Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
NorthShore University HealthSystem
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1301 Central Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Evanston, IL60201
D Employer identification number

36-2167060
E Telephone number

G Gross receipts $ 1,147,860,529
F Name and address of principal officer:
Gerald P Gallagher
1301 Central Street
Evanston,IL60201
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
northshore.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1891
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: The core mission of NorthShore University HealthSystem is to "preserve and improve human life."
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 23
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 18
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 13,026
6 Total number of volunteers (estimate if necessary) ............. 6 283
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 332,170
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 20,194,630 9,643,322
9 Program service revenue (Part VIII, line 2g) ......... 1,843,980,002 459,410,898
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 346,622,924 85,401,672
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 11,678,715 8,924,269
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,222,476,271 563,380,161
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 155,611,528 30,448,532
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 821,271,197 187,326,753
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet682,261    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 949,385,749 234,666,184
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,926,268,474 452,441,469
19 Revenue less expenses. Subtract line 18 from line 12....... 296,207,797 110,938,692
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 6,329,420,517 6,125,356,122
21 Total liabilities (Part X, line 26)............. 2,598,859,757 2,306,706,586
22 Net assets or fund balances. Subtract line 21 from line 20..... 3,730,560,760 3,818,649,536
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: See Schedule O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 397,489,529 including grants of $ 30,217,533 ) (Revenue $ 458,161,600 )
Patient Care - See Schedule O
4b (Code:   ) (Expenses $ 12,205,332 including grants of $   ) (Revenue $ 3,300,124 )
Education - See Schedule O
4c (Code:   ) (Expenses $ 7,240,011 including grants of $ 230,999 ) (Revenue $ 3,812,718 )
Research - See Schedule O
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet416,934,872
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
652
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
13,026
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
23
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
18
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJeff Biesczat1301 Central Street   Evanston,IL60201 (847) 570-5798
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) David F Zucker
 
Board Chairman
 1.0
.................
0.0 		X   X       0 0 0
(2) Gerald P Gallagher
 
President and Chief Executive Officer
 41.0
.................
3.0 		X   X       3,083,846 0 1,301,804
(3) Harry M Jansen Kraemer Jr
 
Board Past Chairman
 1.0
.................
0.0 		X   X       0 0 0
(4) John G Zern
 
Board Vice Chairman
 1.0
.................
0.0 		X   X       0 0 0
(5) William M Farrow III
 
Board Secretary
 1.0
.................
0.0 		X   X       0 0 0
(6) A Steven Crown
 
Director
 1.0
.................
0.0 		X           0 0 0
(7) Ann K Ford
 
Director
 1.0
.................
0.0 		X           0 0 0
(8) Bea Reyna-Hickey
 
Director
 1.0
.................
1.0 		X           0 0 0
(9) Catherine Guthrie
 
Director
 1.0
.................
0.0 		X           0 0 0
(10) Christopher J Olson
 
Director
 1.0
.................
2.0 		X           0 0 0
(11) Connie K Duckworth
 
Director
 1.0
.................
0.0 		X           0 0 0
(12) David A Dohnalek
 
Director
 1.0
.................
0.0 		X           0 0 0
(13) Gregory A Wallman
 
Director and Physician
 19.0
.................
22.0 		X           31,923 37,846 6,293
(14) Gregory K Jones
 
Director
 1.0
.................
0.0 		X           0 0 0
(15) Guy W Eisenhuth
 
Director
 1.0
.................
0.0 		X           0 0 0
(16) John Erwin III
 
Director and Clinical Chairman, Medicine
 33.0
.................
9.0 		X           995,000 629,104 46,033
(17) Kevin Willer
 
Director
 1.0
.................
0.0 		X           0 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Mark S Talamonti
 
Director and Clinical Chairman, Surgery
 32.0
.......................10.0 		X           1,170,311 332,296 45,116
(19) Mary R Sheahan
 
Director
 1.0
.......................0.0 		X           0 0 0
(20) Neil S Freedman
 
Director
 19.0
.......................22.0 		X           387,776 505,741 55,771
(21) Samuel M Mencoff
 
Prior Director
 1.0
.......................0.0 		X           0 0 0
(22) Scott C Schweighauser
 
Director
 1.0
.......................0.0 		X           0 0 0
(23) Susan B Sentell
 
Director
 1.0
.......................0.0 		X           0 0 0
(24) Toure S Claiborne
 
Director
 1.0
.......................0.0 		X           0 0 0
(25) Douglas D Welday
 
Board Treasurer and Chief Financial Officer
 41.0
.......................2.0 		    X       1,540,625 0 400,676
(26) Kristen Murtos
 
Chief Administrative and Strategy Officer
 41.0
.......................2.0 		    X       2,181,921 0 514,771
(27) Sean O'Grady
 
Chief Operations Officer
 41.0
.......................0.0 		    X       2,776,729 0 718,220
(28) Brian Washa
 
Senior Vice President, Business Services and Purchasing
 40.0
.......................0.0 		      X     577,452 0 55,889
(29) David Rahija
 
President, Skokie Hospital
 40.0
.......................0.0 		      X     813,678 0 141,317
(30) Dianna Sparacino
 
Chief Human Resources Officer
 40.0
.......................0.0 		      X     642,569 0 285,668
(31) Douglas M Silverstein
 
President, Evanston Hospital
 40.0
.......................0.0 		      X     1,292,220 0 174,416
(32) Frederick E Miller
 
Clinical Chairman, Psychiatry
 32.0
.......................9.0 		      X     539,462 125,430 46,880
(33) Gabrielle Cummings
 
President, Highland Park Hospital
 40.0
.......................0.0 		      X     792,765 0 122,936
(34) Harry L Jones
 
Chief Compliance Officer
 40.0
.......................0.0 		      X     496,496 0 53,181
(35) Jason L Koh
 
Clinical Chairman, Orthopedics
 26.0
.......................15.0 		      X     987,578 816,798 56,678
(36) Jesse Peterson Hall
 
President, Glenbrook Hospital
 40.0
.......................0.0 		      X     1,033,843 0 161,230
(37) John Tressa
 
Chief Nursing Officer
 40.0
.......................0.0 		      X     602,506 0 125,618
(38) Julian E Bailes
 
Clinical Chairman, Neurosurgery
 29.0
.......................12.0 		      X     1,382,771 551,397 56,250
(39) Karen L Kaul
 
Clinical Chairman, Pathology and Laboratory Medicine
 24.0
.......................17.0 		      X     597,768 397,729 46,212
(40) Mahalakshmi Halasyamani
 
Chief Medical Officer
 40.0
.......................1.0 		      X     1,416,051 0 413,292
(41) Michael S Caplan
 
Clinical Chairman, Pediatrics
 35.0
.......................6.0 		      X     807,923 133,083 29,485
(42) Richard K Silver
 
Clinical Chairman, Obstetrics and Gynecology
 35.0
.......................6.0 		      X     928,445 142,988 47,645
(43) Robert R Edelman
 
Clinical Chairman, Radiology
 38.0
.......................3.0 		      X     1,055,272 228,238 56,250
(44) Scott Kenagy
 
Chief Investment Officer
 40.0
.......................0.0 		      X     703,799 0 57,848
(45) Steven Smith
 
Chief Information Officer
 40.0
.......................0.0 		      X     2,169,944 0 328,943
(46) Susan Rubin
 
Clinical Chairman, Neurology
 31.0
.......................10.0 		      X     515,464 175,393 28,857
(47) William D Bloomer
 
Clinical Chairman, Radiation Medicine
 24.0
.......................17.0 		      X     393,030 728,355 45,211
(48) Anne Martino
 
Chief Marketing Officer
 40.0
.......................0.0 		        X   584,046 0 127,753
(49) Heath (Roger) Bell
 
Senior Vice President, Health Information Technology
 40.0
.......................0.0 		        X   515,606 0 40,767
(50) Jeffery Biesczat
 
Senior Vice President,Finance and Controller
 40.0
.......................0.0 		        X   515,216 0 44,121
(51) Jianfeng Xu
 
Vice President, Translational Research
 40.0
.......................0.0 		        X   612,187 0 39,818
(52) Shivani Bautista
 
General Counsel
 40.0
.......................0.0 		        X   649,914 0 56,529
(53) Mary Keegan
 
Former Chief Nursing Officer
 0.0
.......................0.0 		          X 169,440 0 0
(54) Theodore Mazzone
 
Former Clinical Chairman
 31.0
.......................9.0 		          X 194,062 42,157 30,043
(55) William R Luehrs
 
Former Chief Human Resources Officer
 0.0
.......................0.0 		          X 809,711 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 33,967,349 4,846,555 5,761,521
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet1,482
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Aramark Management Services

27310 Network Place
Chicago,IL60673 		Facilities/Diet Management 52,434,311
Pepper Construction Company

411 Lake Zurich Road
Barrington,IL60010 		Construction Management 31,762,594
TMX Healthcare Technologies LLC

5451 Lakeview Parkways S Drive
Indianapolis,IN46268 		Technology Management 24,200,345
University of Chicago Medical Center

5841 South Maryland Avenue
Chicago,IL60637 		Medical Education 19,728,666
Kelly Scott & Madison Inc

303 East Upper Wacker Drive
8th Floor
Chicago,IL60601 		Media and Marketing 13,502,025
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet282
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a 55,000
b Membership dues..1b 2,805
c Fundraising events..1c  
d Related organizations1d 1,146,479
e Government grants (contributions)1e 182,063
f All other contributions, gifts, grants, and similar amounts not included above1f 8,256,975
g Noncash contributions included in lines 1a - 1f:$ 1g 441,640
h Total. Add lines 1a-1f.......MediumBullet 9,643,322
Program Service RevenueAmt Business Code
2a Patient Revenue 622110 269,837,541 269,837,541    
b Medicare and Medicaid Revenue 622110 178,949,837 178,949,837    
c Rent from Affiliated Exempt Organizations 900003 6,495,747     6,495,747
d Fees and Contracts from Government Agencies 541700 2,255,638 2,255,638    
e
f All other program service revenue. 1,872,135 1,872,135 0 0
g Total. Add lines 2a–2f .....MediumBullet 459,410,898
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 13,603,107   -1,488,849 15,091,956
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 25,000     25,000
(ii) Personal (i) Real
6a Gross rents   802,958 6a
b Less: rental expenses   1,003,419 6b
c Rental income or (loss) 0 -200,461 6c
d Net rental income or (loss).......MediumBullet -200,461     -200,461
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 0 655,200,112 7a
b Less: cost or other basis and sales expenses 19,600 583,381,947 7b
c Gain or (loss) -19,600 71,818,165 7c
d Net gain or (loss).........MediumBullet 71,798,565     71,798,565
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 134,183
b Less: cost of goods sold .. 10b 75,402
c Net income or (loss) from sales of inventory..MediumBullet 58,781     58,781
Business Code Miscellaneous Revenue
11a Lab Reference Testing 621511 1,516,887   1,516,887  
b Cafeteria 722514 962,281     962,281
c Parking 812930 300,172   23,100 277,072
d All other revenue .... 6,261,609 5,863,544 281,032 117,033
e Total. Add lines 11a–11d ...... MediumBullet 9,040,949
12 Total revenue. See instructions.....MediumBullet 563,380,161 458,778,695 332,170 94,625,974
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 30,386,988 30,386,988
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 61,544 61,544
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 15,806,818 5,741,522 10,065,296  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 13,777,329 8,895,577 4,639,447 242,305
7 Other salaries and wages........ 135,931,861 121,062,101 14,654,254 215,506
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 10,446,968 8,296,437 2,150,531  
9 Other employee benefits ....... 617,873 448,437 97,803 71,633
10 Payroll taxes ........... 10,745,904 8,424,369 2,283,317 38,218
11 Fees for services (non-employees):        
a Management ...... 22,191,625 21,002,402 1,189,223  
b Legal ......... 2,841,913   2,841,913  
c Accounting ........... 258,801   258,801  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 10,050,147   10,050,147  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 21,952,070 11,324,283 10,602,866 24,921
12 Advertising and promotion .... 2,685,693   2,685,693  
13 Office expenses ....... 6,904,727 5,403,512 1,500,660 555
14 Information technology ...... 6,895,597 351,751 6,536,496 7,350
15 Royalties ..        
16 Occupancy ........... 8,958,457 5,604,293 3,274,271 79,893
17 Travel ............ 313,791 169,013 144,098 680
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 257,635 146,993 110,612 30
20 Interest ........... 2,089,480 2,089,480    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 20,429,661 13,717,254 6,712,407  
23 Insurance ... 8,553,495 7,938,887 614,608  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 104,518,594 104,518,594    
b Allocation of Indirect Expenses 0 46,529,144 -46,529,144  
c Medicaid Taxes 13,910,646 13,910,646    
d Dues and Subscriptions 732,308 279,305 451,833 1,170
e All other expenses 1,121,544 632,340 489,204 0
25 Total functional expenses. Add lines 1 through 24e 452,441,469 416,934,872 34,824,336 682,261
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 128,990,664 1 49,423,711
2 Savings and temporary cash investments ......... 2,352,682 2 2,294,779
3 Pledges and grants receivable, net ...... 6,561,831 3 5,087,880
4 Accounts receivable, net ............. 238,201,355 4 243,799,358
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 28,428,171 8 28,419,330
9 Prepaid expenses and deferred charges ...... 13,372,806 9 12,981,366
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,582,933,368
b Less: accumulated depreciation 10b 1,133,869,127 1,559,053,750 10c 1,449,064,241
11 Investments—publicly traded securities . 2,663,166,843 11 2,334,582,321
12 Investments—other securities. See Part IV, line 11 ..... 1,331,278,400 12 1,585,782,417
13 Investments—program-related. See Part IV, line 11 .. 18,826,836 13 19,115,442
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 339,187,179 15 394,805,277
16 Total assets. Add lines 1 through 15 (must equal line 33)... 6,329,420,517 16 6,125,356,122
Liabilities 17 Accounts payable and accrued expenses ..... 343,984,072 17 204,182,198
18 Grants payable ...   18  
19 Deferred revenue ......... 11,618,711 19 11,816,328
20 Tax-exempt bond liabilities ......... 535,213,671 20 534,085,689
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
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 1,708,043,303 25 1,556,622,371
26 Total liabilities. Add lines 17 through 25.. 2,598,859,757 26 2,306,706,586
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 3,458,809,326 27 3,533,453,835
28 Net assets with donor restrictions ........... 271,751,434 28 285,195,701
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 3,730,560,760 32 3,818,649,536
33 Total liabilities and net assets/fund balances ........ 6,329,420,517 33 6,125,356,122
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
563,380,161
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
452,441,469
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
110,938,692
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
3,730,560,760
5
Net unrealized gains (losses) on investments ...............
5
-25,132,478
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
2,282,562
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
3,818,649,536
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 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
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 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  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 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 2021 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-2021 		(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
NorthShore University HealthSystem
  		Employer identification number
36-2167060
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
NorthShore University HealthSystem
  		Employer identification number

