING ANNUAL FUNDING TO WOW TO PAY FOR WOMEN TO RECEIVE FREE MAMMOGRAMS. WOW DISTRIBUTES A VOUCHER TO THE PATIENT AT HEALTH EVENTS, PHYSICIAN OFFICES, OR THROUGH THE GREATER ELGIN FAMILY CARE CENTER OR VNA HEALTH CARE, BOTH FEDERALLY QUALIFIED HEALTH CENTERS. IN 2018, WOW PROCESSED 135 SCREENING MAMMOGRAMS AND 2 DIAGNOSTIC MAMMOGRAMS AND 4 ULTRASOUNDS, FOR A TOTAL OF 141 MAMMOGRAMS COMPLETED. THIS IS AN ALMOST SIX PERCENT INCREASE FROM 2017. COMMUNITY-BASED HISPANIC COUNCIL DIABETES IS ONE OF THE COSTLIEST AND HIGHLY PREVALENT CHRONIC DISEASES IN THE UNITED STATES-AFFECTING NEARLY 20 PERCENT OF LATINO MEN AND WOMEN. THIS IS EVIDENT IN THE HIGH RATES OF ER AND HOSPITALIZATIONS FOR DIABETES-RELATED COMPLICATIONS IN ADVOCATE SHERMAN'S SERVICE AREA. TO COMBAT THIS EPIDEMIC, ADVOCATE SHERMAN HAS ESTABLISHED A CROSS-SECTOR, COMMUNITY-BASED HISPANIC COUNCIL TO ADVISE ON THE DEVELOPMENT OF A DIABETES PROGRAM FOR THE LATINO COMMUNITY. IN 2018, THE PROGRAM SCREENED 370 INDIVIDUALS. EIGHTY-SIX PERCENT OF THOSE SCREENED HAD A NORMAL BLOOD GLUCOSE LEVEL, EIGHT PERCENT PRESENTED WITH PRE-DIABETES GLUCOSE LEVELS AND SIX PERCENT PRESENTED WITH GLUCOSE LEVELS THAT MAY INDICATE DIABETES. THIRTY INDIVIDUALS WERE REFERRED TO A PRIMARY CARE PROVIDER FOR ONGOING CARE. IN ADDITION, THERE WERE 167 PHYSICIAN RFERRALS MADE FOR DIABETES FOLLOW-UP APPOINTMENTS AT THE ADVOCATE SHERMAN DIABETES CENTER. GOAL C: POSITIVELY AFFECT THE HEALTH STATUS AND QUALITY OF LIFE OF INDIVIDUALS AND POPULATIONS IN COMMUNITIES SERVED BY ADVOCATE SHERMAN THROUGH EVIDENCE-BASED PROGRAMS, ADDRESSING IDENTIFIED NEEDS AND A COMMITMENT TO HEALTH EQUITY. MOBILE INTEGRATED HEALTH (MIH) TO IMPROVE THE CARE COORDINATION AND REDUCE READMISSIONS OF THE CHRONICALLY ILL PATIENTS AT ADVOCATE SHERMAN AS THEY TRANSITION FROM HOSPITAL TO HOME, A HOSPITAL-BASED MIH SYSTEM HAS BEEN CREATED. NATIONAL DATA SHOWS THAT MOBILE CARE HELPS PREVENT HOSPITAL READMISSIONS, ESPECIALLY IN AREAS WHERE PEOPLE HAVE LIMITED ACCESS TO HEALTH CARE AND TRADITIONAL HOME HEALTH SERVICES ARE RESTRICTED DUE TO A VARIETY OF REASONS. THE MIH PARTNERSHIP BETWEEN A PHYSICIAN AND AN ON-STAFF PARAMEDIC, ALLOWS OUTREACH TO PATIENTS IN THEIR HOMES WHEN THE PATIENT IS UNABLE TO MAKE A SCHEDULED CLINIC VISIT OR WHEN SYMPTOMS/CONDITIONS ARISE THAT WOULD BENEFIT FROM AN IN-PERSON HOME ASSESSMENT WITH COMMUNICATION BACK TO THE PHYSICIAN TO DETERMINE THE PLAN OF CARE. ADDITIONALLY, IN 2018, THE STATE OF ILLINOIS APPROVED THE ADDITION OF PROVIDING IV MEDICATIONS FOR HEART FAILURE PATIENTS THAT HAVE FLUID RETENTION. ANOTHER ADDITION WAS THE ABILITY TO SEE CANCER CARE PATIENTS FOR SYMPTOM MANAGEMENT. IN 2018, THERE WERE 196 PATIENTS ENROLLED IN THE PROGRAM (60 HEART FAILURE, 69 CHRONIC OBSTRUCTIVE PULMONARY DISEASE-COPD, 46 DIABETES, SIX ASTHMA, FIVE POST MI, FIVE PNEUMONIA AND FIVE CANCER CARE). OF THE 196 PATIENTS ENROLLED, THERE WERE ONLY EIGHT PATIENTS THAT WERE READMITTED TO THE HOSPITAL WITHIN 30 DAYS. IN 2018, THERE WAS A REDUCTION OF FIFTY-SEVEN PERCENT IN HOSPITAL ADMISSIONS AND A REDUCTION OF TWENTY-NINE PERCENT IN EMERGENCY DEPARTMENT VISITS FOR THESE ENROLLED MOBILE INTEGRATED HEALTH PATIENTS, WITH A TOTAL OF $2,730,234 IN ESTIMATED COST AVOIDANCE. OBESITY AND OBESITY-RELATED CHRONIC DISEASES IN 2018, ADVOCATE SHERMAN DEVELOPED A PROCESS TO PROVIDE EXCESS PRODUCE FROM THE ON-SITE COMMUNITY GARDEN TO HOSPITAL DIABETES CENTER PATIENTS FOR THOSE PATIENTS WHO ARE IDENTIFIED AS FOOD INSECURE BASED ON THE HUNGER VITAL SIGN QUESTIONNAIRE SCREENING. DISTRIBUTION OF FRESH PRODUCE FROM THE GARDEN TO DIABETES CENTER PATIENTS BEGAN IN MARCH 2018. ADDITIONALLY, THE HOSPITAL INITIATED A NEW PARTNERSHIP WITH THE ELGIN COMMUNITY COLLEGE (ECC) STUDENT FOOD PANTRY. ECC STUDENTS WERE ASSIGNED GARDEN PLOTS AT THE ADVOCATE SHERMAN COMMUNITY GARDEN AND THE PRODUCE THAT WAS HARVESTED WAS PROVIDED TO THE STUDENT FOOD PANTRY. IN THE 2018 GARDEN SEASON, 376 POUNDS OF PRODUCE WAS PROVIDED TO THE PATIENTS IN THE DIABETES CENTER AS WELL AS TO THE ECC STUDENT FOOD PANTRY. AS IDENTIFIED IN THE ADVOCATE SHERMAN CHNA, TWENTY-TWO PERCENT OF THE POPULATION HAS LOW FOOD ACCESS IN KANE COUNTY. THIS IS THE PERCENT OF THE POPULATION LIVING IN DESIGNATED FOOD DESERTS. IN 2018, ADVOCATE SHERMAN BEGAN DEVELOPING A FOOD INSECURITY (FI) SCREENING INITIATIVE. USING THE HUNGER VITAL SIGN SCREENING TOOL, INDIVIDUALS IN THE DIABETES CENTER AND ENROLLED PARTICIPANTS OF THE MOBILE INTEGRATED HEALTH PROGRAM WERE SCREENED AND REFERRED TO AREA FOOD PANTRIES, CONGREGATE MEAL PROGRAMS OR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP). IN 2018, THE HOSPITAL PUBLISHED AND UPDATED A COMPREHENSIVE FOOD AND NUTRITION RESOURCE GUIDE CONTAINING AREA RESOURCES IN BOTH ENGLISH AND SPANISH. IN MARCH 2018, SCREENING BEGAN FOR THESE PATIENTS, WITH 174 INDIVIDUALS SCREENED, OF WHICH 26% SCREENED AS BEING FOOD INSECURE. BABY-FRIENDLY HOSPITAL ADVOCATE SHERMAN ACHIEVED RECOGNITION