Instrumentl eFile Render
Object ID: 202221959349300042 - Rendered 2024-05-07
TIN: 36-4724966
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
20
Open to Public Inspection
Name of the organization
Northwestern Memorial HealthCare Group
Employer identification number
36-4724966
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)
ILLINOIS PROTON CENTER LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
26-0876468
HEALTHCARE
DE
33,733,528
71,372,655
CENTRAL DUPAGE HOSPITAL
(2)
PALOS MEDICAL GROUP LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
27-1472342
HEALTHCARE
IL
20,891,682
2,845,676
PALOS COMMUNITY HOSPITAL
(3)
MIDLAND SURGICAL CENTER LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
35-2194610
HEALTHCARE
IL
2,451,816
745,569
KISHWAUKEE COMMUNITY HOSPITAL
(4)
PALOS IMAGING LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
36-4836347
HEALTHCARE
IL
6,610,042
1,744,013
PALOS COMMUNITY HOSPITAL
(5)
CHICAGO HEALTH COLLEAGUES LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
38-4017932
HEALTHCARE
IL
612,746
1,131,896
PALOS COMMUNITY HOSPITAL
(6)
CADENCE AMBULATORY SURGERY CENTER LLC
541 N Fairbanks Ct
Rm 1630
CHICAGO
,
IL
60611
80-0838376
HEALTHCARE
IL
10,786,999
30,022,244
CENTRAL DUPAGE HOSPITAL
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)
AUXILIARY BOARD OF NORTHWESTERN MEMORIAL HOSPITAL
541 N FAIRBANKS CT
Ste 800
CHICAGO
,
IL
60611
23-7241270
SUPPORTING
IL
501(c)(3)
Type I
NA
No
(2)
SOUTH CAMPUS PARTNERS INC
541 N FAIRBANKS CT
Rm 1630
CHICAGO
,
IL
60611
32-0517854
HEALTHCARE
IL
501(c)(3)
3
PALOS COMMUNITY HOSPITAL
Yes
(3)
MCGAW MEDICAL CENTER NORTHWESTERN UNIV
420 E SUPERIOR ST
Ste 9 900
CHICAGO
,
IL
60611
36-2656113
SUPPORTING
IL
501(c)(3)
Type I
NA
No
(4)
NORTHWESTERN MEMORIAL HEALTHCARE
541 N FAIRBANKS CT
Rm 1630
CHICAGO
,
IL
60611
36-3152959
MANAGEMENT
IL
501(c)(3)
Type III-FI
NA
No
(5)
PAHCS II
541 N FAIRBANKS CT
Rm 1630
CHICAGO
,
IL
60611
36-3887234
OCCUPATIONAL HEALTH
IL
501(c)(3)
10
Northwestern Medical FACULTY FOUNDATION
Yes
(6)
COMMUNITY NURSING SERVICE OF DUPAGE COUNTY
541 N FAIRBANKS CT
Rm 1630
CHICAGO
,
IL
60611
36-6080833
HOME HEALTH
IL
501(c)(3)
10
CENTRAL DUPAGE HOSPITAL
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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)
KISHWAUKEE AREA PHYSICIAN HOSPITAL ORGANIZATION LLC
541 N FAIRBANKS CT
RM 1630
CHICAGO
,
IL
60611
36-4205273
HEALTHCARE
IL
KISHWAUKEE COMM HOSP
Related
0
0
No
0
No
75 %
(2)
NORTHWESTERN MEDICAL FACULTY FOUNDATION DIALYSIS CENTER
541 N FAIRBANKS CT
RM 1630
CHICAGO
,
IL
60611
46-2159685
HEALTHCARE
DE
NMFF
Related
2,755,549
7,237,962
No
0
No
80 %
(3)
PALOS HEALTH SURGERY CENTER LLC
541 N FAIRBANKS CT
RM 1630
CHICAGO
,
IL
60611
35-2634976
HEALTHCARE
IL
PALOS COMM HOSPITAL
Related
-2,655,764
No
0
No
50.5 %
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)
NORTHWESTERN HEALTHCARE CORPORATION
541 N FAIRBANKS CT
SUITE 1630
CHICAGO
,
IL
60611
36-3382383
HEALTHCARE
IL
NORTHWESTERN MEMORIAL HOSPITAL
C Corporation
0
0
100 %
Yes
(2)
DUPAGE HEALTH SERVICES INC
541 N FAIRBANKS CT
SUITE 1630
CHICAGO
,
IL
60611
36-3270521
HEALTHCARE
IL
HEALTH PROGRESS INC
C Corporation
(3)
DELCOM CORPORATION
541 N FAIRBANKS CT
SUITE 1630
CHICAGO
,
IL
60611
36-3334711
HEALTH MGMT
IL
HEALTH PROGRESS INC
C Corporation
(4)
HEALTH PROGRESS INC
541 N FAIRBANKS CT
SUITE 1630
CHICAGO
,
IL
60611
36-3824138
HEALTHCARE
IL
NORTHWESTERN MEMORIAL HEALTHCARE
C Corporation
(5)
NORTHWESTERN MEDICINE HOLDINGS CO
541 N FAIRBANKS CT
Rm 1630
CHICAGO
,
IL
60611
83-4687208
MANAGEMENT
IL
NORTHWESTERN MEMORIAL HEALTHCARE
C Corporation
(6)
ST GEORGE ASSURANCE LTD
541 N FAIRBANKS CT
RM 1630
CHICAGO
,
IL
60611
98-1313176
RISK MGMT
CJ
PALOS COMMUNITY HOSPITAL
C Corporation
7,226,053
53,077,160
100 %
Yes
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
Yes
h
Purchase of assets from related organization(s)
............................
1h
Yes
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020
Schedule R (Form 990) 2020
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) 2020
Additional Data
Software ID:
20011424
Software Version:
2020v4.0