36-2167060
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) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
NorthShore University HealthSystem
  		Employer identification number

36-2167060
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
245,840
j
Total. Add lines 1c through 1i ....................................................................................................
245,840
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY NorthShore University HealthSystem (NorthShore) and its employees are members of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by NorthShore to these organizations are attributable to lobbying activities.
Schedule C (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 .... 317,506,832 188,379,680 171,561,222 173,877,101 155,281,603
b Contributions ... 0 104,547,440 1,525 50,750 300,920
c Net investment earnings, gains, and losses 16,801,567 36,857,501 25,668,427 6,995,963 26,436,023
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		4,301,829 12,277,789 8,851,494 9,362,592 8,141,445
f Administrative expenses ....          
g End of year balance ...... 330,006,570 317,506,832 188,379,680 171,561,222 173,877,101
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet30.62 %
b
Permanent endowment SchDMd Bullet24.83 %
c
Term endowment SchDMd Bullet44.55 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   73,457,282 73,457,282
b Buildings ....   1,767,639,685 717,861,431 1,049,778,254
c Leasehold improvements   56,301,160 49,441,392 6,859,768
d Equipment ....   537,462,238 338,368,895 199,093,343
e Other .....   148,073,003 28,197,409 119,875,594
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,449,064,241
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other 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) Private Equity Funds		 720,842,056 F

(B) Hedge Funds		 821,845,891 F

(C) Other Investments		 43,094,470 F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 1,585,782,417
Part VIII
Investments - Program 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.)Small Bullet  
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)Annuities Trusts and Other 163,996,380
(2)Due from Affiliates 173,845,074
(3)Miscellaneous Receivables 41,436,996
(4)Escrow Deposits 13,827,000
(5)Deferred Income Tax Benefit 1,699,827
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 394,805,277
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  
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,556,622,371
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) 2021

Schedule D (Form 990) 2021
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 ....... 1 478,654,543
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -25,132,478
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 2,033,500
e Add lines 2a through 2d ..................... 2e -23,098,978
3 Subtract line 2e from line 1.................. 3 501,753,521
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 10,050,147
b Other (Describe in Part XIII.) ........... 4b 51,576,493
c Add lines 4a and 4b.................... 4c 61,626,640
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 563,380,161
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 ........... 1 407,807,588
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 -5,397,326
e Add lines 2a through 2d.................... 2e -5,397,326
3 Subtract line 2e from line 1................... 3 413,204,914
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 10,050,147
b Other (Describe in Part XIII.) ............ 4b 29,186,408
c Add lines 4a and 4b..................... 4c 39,236,555
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 452,441,469
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds Endowment fund earnings are used toward research, education, and to fund department chairs, as well as general operations and uncompensated care offered to patients who meet the criteria established under NorthShore University HealthSystem's financial assistance policy. During fiscal year 2021, the Board of Directors designated a portion of net assets without donor restrictions as a board-designated endowment for the purpose of funding community benefit activities to meaningfully advance the health and well-being of the communities served.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote NorthShore, FPA, RMI, Swedish Hospital, SHF, NCH, NCH Hospital, and NCH Foundation have been determined to qualify as tax-exempt organizations under Section 501(c)(3) of the Internal Revenue Code (IRC). Most of the income received by the Corporation is exempt from taxation under Section 501(a) of the IRC, as income related to the mission of the organization. Accordingly, there is no material provision for income tax for this entities. Some of the income received by exempt entities is subject to taxation as unrelated business income. NorthShore and its subsidiaries file federal income tax returns and returns for various states in the U.S. ASC 740-10, Income Taxes, requires that realization of an uncertain income tax position is more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it can be recognized in the financial statements. Furthermore, this interpretation prescribes the benefit to be recorded in the financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the three months ended December 31, 2021. For the three months ended December 31, 2021, the Corporation has a net operating loss carryforward of $336,752,118, which generated assets of $94,968,178. These assets are offset by a valuation allowance of $93,268,351.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 Rental Expenses - 1003419 Gift Shop Expenses - 75402 Equity Transactions - 1189340 Loss on assets other that inventory - 19600 Related Organization Transfers - -254261
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements Internal Support - 27544154 Rent from Affiliated Exempt Organization - 6495747 Equity Transactions - 16128079 Foundation Administrative Expenses - 1387993 Donated Capital - 20520
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 Rental Expenses - 1003419 Loss on assets other than inventory - 19600 Gift Shop Expenses - 75402 Rent from Affiliated Exempt Organization - -6495747
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements Internal Support - 27544154 Foundation Administrative Expenses - 1387993 Related Organization Transfers - 254261
Schedule D (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments   714,886,353
Europe (Including Iceland and Greenland) 0 0 Program Services Medical Supplies 13,647
North America (Canada & Mexico only) 0 0 Program Services Medical Supplies 705,800
Russia and Neighboring States 0 0 Program Services Medical Services 1,000
Middle East and North Africa 0 0 Program Services Medical Supplies 111,798
Central America and the Caribbean 0 0 Program Services Medical Services 1,000
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 715,719,598
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 715,719,598
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds NorthShore University HealthSystem (NorthShore) provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports.
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual, Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; MIDDLE EAST AND NORTH AFRICA-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; RUSSIA AND NEIGHBORING STATES-Accrual
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2021
Additional Data