AS A BABY FRIENDLY HOSPITAL IN 2016 AND MAINTAINS THIS RECOGNITION IN 2018. THE CORE COMPONENTS OF THE BABY-FRIENDLY HOSPITAL INITIATIVE (BFHI) ARE THE UNICEF/WHO TEN STEPS TO SUCCESSFUL BREASTFEEDING, WHICH ARE DESIGNED TO FACILITATE THE ROLE OF THE BIRTHING FACILITY IN PROVIDING WOMEN THE INFORMATION, CARE PRACTICES AND OPPORTUNITY TO BREASTFEED, REGARDLESS OF THE METHOD OF BIRTH. NATIONAL HEALTHY PEOPLE 2020 OBJECTIVES TO INCREASE AND EXTEND BREASTFEEDING ARE ALIGNED WITH THIS INITIATIVE. GOAL D: EXAMINE AND ADDRESS IN PARTNERSHIP WITH OTHERS THE ROOT CAUSES OF HEALTH INEQUITIES IN ADVOCATE SHERMAN COMMUNITIES INCLUDING, BUT NOT LIMITED TO, UNEMPLOYMENT, LACK OF EDUCATION, POVERTY, ENVIRONMENTAL INJUSTICE AND RACISM. PROMOTING READING AND LITERACY ADVOCATE SHERMAN HAS BEEN WORKING TO IMPROVE LITERACY IN THE COMMUNITY. LOW LITERACY IS ASSOCIATED WITH POOR HEALTH, QUALITY OF LIFE AND ECONOMIC OPPORTUNITY. TO SET ELGIN FAMILIES ON COURSE FOR A HEALTHY LIFE, ADVOCATE SHERMAN HAS PARTNERED WITH THE GAIL BORDEN PUBLIC LIBRARY, UNITED WAY OF ELGIN AND SCHOOL DISTRICT U-46 FOR THE "WELCOME BABY" INITIATIVE, WHICH PROMOTES LITERACY AND EARLY READING OPPORTUNITIES. THROUGH THIS INITIATIVE, ALL NEWBORNS LIVING WITHIN THE GAIL BORDEN DISTRICT RECEIVE A LIBRARY CARD AND PARENTS ARE INVITED TO A "BABY'S FIRST LIBRARY VISIT," WHERE THEY CAN CHECK OUT "BABY BUNDLES" BOOKS AND PARTICIPATE IN LITERACY CLASSES IN ENGLISH OR SPANISH. IN 2018, 87 BABIES RECEIVED LIBRARY CARDS. FAMILIES ARE ALSO ENROLLED IN UNITED WAY OF ELGIN'S DOLLY PARTON IMAGINATION LIBRARY PROGRAM, WHICH SENDS A BOOK A MONTH TO CHILDREN FROM BIRTH THROUGH THE AGE FIVE. GOAL E: LEVERAGE RESOURCES AND MAXIMIZE COMMUNITY ENGAGEMENT BY BUILDING AND STRENGTHENING COMMUNITY PARTNERSHIPS WITH HEALTH DEPARTMENTS AND OTHER DIVERSE COMMUNITY ORGANIZATIONS. COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVES ADVOCATE SHERMAN HAS BEEN WORKING COLLABORATIVELY WITH THE MCHENRY COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE KANE COUNTY HEALTH DEPARTMENT TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. PARTICIPATING IN THE COUNTY-WIDE HEALTH NEEDS ASSESSMENTS LED BY BOTH HEALTH DEPARTMENTS, COMMUNITY HEALTH TEAM MEMBERS HAVE PLAYED IMPORTANT ROLES ON THE EXECUTIVE LEADERSHIP OVERSIGHT COMMITTEES AND SUB-COMMITTEES OF THESE INITIATIVES SINCE 2006. OTHER HOSPITAL TEAM MEMBERS SERVE IN KEY LEADERSHIP ROLES IN THE OVERSIGHT COMMITTEES OF BOTH COUNTIES AS WELL AS SERVING ON MANY SUBCOMMITTEES OF PUBLIC AND PRIVATE NON-PROFIT ORGANIZATIONS WITHIN THE COMMUNITY. MISSION & SPIRITUAL CARE PARTNERSHIPS ADVOCATE SHERMAN'S MISSION AND SPIRITUAL CARE OFFICE DEVELOPS PARTNERSHIPS WITH COMMUNITIES AND CONGREGATIONS TO HELP ADDRESS LOCAL HEALTH CARE NEEDS AND PROVIDES HEALTH EDUCATION ON TOPICS SUCH AS DIABETES AND MENTAL HEALTH. THE HOSPITAL'S CLINICAL CHAPLAINS ALSO PROVIDE SUPPORT AND SERVICES 24 HOURS EACH DAY TO THE INDIVIDUALS AND FAMILIES THAT ADVOCATE SHERMAN SERVES. GOAL F: PROMOTE ACCOUNTABILITY FOR SYSTEM AND SITE ALIGNMENT BY INCREASING PROGRAM COORDINATION AND DEVELOPING STRONG GOVERNANCE RELATIONSHIPS.
FORM 990, PART III, LINE 4C - CONTINUED	STRENGTHENED GOVERNANCE RELATIONSHIPS ADVOCATE SHERMAN'S COMMUNITY HEALTH PROGRAMMING IS OVERSEEN BY A COMMUNITY HEALTH COUNCIL MADE UP OF DIVERSE PARTNERS FROM THE COMMUNITY. THE COUNCIL INCLUDES REPRESENTATIVES FROM THE KANE COUNTY HEALTH DEPARTMENT, THE MCHENRY COUNTY HEALTH DEPARTMENT, LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, THE UNITED WAY, THE AMERICAN CANCER SOCIETY, AREA SCHOOL DISTRICTS, AND PHYSICIANS AND HOSPITAL LEADERSHIP. THE COUNCIL MEETS QUARTERLY TO COLLABORATE ON EXISTING AND FUTURE HEALTH PROGRAMMING AT THE HOSPITAL. THE COUNCIL ALSO OVERSEES THE ONGOING COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS (CHNA), WHICH INVOLVES CONTINUOUS EXAMINATION OF HOSPITAL AND COMMUNITY DATA AND SURVEYS TO IDENTIFY AND ANALYZE COMMUNITY HEALTH NEEDS. AS WITH THE OTHER ADVOCATE ILLINOIS HOSPITALS IN THE ADVOCATE AURORA HEALTH SYSTEM, THE ADVOCATE SHERMAN CHNA REPORT, AND ITS COMMUNITY HEALTH IMPLEMENTATION PLAN, IS ENDORSED BY ITS GOVERNING COUNCIL. HOSPITAL PLANS ARE ALSO SHARED AND ENDORSED EACH YEAR BY THE HOSPITAL'S SENIOR LEADERSHIP TEAM AND ARE SHARED PERIODICALLY WITH THE SYSTEM LEVEL EXECUTIVE MANAGEMENT TEAM AND WITH ADVOCATE HEALTH CARE'S MISSION AND SPIRITUAL CARE COMMITTEE OF THE BOARD. ALIGNMENT OF SITE AND SYSTEM COMMUNITY HEALTH STRATEGY BEGINNING IN 2016, ADVOCATE SHERMAN COMMUNITY HEALTH STAFF BEGAN REPORTING TO ADVOCATE'S VICE PRESIDENT OF COMMUNITY HEALTH AND FAITH OUTREACH THROUGH THE NEWLY CREATED COMMUNITY HEALTH DEPARTMENT. AS IS THE CASE EACH YEAR, COMMUNITY HEALTH STAFF FROM ALL ADVOCATE HOSPITALS MEET MONTHLY TO PLAN COMMUNITY HEALTH STRATEGIES. THE FOCUS OF THE NEW DEPARTMENT AND THESE MEETINGS WAS TO COMPLETE AND POST THE HOSPITAL CHNA'S IN 2016, INCLUDING GAINING APPROVAL