990.. returnoforganization...

67
Form 9 9 0 .. Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung Department of the Treasury benefit trust or private foundation) Internal Revenue Service The organization may have to use a copy of this return to satisfy state reporting requirements. f^- C cc ra ror [ne cuue caienaar ear , or sax y ear De morn 1U 1 01 wua ana enain 09 / 30 / 2005 B ch.. if wkaa.- Pleas C Name of organization D Employer Identificati on number Addnm reIRs EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060 label or Name tharg. print or Number and street ( or P.O . box if mail Is not delivered to street address) Room/ suite E Telephone number INNai r.urn type. Final nOm ^C 2650 RIDGE AVENUE ( 847 11 570-2000 ---Tu id c City or town , state or country, and ZIP + 4 cosh X nceruel p°oes"„ss° " son` STON IL 60201 Other • Section 601(c)(3) organizations and 4947 (a)(1) nonexempt charitable H andl are not applicable to section 527organizations- trusts must attach a completed Schedule A ( Form 990 or 990-EZ). H(a) Is this a group return for affiliates? [] Yes a No O websfte : WWW. ENH . ORG H ( b) If "Yes ," enter number of affiliates 0, NA J Organization type (check only one) X 501(c ) ( 3 ) 4 (insert no-) 947(a )( 1) or 527 H(c) Are all affiliates Included? E7T;.- . No K Check here If the organization's gross receipts are normally not more than $25,000 . The (If 'No," attach a list See Instructions Hid) Is this a separate realm Ned by an organization need not file a return with the IRS , but if the organ ization received a Form 990 Package organ ation covered a g rou p rulIn Y. 7[ No In the mail , it should file a return without financial data. Some states require a complete return. I Grou p Exem ption Number M Check If the organization Is not required L Gross receipts : Add lines 6b, 8b, 9b, and 1 Ob to line 12 2 9 48 987 650 . to attach Sch. B (Form 990, 990-EZ , or 990-PF). Revenue Ex p enses , and Chan g es In Net Assets or Fund Balances ( See p a g e 18 of the instructions. 1 Contributions , gifts , grants , and similar amounts received: a Direct public support . .. . .. . .... .. ...... .. . 1 a t b Indirect public support ....... lb 1 , 015 , 947. . . ... . .... .. . . . . c Government contributions (grants ) . I c 1 , 507 , 944. d Total ( add lines Is Cuough tc) (cash $ 9,523 , 891. noncash s ) l d 9 , 523 , 891. 1 2 Program service revenue Including government fees and contracts (from Part VII, line 93) .. . . .. 2 766 , 110 , 085. 3 Membership dues and assessments . ... .......... . . .... . .... . . . 3 362 , 816 . 4 Interest on savings and temporary cash investments 4 613 , 715 . 5 Dividends and interest from securities .. .. .. . ... .. . . , , , , , , 5 16 , 383 , 098o 6 a Gross rents 6 a b Less : rental expenses ... . .... .. ........... . 6 b c Net rental Income or ( loss) (subtract line 6b from line 6a) . . .. . . ... .... . .. . . .. . 6 c 3 , 729 , 028. 7 Other investment income ( describe 7 > 8a Gross amount from sales of assets other (A) Securities (B) Other O than Inventory ........ . .... 137 901 634 . 8a NONE b Less : cost or other basis and sales expenses , . 095 , 827 , 685 . 8b NONE c Gain or (loss) (attach schedule) . ... .. 42 , 073 , 94-9. 8c NONE d Net gain or ( loss) (combine line 8c, columns (A) and ( B)) .. ,. ,SST l , i. 4 X,i .. _.. , . 8d 42 , 073 , 949. 9 Special events and activities ( attach schedule). If any amount Is from gaming, check here Ili- E a Gross revenue (not including $ of contributions reported on line 1a) . .. ... . ......... 9a b Less : direct expenses other than fundraising expenses .. .... . 9 b c Net Income or (loss) from special events (subtract line 9b from line 9a ) ... .... .... . . . 9c Gross sales of inventory , less returns and allowances $'I 1 oa 824 518 . $Tt-M 2 ob 468 664. . R EIGIN fro sales of inventory (attach ,schedule)(subtract line 10b from line 10a) , , , , , 1 oc 355 , 854 . er revenue rom II, line 103) 11 13 , 538 , 865. F2 . Total e e dd 100 1d 2 34 5 6c 7 8d 9c 10c and 11 . 12 852 691 301. 3 Welo nfin e fro 44 , column ( B)) .................... 13 676 , 838 , 683. 4 Ma a from line 44 , column (C)) ... . . .. . . . . . ... . ... .. . . . 14 133 , 071 , 062. v s^ eB ?tfri T lumn (D)) 15 W -r-V- 1-11yrnerits to a ffiliates a h schedule) .. .. .. ... .. . . . ... . ... .... .... . . 16 17 Total ex p enses ( add lines 16 and 44 , column A 17 809 , 909 , 745. , 18 Excess or (deficit ) for the year (subtract line 17 from line 12) . 18 42 , 781 , 556. 19 Net assets or fund balances at beginning of year (from line 73 , column (A)) . ....... . . . . . . 19 1 1 111 , 397 , 090. 20 Other changes In net assets or fund balances (attach explanation ) . .....STjt ' .3. . . =4T. 20 34 , 907 , 988 . Z 21 Net assets or fund balances at end of year (combine lines 18 , 19 , and 20) 21 1 , 119 , 270 , 658. For Privacy Act and Paperwork Reduction Act Notice , see the separate instructions . Form 990 (2004) 4EI01o 1 .000 C-? 016969 533P 08/10 / 2006 11 : 38.34 V04-8