Software ID: 21014044
Software Version: 2021v4.2



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    4,688,533 37,897 4,650,636 1.00 %
b Medicaid (from Worksheet 3, column a) . . . . .     35,915,776 34,087,623 1,828,153 0.39 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 40,604,309 34,125,520 6,478,789 1.40 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     455,461   455,461 0.10 %
f Health professions education (from Worksheet 5) . . .     12,223,917 3,300,124 8,923,793 1.92 %
g Subsidized health services (from Worksheet 6) . . . .     11,569,153 5,296,732 6,272,421 1.35 %
h Research (from Worksheet 7) .     6,451,689 5,758,996 692,693 0.15 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     415,083   415,083 0.09 %
j Total. Other Benefits . . 0 0 31,115,303 14,355,852 16,759,451 3.61 %
k Total. Add lines 7d and 7j . 0 0 71,719,612 48,481,372 23,238,240 5.01 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building     6,369   6,369 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 6,369 0 6,369 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
3,940,609
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
117,894,617
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
141,059,428
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-23,164,811
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1Ravine Way Surgery Center LLC
  		Operates an orthopaedic surgery center 27 % 0 % 73 %
2NorthShoreUSP Surgery Centers II LLC
  		Operates general surgery centers 49.9 % 0 % 50.1 %
3Morton Grove Medical Imaging LLC
  		Operates a diagnostic testing facility 49 % 0 % 51 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?4Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Evanston Hospital
2650 Ridge Avenue
Evanston,IL60201
northshore.org
0000646 		X X   X   X X     A
2 Glenbrook Hospital
2100 Pfingsten Road
Glenview,IL60026
northshore.org
0003483 		X X   X   X X     A
3 Highland Park Hospital
777 Park Avenue West
Highland Park,IL60035
northshore.org
0005066 		X X   X   X X     A
4 Skokie Hospital
9600 Gross Point Road
Skokie,IL60076
northshore.org
0005587 		X X   X   X X     A
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
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 No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): northshore.org/community/implementation-strategy-plan/
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
northshore.org/about-us/billing/financial-assistance/
b
northshore.org/about-us/billing/financial-assistance/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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, 20a, 20b, 20c, 20d, 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
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - Facility Reporting Group A. Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital NorthShore University HealthSystem (NorthShore) contracted with Crowe LLP (Crowe) to facilitate and conduct the Community Health Needs Assessment (CHNA). Crowe has significant healthcare experience including providing services to hundreds of large healthcare organizations across the country. NorthShore has conducted a CHNA using primary and secondary data, to ensure community benefit programs and resources are focused on significant health needs as perceived by the community at large, as well as alignment with NorthShore's mission, services and strategic priorities. NorthShore obtained input from 44 leaders representing public health, major employers, public schools, social services, NorthShore leaders and the community at-large through two focus groups and one-on-one interviews. Primary input was also obtained by conducting an online community health survey distributed to members of the community. Additionally, health needs assessments prepared by four local health departments serving the NorthShore community were also reviewed and considered. Secondary data was assessed including: Demographics (population, age, sex, race), Socioeconomic indicators (household income, poverty, unemployment, educational attainment), Health access indicators, Community health status indicators (causes of death, chronic conditions, health behaviors, etc.), and Availability of health care facilities and resources. Community input was obtained through two focus groups and seven interviews with key stakeholders. The first focus group was conducted with members of NorthShore's community advisory committees representing twenty-eight organizations. The attendees included health care providers, social service providers, public health agency representatives, local government agency leaders, and small business organizations working throughout the NorthShore service area. The organizations represented included the City of Evanston-Department of Health, Moraine Township, CJE Senior Life, NAMI Cook County North Suburban, Deerfield Parent Network, Niles Township High School District 219, Erie Family Health Center, Northbrook Chamber of Commerce, Evanston Fire Department, Northfield Township, Evanston/Skokie School District 65, Northwest Suburban United Way, Faith in Action, Peer Services, Family Services of Glencoe, Skokie Police Department, Frisbie Senior Center, St. Philip Lutheran Church, Glenbrook South High School, Terry Performance Group, Glenview Chamber of Commerce, Tri-Con Child Care Center, Great Lakes Adaptive Sports Association, Turning Point Behavioral Health, Lake County Health Department, Village of Glenview, McGaw YMCA, and Village of Skokie, Health Department. Participants provided input on behalf of public health, medically underserved and minority populations and the community as a whole. A second focus group was conducted with leaders from NorthShore's staff representing a wide range of departments, including Emergency Medicine, Kellogg Cancer Center, Nursing, Cardiology, Psychiatry and Behavioral Health, Neurology, Managed Care, and Infection Control. The group discussed prominent health and wellness issues, barriers and assets to health in the communities NorthShore serves, and potential strategies to address barriers to community health and well-being. Community input was also obtained through an electronic survey distributed to the community. Identified health needs were then prioritized taking into account community perception regarding the significance of each identified need as well as the ability for NorthShore to impact overall health based on alignment with NorthShore's mission and services provided. NorthShore's leadership participated in identifying and prioritizing significant health needs.
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Facility Reporting Group A. Facility Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital The Community Health Needs Assessment (CHNA) conducted by NorthShore University HealthSystem (NorthShore) included all four NorthShore hospitals: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital.
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Facility Reporting Group A. Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Highland Park Hospital 3 - Glenbrook Hospital 4 - Skokie Hospital NorthShore University HealthSystem (NorthShore) has implemented a three-fold strategy to address the identified health needs of the communities it serves, which includes: 1) Community benefits programs and partnerships will address a need identified in the Community Health Needs Assessment (CHNA), with a rationale provided for any identified health needs not addressed by NorthShore, 2) Community benefits programs, initiatives, and partnerships will address a need identified by the community, and 3) Community benefits programs, initiatives, and partnerships will be aligned with the guiding principles outlined in Advancing the State of the Art of Community Benefits for Nonprofit Hospitals. The guiding principles are: Disproportionate Unmet Health-Related Needs, Primary Prevention, Seamless Continuum of Care, Build Community Capacity, and Community Collaboration. NorthShore places priority on providing community benefits and services in the communities located nearest to its hospitals, where NorthShore believes it has the greatest capacity and responsibility to serve. NorthShore evaluates the impact of the initiatives developed to address the identified needs by collecting data on how many individuals utilize components of the initiative. Measurement of the impact was also assessed by gathering ongoing feedback from the hospitals' Community Advisory Committees, along with feedback from senior and physician leadership. The needs identified in the most recently conducted CHNA were: Access to Behavioral Health, Health Literacy and Navigating the Healthcare Environment, Access and Coordination of Care (affordability, education, transportation, specialty care, cultural competency), Substance Abuse, Behavioral Health (mental health and substance abuse, psychiatry and community based services), Chronic Risk Factors (prevention and management of obesity, tobacco use, hypertension), Alzheimer's/Dementia (prevention, management, caregiver support, long-term care), Oral Health, Diabetes, Cardiovascular Disease and Stroke, Cancer, Lung Health, and Maternal and Child Health (infant mortality, low birth weight). NorthShore plans to address all the needs identified in the CHNA, although the following needs have been addressed in a limited capacity through existing services and financial contributions to outside organizations: Violence Prevention. Actions taken during fiscal year 2021 to address the needs identified in the CHNA include the following NorthShore programs and services by hospital facility:
Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - A, 1 Evanston Hospital. The NorthShore Evanston Hospital Community Health Center provides medical care to adults who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In the fourth quarter of calendar year 2021, the clinic treated 884 adult patients at 1,558 visits. Emergency Departments within NorthShore are staffed 24/7 with physicians, nurses, and technicians who are trained to respond to medical emergencies. Evanston Hospital provides Level 1 trauma services. During the fiscal year, the NorthShore Emergency Departments had 27,558 patient visits. The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided discounted care for adult patients making 728 visits during the fourth quarter of calendar year 2021. NorthShore's Cardiovascular Center provides comprehensive cardiology services with a combined expertise of cardiologists and cardiac surgeons working together to develop treatment plans designed to provide patients with exceptional heart care including cardiac imaging, cardiovascular surgery, clinical cardiology, electrophysiology, heart failure, interventional cardiology and a women's heart program. The Kellogg Cancer Center is a cancer treatment center that offers comprehensive, compassionate cancer care and treatments for oncology patients and their families. NorthShore's collaborative cancer treatment model focuses on each patient's individual needs, providing medical, surgical, radiation, psychological, and emotional care. During the fiscal year, the Kellogg Cancer Centers at Evanston, Glenbrook, and Highland Park Hospitals had a total of 22,569 patient visits. The Maternal Health Department at Evanston Hospital offers comfortable, high-tech birthing facilities. Evanston Hospital also serves as a Regional Perinatal Network hospital for northeastern Illinois. Both high-risk mothers and high-risk babies are transferred to Evanston Hospital for access to the latest technology and highly trained staff. During the fiscal year, the Evanston Hospital Maternal Health Department had a total of 10,361 patient visits. The Pediatric Rehabilitation Clinic offers a wide array of outpatient services for young patients (from birth through adolescence) with special needs. A team of licensed physical, occupational, and speech therapists specializing in pediatric care provide one-on-one individualized treatment as well as group classes to help patients achieve or regain functional skills. During the fiscal year, the Pediatric Rehabilitation Clinic had a total of 1,357 patient visits. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offers referrals for women who may need additional help. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. All services are provided free of charge. In fiscal year 2021, NorthShore physicians conducted 7,974 screenings to identify at-risk patients, and the hotline received 1,266 calls. Free psychological support and referrals were provided for 611 women identified as at-risk for perinatal mood disorders. NorthShore's Medication Assistance Program helps with the cost of prescriptions for patients of the Evanston Hospital Community Health Center. The Medication Assistance Program provided 5,880 prescriptions to 1,247 low-income patients during 10/1/2021-12/31/2021. NorthShore Mental Health Services for adults, adolescents and children offers along with a continuum of care including group, individual and family outpatient services, intensive outpatient, partial hospital programs, inpatient centers for both adults and adolescents, and crisis call center. The Access/Crisis Center offers 24-hour crisis intervention and triage over the phone and in the emergency department. During the fiscal year, the Mental Health Services Departments at Evanston, Highland Park, and Skokie Hospitals had a total of 7,235 patient visits. The Evanston Township High School Health Center is a school-based health clinic that provides physical exams, immunizations, treatment of acute and chronic illnesses, individual counseling, health education, gynecological care, and support groups to students whose parents allow them to enroll in the health center. For the 2020-2021 academic year, 667 students made 1,392 visits.
Schedule H, Part V, Section B, Line 11 Facility A, 3 Facility A, 3 - A, 2 Highland Park Hospital. Emergency Departments within NorthShore are staffed 24/7 with physicians, nurses, and technicians who are trained to respond to medical emergencies. Evanston Hospital provides Level 1 trauma services. During the fiscal year, the NorthShore Emergency Departments had 27,558 patient visits. NorthShore's Cardiovascular Center provides comprehensive cardiology services with a combined expertise of cardiologists and cardiac surgeons working together to develop treatment plans designed to provide patients with exceptional heart care including cardiac imaging, cardiovascular surgery, clinical cardiology, electrophysiology, heart failure, interventional cardiology and a women's heart program. The Kellogg Cancer Center is a cancer treatment center that offers comprehensive, compassionate cancer care and treatments for oncology patients and their families. NorthShore's collaborative cancer treatment model focuses on each patient's individual needs, providing medical, surgical, radiation, psychological, and emotional care. During the fiscal year, the Kellogg Cancer Centers at Evanston, Glenbrook, and Highland Park Hospitals had a total of 22,569 patient visits. The Maternal Health Department at Highland Park Hospital is committed to providing the best in family care and strives to provide individualized care for each family. The Center's state-of-the-art birthing center rooms were designed to achieve the labor-delivery-recovery-postpartum, or single-room care experience with the latest technology. During the fiscal year, the Highland Park Hospital Maternal Health Department has a total of 793 patient visits. The Pediatric Rehabilitation Clinic offers a wide array of outpatient services for young patients (from birth through adolescence) with special needs. A team of licensed physical, occupational, and speech therapists specializing in pediatric care provide one-on-one individualized treatment as well as group classes to help patients achieve or regain functional skills. During the fiscal year, the Pediatric Rehabilitation Clinic had a total of 1,357 patient visits. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offers referrals for women who may need additional help. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. All services are provided free of charge. In fiscal year 2021, NorthShore physicians conducted 7,974 screenings to identify at-risk patients, and the hotline received 1,266 calls. Free psychological support and referrals were provided for 611 women identified as at-risk for perinatal mood disorders. NorthShore Mental Health Services for adults, adolescents and children offers along with a continuum of care including group, individual and family outpatient services, intensive outpatient, partial hospital programs, inpatient centers for both adults and adolescents, and crisis call center. The Access/Crisis Center offers 24-hour crisis intervention and triage over the phone and in the emergency department. During the fiscal year, the Mental Health Services Departments at Evanston, Highland Park, and Skokie Hospitals had a total of 7,235 patient visits.
Schedule H, Part V, Section B, Line 11 Facility A, 4 Facility A, 4 - A, 3 Glenbrook Hospital. Emergency Departments within NorthShore are staffed 24/7 with physicians, nurses, and technicians who are trained to respond to medical emergencies. Evanston Hospital provides Level 1 trauma services. During the fiscal year, the NorthShore Emergency Departments had 27,558 patient visits. NorthShore's Cardiovascular Center provides comprehensive cardiology services with a combined expertise of cardiologists and cardiac surgeons working together to develop treatment plans designed to provide patients with exceptional heart care including cardiac imaging, cardiovascular surgery, clinical cardiology, electrophysiology, heart failure, interventional cardiology and a women's heart program. The Kellogg Cancer Center is a cancer treatment center that offers comprehensive, compassionate cancer care and treatments for oncology patients and their families. NorthShore's collaborative cancer treatment model focuses on each patient's individual needs, providing medical, surgical, radiation, psychological, and emotional care. During the fiscal year, the Kellogg Cancer Centers at Evanston, Glenbrook, and Highland Park Hospitals had a total of 22,569 patient visits. The Pediatric Rehabilitation Clinic offers a wide array of outpatient services for young patients (from birth through adolescence) with special needs. A team of licensed physical, occupational, and speech therapists specializing in pediatric care provide one-on-one individualized treatment as well as group classes to help patients achieve or regain functional skills. During the fiscal year, the Pediatric Rehabilitation Clinic had a total of 1,357 patient visits. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offers referrals for women who may need additional help. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. All services are provided free of charge. In fiscal year 2021, NorthShore physicians conducted 7,974 screenings to identify at-risk patients, and the hotline received 1,266 calls. Free psychological support and referrals were provided for 611 women identified as at-risk for perinatal mood disorders.
Schedule H, Part V, Section B, Line 11 Facility A, 5 Facility A, 5 - A, 4 Skokie Hospital. Emergency Departments within NorthShore are staffed 24/7 with physicians, nurses, and technicians who are trained to respond to medical emergencies. Evanston Hospital provides Level 1 trauma services. During the fiscal year, the NorthShore Emergency Departments had 27,558 patient visits. NorthShore's Cardiovascular Center provides comprehensive cardiology services with a combined expertise of cardiologists and cardiac surgeons working together to develop treatment plans designed to provide patients with exceptional heart care including cardiac imaging, cardiovascular surgery, clinical cardiology, electrophysiology, heart failure, interventional cardiology and a women's heart program. The Pediatric Rehabilitation Clinic offers a wide array of outpatient services for young patients (from birth through adolescence) with special needs. A team of licensed physical, occupational, and speech therapists specializing in pediatric care provide one-on-one individualized treatment as well as group classes to help patients achieve or regain functional skills. During the fiscal year, the Pediatric Rehabilitation Clinic had a total of 1,357 patient visits. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offers referrals for women who may need additional help. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. All services are provided free of charge. In fiscal year 2021, NorthShore physicians conducted 7,974 screenings to identify at-risk patients, and the hotline received 1,266 calls. Free psychological support and referrals were provided for 611 women identified as at-risk for perinatal mood disorders. NorthShore Mental Health Services for adults, adolescents and children offers along with a continuum of care including group, individual and family outpatient services, intensive outpatient, partial hospital programs, inpatient centers for both adults and adolescents, and crisis call center. The Access/Crisis Center offers 24-hour crisis intervention and triage over the phone and in the emergency department. During the fiscal year, the Mental Health Services Departments at Evanston, Highland Park, and Skokie Hospitals had a total of 7,235 patient visits.
Schedule H, Part V, Section B, Line 20 Facility A, 1 Facility A, 1 - Facility Reporting Group A. Facility Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Highland Park Hospital 3 - Glenbrook Hospital 4 - Skokie Hospital Per the Billing and Collections Policy of NorthShore University HealthSystem (NorthShore), NorthShore does not engage in Extraordinary Collection Actions (ECAs), nor does it permit its collections vendors to engage in ECAs.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?47
Name and address Type of Facility (describe)
1 Glenbrook Ambulatory Care Center
2180 Pfingsten Road
Glenview,IL60026 		Outpatient Clinic
2 Skokie Ambulatory Care Center
9650 Gross Point Road
Skokie,IL60076 		Outpatient Clinic
3 Graham Medical Office Building
1000 Central Street
Evanston,IL60201 		Outpatient Clinic
4 Highland Park Ambulatory Care Center
757 Park Avenue West
Highland Park,IL60035 		Outpatient Clinic
5 Gurnee Ambulatory Care Center
7900 Rollins Road
Gurnee,IL60031 		Outpatient Clinic
6 Old Orchard Medical Office Building
9977 Woods Drive
Skokie,IL60077 		Outpatient Clinic