OF STRATEGIES TO ADDRESS IDENTIFIED HEALTH PRIORITY NEEDS MOVING FORWARD. IN 2017, ADVOCATE SHERMAN DEVELOPED AN IMPLEMENTATION PLAN THAT INCLUDES STRATEGIES TO ADDRESS DIABETES AND OBESITY. PROGRAMMING BEGAN IN 2017 AND WILL CONTINUE THROUGH 2019. GOAL G: PROMOTE THE TRAINING OF FUTURE HEALTH PROFESSIONALS. REGION 9 EMERGENCY MEDICAL SERVICES THE GREATER ELGIN AREA EMS SYSTEM IS OPERATED OUT OF ADVOCATE SHERMAN. ALL NEW PARAMEDICS COMPLETE TRAINING AT ADVOCATE SHERMAN AND ALL EXISTING GREATER ELGIN EMS PERSONNEL COMPLETE THEIR CONTINUING EDUCATION AT THE HOSPITAL. EMS STAFF ARE TRAINED BY A FULL-TIME PARAMEDIC INSTRUCTOR AND A FULL-TIME EMS CONTINUING EDUCATION COORDINATOR WHO ARE EMPLOYED BY THE HOSPITAL. ADVOCATE SHERMAN ALSO COLLABORATES WITH EMERGENCY MEDICAL SERVICE PROVIDERS TO SHARE BEST PRACTICE INFORMATION THROUGHOUT ILLINOIS DEPARTMENT OF PUBLIC HEALTH (IDPH) DESIGNATED REGION 9. TRAINING OF NURSES AND OTHER MEDICAL PROFESSIONALS IN ADDTION TO ADVOCATE SHERMAN STAFF PROVIDING TRAINING TO NURSING STDENTS FROM CHAMBERLAIN COMMUNITY, ELGIN COMMUNITY AND MCHENRY COUNTY COMMUNITY COLLEGES, AND AURORA AND NORTHERN ILLINOIS UNIVERSITIES, HOSPITAL STAFF ALSO TRAIN STUDENTS IN MANY OTHER CLINICAL AREAS OF THE HOSPITAL. THESE OTHER STUDENTS, FROM THE SAME LEARNING INSTITUTIONS, ARE WORKING TOWARD CAREERS AS MEDICAL ASSISTANTS, PHLEBOTOMISTS, SURGICAL TECHNICIANS AND PHYSICAL THERAPISTS. IN 2018, ADVOCATE SHERMAN DEVOTED OVER $2.6 MILLION IN RESOURCES TO STUDENT EDUCATION.
FORM 990, PART VI, SECTION A, LINE 2	FAMILY RELATIONSHIP BETWEEN INTERESTED PERSON KELLY DEERING AND ORGANIZATION: FAMILY MEMBER LINDA DEERING
FORM 990, PART VI, SECTION A, LINE 6	CORPORATE MEMBER THE BYLAWS PROVIDE FOR ADVOCATE HEALTH CARE NETWORK AS THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	POWER TO ELECT OTHER MEMBERS ADVOCATE SHERMAN HOSPITAL HAS A SOLE CORPORATE MEMBER, ADVOCATE HEALTH CARE NETWORK, WHO ELECTS ITS DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	GOVERNANCE DECISIONS THE FOLLOWING REQUIRE A RECOMMENDATION INITIATED BY THE BOARD OF DIRECTORS AND THE SUBSEQUENT APPROVAL BY THE CORPORATE MEMBER, ADVOCATE HEALTH CARE NETWORK, TO BE VALID: A) APPOINTMENT OF THE MEMBERS OF THE BOARD OR ITS AFFILIATES, OTHER THAN THE EX OFFICIO DIRECTORS; B) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION OR ITS AFFILIATES; C) AMENDMENT OF THE BYLAWS OF THE CORPORATION OR ITS AFFILIATES; D) IMPLEMENTATION OF ANY CHANGE TO THE STRUCTURE OR OPERATION OF THE CORPORATION OR ITS AFFILIATES THAT COULD AFFECT THE CORPORATION'S OR ANY AFFILIATE'S TAX-EXEMPT STATUS; E) ADOPTION OF A STRATEGIC PLAN; F) APPROVAL OF THE CORPORATION'S OR ANY AFFILIATE'S ANNUAL CAPITAL PLAN; G) APPROVAL OF THE CORPORATION'S OR ANY AFFILIATE'S ANNUAL OPERATING BUDGET; H) TRANSFER OR ENCUMBRANCE OF ANY OF THE CORPORATION'S OR ANY AFFILIATE'S ASSETS BY PURCHASE, SALE, CAPITAL LEASE, MORTGAGE, DISPOSITION OR HYPOTHECATION IN EXCESS OF LIMITS ESTABLISHED BY THE CORPORATE MEMBER'S FINANCIAL APPROVAL POLICY; I) FILING OF A CERTIFICATE OF NEED OR EXEMPTION APPLICATION (OR ANY AMENDMENT THERETO) BY THE CORPORATION OR ANY AFFILIATE; J) DISSOLVING OR WINDING-UP THE CORPORATION, OR AN AFFILIATE, OR ABANDONING AN ENTIRE BUSINESS ENTERPRISE THEREOF; K) FILING ANY ACTION IN BANKRUPTCY OR RECEIVERSHIP REGARDING THE CORPORATION OR ANY AFFILIATE; L) THE SALE OR TRANSFER OF ANY MEMBER INTEREST, STOCK, OR OTHER OWNERSHIP INTEREST IN ANY AFFILIATE OF THE CORPORATION; M) THE MERGER OR CONSOLIDATION OF THE CORPORATION OR ANY AFFILIATE, OR THE FORMATION OF ANY PARTNERSHIP, CO-SPONSORSHIP ARRANGEMENT OR JOINT VENTURE BETWEEN OR AMONG THE CORPORATION OR ANY AFFILIATE AND ANY THIRD PARTY; N) ADOPTION OR AMENDMENT OF ANY POLICY, PROTOCOL OR PROCEDURE THAT IS INCONSISTENT WITH ONE OR MORE OF THE CORPORATE MEMBER'S SYSTEM-WIDE POLICIES, PROTOCOLS OR PROCEDURES OR THE CORPORATE MEMBER'S ARTICLES OF INCORPORATION AND/OR BYLAWS; PROVIDED, HOWEVER, THAT THIS COLLABORATIVE AUTHORITY DOES NOT ABROGATE THE POWER OF THE BOARD TO ADOPT POLICIES, PROTOCOLS AND/OR PROCEDURES FOR WHICH NO SYSTEM-WIDE POLICY, PROTOCOL OR PROCEDURE EXISTS AND THAT ARE RELATED SOLELY TO THE INTERNAL OPERATIONS OF THE CORPORATION AND/OR ANY OF ITS AFFILIATES; AND O) APPOINTMENT OF THE CORPORATION'S OFFICERS IDENTIFIED IN SECTION 6.2 OF THE CORPORATION'S BYLAWS. THE CORPORATE MEMBER MAY TAKE THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OR RECOMMENDATION OF THE BOARD OF DIRECTORS: A) REMOVAL OF ANY OF THE MEMBERS OF THE BOARD "FOR CAUSE" IN ACCORDANCE WITH SECTION 3.15 OF THE CORPORATION'S BYLAWS; B) THE INCURRENCE OR MODIFICATION OF SHORT OR LONG-TERM DEBT AND LEASE OBLIGATIONS; C) APPOINTMENT OR REMOVAL OF THE CORPORATION'S PRESIDENT OR CHIEF FINANCIAL OFFICER ("CFO"); D) ADOPTION OF AN ANNUAL CAPITAL PLAN FOR THE CORPORATION, BUT ONLY AFTER THE CORPORATE MEMBER HAS MADE A GOOD FAITH DETERMINATION THAT THE BOARD HAS NOT RECOMMENDED AN ACCEPTABLE ANNUAL CAPITAL PLAN IN A TIMELY MANNER; AND E) ADOPTION OF AN ANNUAL OPERATING BUDGET FOR THE CORPORATION, BUT ONLY AFTER THE CORPORATE MEMBER HAS MADE A GOOD FAITH DETERMINATION THAT THE BOARD HAS NOT RECOMMENDED AN ACCEPTABLE ANNUAL OPERATING BUDGET IN A TIMELY MANNER.
