Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 41,000 | 35,000 | 21,000 | 21,000 | 17,770 | 135,770 |
| 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 | 41,000 | 35,000 | 21,000 | 21,000 | 17,770 | 135,770 |
| 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).. | 1,384 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 134,386 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 41,000 | 35,000 | 21,000 | 21,000 | 17,770 | 135,770 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 6,163 | 10,548 | 19,682 | 18,907 | 5,066 | 60,366 |
| 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 | 196,136 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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.).. | ||||||
| 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) |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE ENTITY'S BOARD IS COMPRISED OF THE FOLLOWING INDIVIDUALS WHO ARE ALSO ON THE BOARD(S) OR AN OFFICER OF ONE OR MORE RELATED ORGANIZATIONS: TERRI ALLEN AND ARTHUR J. WILHELMI. THE ENTITY'S FOLLOWING OFFICERS ARE INDIVIDUALS WHO ARE ALSO ON THE BOARD(S) OR AN OFFICER OF ONE OR MORE RELATED ORGANIZATIONS: JEAN KIRKEL, TERRI ALLEN, KAREN HARRIS, AND ARTHUR J. WILHELMI. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE FOUNDATION HAS ONE MEMBER, THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER HAS THE POWER TO APPOINT ALL DIRECTORS OF THE ORGANIZATION AND THE POWER TO REMOVE OFFICERS AND DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER SHALL INITIATE AND APPROVE THE FOLLOWING: A. APPOINT ALL DIRECTORS OF THE CORPORATION. DIRECTORS MUST BE PERSONS WHO HOLD MANAGEMENT POSITIONS WITH THE MEMBER AND OFFICERS MUST BE PERSONS WHO ARE EMPLOYEES OF THE MEMBER. AN INDIVIDUAL WILL BE DEEMED TO HAVE RESIGNED FROM ANY OFFICE HE OR SHE HOLDS EFFECTIVE ON THE DATE OF THEIR TERMINATION OF HIS OR HER EMPLOYMENT WITH THE MEMBER. B. APPOINT THE CHAIRMAN OF THE CORPORATION'S BOARD OF DIRECTORS AND THE PRESIDENT SECRETARY AND TREASURER OF THE CORPORATION. C. REMOVE THE DIRECTORS OF THE CORPORATION, INCLUDING THE CHAIR, PRESIDENT, SECRETARY AND TREASURER OF THE CORPORATION. D. APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. E. APPROVE EACH ANNUAL OPERATING AND CAPITAL BUDGET AND LONG-RANGE PLAN OF THE CORPORATION BEFORE EXPENDITURES MAY BE MADE THEREFROM. THE SELECTION OF LEGAL COUNSEL, THE APPOINTMENT OF INDEPENDENT AUDITORS, ALL ACCOUNTING POLICIES, ALL INVESTMENT GUIDELINES AND ALL DONATION POLICIES OF THE CORPORATION. F. ESTABLISH COMPENSATION, IF ANY, OF DIRECTORS AND OFFICERS FOR SERVICES TO THE CORPORATION AS DIRECTORS AND OFFICERS, IRRESPECTIVE OF ANY PERSONAL INTEREST. G. APPROVE ANY INDEBTEDNESS OF THE CORPORATION IN AN AGGREGATE PRINCIPAL AMOUNT IN EXCESS OF $50,000 WHICH WAS NOT INCLUDED IN THE ANNUAL BUDGET PREVIOUSLY APPROVED BY THE MEMBER. H. APPROVE ANY EXPENDITURE OR INVESTMENT OF THE CORPORATION WHICH EXCEEDS 10% OF THE APPROVED BUDGET; I. TO APPROVE ANY PLAN OF MERGER OR CONSOLIDATION; J. TO APPROVE A VOLUNTARY PARTIAL OR TOTAL DISSOLUTION OF THE CORPORATION K. TO APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION; L. TO APPROVE THE CREATION OF CONTROLLED OR OWNED SUBSIDIARIES OR AFFILIATES BY THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | WITH ASSISTANCE FROM THE LEGAL DEPARTMENT OF IHA, THE INFORMATION NEEDED TO PREPARE THE FOUNDATION'S FORM 990 IS PREPARED BY THE FINANCE STAFF OF THE FOUNDATION'S PARENT, ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA). THE FORM IS THEN PREPARED AND REVIEWED BY THE ASSOCIATION'S OUTSIDE TAX ADVISORS, KPMG. AFTER KPMG'S REVIEW, THE FORM IS FURTHER REVIEWED BY THE ASSOCIATION'S CHIEF ACCOUNTING OFFICER. EACH BOARD MEMBER RECEIVES A COPY OF THE FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST DISCLOSURE FORMS ARE REVIEWED, COMPLETED AND SIGNED BY BOARD MEMBERS AND OFFICERS OF THE ENTITY. THESE ARE REVIEWED BY HUMAN RESOURCES STAFF AND SENIOR MANAGEMENT. WHEN A DIRECTOR OR OFFICER IS AWARE OF A CONFLICT OR POTENTIAL CONFLICT OF INTEREST FOR HIMSELF/HERSELF OR A FAMILY MEMBER, THE DIRECTOR OR OFFICER MUST DISCLOSE IT TO THE BOARD OR THE COMPLIANCE OFFICER OF ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST, THE REMAINING BOARD MEMBERS OR OFFICERS, AS THE CASE MAY BE, WOULD DECIDE IF A CONFLICT EXISTS. IF A CONFLICT IS DEEMED TO EXIST, THAT BOARD MEMBER OR OFFICER, AS THE CASE MAY BE, IS NOT ALLOWED TO VOTE ON THE MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | FORM 990 PART VI SECTION B LINE 15A A COMPENSATION COMMITTEE, COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, IS RESPONSIBLE FOR REVIEWING AND APPROVING THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES. AN INDEPENDENT COMPENSATION CONSULTANT, AS WELL AS COMPENSATION STUDIES OF OTHER SIMILAR ORGANIZATIONS ARE UTILIZED IN THE PROCESS. THE COMPENSATION COMMITTEE DOCUMENTS ALL COMPENSATION DECISIONS ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ILLINOIS HOSPITAL RESEARCH AND EDUCATIONAL FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990 PART VII SECTION A LINE 1 | THE TRUSTEES OF IHREF ARE EMPLOYEES OF THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. APPROXIMATELY 5% OF EACH INDIVIDUALS TIME IS DEVOTED TO THE ACTIVITIES OF THE FOUNDATION, FOR WHICH THE ASSOCIATION RECEIVES NO REIMBURSEMENT. |
| FORM 990, PART XI, LINE 9: | SCHOLARSHIP -1,891. |
| Software ID: | |
| Software Version: |