7 Highland Park Medical Office Building
767 Park Avenue West
Highland Park,IL60035 		Outpatient Clinic
8 Glenbrook Medical Office Building North
2150 Pfingsten Road
Glenview,IL60026 		Outpatient Clinic
9 Glenbrook Medical Office Building South
2050 Pfingsten Road
Glenview,IL60026 		Outpatient Clinic
10 Fetal Diagnostic Center
71 Waukegan Road
Lake Bluff,IL60044 		Outpatient Clinic
11 Vernon Hills Specialty Care Center
225 N Milwaukee Avenue
Vernon Hills,IL60061 		Outpatient Clinic
12 NorthShore Lab Services - Evanston
2500 Ridge Avenue
Evanston,IL60201 		Outpatient Clinic
13 Bannockburn Medical Office Building
2151 Waukegan Road
Bannockburn,IL60015 		Outpatient Clinic
14 Lincolnshire Medical Office Building
920 N Milwaukee Avenue
Lincolnshire,IL60048 		Outpatient Clinic
15 Pediatric Outpatient Center
3232 Lake Avenue
Wilmette,IL60091 		Outpatient Clinic
16 Niles Medical Office Building
6450 W Touhy Avenue
Niles,IL60714 		Outpatient Clinic
17 Lakeshore Imaging
680 N Lake Shore Drive
Chicago,IL60611 		Outpatient Clinic
18 Ravinia X-Ray and GI Lab
1777 Green Bay Road
Highland Park,IL60035 		Outpatient Clinic
19 NorthShore Medical Group - Round Lake Beach
1000 Rollins Road
Round Lake Beach,IL60073 		Outpatient Clinic
20 Gurnee Medical Office Building
15 Tower Court
Gurnee,IL60031 		Outpatient Clinic
21 Mount Prospect Medical Office Building
1329 N Wolf Road
Mount Prospect,IL60056 		Outpatient Clinic
22 Glenview Park Center
2400 Chestnut Avenue
Glenview,IL60026 		Outpatient Clinic
23 NorthShore Immediate Care Center - Chicago at Sauganash
6141 N Cicero Avenue
Chicago,IL60646 		Outpatient Clinic
24 PM&R Fitness Center
1501 Busch Parkway
Buffalo Grove,IL60089 		Outpatient Clinic
25 NorthShore Immediate Care Center - Chicago at Bucktown
1942 W Fullerton Avenue
Chicago,IL60647 		Outpatient Clinic
26 NorthShore Immediate Care Center - Des Plaines
1535 Ellinwood
Des Plaines,IL60016 		Outpatient Clinic
27 NorthShore Immediate Care Center - Chicago at NorthCenter
2019 W Irving Park Road
Chicago,IL60618 		Outpatient Clinic
28 PM&R Benson Avenue
1729 Benson Avenue
Evanston,IL60201 		Outpatient Clinic
29 Northbrook Court Imaging
1182 Northbrook Court
Northbrook,IL60062 		Outpatient Clinic
30 NorthShore Immediate Care Center - Chicago at Broadway Square
5238 N Broadway Avenue
Chicago,IL60640 		Outpatient Clinic
31 NorthShore Immediate Care Center - Chicago at Andersonville
4914 N Clark Street
Chicago,IL60640 		Outpatient Clinic
32 NorthShore Immediate Care Center - Evanston
524 Main Street
Evanston,IL60201 		Outpatient Clinic
33 NorthShore Immediate Care Center - Arlington Heights
206 W Rand Road
Arlington Heights,IL60004 		Outpatient Clinic
34 NorthShore Immediate Care Center - Chicago at Jefferson Park
5211 W Lawrence Avenue
Chicago,IL60630 		Outpatient Clinic
35 NorthShore Immediate Care Center - Chicago at Belle Plaine
4070 N Milwaukee Avenue
Chicago,IL60641 		Outpatient Clinic
36 NorthShore Immediate Care Center - Skokie Commons
3304 W Touhy Ave
Skokie,IL60076 		Outpatient Clinic
37 NorthShore Immediate Care Center - Chicago at Mayfair Commons
5240 N Pulaski
Chicago,IL60630 		Outpatient Clinic
38 NorthShore Immediate Care Center - Chicago at Lincoln Village
6071 N Lincoln Ave
Chicago,IL60659 		Outpatient Clinic
39 NorthShore Immediate Care Center - Chicago at Lincoln Square
2323 W Lawrence
Chicago,IL60625 		Outpatient Clinic
40 Fetal Diagnostic Center
890 Garfield Avenue
Libertyville,IL60048 		Outpatient Clinic
41 Fetal Diagnostic Center
800 W Central Road
Arlington Heights,IL60005 		Outpatient Clinic
42 Breast Health and Mammography Program
71 Old Orchard Shopping Center
Skokie,IL60077 		Outpatient Clinic
43 Ravine Way Surgery Center
2350 Ravine Way
Glenview,IL60025 		Ambulatory Surgery Center
44 North Shore Same Day Surgery
3725 W Touhy Avenue
Lincolnwood,IL60712 		Ambulatory Surgery Center
45 River North Same Day Surgery
One East Erie Street
Chicago,IL60611 		Ambulatory Surgery Center
46 Morton Grove Medical Imaging
9000 Waukegan Road
Morton Grove,IL60053 		Ambulatory Surgery Center
47 25 East Same Day Surgery Center
25 E Washington Street
Chicago,IL60602 		Ambulatory Surgery Center
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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
Schedule H, Part I, Line 3c Other Factors Used to Determine Eligibility for Financial Assistance In addition to the Federal Poverty Guidelines, NorthShore University HealthSystem uses the following factors to determine eligibility for financial assistance: asset level, medical indigency, insurance status, underinsurance status, and residency.
Schedule H, Part V, Section B, Line 3 Explanation of CHNA Noncompliance Due to Change in Fiscal Year IRC Section 501(r)(3) requires a hospital organization to conduct a community health needs assessment (CHNA) every three years and adopt an implementation strategy to meet the community health needs identified through such assessment. With respect to any taxable year, a hospital organization meets the requirements of section 501(r)(3) with respect to a hospital facility it operates only if the hospital facility has conducted a CHNA in such taxable year or in either of the two taxable years immediately preceding such taxable year. NorthShore previously conducted a CHNA before September 30, 2019. In connection with a system affiliation agreement with Edward-Elmhurst Healthcare (EEH), effective January 1, 2022, the fiscal year of NorthShore University HealthSystem (NorthShore) was changed from September 30 to December 31, resulting short tax year for the three-month period ended December 31, 2021. As a result of the short tax year, which was not contemplated prior to the affiliation with EEH, NorthShore did not complete its most recent CHNA within the short tax year nor the two previous years. NorthShore was in the process of completing the CHNA as of December 31, 2021 and was fully expecting to have it completed by the historical September 30, 2022 deadline to comply with 501(r)(3). The failure to have the CHNA conducted before December 31, 2021 was discovered by NorthShore during January 2022. Afterwards, NorthShore communicated the error and expedited the CHNA to be completed as soon as reasonably possible. NorthShore made the CHNA report widely available to the public on its website and finished conducting the CHNA on September 7, 2022. The CHNA was conducted for the following hospital facilities: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital. The implementation strategy was adopted by the Board of Directors on September 15, 2022. As described in 26 CFR Section 1.501(r)-2(c), ..."a hospital facility's failure to meet one or more of the requirements described in 1.501(r)-3 that is neither willful nor egregious shall be excused... if the hospital facility corrects and makes disclosure in accordance with rules set forth by revenue procedure, notice, or other guidance published in the Internal Revenue Bulletin. A "willful" failure includes a failure due to gross negligence, reckless disregard, or willful neglect, and an "egregious" failure includes only a very serious failure, taking into account the severity of the impact and the number of affected persons. Whether a failure is willful or egregious will be determined based on all the facts and circumstances. A hospital facility's correction and disclosure of a failure in accordance with the relevant guidance is a factor tending to show that the failure was not willful." The failure was not willful because the CHNA process began before the change in fiscal year and with the expectation to be conducted before the end of the third tax year following the previously conducted CHNA. Further, NorthShore discovered the error and expedited to correct by finish conducting the CHNA as soon as reasonably possible. The failure is not egregious because the CHNA would have been timely conducted if the fiscal year had not changed. The previous CHNA was conducted during September 2019, which was within the last three years at the time failure occurred. Based on the facts and circumstances described above, NorthShore did not willfully nor egregiously fail to comply with 501(r)(3). Further, Northshore corrected the failure by promptly completing the most recent CHNA following the unexpected change in fiscal year. Accordingly, NorthShore has not filed an excise tax return or paid any related tax imposed under IRC section 4959. NorthShore has reviewed its procedures in place to address and monitor its compliance with the requirements of IRC section 501(r), including the timely adoption of future CHNA. The next CHNA will be adopted during tax year 2024, which will be the third consecutive tax year after the short tax year 2021.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance NorthShore University HealthSystem calculated the cost of charity care and means-tested government programs using the cost-to-charge ratio derived from Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges. Amounts in the other benefits section of Line 7 were calculated using costs charged directly to the individual programs from the financial accounting system. An indirect cost allocation factor for hospital shared services was also calculated and included for each program indicated in other benefits.
Schedule H, Part II Community Building Activities NorthShore University HealthSystem (NorthShore) employees are involved in numerous community building activities which promote the health of the communities it serves. NorthShore encourages its employees to serve on community collaboration boards and participate in health advocacy programs to promote the health of the communities served.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense was reported at cost using a cost-to-charge methodology. The Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges calculated to report charity care on Part I, Line 7a was multiplied by the bad debt expense to determine the bad debt expense at cost. Discounts and payments on patient accounts are excluded from bad debt expense in order to reflect the expected amount to be paid.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote See pages 13-17 of the audited financial statements for footnotes describing accounts receivable and bad debt expense.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to determine the Medicare costs reported on Part III, Line 6. NorthShore University HealthSystem (NorthShore) believes that all of the $23,164,811 Medicare shortfall should be considered as community benefit. The Internal Revenue Service Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by NorthShore in order to continue treating the elderly in our community. During the fiscal year, Medicare accounted for approximately 51% of hospital gross patient revenues. The hospital provides care regardless of this shortfall and thereby relieves the government of the burden of paying the full cost of care for Medicare beneficiaries.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance NorthShore University HealthSystem (NorthShore) follows the Illinois Fair Patient Billing Act. The collection policy is the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off. Any remaining balance would be collected under the existing debt collection policy.
Schedule H, Part V, Section B, Line 16a FAP website A - Evanston Hospital: Line 16a URL: northshore.org/about-us/billing/financial-assistance/;
Schedule H, Part V, Section B, Line 16b FAP Application website A - Evanston Hospital: Line 16b URL: northshore.org/about-us/billing/financial-assistance/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Evanston Hospital: Line 16c URL: northshore.org/about-us/billing/financial-assistance/;
Schedule H, Part VI, Line 2 Needs assessment See the information reported in Part V Section B regarding the most recently completed Community Health Needs Assessment (CHNA). NorthShore University HealthSystem (NorthShore) contracted with Crowe LLP (Crowe) to compile and analyze existing data which led to the collection of community input data for the 2019 CHNA. The CHNA process included community input data collection including a focus group with NorthShore staff, as well as a focus group with community advisory committees representing twenty-eight organizations. The assessment process also included the development of a Community Health Profile using secondary data from local health department, federal, and state data sources.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance NorthShore University HealthSystem (NorthShore) informs and educates low-income patients of our Financial Assistance program across many points within the system. We have posted signs--both English and Spanish--in all our facilities' Emergency Departments and at our Central Registration areas. The NorthShore patient information television channel is available to all patients upon admission and a section describes how to obtain Financial Assistance. The NorthShore billing statements describes the Financial Assistance program and necessary contact information. Our collection agencies and billing offices also coordinate charity care to potentially eligible patients. Finally, the NorthShore website (northshore.org) is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. NorthShore also has approximately 16 full-time financial counselors and 38 Customer Service agents representing our hospitals, clinics, and physician offices. These counselors and representatives are responsible for helping patients understand their bills and coordinating financial assistance and insurance eligibility when appropriate. Any uninsured patient admitted to our hospitals will have their case reviewed by a financial counselor. NorthShore has also earned Certified Application Counselor Organization (CACO) status with the Centers for Medicare and Medicaid Services (CMS). Our counselors are certified and capable of helping patients navigate Medicaid and Insurance Exchange options. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible for financial assistance will have their case reviewed by calling our centralized Customer Service billing department. Our Customer Service department responds to approximately 1,400 calls per day from patients with questions about their bill or that are unable to pay. In addition to the formal application process for Financial Assistance, NorthShore may also grant Financial Assistance on a presumptive basis. Presumptive Financial Assistance approvals are based upon individual life circumstances such as enrollment in low-income government programs with income eligibility below 200 percent of federal poverty level income guidelines or verification of financial indigence through a credit rating agency and their calculated healthcare credit score.
Schedule H, Part VI, Line 4 Community information NorthShore University HealthSystem (NorthShore) has four hospital facilities located in the northern suburbs of Chicago, Illinois. The NorthShore service area has a total population size of approximately 1.6 million. The median household income is approximately $92,000. During the fiscal year, approximately 2% of NorthShore's patients had no insurance and 5% qualified for Medicaid. Within NorthShore's service area, there are four federally-designated medically underserved areas. NorthShore's service area also includes 11 other hospitals.
Schedule H, Part VI, Line 5 Promotion of community health NorthShore University HealthSystem (NorthShore) extends medical staff privileges to all qualified physicians in the NorthShore community. A majority of the NorthShore Board members also reside in NorthShore's service area and are not employees, independent contractors, or family members thereof. NorthShore also uses surplus funds to add new buildings and renovate existing facilities to better serve patients and the community. Additional programs conducted by NorthShore to help promote the health of the community include: Residency and Education Programs - NorthShore is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at its teaching and research facilities. During fiscal year ending 12/31/21, 223 resident and fellow full-time equivalents (FTEs) participated in NorthShore and affiliate-based programs. The NorthShore residency program areas include: Dentistry, Family Medicine, Internal Medicine (Categorical, Preliminary, and Transitional), and Pathology. The NorthShore fellowship program areas include: Breast Surgery, Cardiology, Endocrine Surgery, Family Medicine-Sports Medicine, Gastroenterology, Maternal-Fetal Medicine, Musculoskeletal Imaging, Simulation-Emergency Medicine, and Urogynecology. The affiliate-based residency program areas include: Anesthesiology, Emergency Medicine, General Surgery, Neurology, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Radiology, and Urology. The affiliate-based fellowship program areas include: Cardiothoracic Surgery, Child Psychiatry, Colon Rectal Surgery, Gynecology-Oncology, Hematology-Oncology, Mammography, Maternal-Fetal Medicine, Medical Microbiology, Molecular Genetics Pathology, Neonatal-Perinatal Medicine, Nephrology, Neuroradiology, Orthopaedic Hand, Orthopaedic Sports, Palliative Medicine, Peripheral Vascular Surgery, and Surgical Oncology. NorthShore also offers a comprehensive Pharmacy residency program, with resident positions located at all four hospitals. The Pharmacy residency program includes both clinical and administrative exposure focusing on inpatient and ambulatory practice. The program also includes specialty residencies in oncology, pharmacy informatics, and pharmacy administration. The program consists of a multitude of experiences that reinforce residents' knowledge and skills and help them advance into well-rounded practitioners. During fiscal year ending 12/31/21, 16 residents participated in the program. The NorthShore School of Nurse Anesthesia operates out of Evanston Hospital and is affiliated with DePaul University. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year ending 12/31/21, 96 students participated in the program. NorthShore also provided clinical training and internships during the fiscal year for 101 high school and college students. Students interned in the following areas: Nursing, Diagnostic Radiology, and Physical Therapy. Community Advisory Committees - The Community Advisory Committees' (CAC) role is to advise hospital administration on services and initiatives from a community perspective. The CACs are structured to ensure NorthShore's accountability to the community and to assist in the fulfillment of the community relations vision, to be the most trusted and indispensable heath partner throughout the communities we serve. The CACs are primarily comprised of community members, along with hospital administrative and professional staff. NorthShore strives for diverse membership to include business, faith community, social services, civic organizations, government and elected officials, as well as interested citizens. The CACs meet quarterly and help to identify gaps in healthcare services within the community and seek opportunities for partnerships between the hospitals and community organizations. In addition, the CACs assist NorthShore with the community health needs assessment process. NorthShore Community Health Center - The NorthShore Evanston Hospital Community Health Center provides medical care to adults who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In the fourth quarter of calendar year 2021, the clinic treated 884 adult patients at 1,558 visits. Dental Center - The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided discounted care for adult patients making 728 visits during the fourth quarter of calendar year 2021. Erie Evanston/Skokie Health Center - NorthShore partners with this Federally Qualified Health Center to provide services to the underserved. During fiscal year 2021, NorthShore provided services to 2,593 Erie patients. Evanston Township High School Health Center - The Evanston Township High School Health Center is a school-based health clinic that provides physical exams, immunizations, treatment of acute and chronic illnesses, individual counseling, health education, gynecological care, and support groups to students whose parents allow them to enroll in the health center. For the 2020-2021 academic year, 667 students made 1,392 visits. NorthShore's Medication Assistance Program helps with the cost of prescriptions for patients of the Evanston Hospital Community Health Center. The Medication Assistance Program provided 5,880 prescriptions to 1,247 low-income patients during 10/1/2021-12/31/2021. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offers referrals for women who may need additional help. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. All services are provided free of charge. In fiscal year 2021, NorthShore physicians conducted 7,974 screenings to identify at-risk patients, and the hotline received 1,266 calls. Free psychological support and referrals were provided for 611 women identified as at-risk for perinatal mood disorders. Employee Volunteerism - NorthShore employees participate in various volunteer activities that meet community needs and promote goodwill. Several NorthShore publications include information about volunteer organizations and employee volunteer opportunities. NorthShore also recognizes and rewards employees for community service and volunteerism through the annual Sharing Spirit Volunteer Award. Home and Hospice Services - NorthShore Home and Hospice Services offers the full spectrum of home and hospice care, including skilled nursing, physical and occupational therapy, and home medical equipment. The Home and Hospice caregivers represent a wide range of medical specialties and work with the patient, family, and physician to tailor home care to meet the individual needs of each patient. During the fiscal year, there were 14,633 patient visits and 1,217 admissions.
Schedule H, Part VI, Line 6 Affiliated health care system NorthShore University HealthSystem (NorthShore) is an integrated health care system dedicated to providing health care services, including inpatient acute and non-acute care, primary and specialty physician services, and various outpatient services. NorthShore operates six acute care facilities, including Evanston Hospital, Highland Park Hospital, Glenbrook Hospital, Skokie Hospital, Swedish Hospital, and Northwest Community Hospital that serve the greater Chicago "North Shore" and northern Illinois communities.
Schedule H, Part VI, Line 7 State filing of community benefit report IL
Schedule H (Form 990) 2021
Additional Data