FORM 990, PART VI, SECTION B, LINE 11B	TAX PREPARATION AND REVIEW PROCESS ADVOCATE'S TAX PREPARATION PROCESS INCLUDES ONGOING CONSULTATION WITH ITS OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE, TAX, AND LEGAL ASSOCIATES AND OTHER MEMBERS OF THE ORGANIZATION'S TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF THE FORM 990. THE FORM 990 IS REVIEWED BY FINANCE MANAGEMENT, THE TAX MANAGER, THE VP OF FINANCE/CORPORATE CONTROLLER, THE CHIEF FINANCIAL OFFICER, AND ADVOCATE'S OUTSIDE TAX CONSULTING FIRM AND TAX LEGAL COUNSEL. PRIOR TO PRESENTING THE FORM 990 TO THE BOARD OF DIRECTOR'S AUDIT COMMITTEE IN NOVEMBER, THE ORGANIZATION'S TEAM--INCLUDING ITS ADVISORS--MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF THE FORM 990. AT THE NOVEMBER AUDIT COMMITTEE MEETING, THE VP OF FINANCE/CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER COORDINATED A REVIEW OF THE FORM 990 WITH COMMITTEE MEMBERS, AS THE AUDIT COMMITTEE IS THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH OVERSIGHT OF AUDIT AND TAX MATTERS. THE VP OF FINANCE/CORPORATE CONTROLLER AND CHIEF FINANCIAL OFFICER RESPONDED TO THE AUDIT COMMITTEE MEMBERS' QUESTIONS AND PROVIDED THE OPPORTUNITY FOR DETAILED DISCUSSION OF THE FORM 990. THE CHANGES IDENTIFIED WERE INCORPORATED, AND THEN A COMPLETE COPY OF THE FINAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE THE FORM 990 WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO VARIOUS PEOPLE, INCLUDING MEMBERS OF ADVOCATE'S BOARD OF DIRECTORS, GOVERNING COUNCILS, OFFICERS, ASSOCIATES, VOLUNTEERS, AND MEDICAL STAFF MEMBERS WITH ADMINISTRATIVE RESPONSIBILITIES. ANNUALLY, THE COMPLIANCE DEPARTMENT SENDS THIS POLICY AND THE ADVOCATE CODE OF BUSINESS CONDUCT TO A RANGE OF INDIVIDUALS WHO MAY BE IN A POSITION TO EXERCISE SUBSTANTIAL INTEREST OVER A PARTICULAR MATTER (DEFINED AS "INTERESTED PERSONS"). THEY ARE REQUIRED TO READ THE POLICIES AND PROVIDE THE COMPLIANCE DEPARTMENT WITH A DISCLOSURE STATEMENT, WHICH IDENTIFIES ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER REVIEWS THE DISCLOSURES AND PROVIDES A REPORT TO THE SYSTEM BUSINESS CONDUCT (COMPLIANCE) COMMITTEE, EXECUTIVE MANAGEMENT TEAM AND THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. THE REPORT IS THEN PROVIDED, IN RELEVANT PART, TO THE SITE CHIEF EXECUTIVE OFFICERS. POTENTIAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE DEPARTMENT ON A CASE BY CASE BASIS. FOLLOW-UP PROCEDURES CONDUCTED ARE UNIQUE TO THE GIVEN CIRCUMSTANCE AND MAY INCLUDE REVIEWING THE POTENTIAL CONFLICT WITH THE INTERESTED PERSON OR INVESTIGATING THE MATTER IN CONSULTATION WITH THE INTERESTED PERSON'S SUPERVISOR AND/OR SITE MANAGEMENT. IN CIRCUMSTANCES WHERE THE INTERESTED PERSON IS NOT A MEMBER OF THE BOARD OR GOVERNING COUNCIL OR A COMMITTEE THEREOF OR A PERSON OF INTEREST, AND IT IS DETERMINED THAT THERE IS AN ACTUAL CONFLICT OF INTEREST, THE SUPERVISOR OF THE INDIVIDUAL IS RESPONSIBLE FOR MAKING AN APPROPRIATE RESPONSE--POTENTIALLY INCLUDING A RESTRICTION OF THE INDIVIDUAL'S JOB DUTIES WITH RESPECT TO THE MATTER GIVING RISE TO THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	EXECUTIVE COMPENSATION EXECUTIVE COMPENSATION AT ADVOCATE HEALTH CARE NETWORK AND SUBSIDIARIES IS BASED ON A BOARD-APPROVED STRATEGY THAT GUIDES THE CORPORATION IN ESTABLISHING COMPENSATION OPPORTUNITIES FOR EXECUTIVES, MANAGERS, PROFESSIONALS AND EMPLOYEES. IN THIS STRATEGY, SPECIFIC MARKET COMPENSATIONS ARE IDENTIFIED AND THE DESIRED LEVEL OF COMPETITIVENESS IN THOSE MARKETS SPECIFIED. IN ADDITION, THE LINKAGE OF EXECUTIVE PAY TO PERFORMANCE IS ARTICULATED AND HOW THIS RELATIONSHIP IS TO BE MAINTAINED IS OUTLINED. TO SUPPORT AND IMPLEMENT THE COMPENSATION STRATEGY, FIVE BASIC ELEMENTS ARE UTILIZED. THESE ELEMENTS ARE: - A SOLID, RELIABLE AND TESTED JOB EVALUATION METHODOLOGY, - ACCURATE, QUALITY AND RELEVANT COMPENSATION SURVEY INFORMATION, - A CONSISTENT ANNUAL PROCESS FOR UPDATING THE COMPENSATION LEVELS, - AN ACTIVE BOARD REVIEW PROCESS THAT ASSURES COMPLIANCE WITH THE COMPENSATION STRATEGY AND ONGOING REVIEW OF THE PERFORMANCE OF THE ORGANIZATION, AND - ACTIVE REVIEW AND AUDITING OF COMPENSATION BY EXTERNAL INDEPENDENT CONSULTANTS.
FORM 990, PART VI, SECTION C, LINE 19	AVAILABILITY OF DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH THE FOLLOWING WEBSITES: - DACBOND.COM (DIGITAL ASSURANCE CERTIFICATION LLC) - EMMA.MSRB.ORG (ELECTRONIC MUNICIPAL MARKET ACCESS) THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:	BOOK/TAX DIFFERENCE RELATED TO JOINT VENTURES -44,996.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ADVOCATE SHERMAN HOSPITAL