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Page 1: 990.. ReturnofOrganization ExemptFromIncomeTax990s.foundationcenter.org/990_pdf_archive/362/362167060/362167060... · Form 990.. ReturnofOrganization ExemptFromIncomeTax Undersection

Form 9 9 0 .. Return of Organization Exempt From Income TaxUnder section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung

Department of the Treasury benefit trust or private foundation)Internal Revenue Service ► The organization may have to use a copy of this return to satisfy state reporting requirements.

f^-

Ccc

ra ror [ne cuue caienaar ear, or sax year De morn 1U 1 01 wua ana enain 09 / 30 /2005

B ch.. if wkaa.- Pleas C Name of organization D Employer Identification numberAddnm reIRs

EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060label or

Name tharg. pri nt or Number and street (or P.O. box if mail Is not delivered to street address) Room/suite E Telephone numberINNai r.urn type.

Final nOm ^C 2650 RIDGE AVENUE ( 847 11 570-2000---Tuid c City or town , state or country, and ZIP + 4 cosh X nceruel

p°oes"„ss° " son` STON IL 60201 Other ►• Section 601(c)(3) organizations and 4947(a)(1) nonexempt charitable H andl are not applicable to section 527organizations-

trusts must attach a completed Schedule A (Form 990 or 990-EZ). H(a) Is this a group return for affiliates? [] Yes a No

O websfte : ► WWW. ENH . ORG H(b) If "Yes," enter number of affiliates 0, NA

J Organization type (check only one) ► X 501(c ) ( 3 ) 4 (insert no-) 947(a )( 1) or 527 H(c) Are all affiliates Included? E7T;.-. No

K Check here ► If the organization's gross receipts are normally not more than $25,000 . The(If 'No," attach a list See Instructions

Hid) Is this a separate realm Ned by anorganization need not file a return with the IRS , but if the organization received a Form 990 Package organ ation covered a grou p rulIn Y. 7[ No

In the mail , it should file a return without financial data. Some states require a complete return. I Grou p Exemption Number ►M Check ► If the organization Is not required

L Gross receipts : Add lines 6b, 8b, 9b, and 1 Ob to line 12 ► 2 9 48 987 650 . to attach Sch. B (Form 990, 990-EZ, or 990-PF).

Revenue Expenses , and Changes In Net Assets or Fund Balances (See page 18 of the instructions.

1 Contributions , gifts , grants , and similar amounts received:

a Direct public support . .. . .. . .... .. ...... .. . 1 a

t b Indirect public support ....... lb 1 , 015 , 947.

. . ... ..... .. . . . .c Government contributions (grants) . I c 1 , 507 , 944.

d Total (add lines Is Cuough tc) (cash $ 9,523 , 891. noncash s ) l d 9 , 523 , 891.