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Software Version: 2021v4.2

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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
2021
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number
36-2167060
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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) Erie Family Health Center
1701 W Superior Street
Chicago,IL60622 		36-3088628 501(c)(3) 333,333       Community Contribution
(2) Greater Chicago Food Depository
4100 W Ann Lurie Place
Chicago,IL60632 		36-2971864 501(c)(3) 30,000       Community Contribution
(3) Northern Illinois Food Bank
273 Dearborn Court
Geneva,IL60134 		36-3203648 501(c)(3) 22,500       Community Contribution
(4) NorthShore Faculty Practice Associates
1301 Central Street
Evanston,IL60201 		36-3738206 501(c)(3) 30,106,789       General Support
(5) Northwestern University
633 Clark Street
Evanston,IL60208 		36-2167817 501(c)(3) 14,308       Research
(6) University of Chicago
6054 S Drexel Avenue
Chicago,IL60637 		36-2177139 501(c)(3) 84,650       Research
(7) University of Illinois
809 S Marshfield Avenue
Chicago,IL60612 		37-6000511 501(c)(3) 17,694       Research
(8) University of Miami
PO Box 248106
Coral Gables,FL33124 		59-0624458 501(c)(3) 33,304       Research
(9) Upstate Affiliate Organization (UAO)
300 E McBee Avenue
Greenville,SC29801 		61-1723202 501(c)(3) 81,042       Research
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
9
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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) Scholarships in Medical Field 40 61,544      
(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, Part I, Line 2 Procedures for monitoring use of grant funds. NorthShore University HealthSystem (NorthShore) provides cash and non-cash assistance to organizations that help support NorthShore's mission to preserve and improve human life. Requests to support an outside organization must be reviewed and approved by the Community Relations department and NorthShore management to ensure the organization is aligned with NorthShore's mission and charitable purpose. NorthShore also provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports. In addition, NorthShore provides cash support to related organizations. Support to related organizations is monitored through the NorthShore budget and reporting procedures for the consolidated financial statements. NorthShore also provides nursing scholarships to individuals. The scholarship amount depends on the degree sought, and the number of scholarships awarded depends on the available funds for each year. Scholarships are awarded on an annual basis to applicants that meet the eligibility criteria. Applicants must be current employees of NorthShore as a staff nurse or other related clinical position. Applicants must also be currently enrolled in a nursing degree program, and enrollment must be maintained for the year the scholarship is received. In addition, applicants must sign a Scholarship Agreement to work for NorthShore as a staff nurse or in a related clinical position for one year following receipt of the scholarship.
Schedule I (Form 990) 2021



Additional Data


Software ID: 21014044
Software Version: 2021v4.2


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
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Gerald P Gallagher
 
President and Chief Executive Officer 		(i)

(ii)		 1,389,035
-------------
0 		1,685,590
-------------
0 		9,221
-------------
0 		1,259,784
-------------
0 		42,020
-------------
0 		4,385,650
-------------
0 		792,990
-------------
0
2John Erwin III
 
Director and Clinical Chairman, Medicine 		(i)

(ii)		 880,000
-------------
213,472 		115,000
-------------
400,000 		0
-------------
15,632 		20,884
-------------
5,066 		16,162
-------------
3,921 		1,032,046
-------------
638,091 		0
-------------
0
3Mark S Talamonti
 
Director and Clinical Chairman, Surgery 		(i)

(ii)		 1,037,311
-------------
284,004 		133,000
-------------
0 		0
-------------
48,292 		20,372
-------------
5,578 		15,046
-------------
4,120 		1,205,729
-------------
341,994 		0
-------------
0
4Neil S Freedman
 
Director 		(i)

(ii)		 326,414
-------------
418,239 		61,362
-------------
77,511 		0
-------------
9,991 		11,375
-------------
14,575 		13,072
-------------
16,749 		412,223
-------------
537,065 		0
-------------
0
5Sean O'Grady
 
Chief Operations Officer 		(i)

(ii)		 957,077
-------------
0 		965,560
-------------
0 		854,092
-------------
0 		684,594
-------------
0 		33,626
-------------
0 		3,494,949
-------------
0 		1,284,790
-------------
0
6Kristen Murtos
 
Chief Administrative and Strategy Officer 		(i)

(ii)		 711,763
-------------
0 		850,300
-------------
0 		619,858
-------------
0 		481,335
-------------
0 		33,436
-------------
0 		2,696,692
-------------
0 		971,221
-------------
0
7Douglas D Welday
 
Board Treasurer and Chief Financial Officer 		(i)

(ii)		 739,525
-------------
0 		780,900
-------------
0 		20,200
-------------
0 		369,198
-------------
0 		31,478
-------------
0 		1,941,301
-------------
0 		375,200
-------------
0
8Steven Smith
 
Chief Information Officer 		(i)

(ii)		 556,973
-------------
0 		557,720
-------------
0 		1,055,251
-------------
0 		303,489
-------------
0 		25,454
-------------
0 		2,498,887
-------------
0 		1,328,741
-------------
0
9Julian E Bailes
 
Clinical Chairman, Neurosurgery 		(i)

(ii)		 1,280,771
-------------
488,535 		102,000
-------------
0 		0
-------------
62,862 		18,785
-------------
7,165 		21,934
-------------
8,366 		1,423,490
-------------
566,928 		0
-------------
0
10Jason L Koh
 
Clinical Chairman, Orthopedics 		(i)