Employer identification number

36-2167920

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADVOCATE HEALTH CARE NETWORK 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-2167779	PARENT CORP	IL	501(C)(3)	LINE 12C, III-FI	N/A		No
(2)ADVOCATE CONDELL MEDICAL CENTER 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 26-2525968	HEALTH CARE	IL	501(C)(3)	LINE 3	AHHC		No
(3)ADVOCATE NORTH SIDE HEALTH NETWORK 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3196629	HEALTH CARE	IL	501(C)(3)	LINE 3	AHHC		No
(4)ADVOCATE HEALTH & HOSPITALS CORPORATION 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-2169147	HEALTH CARE	IL	501(C)(3)	LINE 3	AHCN		No
(5)ADVOCATE CHARITABLE FOUNDATION 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3297360	FUNDRAISING	IL	501(C)(3)	LINE 7	AHCN		No
(6)EHS HOME HEALTH CARE SERVICE INC 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-2913108	HOME CARE	IL	501(C)(3)	LINE 10	AHHC		No
(7)MERIDIAN HOSPICE 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3158667	HOSPICE CARE	IL	501(C)(3)	LINE 10	EHSHHCS		No
(8)HISPANO CARE INC 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3606486	HEALTH CARE	IL	501(C)(3)	LINE 10	ANSHN		No
(9)RAVENSWOOD HEALTH CARE FOUNDATION 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3196628	FUNDRAISING	IL	501(C)(3)	LINE 12B, II	N/A		No
(10)MASONIC FAMILY HEALTH FOUNDATION INC 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-4397387	FUNDRAISING	IL	501(C)(3)	LINE 12A, I	MFHS		No
(11)SHERMAN WEST COURT 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 36-3725580	NURSING CARE	IL	501(C)(3)	LINE 10	ASH	Yes
(12)ADVOCATE AURORA HEALTH INC 3075 HIGHLAND PARKWAY STE 600 DOWNERS GROVE,IL60515 82-4184596	SUPPORT ORG	DE	501(C)(3)	LINE 12D, III-O	N/A	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) DMA SURGERY CENTER 2357 SEQUOIA DRIVE AURORA,IL60506 36-3890298	MEDICAL SERVICES	IL	N/A				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ADVOCATE HOME CARE PRODUCTS 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-3315416	HEALTH SERVICES	IL	N/A	C				No
(2) ADVOCATE HEALTH CENTERS INC 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-4217291	MEDICAL SERVICES	IL	N/A	C				No
(3) EVANGELICAL SERVICES CORPORATION 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-3208101	MGMT SERVICES	IL	N/A	C				No
(4) HIGH TECHNOLOGY INC 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-3368224	MEDICAL SERVICES	IL	N/A	C				No
(5) DREYER CLINIC INC 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-2690329	MEDICAL SERVICES	IL	N/A	C				No
(6) BROMENN PHYSICIAN MANAGEMENT CORPORATION 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 37-1313150	MEDICAL SERVICES	IL	N/A	C				No
(7) PARKSIDE CENTER CONDO ASSOCIATION 1775 WEST DEMPSTER STREET PARK RIDGE,IL60068 36-3452486	PROPERTY MGMT	IL	N/A	C				No
(8) THE DELPHI GROUP IV INC 1425 N RANDALL ROAD ELGIN,IL60123 36-4017279	HEALTH COST MGT	IL	N/A	C				No
(9) SHERMAN VENTURES INC 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 36-4292309	HOLDING COMPANY	IL	N/A	C				No
(10) ADVOCATE HPN NFP 3075 HIGHLAND PARKWAY SUITE 600 DOWNERS GROVE,IL60515 81-0893878	HEALTH IMPRV	IL	N/A	C				No
(11) ADVOCATE INSURANCE SPC 878 W BAY RD PO BOX 1159 GRAND CAYMAN KY1-1102 CJ 98-0422925	INSURANCE	CJ	N/A	C				No
(12) ADVOCATE HEALTH PARTNERS 1701 WEST GOLF ROAD ROLLING MEADOWS,IL60008 36-4032117	HEALTH CARE MGT	IL	N/A	C				No
(13) ADVOCATE PHYSICIAN PARTNERS ACCTBLE CARE 1701 WEST GOLF ROAD ROLLING MEADOWS,IL60008 45-5498384	HEALTH CARE MGT	IL	N/A	C				No
(14) ADVOCATE PHYSICIAN PTNRS RISK PURC GROUP 1701 WEST GOLF ROAD ROLLING MEADOWS,IL60008 38-3914173	GROUP MALPRACTICE	IL	N/A	C				No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

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

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

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

Yes

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

Yes

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ADVOCATE SHERMAN WEST COURT	A	71,250	COST
(2) ADVOCATE CHARITABLE FOUNDATION	C	344,570	COST
(3) ADVOCATE SHERMAN WEST COURT	Q	60,706	COST
(4) ADVOCATE HEALTH CARE NETWORK	D	6,425,000	COST
(5) ADVOCATE HEALTH CARE NETWORK	R	3,318,454	COST

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SERVE HEALTH NEEDS OF COMMUNITIES THROUGH WHOLISTIC PHILOSOPHY ROOTED IN FUNDAMENTAL UNDERSTANDING OF HUMANS AS CREATED IN THE IMAGE OF GOD.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	2,127
6	Total number of volunteers (estimate if necessary) .............	6	453
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	406,704
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	308,004

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,396,438	1,119,961
9	Program service revenue (Part VIII, line 2g) .........	428,306,885	461,943,124
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,846,968	5,943,301
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,024,472	1,344,055
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	440,574,763	470,350,441
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	95,887	129,058
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	2,753,287
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	126,483,701	127,780,428
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	289,509,268	319,937,953
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	416,088,856	450,600,726
19	Revenue less expenses. Subtract line 18 from line 12.......	24,485,907	19,749,715
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	520,433,518	521,356,283
21	Total liabilities (Part X, line 26).............	327,916,556	311,748,973
22	Net assets or fund balances. Subtract line 21 from line 20.....	192,516,962	209,607,310

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 378,785,830 including grants of $ 129,058 ) (Revenue $ 435,823,958 )
	PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENTS' ABILITY TO PAY. AS PART OF ITS COMMUNITY BENEFITS STRATEGY, ADVOCATE SHERMAN HOSPITAL (ADVOCATE SHERMAN) IS COMMITTED TO PROMOTING INITIATIVES THAT ENHANCE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED. AN EXAMPLE OF THIS IS THE HOSPITAL'S PROVISION OF CHARITY CARE. ADVOCATE SHERMAN OFFERS A VERY GENEROUS CHARITY CARE PROGRAM REQUIRING NO PAYMENTS FROM THE PATIENTS MOST IN NEED AND PROVIDING DISCOUNTS TO UNINSURED PATIENTS EARNING UP TO SIX TIMES THE FEDERAL POVERTY LEVEL AND TO INSURED PATIENTS EARNING UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. THE HOSPITAL ALSO CONSIDERS A PATIENT'S EXTENUATING CIRCUMSTANCES TO QUALIFY PATIENTS FOR CHARITY CARE. FOR UNINSURED PATIENTS, THE HOSPITAL WILL PRESUMPTIVELY PROVIDE CHARITY CARE IF THE FINANCIAL STATUS HAS BEEN VERIFIED BY A THIRD PARTY AND, IN SOME CASES, THE PATIENT IS NOT REQUIRED TO SUBMIT A SEPARATE CHARITY APPLICATION. IF PRESUMPTIVE CRITERIA IS NOT AVAILABLE FOR UNINSURED PATIENTS, THEN FINANCIAL ASSISTANCE ELIGIBILITY IS AVAILABLE USING AN INCOME-BASED SCREENING. ADVOCATE SHERMAN EXTENDS ITS INCOME-BASED FINANCIAL ASSISTANCE POLICY TO ITS INSURED PATIENTS AS WELL, ALSO TAKING INTO CONSIDERATION THE INSURED PATIENT'S EXTENUATING CIRCUMSTANCES. ALTHOUGH THE HOSPITAL'S CHARITY CARE POLICY IS VERY GENEROUS, ADVOCATE SHERMAN CONTINUES TO REVIEW AND REFINE ITS POLICY IN AN ONGOING EFFORT TO ENSURE THAT FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS WHEN THEY NEED IT. THE HOSPITAL MAINTAINS HIGHLY VISIBLE SIGNAGE AND BROCHURES IN MULTIPLE LANGUAGES TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL HELP AND FINANCIAL COUNSELORS. INFORMATION ABOUT THE CHARITY CARE PROGRAM AND A CHARITY APPLICATION IS PROVIDED TO ALL UNINSURED PATIENTS DURING REGISTRATION AND IS MAILED TO THEM IN ADVANCE OF THE FIRST PATIENT BILLING. AFTER THAT, EACH UNINSURED PATIENT'S BILL INCLUDES SUMMARY INFORMATION REGARDING THE CHARITY CARE PROGRAM. ADVOCATE SHERMAN, AS A LEVEL II TRAUMA CENTER, PROVIDES EXPERT EMERGENCY CARE REGARDLESS OF THE PATIENTS' ABILITY TO PAY. THE HOSPITAL HAD 371 TRAUMA VISITS OUT OF A TOTAL OF 60,027 EMERGENCY DEPARTMENT VISITS IN 2018.

