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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.
Graphic Arrow Attach to Form 990.
Graphic Arrow 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 ................. Graphic Arrow
9
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
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



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