(ii)		 885,578
-------------
488,019 		102,000
-------------
312,173 		0
-------------
16,606 		16,730
-------------
9,220 		19,811
-------------
10,917 		1,024,119
-------------
836,935 		0
-------------
0
11Mahalakshmi Halasyamani
 
Chief Medical Officer 		(i)

(ii)		 730,813
-------------
0 		678,200
-------------
0 		7,038
-------------
0 		409,625
-------------
0 		3,667
-------------
0 		1,829,343
-------------
0 		308,000
-------------
0
12Robert R Edelman
 
Clinical Chairman, Radiology 		(i)

(ii)		 915,272
-------------
39,376 		140,000
-------------
150,000 		0
-------------
38,862 		24,880
-------------
1,070 		29,050
-------------
1,250 		1,109,202
-------------
230,558 		0
-------------
0
13Douglas M Silverstein
 
President, Evanston Hospital 		(i)

(ii)		 650,477
-------------
0 		621,280
-------------
0 		20,463
-------------
0 		161,337
-------------
0 		13,079
-------------
0 		1,466,636
-------------
0 		350,280
-------------
0
14William D Bloomer
 
Clinical Chairman, Radiation Medicine 		(i)

(ii)		 393,030
-------------
259,438 		0
-------------
445,680 		0
-------------
23,237 		15,632
-------------
10,318 		11,602
-------------
7,659 		420,264
-------------
746,332 		0
-------------
0
15Richard K Silver
 
Clinical Chairman, Obstetrics and Gynecology 		(i)

(ii)		 813,445
-------------
118,486 		115,000
-------------
0 		0
-------------
24,502 		22,651
-------------
3,299 		18,937
-------------
2,758 		970,033
-------------
149,045 		0
-------------
0
16Jesse Peterson Hall
 
President, Glenbrook Hospital 		(i)

(ii)		 511,217
-------------
0 		506,540
-------------
0 		16,086
-------------
0 		133,457
-------------
0 		27,773
-------------
0 		1,195,073
-------------
0 		279,440
-------------
0
17Karen L Kaul
 
Clinical Chairman, Pathology and Laboratory Medicine 		(i)

(ii)		 416,768
-------------
281,356 		181,000
-------------
100,000 		0
-------------
16,373 		15,492
-------------
10,458 		12,096
-------------
8,166 		625,356
-------------
416,353 		0
-------------
0
18Michael S Caplan
 
Clinical Chairman, Pediatrics 		(i)

(ii)		 696,923
-------------
110,000 		111,000
-------------
0 		0
-------------
23,083 		22,412
-------------
3,538 		3,053
-------------
482 		833,388
-------------
137,103 		0
-------------
0
19David Rahija
 
President, Skokie Hospital 		(i)

(ii)		 416,679
-------------
0 		394,020
-------------
0 		2,979
-------------
0 		114,025
-------------
0 		27,292
-------------
0 		954,995
-------------
0 		227,920
-------------
0
20Gabrielle Cummings
 
President, Highland Park Hospital 		(i)

(ii)		 413,739
-------------
0 		376,120
-------------
0 		2,906
-------------
0 		111,913
-------------
0 		11,023
-------------
0 		915,701
-------------
0 		223,720
-------------
0
21Dianna Sparacino
 
Chief Human Resources Officer 		(i)

(ii)		 399,309
-------------
0 		238,800
-------------
0 		4,460
-------------
0 		264,899
-------------
0 		20,769
-------------
0 		928,237
-------------
0 		0
-------------
0
22Scott Kenagy
 
Chief Investment Officer 		(i)

(ii)		 455,929
-------------
0 		245,200
-------------
0 		2,670
-------------
0 		25,950
-------------
0 		31,898
-------------
0 		761,647
-------------
0 		0
-------------
0
23Susan Rubin
 
Clinical Chairman, Neurology 		(i)

(ii)		 413,464
-------------
124,998 		102,000
-------------
26,538 		0
-------------
23,857 		19,926
-------------
6,024 		2,232
-------------
675 		537,622
-------------
182,092 		0
-------------
0
24Frederick E Miller
 
Clinical Chairman, Psychiatry 		(i)

(ii)		 412,462
-------------
102,259 		127,000
-------------
0 		0
-------------
23,171 		20,795
-------------
5,155 		16,772
-------------
4,158 		577,029
-------------
134,743 		0
-------------
0
25John Tressa
 
Chief Nursing Officer 		(i)

(ii)		 398,650
-------------
0 		194,200
-------------
0 		9,656
-------------
0 		109,379
-------------
0 		16,239
-------------
0 		728,124
-------------
0 		0
-------------
0
26Brian Washa
 
Senior Vice President, Business Services and Purchasing 		(i)

(ii)		 389,190
-------------
0 		184,400
-------------
0 		3,862
-------------
0 		25,950
-------------
0 		29,939
-------------
0 		633,341
-------------
0 		0
-------------
0
27Harry L Jones
 
Chief Compliance Officer 		(i)

(ii)		 331,744
-------------
0 		149,500
-------------
0 		15,252
-------------
0 		25,950
-------------
0 		27,231
-------------
0 		549,677
-------------
0 		0
-------------
0
28Shivani Bautista
 
General Counsel 		(i)

(ii)		 355,583
-------------
0 		293,600
-------------
0 		731
-------------
0 		25,950
-------------
0 		30,579
-------------
0 		706,443
-------------
0 		0
-------------
0
29Jianfeng Xu
 
Vice President, Translational Research 		(i)

(ii)		 446,162
-------------
0 		157,300
-------------
0 		8,725
-------------
0 		25,950
-------------
0 		13,868
-------------
0 		652,005
-------------
0 		0
-------------
0
30Anne Martino
 
Chief Marketing Officer 		(i)

(ii)		 355,558
-------------
0 		211,200
-------------
0 		17,288
-------------
0 		118,355
-------------
0 		9,398
-------------
0 		711,799
-------------
0 		0
-------------
0
31Jeffery Biesczat
 
Senior Vice President,Finance and Controller 		(i)

(ii)		 344,925
-------------
0 		168,800
-------------
0 		1,491
-------------
0 		25,950
-------------
0 		18,171
-------------
0 		559,337
-------------
0 		0
-------------
0
32Heath (Roger) Bell
 
Senior Vice President, Health Information Technology 		(i)

(ii)		 348,938
-------------
0 		164,500
-------------
0 		2,168
-------------
0 		25,950
-------------
0 		14,817
-------------
0 		556,373
-------------
0 		0
-------------
0
33William R Luehrs
 
Former Chief Human Resources Officer 		(i)

(ii)		 8,305
-------------
0 		271,040
-------------
0 		530,366
-------------
0 		0
-------------
0 		0
-------------
0 		809,711
-------------
0 		271,040
-------------
0
34Theodore Mazzone
 
Former Clinical Chairman 		(i)

(ii)		 141,185
-------------
40,196 		39,167
-------------
1,961 		13,710
-------------
0 		16,549
-------------
4,711 		6,837
-------------
1,946 		217,448
-------------
48,814 		0
-------------
0
35Mary Keegan
 
Former Chief Nursing Officer 		(i)

(ii)		 0
-------------
0 		169,440
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		169,440
-------------
0 		0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 4a Severance or change-of-control payment The following individual received a severance payment based upon a mutually agreed-upon separation agreement entered into with the organization: William R Luehrs - $529,615
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The following individuals participated in a supplemental nonqualified retirement plan and accrued the following benefits: Gerald P Gallagher - $823,981 Mahalakshmi Halasyamani - $201,344 Kristen Murtos - $267,935 Sean O'Grady - $407,830 Steven Smith - $163,485 Dianna Sparacino - $133,343 Douglas D Welday - $149,197 The following individuals received payments from a supplemental nonqualified retirement plan reported as taxable compensation: Kristen Murtos - $612,821 Sean O'Grady - $846,030 Steven Smith - $1,037,821
Schedule J, Part I, Line 7 Non-fixed payments NorthShore University HealthSystem provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the Compensation Committee of the Board of Directors.
Schedule J (Form 990) 2021

Additional Data


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Software Version: 2021v4.2

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number
36-2167060
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A Illinois Finance Authority
  		86-1091967 45204FBG9 04-30-2020 560,804,233 See Part VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 14,400,000      
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 560,804,233      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 4,365,812      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 242,130,000      
11 Other spent proceeds ............. 314,308,421      
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2020
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X              
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X            
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X              
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X              
c Are there any research agreements that may result in private business use of bond-financed property? ............. X              
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.1 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 %      
6 Total of lines 4 and 5 ............. 0.1 %      
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X              
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X              
b Exception to rebate? ........ X              
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X              
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part I, Column (c) Bond A - CUSIP # In addition to the CUSIP number shown here, Form 8038 lists the following CUSIP numbers: 45204FAG0 and 45204FAH8.
Schedule K, Part I, Column (f) Bond A - Description of Purpose The 2020 ABC issue refinanced NorthShore University HealthSystem issues dated 7/7/1995, 8/28/1996, 7/3/2001, 12/11/2008, and 7/14/2010, acquired assets of Swedish Covenant Health, and financed new capital projects of the health system.
Schedule K (Form 990) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2

SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 3,811 Cost
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 9 424,928 Other - Sales Proceeds
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 2 390 Other - Comparables
19 Food inventory ... X 4 114 Cost
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Gift Cards/Certificates ) X 30 12,397 Cost
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2021)
Schedule M (Form 990) (2021)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I Column (b) - Number of Contributions or Items Contributed The amounts reported on Part I, Column (b) represent the number of contributions.
Schedule M (Form 990) (2021)

Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
Return Reference Explanation
Form 990, Part III, Line 1 Organization's Mission The core mission of NorthShore University HealthSystem (NorthShore) is to "preserve and improve human life." This mission will be achieved through the provision of superior clinical care, academic excellence and innovative research. NorthShore is a not-for-profit organization principally formed to provide quality healthcare services for the communities it serves. The delivery of healthcare services is provided in a wide range of inpatient and ambulatory healthcare settings, community-wide, employing modern technology and expertise. Support for qualified patients who may not be able to pay the entire cost of their care is a part of the organization's commitment. In support of its primary mission of patient care, the organization engages in a wide range of academic activities in medical education and research. This statement recognizes the Board of Directors' responsibility to maintain the organization's viability to meet its long-term commitment to the communities it serves. It further recognizes the responsibility to maintain technologically current assets for this purpose. This includes the cultivation and development of our physicians, graduate medical students, employees, physical plant, equipment and other resources to assure orderly growth of our services.
Form 990, Part III, Line 4a Program Service Description - Patient Care NorthShore University HealthSystem (NorthShore) is an integrated, healthcare delivery system. NorthShore, headquartered in Evanston, Illinois, includes five hospitals - Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, Skokie Hospital, and Swedish Hospital. NorthShore also includes a 900 physician multispecialty group practice, NorthShore University HealthSystem Faculty Practice Associates, with more than 140 locations in the Chicagoland area. NorthShore is a Magnet-recognized organization, the first in Illinois to receive this prestigious honor as an entire system that demonstrates excellence in nursing and high standards in patient care. NorthShore also is a national leader in the implementation of innovative technologies, including an Electronic Medical Record (EMR) system. In 2003, NorthShore was among the first in the country to successfully implement a system-wide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement. As the principal teaching affiliate for the University of Chicago Pritzker School of Medicine, NorthShore is dedicated to excellence in medical education and research. Combined with NorthShore's established reputation for advanced information technology and its strong clinical environment, this affiliation represents an exciting advancement in patient care for the Chicagoland area. NorthShore's health system includes significant capabilities in a wide spectrum of leading clinical programs, including Kellogg Cancer Center, NorthShore Neurological Institute, NorthShore Orthopaedic Institute, NorthShore Cardiovascular Institute, Neaman Center for Personalized Medicine and High-Risk Maternity. NorthShore is nationally named a 2020 Most Wired health system for the 17th straight year by the College of Healthcare Information Management Executives. NorthShore receives a "Level 9 Quality Award" (out of 10) for both Acute and Ambulatory surveys. NorthShore receives the Press Ganey Guardian of Excellence Award, recognizing 17 of NorthShore's off-site Outpatient Services that have achieved the 95th percentile or above for performance in Patient Experience. NorthShore is named to the 2021 Fortune/IBM Watson Health 100 Top Hospitals list for a record 22 times, more than any other hospital or health system in the U.S. in the award's 28-year history. NorthShore also is among the Top 15 Major Teaching Hospitals. NorthShore earns five stars-the highest possible quality rating from the Centers for Medicare & Medicaid Services (CMS), as part of its consumer-oriented Hospital Compare program. Evanston, Glenbrook and Northwest Community hospitals receive "A" grades and Highland Park and Swedish hospitals receive "B" grades in Spring ratings from The Leapfrog Group, a national organization that focuses on quality and safety in American health care. Evanston, Highland Park and Swedish hospitals are proud to be recognized by Blue Cross Blue Shield with a Blue Distinction Centers (BDC) for Maternity Care designation, as part of the Blue Distinction Specialty Care program. NorthShore Orthopaedic & Spine Institute is named one of the top 50 specialty programs in the country in U.S. News & World Report's annual 'Best Hospital' rankings for 2021-22. Legacy NorthShore also is ranked the #6 hospital in both Illinois and the Chicago metro area. NorthShore is recognized as a LinkedIn 'Top 25 Company' in the greater Chicago area for 2021. NorthShore recognizes and embraces its responsibility to ensure that it fulfills its charitable obligations in the most cost-effective and sustainable manner. In order to achieve this goal, NorthShore has aligned its community benefits program with the guiding principles outlined in Advancing the State of the Art of Community Benefit for nonprofit hospitals, which provides a set of uniform standards to increase accountability and align governance, management, and operations to return benefit to local communities. NorthShore is guided and its initiatives measured by five guiding principles, including: 1) Disproportionate Unmet Health-Related Needs, 2) Primary Prevention, 3) Seamless Continuum of Care, 4) Build Community Capacity, and 5) Community Collaboration. NorthShore informs and educates low-income patients of our Financial Assistance program across many points within the system. We have posted signs--both English and Spanish--in all our facilities' Emergency Departments and at our Central Registration areas. The NorthShore patient information television channel is available to all patients upon admission and a section describes how to obtain Financial Assistance. The NorthShore billing statements describes the Financial Assistance program and necessary contact information. Our collection agencies and billing offices also coordinate charity care to potentially eligible patients. Finally, the NorthShore website (northshore.org) is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. NorthShore also has approximately 16 full-time financial counselors and 38 Customer Service agents representing our hospitals, clinics, and physician offices. These counselors and representatives are responsible for helping patients understand their bills and coordinating financial assistance and insurance eligibility when appropriate. Any uninsured patient admitted to our hospitals will have their case reviewed by a financial counselor. NorthShore has also earned Certified Application Counselor Organization (CACO) status with the Centers for Medicare and Medicaid Services (CMS). Our counselors are certified and capable of helping patients navigate Medicaid and Insurance Exchange options. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible for financial assistance will have their case reviewed by calling our centralized Customer Service billing department. Our Customer Service department responds to approximately 1,400 calls per day from patients with questions about their bill or that are unable to pay. In addition to the formal application process for Financial Assistance, NorthShore may also grant Financial Assistance on a presumptive basis. Presumptive Financial Assistance approvals are based upon individual life circumstances such as enrollment in low-income government programs with income eligibility below 200 percent of federal poverty level income guidelines or verification of financial indigence through a credit rating agency and their calculated healthcare credit score. NorthShore Evanston Hospital - Evanston Hospital continues to serve the community as a comprehensive acute-care facility and the nucleus of NorthShore. Principal home to NorthShore Cardiovascular Institute and Kellogg Cancer Center, Evanston Hospital also offers a variety of surgical specialties: neurosurgery, gynecological surgery, robot-assisted surgery, surgical oncology and urology surgery. Evanston Hospital is certified by the Joint Commission in palliative care and as a Primary Stroke Center - providing an acute stroke team 24 hours a day, seven days a week for rapid diagnosis and treatment. Evanston Hospital also is a premier Level I Trauma Center in the northern suburbs with a recently renovated and expanded Emergency Department. Physicians work alongside leading researchers to translate the latest technology, treatment and research into improved patient care. As the regional center for high-risk obstetrics, the Infant Special Care Unit and the Women's Hospital offer a comfortable birthing environment where high-risk mothers and their babies have access to the latest technology and a highly trained staff. Evanston Hospital also offers leading-edge lab capabilities and serves as a home base for NorthShore's pioneering Neaman Center for Personalized Medicine, which customizes a patient's care and treatment plan based on the individual's unique genetic characteristics and health history. It also houses the Grainger Center for Simulation and Innovation, which provides nurses, physicians, residents, paramedics, firefighters and police with simulated clinical care, trauma and emergency preparedness training in a controlled environment. During fiscal year ending 12/31/21, Evanston Hospital total admissions were 5,288, and total patient days were 26,644 NorthShore Glenbrook Hospital - Glenbrook Hospital is well known in the northern suburbs as a comprehensive medical center providing advanced diagnostic and therapeutic interventions - particularly focused on advanced ophthalmology and outpatient surgery, and the specialized needs of geriatric patients.
Form 990, Part III, Line 4a Program Service Description - Patient Care (continued) The hospital boasts a 25,000 square-foot Emergency Department featuring 30 private exam/treatment rooms . In addition to being a Level II Trauma Center, Glenbrook Hospital is certified by the Joint Commission as a Primary Stroke Center - providing an acute stroke team 24 hours a day, seven days a week for rapid diagnosis and treatment. Glenbrook Hospital provides advanced medical and surgical care in a beautiful healing environment. Notable specialties include NorthShore Kellogg Cancer Center, NorthShore Neurological Institute, NorthShore Cardiovascular Institute, the John and Carol Walter Center for Urological Health, Patricia Nolan Center for Breast Health, Simms Family GI Lab, and the Eye and Vision Center. In addition, the hospital offers leading-edge interventional radiology and diagnostic radiology services. During fiscal year ending 12/31/21, Glenbrook Hospital total admissions were 2,209, and total patient days were 12,129. NorthShore Highland Park Hospital - Highland Park Hospital includes an updated surgical pavilion offering the latest technology and leading-edge operating rooms. Construction of the Women's Hospital was completed in 2017, providing the only dedicated Labor, Delivery and Post-Partum Unit in Lake County. Highland Park Hospital is the site of the first open-heart surgery in Lake County and continues to provide a full range of cardiac diagnosis and intervention services. Highland Park Hospital's Kellogg Cancer Center offers the most comprehensive subspecialty care in the northern suburbs including: thoracic and lung, hematology, breast, ovarian, head and neck, melanoma and sarcoma, gastrointestinal, prostate and stomach. Highland Park Hospital is a Joint Commission-certified Primary Stroke Center - providing an acute stroke team 24/7 for rapid diagnosis and treatment. Highland Park Hospital's Emergency Department also is the region's "pod" hospital for disaster-response activities across Lake County. During fiscal year ending 12/31/21, Highland Park Hospital total admissions were 2,274, and total patient days were 10,746. NorthShore Skokie Hospital - Skokie Hospital is not only home to Illinois' only destination hospital dedicated to orthopaedic and spine care, but it also offers emergency and outpatient services to meet the needs of the local community. The Orthopaedic & Spine Institute provides advanced care and is designed for both outpatient and inpatient procedures, including joint replacement, fracture care and complex spine surgeries. The Institute's team is comprised of trained experts, from orthopaedic surgeons, neurosurgeons and anesthesiologists, to nurses, physical and occupational therapists. Each member of the team is highly experienced in using the latest innovations and leading-edge techniques, including Enhanced Recovery After Surgery (ERAS) protocols to minimize opioid use and achieve a higher level of patient satisfaction pre- and post-surgery. Established in 1963, Skokie Hospital also provides patients access to a vast network of outpatient clinical resources as well, from multispecialty physician offices to cardiac imaging, radiology and gastrointestinal services - and a Level II Trauma Center and Emergency Department. Skokie Hospital recently completed a seven-year, multimillion-dollar renovation and expansion ensuring the hospital continues to provide the community with exceptional medical care for years to come. A newly opened state-of-the-art surgical pavilion includes eight new operating rooms and a sterile processing center. During fiscal year ending 12/31/21, Skokie Hospital total admissions were 541, and total patient days were 3,150. Swedish Hospital - Part of NorthShore - Swedish Hospital has served the diverse communities of Chicago's North Side for more than 130 years, and on January 1, 2020, Swedish Hospital and its various clinical entities became part of NorthShore University. Swedish Hospital provides the full range of comprehensive health and wellness services including an acute care 312-bed hospital, a talented team of primary and specialty care physicians in the Swedish Medical Group, strong community outreach programs, and Chicago's only certified medical fitness center - Galter LifeCenter. Swedish Hospital offers advanced clinical care in more than 50 academic-level medical specialties. This includes the Mayora Rosenberg Women's Health Center, which offers 3-D mammography and is home to the region's top midwifery program. Swedish Hospital also is certified by the Joint Commission as a Primary Stroke Center. Northwest Community Hospital - Part of NorthShore - On January 1, 2021 Northwest Community Hospital (NCH) became part of NorthShore. Serving Chicago's northwest suburbs since 1959, NCH is dedicated to providing outstanding care in the communities it calls home. The hospital serves more than 200,000 outpatients and treat more than 20,000 inpatients annually. The NCH hospital houses a Level III NICU, Level II Trauma Center and a dedicated pediatric emergency department. The hospital has 509 beds, including the South Pavilion with 200 private rooms and a 33-bed acute inpatient rehabilitation unit and seven outpatient rehabilitation centers. The NCH campus houses the Wellness Center, a premier health and fitness center and spa, as well as a full-service, retail pharmacy. NorthShore University HealthSystem Faculty Practice Associates - NorthShore University HealthSystem Faculty Practice Associates (FPA) is comprised of about 900 primary and specialty care physicians located in Chicago and many of the northern suburbs. With more than 140 locations, the primary care team includes experts in internal medicine, family medicine, pediatrics and obstetrics and gynecology. Our primary care team works in close collaboration with physicians in over 50 specialty services in every field of medicine, including cancer, orthopaedics, neurological and cardiovascular care. Additionally, NorthShore advanced primary care by integrating genetics into patient care plans to more precisely guide medical management. Patients who see a FPA primary care physician, now receive a Genetic and Wellness Assessment as part of a patient's annual physical. This personalized medicine tool helps the doctor better identify risk factors and detect diseases at their earliest, most treatable stages. Through NorthShore's teaching affiliation with the University of Chicago Pritzker School of Medicine, FPA physicians hold academic appointments at the Pritzker School of Medicine, helping to teach and train the physicians of tomorrow. NorthShore University HealthSystem Foundation - NorthShore University HealthSystem Foundation (Foundation) is dedicated to attracting and stewarding philanthropy in support of the integrated healthcare delivery system's mission to "preserve and improve human life." Generous donations of time, talent and treasure - from individuals, foundations and corporations - help to ensure that world-class healthcare is available close to home. Philanthropy was integral to the founding of NorthShore in 1891, and is simply a part of NorthShore - past, present and future. NorthShore University HealthSystem Home and Hospice Services - NorthShore University HealthSystem Home and Hospice Services (Home and Hospice) offers the full spectrum of home and hospice care, including skilled nursing, physical and occupational therapy and home medical equipment. Home and Hospice caregivers represent a wide range of medical specialties and work with the patient, family and physician to tailor home care to meet the individual needs of each patient.
Form 990, Part III, Line 4a Program Service Description - Education As a primary teaching affiliate for University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem (NorthShore) is dedicated to excellence in medical education and research. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore physician-educators connect and innovate with the next generation of medical specialists to help shape the future of healthcare. Combined with NorthShore's established reputation for advanced information technology and its strong clinical environment, this affiliation represents an exciting advancement in academic medicine for the Chicagoland area and for future physician leaders. NorthShore has an extensive selection of training programs and fellowships to offer physicians at its teaching and research facilities. During fiscal year ending 12/31/21, 223 resident and fellow full-time equivalents (FTEs) participated in NorthShore and affiliate-based programs. The NorthShore residency program areas include: Dentistry, Family Medicine, Internal Medicine (Categorical, Preliminary, and Transitional), and Pathology. The NorthShore fellowship program areas include: Breast Surgery , Cardiology, Endocrine Surgery, Family Medicine-Sports Medicine, Gastroenterology, Maternal-Fetal Medicine, Musculoskeletal Imaging, Simulation-Emergency Medicine, and Urogynecology. The affiliate-based residency program areas include: Anesthesiology, Emergency Medicine, General Surgery, Neurology, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Radiology, and Urology. The affiliate-based fellowship program areas include: Cardiothoracic Surgery, Child Psychiatry, Colon Rectal Surgery, Gynecology-Oncology, Hematology-Oncology, Mammography, Maternal-Fetal Medicine, Medical Microbiology, Molecular Genetics Pathology, Neonatal-Perinatal Medicine, Nephrology, Neuroradiology, Orthopaedic Hand, Orthopaedic Sports, Palliative Medicine, Peripheral Vascular Surgery, and Surgical Oncology. NorthShore also offers a comprehensive Pharmacy residency program, with resident positions located at all four hospitals. The Pharmacy residency program includes both clinical and administrative exposure focusing on inpatient and ambulatory practice. The program also includes specialty residencies in oncology, pharmacy informatics, and pharmacy administration. The program consists of a multitude of experiences that reinforce residents' knowledge and skills and help them advance into well-rounded practitioners. During fiscal year ending 12/31/21, 16 residents participated in the program. The NorthShore School of Nurse Anesthesia operates out of Evanston Hospital and is affiliated with DePaul University. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the school is to prepare qualified professional registered nurses for the advanced practice of nurse anesthesia in a variety of practice settings. The graduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take on leadership roles in the practice of nurse anesthesia. During fiscal year ending 12/31/21, 96 students participated in the program. NorthShore also provided clinical training and internships during the fiscal year for 101 high school and college students. Students interned in the following areas: Nursing, Diagnostic Radiology, and Physical Therapy.
Form 990, Part III, Line 4a Program Service Description - Research The NorthShore University HealthSystem Research Institute (Research Institute) was organized in 1996 to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute now houses more than 210 principal investigators who currently occupy 95,000 net square feet of research space and work on 1,200 active research protocols. The Research Institute builds on NorthShore's promise to deliver excellence in all aspects of patient care. Efforts are directed to research initiatives that make a difference across multiple disciplines. From oncology and neurology to orthopaedics and cardiovascular care, the Research Institute focuses on areas of inquiry that have the potential to make the greatest impact on improving and saving lives. NorthShore offers some 1,000 active clinical trials of various types, from innovative surgical procedures to the latest drug therapies. NorthShore's clinical research portfolio focuses on a range of conditions, including cancer, neurologic disorders and stroke, cardiovascular disorders, and a wide range of pediatric and gynecologic conditions. Additionally, major clinical trial programs in advanced imaging and medical genetics are also offered. The Research Institute is also a member of the Illinois Precision Medicine Consortium (IPMC), which is part of a national landmark longitudinal All of Us Research Program (AoURP) cohort program to improve the ability to prevent and treat disease based on individual lifestyle, environment, and genetics. NorthShore will enroll over 9,000 NorthShore patients in the study, and participants in NorthShore's AoURP will be asked to share a wide-range of health, environmental, and lifestyle information. The NorthShore Program for Personalized Cancer Care (PPCC) is pioneering new strategies in cancer care. The PPCC uniquely focuses on the genetic pattern of an individual's hereditary DNA to derive a personalized cancer risk assessment profile. Based on the inherited risk of developing a given cancer, the PPCC is beginning to implement personalized cancer care strategies that encompass the entire spectrum of disease. The PPCC believes this approach will lead to more efficient use of health care resources by targeting prevention and screenings toward individuals at greater risk of developing cancer, earlier cancer detection, and, ultimately and most importantly, reduced cancer deaths and suffering.
Form 990, Part VI, Line 15 Process to Establish Compensation of Top Official and Other Employees A detailed compensation review of the top 17 executives, including the Chief Executive Officer, is conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market data for base and variable compensation is assessed annually for local, regional and national hospitals, integrated delivery systems, and academic medical centers. A detailed total compensation market review is conducted every two years. The market assessment includes assessing job content in order to make appropriate market data comparisons. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation. A detailed compensation review of the 13 Clinical Chairs is also conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting for physicians within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market compensation data for each physician's specialized area of training is assessed annually. A detailed total compensation and Fair Market Value review is conducted every two years. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Toure S Claiborne, A Steven Crown, David A Dohnalek, Connie K Duckworth, Guy W Eisenhuth, John Erwin III, William M Farrow III, Ann K Ford, Neil S Freedman, Gerald P Gallagher, Catherine Guthrie, Mahalakshmi Halasyamani, Gregory K Jones, Jason L Koh, Harry M Jansen Kraemer Jr, Samuel M Mencoff, Kristen Murtos, Christopher J Olson, Bea Reyna-Hickey, Scott C Schweighauser, Susan B Sentell, Mark S Talamonti, Gregory Wallman, Kevin Willer, John G Zern, David F Zucker - Business relationship, Harry M Jansen Kraemer Jr and Samuel M Mencoff - Business relationship, Kristen Murtos and David Rahija - Business relationship, Mahalakshmi Halasyamani and Kristen Murtos - Business relationship, Sean O'Grady and Michael S Caplan - Business relationship, Douglas D Welday and Jesse Peterson Hall - Business relationship
Form 990, Part VI, Line 11b Review of form 990 by governing body The NorthShore University HealthSystem (NorthShore) Form 990 was reviewed by executive management and an outside accounting firm. The NorthShore Form 990 was then provided to the Chairman of the Board of Directors via email for review and ability to ask questions of management prior to filing.
Form 990, Part VI, Line 12c Conflict of interest policy All officers, directors and employees are required to report any potential or actual conflicts of interest as they arise, promptly and in writing, to the Chief Compliance Officer. In addition, on an annual basis, the Chief Compliance officer requires all officers, directors, and key employees to complete, sign and return a Conflict of Interest Disclosure Statement requiring information about any and all potential or actual conflicts. Timely and accurate completion of the Statement is mandatory, and completed Statements must be returned to the Chief Compliance Officer within 15 days. Any disclosures included on the Statements are reviewed and acted upon as necessary by the Chief Compliance Officer and the Corporate Compliance Committee.
Form 990, Part VI, Line 19 Required documents available to the public The NorthShore University HealthSystem (NorthShore) governing documents, conflict of interest policy, and financial statements are available to the public upon request. The NorthShore annual audit report and financial statements are also available to the public through GuideStar and the Illinois Attorney General's Office websites as part of the federal and state tax return filings. The NorthShore quarterly and annual financial statements and annual audit are also made available to the public through the Electronic Municipal Market Access (EMMA) website as part of the tax-exempt bond offerings.
Form 990, Part VIII, Line 2f Other Program Service Revenue Other - Total Revenue: 1872135, Related or Exempt Function Revenue: 1872135, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other - Total Revenue: 6261609, Related or Exempt Function Revenue: 5863544, Unrelated Business Revenue: 281032, Revenue Excluded from Tax Under Sections 512, 513, or 514: 117033;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Equity adjustments for the Pension Plan - 3950388; Research Fund Deferred Income Reversal - -1667826;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
NorthShore University HealthSystem
 