4b	(Code: ) (Expenses $ 2,672,253 including grants of $ ) (Revenue $ )
	PROVISION OF NURSING EDUCATIONADVOCATE SHERMAN IS COMMITTED TO PROVIDING EDUCATION TO NURSING STUDENTS NOW AND IN THE FUTURE. THE HOSPITAL PROVIDES EDUCATION IN A CLINICAL ENVIRONMENT TO NURSING STUDENTS FROM FIVE AREA COLLEGES AND UNIVERSITIES, INCLUDING CHAMBERLAIN COLLEGE, ELGIN COMMUNITY COLLEGE, MCHENRY COUNTY COLLEGE, AURORA UNIVERSITY AND NORTHERN ILLINOIS UNIVERSITY. IN 2018, ADVOCATE SHERMAN'S REGISTERED NURSES SUPERVISED AND TAUGHT 391 UNDERGRADUATE NURSING STUDENTS. HOSPITAL STAFF PROVIDED NEARLY $1.4 MILLION IN STAFF TIME DEVOTED TO DEVELOPING PROFICIENCY AND EXCELLENCE IN THESE NURSING STUDENTS THAT WILL SOON TAKE THEIR PLACE PROVIDING CARE AT VARIOUS HEALTH CARE ORGANIZATIONS IN THE COMMUNITY.HEALTH CARE SERVICES PROVIDED BY PHYSICIANS, NURSES, CLINICIANS AND OTHER ASSOCIATES EMPLOYED BY ADVOCATE SHERMAN ADVOCATE SHERMAN CLINICIANS PROVIDE CARE TO THE COMMUNITY BOTH AT THE HOSPITAL AND IN THE COMMUNITY. ADVOCATE SHERMAN HAS MORE THAN 30 YEARS OF CARDIOVASCULAR EXCELLENCE FOCUSING ON PROACTIVELY PREVENTING, DIAGNOSING AND TREATING AN ARRAY OF HEART CONDITIONS. AS AN ACCREDITED CHEST PAIN CENTER THROUGH THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, ADVOCATE SHERMAN IS DEDICATED TO THE CARE OF ITS CARDIAC PATIENTS. THIS ACCREDITATION MEANS THAT THE HOSPITAL INTEGRATES THE INDUSTRY'S BEST PRACTICES TO PROVIDE THE BEST POSSIBLE OUTCOMES IN CARDIAC CARE. THE HOSPITAL'S HEART FAILURE PROGRAM HAS ACHIEVED ADVANCED CERTIFICATION IN HEART FAILURE DESIGNATION FOR BEST PRACTICES IN CARING FOR HEART FAILURE PATIENTS. IN 2018, ADVOCATE SHERMAN PROVIDED 743 INPATIENT CARDIAC CATHERIZATIONS AND 122 INPATIENT CARDIOVASCULAR OPEN-HEART SURGERIES.ADVOCATE SHERMAN IS RECOGNIZED AS A CENTER OF EXCELLENCE IN TREATING DISEASES AND INJURIES OF MUSCLES, BONES AND JOINTS AND IS A LEADER IN STATE-OF-THE-ART ORTHOPEDIC DIAGNOSTIC AND TREATMENT OPTIONS. DEPENDING ON THE INJURY OR ILLNESS, TREATMENT CAN RANGE FROM NON-SURGICAL OPTIONS SUCH AS CASTS, SPLINTS AND PHYSICAL THERAPY, TO SURGICAL OPTIONS, FROM MINIMALLY INVASIVE ARTHROSCOPY TO TOTAL JOINT REPLACEMENT. IN 2018, ADVOCATE SHERMAN PERFORMED 915 INPATIENT ORTHOPEDIC SURGERIES. ADVOCATE SHERMAN'S CANCER CARE CENTER IS ACCREDITED THROUGH THE COMMISSION ON CANCER (COC) AND THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC). THE HOSPITAL IS LEADING HEALTH BY PROMOTING HEALTHY LIFESTYLES, FOCUSING ON PREVENTATIVE AND INNOVATIVE MEDICINE, ESTABLISHING A COMPREHENSIVE GENETIC PROGRAM, SECURING NURSE NAVIGATION, ENHANCING THE ONCOLOGY SERVICE LINE (INPATIENT, OUTPATIENT AND COMMUNITY), AS WELL AS PARTNERING WITH THE AMERICAN CANCER SOCIETY, LIVING WELL AND JOURNEY CARE. IN ADDITION, THE HOSPITAL PARTICIPATED IN A COLEMAN GRANT FOR SUPPORTIVE ONCOLOGY AND NATIONAL CANCER INSTITUTE/YALE UNIVERSITY GRANT FOR DISTRESS SCREENING. THE HOSPITAL IS ALSO FOCUSED ON DEVELOPING NEW EDUCATION AND PREVENTION PROGRAMS (INCLUDING COLORECTAL CANCER OUTREACH AND SCREENINGS, AND LUNG CANCER SCREENINGS), ENHANCEMENTS TO GENETIC COUNSELING, THE ADDITION OF AN ONCOLOGY NURSE NAVIGATION RESOURCE INCLUDING AN ONCOLOGY FINANCIAL NAVIGATOR AND A PARTNERSHIP WITH ADVOCATE LUTHERAN GENERAL FOR RESEARCH AND CLINICAL TRIALS.ADVOCATE SHERMAN'S PRIMARY STROKE CENTER IS ACCREDITED THROUGH DET NORSKE VERITAS HEALTHCARE, INC. (DNV HEALTHCARE). THE SCOPE OF THE PROGRAM ENCOMPASSES THE ADULT POPULATION ENTERING THE HOSPITAL WITH A HEMORRHAGIC/ISCHEMIC STROKE OR TRANSIENT ISCHEMIC ATTACK (TIA) DIAGNOSIS. DATA IS ABSTRACTED, SUBMITTED AND REPORTED THROUGH THE STROKE DATA REGISTRY AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. OTHER IMPORTANT HOSPITAL-BASED SERVICES INCLUDE A COMPREHENSIVE DIABETES CENTER, A BIRTHING CENTER PROFICIENT IN HANDLING HIGH RISK DELIVERIES AND AN EMERGENCY DEPARTMENT AND LEVEL II TRAUMA CENTER. IN 2015, THE NEED FOR A CONSOLIDATED LOCATION AND STREAMLINED PROCESSES WAS IDENTIFIED FOR OUTPATIENTS WITH CHRONIC HEALTH CONDITIONS. IN 2016, A NEW COMPLETE CARE CENTER WAS LAUNCHED AT ADVOCATE SHERMAN, HOUSING THE HEART FAILURE RECOVERY CENTER, DIABETES AND NUTRITION CARE CENTER, ANTI-COAGULATION CLINIC AND THE WOUND CARE CENTER. THE COMPLETE CARE CENTER IS LOCATED ADJACENT TO THE HEART AND VASCULAR CENTER AND OUTPATIENT PHYSICAL THERAPY UNIT FOR EASE OF ACCESS AND COORDINATED APPOINTMENTS FOR OUTPATIENTS. HOSPITAL CLINICIANS ALSO PROVIDE CARE TO PATIENTS AT SEVERAL OFF-SITE LOCATIONS INCLUDING THREE IMMEDIATE CARE CENTERS FOR IMAGING, LABORATORY, PHYSICAL REHABILITATION AND PRIMARY CARE SERVICES, AS WELL AS SERVICES PROVIDED AT A NURSING/REHABILITATION CENTER AND A STAND-ALONE IMAGING CENTER. ADVOCATE SHERMAN CLINICIANS LEAD PRENATAL/CHILDBIRTH, PARENTING EDUCATION AND DIABETES EDUCATION CLASSES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS FOCUSED ON INDIVIDUALS STRUGGLING WITH HEALTH ISSUES SUCH AS DIABETES, HEART DISEASE, CANCERS, OSTOMIES AND BREASTFEEDING.