Employer identification number

36-2167060
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
(1) NorthShore Physician Partners LLC
1301 Central Street
Evanston,IL60201
87-4293274 		Healthcare IL 0 0 NorthShore University HealthSystem
 
(2) NorthShore Physician Associates LLC
1301 Central Street
Evanston,IL60201
88-1019298 		Healthcare IL 0 0 NorthShore Physician Partners LLC
 








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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)NorthShore University HealthSystem Faculty Practice Associates
1301 Central Street

Evanston,IL60201
36-3738206 		Healthcare IL 501(c)(3) Type I NorthShore University HealthSystem
 
Yes
 
(2)Radiation Medicine Institute
1301 Central Street

Evanston,IL60201
36-3815543 		Healthcare IL 501(c)(3) Type I NorthShore University HealthSystem
 
Yes
 
(3)Healthcare Foundation of Highland Park
610 Central Avenue

Highland Park,IL60035
36-3196647 		Fundraising IL 501(c)(3) Type II NA
 
 
No
(4)Swedish Covenant Health
5145 N California Avenue

Chicago,IL60625
36-2179813 		Hospital IL 501(c)(3) 3 NorthShore University HealthSystem
 
Yes
 
(5)Swedish Covenant Hospital Foundation
5145 N California Avenue

Chicago,IL60625
20-5055155 		Support of Swedish Covenant Hospital IL 501(c)(3) 7 Swedish Covenant Health
 
Yes
 
(6)Northwest Community Healthcare
3040 Salt Creek Lane

Arlington Heights,IL60005
36-3125209 		Support of Northwest Community Hospital IL 501(c)(3) Type II NorthShore University HealthSystem
 
Yes
 
(7)Northwest Community Hospital
3040 Salt Creek Lane

Arlington Heights,IL60005
36-2340313 		Hospital IL 501(c)(3) 3 Northwest Community Healthcare
 
Yes
 
(8)Northwest Community Hospital Foundation
3040 Salt Creek Lane

Arlington Heights,IL60005
36-3125193 		Fundraising IL 501(c)(3) 7 Northwest Community Healthcare
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Ravine Way Surgery Center LLC

2401 Ravine Way
Glenview,IL60025
20-1245279 		Healthcare IL NorthShore University HealthSystem
  		Related 733,862 1,051,362   No   Yes   27 %
(2) NPC Cyberknife LLC

3040 Salt Creek Lane
Arlington Heights,IL60005
20-4462828 		Equipment Leasing IL Northwest Community Healthcare
  		N/A                
(3) NWC Day Surgery Center II LLC

3040 Salt Creek Lane
Arlington Heights,IL60005
30-0798249 		Outpatient Care IL Northwest Community Healthcare
  		N/A                
(4) Northwest Endo Center LLC

3040 Salt Creek Lane
Arlington Heights,IL60005
81-2338623 		Surgical Care IL NWC Health Services Inc
  		N/A                
(5) EnVision Medical Imaging LLC

8930 Waukegan Road
Suite 130
Morton Grove,IL60053
82-2067179 		Imaging Services IL NWC Health Services Inc
  		N/A                




Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) NorthShore Physician Associates Inc

1301 Central Street
Evanston,IL60201
36-3648026 		Healthcare IL NorthShore University HealthSystem Faculty Practice Associates
  		C Corporation       Yes  
(2) NorthShore Physician Associates Value Based Care LLC

1301 Central Street
Evanston,IL60201
82-2268872 		Healthcare IL NorthShore Physician Associates Inc
  		C Corporation       Yes  
(3) NorthShore University HealthSystem Insurance International

 
 
98-0419452 		Insurance CJ NorthShore University HealthSystem
  		C Corporation 1,464,137 20,925,739 100 % Yes  
(4) Swedish Covenant Management Services Inc

5145 N California Avenue
cHICAGO,IL60625
36-4073303 		Physician Practice Management IL Swedish Covenant Health
  		C Corporation       Yes  
(5) Swedish Covenant Physician Partners Ltd

5145 N California Avenue
Chicago,IL60625
36-3120220 		Physician Practice Management IL Swedish Covenant Health
  		C Corporation       Yes  
(6) Central Insurance Company Ltd

PO Box 10233
  Grand CaymanKY11002
CJ
98-1109518 		Insurance CJ Northwest Community Healthcare
  		C Corporation       Yes  
(7) Northwest Community Health Services Inc

800 West Central Road
Arlington Heights,IL60005
36-3312906 		Healthcare IL Northwest Community Healthcare
  		C Corporation       Yes  
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) NorthShore University HealthSystem Faculty Practice Associates

 A 6,495,747 FMV
(2) NorthShore University HealthSystem Faculty Practice Associates

 B 30,106,789 FMV
(3) NorthShore University HealthSystem Faculty Practice Associates

 C 846,479 FMV
(4) Healthcare Foundation of Highland Park

 C 300,000 FMV
(5) NorthShore University HealthSystem Faculty Practice Associates

 P 14,116,692 FMV
(6) NorthShore University HealthSystem Faculty Practice Associates

 Q 5,071,961 FMV
(7) NorthShore Physician Associates Inc

 Q 154,504 FMV
(8) Radiation Medicine Institute

 Q 29,866 FMV
(9) NorthShore University HealthSystem Faculty Practice Associates

 R 145,699,625 FMV
(10) Radiation Medicine Institute

 R 1,248,690 FMV
(11) Swedish Covenant Health

 R 42,059,172 FMV
(12) NorthShore Physician Associates Inc

 R 31,572,227 FMV
(13) Northwest Community Healthcare

 R 18,332,799 FMV
(14) Radiation Medicine Institute

 S 1,218,823 FMV
(15) NorthShore Physician Associates Inc

 S 31,335,313 FMV
(16) Ravine Way Surgery Center LLC

 S 162,000 FMV
(17) NorthShore University HealthSystem Faculty Practice Associates

 S 150,419,272 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2