4c	(Code: ) (Expenses $ 28,560,810 including grants of $ ) (Revenue $ 26,119,166 )
	DESCRIPTION OF ADVOCATE SHERMANADVOCATE HEALTH CARE BASED IN ILLINOIS AND AURORA HEALTH CARE BASED IN WISCONSIN MERGED TO BECOME ADVOCATE AURORA HEALTH IN APRIL 2018. ADVOCATE SHERMAN IS A 255-BED NOT-FOR-PROFIT HOSPITAL LOCATED IN ELGIN, ILLINOIS, AND IS ONE OF 27 ACUTE CARE HOSPITALS IN THE ADVOCATE AURORA HEALTH SYSTEM. ADVOCATE SHERMAN PROVIDES ACUTE INPATIENT AND OUTPATIENT MEDICAL CARE TO INDIVIDUALS RESIDING IN THE GREATER ELGIN, ILLINOIS AREA. FOUNDED IN 1888, THE HOSPITAL HAS EXPANDED ITS SERVICES TO SEVERAL OFF-SITE LOCATIONS, INCLUDING THREE IMMEDIATE CARE CENTERS, A NURSING/REHABILITATION CENTER AND A STAND-ALONE IMAGING CENTER. AT ALL THESE SITES OF CARE, THE HOSPITAL'S 650 PHYSICIANS AND 2,200 TEAM MEMBERS (EMPLOYEES) PROVIDE QUALITY AND COMPASSIONATE CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES RECEIVED. THE HOSPITAL MOVED TO ITS CURRENT LOCATION ON RANDALL ROAD FOLLOWING COMPLETION OF A NEW HOSPITAL BUILDING IN DECEMBER 2009. ADVOCATE SHERMAN HAS BEEN RECOGNIZED FOR ITS COMMITMENT TO CONTINUALLY IMPROVING PERFORMANCE AND PATIENT CARE AS DEMONSTRATED THROUGH ITS ACHIEVEMENT OF SEVERAL AWARDS. CONSIDERED THE NATIONAL "GOLD STANDARD" FOR NURSING EXCELLENCE AMONG HOSPITALS, THE HOSPITAL HAS RECEIVED MAGNET RECOGNITION BY THE AMERICAN NURSES CREDENTIALING CENTER, AN AFFILIATE OF THE AMERICAN NURSES ASSOCIATION. MAGNET RECOGNITION IS GIVEN ONLY TO HOSPITALS THAT SATISFY A SET OF CRITERIA DESIGNED TO MEASURE STRENGTH AND QUALITY IN NURSING CARE WITH LESS THAN SEVEN PERCENT OF HOSPITALS NATION-WIDE ACHIEVING THIS STATUS. THE CENTER FOR BREAST CARE AT ADVOCATE SHERMAN IS DESIGNATED AS A BREAST IMAGING CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY FOR ITS DEDICATION TO IMPROVING WOMEN'S HEALTH. THE HOSPITAL IS ALSO AN ACCREDITED CHEST PAIN CENTER, WHICH MEANS THE HOSPITAL INTEGRATES THE INDUSTRY'S BEST PRACTICES AND NEWEST MODELS TO PROVIDE THE BEST POSSIBLE OUTCOMES IN CARDIAC CARE. THE HOSPITAL'S HEART FAILURE PROGRAM RECEIVED GOLD LEVEL RECOGNITION FROM THE AMERICAN HEART ASSOCIATION'S "GET WITH THE GUIDELINES-HEART FAILURE PROGRAM" FOR COMMITMENT TO IMPROVING QUALITY CARE. ADVOCATE SHERMAN'S HEALTHCARE PROVIDERS ARE ENGAGED IN ONGOING EFFORTS FOCUSED ON QUALITY IMPROVEMENT INITIATIVES. THESE PROVIDERS USE EVIDENCE-BASED PRACTICES AS AN APPROACH TO IMPROVE QUALITY WHILE REDUCING UNNECESSARY VARIATION IN PRACTICE, COST AND HOSPITALIZATION. THESE EFFORTS ARE DESIGNED TO MAINTAIN AND ENHANCE PATIENT, STAFF AND VISITOR SAFETY AND TO IMPROVE THE ENVIRONMENT OF CARE.WITH A TEAM OF NEARLY 50 CARDIOLOGISTS, ADVOCATE SHERMAN HAS OVER 35 YEARS OF EXERIENCE WITH OPEN HEART PROCEDURES AND ALL FORMS OF CARDIAC CARE. IN ADDITION TO A WIDE RANGE OF CARDIOVASCULAR SERVICES, THE HOSPITAL IS ALSO AN ACCREDITED CHEST PAIN CENTER WITH DEDICATED INTERVENTIONAL CARDIOLOGISTS AND CARDIOLOGY AND EMERGENCY PERSONNEL TRAINED IN RAPID RESPONSE AND TREATMENT OF HEART ATTACKS, WHICH HELPS ENSURE REDUCED HEART MUSCLE DAMAGE AND SAVES LIVES. THE HOSPITAL'S CENTER FOR CANCER CARE OFFERS THE LATEST CANCER TREATMENTS AND STATE-OF-THE-ART TECHNOLOGY IN AN ENVIRONMENT CUSTOM-DESIGNED FOR HEALING AND COMPASSIONATE CARE. THE CENTER FOR ADVANCED LIVER & PANCREATIC CARE PROVIDES PATIENTS WITH ACCESS TO SPECIALIZED CARE FOR THE TREATMENT OF A WIDE RANGE OF LIVER AND PANCREATIC DISEASES THAT TYPICALLY HAVE ONLY BEEN TREATED AT ACADEMIC MEDICAL CENTERS. AS AN ADVOCATE AURORA HOSPITAL, ADVOCATE SHERMAN SUPPORTS THE ORGANIZATION'S VISION OF "WE HELP PEOPLE LIVE WELL AND TO FULFILL ITS VALUES OF: EXCELLENCE - WE ARE A TOP PERFORMER IN ALL THAT WE DO; COMPASSION - WE UNSELFISHLY CARE FOR OTHERS; AND RESPECT - WE VALUE THE UNIQUE NEEDS AND PREFERENCES OF ALL PEOPLE. POPULATION SERVEDADVOCATE SHERMAN PROVIDES QUALITY HEALTH CARE TO INDIVIDUALS REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. IN 2018, THE HOSPITAL'S 846 PHYSICIANS AND 1,718 TEAM MEMBERS (EMPLOYEES) TREATED 14,400 INPATIENT ADMISSIONS, INCLUDING 2,435 DELIVERIES, AND HANDLED 310,813 OUTPATIENT VISITS. AS A LEVEL II TRAUMA CENTER, ADVOCATE SHERMAN PROVIDED 371 TRAUMA VISITS AND 60,027 (INCLUDING TRAUMA) EMERGENCY DEPARTMENT VISITS IN 2018.ADVOCATE SHERMAN SERVES A PRIMARY SERVICE AREA (PSA) INCLUDING 301,055 PEOPLE WHO RESIDE IN THE COMMUNITIES OF ALGONQUIN, CARPENTERSVILLE, DUNDEE, ELGIN, GILBERTS, HUNTLEY, LAKE IN THE HILLS AND SOUTH ELGIN (DATA UPDATED JANUARY 2019).THE PERCENT OF THE FAMILIES IN THE POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL WAS 7.3% FOR THE PSA AS COMPARED TO 9.8% FOR THE STATE ACCORDING TO JANUARY 2019 DATA (CLARITAS 2019). THERE ARE SEVERAL COMMUNITIES IN THE HOSPITAL'S PSA WHICH ARE FINANCIALLY CHALLENGED, WITH A HIGHER PERCENTAGE LIVING BELOW POVERTY THAN THE STATE, INCLUDING CARPENTERSVILLE WITH 14.55% OF THE FAMILIES IN THE POPULATION LIVING BELOW POVERTY, AND ELGIN (60120) AT TWELVE PERCENT. THE PSA MEDIAN HOUSEHOLD INCOME IS $80,036.THE PSA HAS A HIGH PORTION OF THE POPULATION OF LATINO ETHNICITY (TWENTY-NINE PERCENT). THERE IS ALSO A LOW RATE OF AFRICAN AMERICAN POPULATION (4.79%) IN THE PSA. COMMITMENT TO THE COMMUNITYEVEN IN THE FACE OF LOW REIMBURSEMENTS, ADVOCATE SHERMAN IS DEDICATED TO MAINTAINING A STRONG PRESENCE WITHIN ITS COMMUNITY AND CONTINUES TO MONITOR EXPENDITURES TO MAKE CERTAIN THAT THE PROGRAMS AND SERVICES SUPPORTED ARE IN DIRECT RESPONSE TO COMMUNITY NEED. IN 2018, ADVOCATE SHERMAN PROVIDED OVER $36.5 MILLION IN COMMUNITY BENEFIT PROGRAMS AND SERVICES. THESE BENEFITS INCLUDED NOT ONLY THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID AND MEDICARE, FOR EXAMPLE, BUT ALSO THE COST FOR IMPLEMENTING AND SUSTAINING PROGRAMS SPECIFICALLY DESIGNED TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY. COMMUNITY BENEFITS PLAN GOALS AND EXAMPLES OF PROGRAM SERVICE ACCOMPLISHMENTSAS ONE OF ELEVEN ADVOCATE AURORA HEALTH HOSPITALS LOCATED IN ILLINOIS, ADVOCATE SHERMAN'S COMMUNITY BENEFITS EFFORTS ARE ALIGNED WITH THE ORGANIZATION'S VISION AND VALUES. WHILE COMMUNITY HEALTH AND COMMUNITY BENEFITS INTEGRATION EFFORTS CONTINUE IN THE NEWLY MERGED ENTITY, IN 2018 THE HOSPITAL'S COMMUNITY EFFORTS ALIGNED WITH ADVOCATE HEALTH CARE'S COMMUNITY BENEFITS PLAN THAT WAS IN PLACE PRIOR TO THE MERGER AND THAT FOCUSES ON COMMUNITY HEALTH IMPROVEMENT EFFORTS SPECIFIC TO THE ILLINOIS HOSPITALS' COMMUNITIES. THE COMMUNITY BENEFITS PLAN WAS DEVELOPED TO ESTABLISH STRATEGIES FOR IMPROVING ACCESS TO CARE AND POSITIVELY AFFECTING THE HEALTH OF THE COMMUNITIES SERVED BY THE HOSPITAL. THE COMMUNITY BENEFITS PLAN INCLUDES GOALS AND OBJECTIVES FOCUSED ON ADDRESSING NEEDS AS IDENTIFIED THROUGH A HOSPITAL-SPECIFIC COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS OTHER COMMUNITY BENEFITS SUCH AS CHARITY CARE, UNREIMBURSED MEDICAID AND MEDICARE. THE COMMUNITY BENEFITS PLAN SETS THE COURSE FOR STRENGTHENING EXISTING PARTNERSHIPS AND BUILDING NEW ONES WITH INDIVIDUALS AND ORGANIZATIONS WITHIN ADVOCATE SHERMAN'S SERVICE AREA TO LEVERAGE AND MAXIMIZE THE IMPACT OF ITS PROGRAMS. ADVOCATE SHERMAN HAS SET GOALS AND OBJECTIVES TO ACCOMPLISH THIS STRATEGY. THE COMMUNITY BENEFITS PLAN GOALS AND SOME SPECIFIC EXAMPLES OF PROGRAMS AND SERVICES PROVIDED BY THE HOSPITAL THAT ADDRESS THESE GOALS ARE PROVIDED BELOW.GOAL A: OPTIMIZE ADVOCATE'S CAPACITY TO MANAGE AN EFFECTIVE COMMUNITY HEALTH STRATEGY BY IMPLEMENTING REGULAR COMMUNITY HEALTH ASSESSMENTS (CHNAS) AND USING DATA FROM THESE ASSESSMENTS TO GUIDE PROGRAM DEVELOPMENT.PARTNERING TO ASSESS COMMUNITY NEEDSADVOCATE SHERMAN HAS BEEN WORKING COLLABORATIVELY WITH THE MCHENRY COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE KANE COUNTY HEALTH DEPARTMENT TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. PARTICIPATING IN THE COUNTY-WIDE HEALTH ASSESSMENTS LED BY BOTH HEALTH DEPARTMENTS, COMMUNITY HEALTH ASSOCIATES HAVE PLAYED IMPORTANT ROLES ON THE EXECUTIVE LEADERSHIP OVERSIGHT COMMITTEES AND SUB-COMMITTEES OF THESE INITIATIVES SINCE 2006. OTHER HOSPITAL ASSOCIATES SERVE IN KEY LEADERSHIP ROLES IN THE OVERSIGHT COMMITTEES OF BOTH COUNTIES, AS WELL AS SERVING ON MANY SUBCOMMITTEES. ADVOCATE SHERMAN ALSO FOCUSES ITS INTERNAL STRENGTHS TO ASSESS COMMUNITY NEEDS AND TO GUIDE PROGRAM DEVELOPMENT. THE HOSPITAL'S COMMUNITY HEALTH DEPARTMENT PLAYS A KEY ROLE IN WORKING COLLABORATIVELY WITH INTERNAL HOSPITAL DEPARTMENTS AS WELL AS WITH COMMUNITY PARTNERS TO ENHANCE THE HEALTH OF THE COMMUNITY. THE DEPARTMENT ALSO PLANS AND IMPLEMENTS COMMUNITY OUTREACH EVENTS AND HEALTH EDUCATION CLASSES AND OVERSEES THE AMERICAN HEART ASSOCIATION TRAINING CENTER AT THE HOSPITAL. GOAL B: UNDERTAKE OR SUPPORT INITIATIVES THAT ENHANCE ACCESS TO HEALTH CARE, PREVENTION AND WELLNESS SERVICES ACROSS THE LIFESPAN AND WITHIN THE DIVERSE COMMUNITIES ADVOCATE SERVES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses410,018,893

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,827,916	16,983,096	1,327,139

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	344,570
e	Government grants (contributions)		1e	775,391

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		1,119,961

		Business Code
2a	BLUE CROSS/MGD CARE	622110	144,817,365	144,817,365
b	MEDICARE/MEDICAID	621110	138,194,348	138,194,348
c	PATIENT SVC REVENUE	622110	109,730,209	109,730,209
d	PHARMACY	446110	42,219,895	42,219,895
e	LABORATORY	621511	26,981,307	26,585,403	395,904
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		461,943,124

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,271,081			2,271,081
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		-404,948
b	Less: rental expenses		0
c	Rental income or (loss)		-404,948
d	Net rental income or (loss)......			-404,948			-404,948
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,356,191	71,619,666
b	Less: cost or other basis and sales expenses	723,044	68,580,593
c	Gain or (loss)	633,147	3,039,073
d	Net gain or (loss).....			3,672,220			3,672,220
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS		900099	1,103,345		10,800	1,092,545
b	CAFETERIA REVENUE		722514	645,658			645,658
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,749,003
12	Total revenue. See Instructions......			470,350,441	461,547,220	406,704	7,276,556

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	116,558	116,558
2	Grants and other assistance to domestic individuals. See Part IV, line 22	12,500	12,500
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members	2,753,287	2,753,287
5	Compensation of current officers, directors, trustees, and key employees ....	68,860	68,860
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	102,925,191	101,084,292	1,840,899
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,901,270	3,901,270
9	Other employee benefits .......	13,542,287	13,529,885	12,402
10	Payroll taxes ...........	7,342,820	7,257,969	84,851
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	5,000		5,000
c	Accounting ...........	11,416		11,416
d	Lobbying ...........	41,152		41,152
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	593,478		593,478
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,026,858		15,026,858
12	Advertising and promotion ....	58,262	28,578	29,684
13	Office expenses .......	2,004,509	1,969,815	34,694
14	Information technology ......	10,932,539	92,656	10,839,883
15	Royalties ..
16	Occupancy ...........	5,644,854	5,644,854
17	Travel ............	153,132	94,583	58,549
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	355,019	200,973	154,046
20	Interest ...........	9,063,024	9,063,024
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	22,641,563	22,104,627	536,936
23	Insurance ...	802,576	802,576
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 INTERCOMPANY	140,929,438	140,912,776	16,662
b	MEDICAL SUPPLIES	59,293,994	59,293,843	151
c	BAD DEBT	20,443,653	20,443,653
d	INCOME TAXES	12,172	12,172
e	All other expenses	31,925,314	20,630,142	11,295,172
25	Total functional expenses. Add lines 1 through 24e	450,600,726	410,018,893	40,581,833	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			14,065,109	1	41,642,139
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			193,942	3	319,538
4	Accounts receivable, net .............			47,223,879	4	38,893,509
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 ....			4,079,135	7	0
8	Inventories for sale or use ........			5,333,504	8	5,623,887
9	Prepaid expenses and deferred charges ......			564,698	9	283,986
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	378,402,827
b	Less: accumulated depreciation	10b	111,039,433	277,262,451	10c	267,363,394
11	Investments—publicly traded securities .			153,744,299	11	156,714,099
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			3,743,211	13	4,180,974
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			14,223,290	15	6,334,757
16	Total assets. Add lines 1 through 15 (must equal line 34)...			520,433,518	16	521,356,283

17	Accounts payable and accrued expenses .....	52,312,396	17	45,019,308
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
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	275,604,160	25	266,729,665
26	Total liabilities. Add lines 17 through 25..	327,916,556	26	311,748,973

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	192,395,757	27	209,486,105
28	Temporarily restricted net assets ...........	121,205	28	121,205
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	192,516,962	33	209,607,310
34	Total liabilities and net assets/fund balances ........	520,433,518	34	521,356,283