1 2 Program service revenue Including government fees and contracts (from Part VII, line 93) .. . . .. 2 766 , 110 , 085.3 Membership dues and assessments . ... .......... . . .... . .... . . . 3 362 , 816 .4 Interest on savings and temporary cash investments 4 613 , 715 .5 Dividends and interest from securities .. .. .. . ... .. . . , , , , , , 5 16 , 383 , 098o6 a Gross rents 6 a

•b Less : rental expenses ... . .... .. ........... . 6 b

c Net rental Income or (loss) (subtract line 6b from line 6a) . . .. . . ... .... . .. . . .. . 6 c 3 , 729 , 028.

7 Other investment income (describe ► 7

> 8a Gross amount from sales of assets other (A) Securities (B) OtherO

than Inventory ........ . .... 137 901 634 . 8a NONE

b Less : cost or other basis and sales expenses , . 095 , 827 , 685 . 8b NONE

c Gain or (loss) (attach schedule) . ... .. 42 , 073 , 94-9. 8c NONE

d Net gain or (loss) (combine line 8c, columns (A) and (B)) .. ,. ,SST l ,i. 4 X,i.. _..

,

. 8d 42 , 073 , 949.

9 Special events and activities (attach schedule). If any amount Is from gaming, check here Ili- E

a Gross revenue (not including $ of

contributions reported on line 1a) . .. ... . ......... 9a

b Less : direct expenses other than fundraising expenses .. .... . 9 b

c Net Income or (loss) from special events (subtract line 9b from line 9a) ... .... .... . . . 9c

Gross sales of inventory , less returns and allowances $'I 1 oa 824 518 .

$Tt-M 2 ob 468 664..

REIGIN fro sales of inventory (attach ,schedule) (subtract line 10b from line 10a) , , , , , 1 oc 355 , 854 .

er revenue rom II, line 103) 11 13 , 538 , 865.

F2. Total e e dd 100 1d 2 3 4 5 6c 7 8d 9c 10c and 11 . 12 852 691 301.3 Welonfin e fro 44 , column ( B)) .................... 13 676 , 838 , 683.4 Ma a from line 44 , column (C)) ... . . .. . . . . . ... . ... .. . . . 14 133 , 071 , 062.

v s^eB ?tfri T lumn (D)) 15

W -r-V- 1-11yrnerits to a ffiliates a h schedule) .. .. .. ... .. . . . ... . ... .... .... . . 16

17 Total expenses (add lines 16 and 44 , column A 17 809 , 909 , 745.

, 18 Excess or (deficit ) for the year (subtract line 17 from line 12) . 18 42 , 781 , 556.19 Net assets or fund balances at beginning of year (from line 73 , column (A)) . ....... . . . . . . 19 1 1 111 , 397 , 090.

20 Other changes In net assets or fund balances (attach explanation ) . .....STjt ' .3. . . =4T. 20 34 , 907 , 988 .

Z 21 Net assets or fund balances at end of year (combine lines 18 , 19, and 20) • 21 1 , 119 , 270 , 658.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions . Form 990 (2004)

4EI01o 1 .000

C-?016969 533P 08/10 /2006 11 : 38.34 V04-8

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Form 990 (2004) 36-2167060 Piige 2

Statement of All organizations must complete column (A) Columns (B), (C), and (O) are required for section 501(c)(3) and (4) organizationsFunctional Exnenses and section 4947(a)(l) nonexempt chartable trusts but optional for others (See oaoe 22 of the Instructlons.1

Do not include amounts reported on line6b. 9 0b oI 16 Part I

(A) Total (B) Programservices

(C) Managementand general

(0) Fundraising

22 Grants and allocations (attach schedule)

(Cash s 15 , 930,294 . noneash s 22 15 930 294 . 15 930 2 9 4 . v- v`' yt `f:+ fY ^' 4 h' {A4r .p K v

23 Specific assistance to Individuals (attach schedule ) 2 34••. .v yr

te r`. r F t^ti r h 4£ 4;

} yv ti w4

yr\ tiff rX$ . ' ;.

24 Benefits paid to or for members (attach schedule) 24 A•wy 4:vv fv } L ' -

; [ • a ^

\v.. }v v\i\'\v1

25 Compensation of officers , directors , etc. 25 6 , 647 , 370. 1 , 88-3 , 500 . 4 , 763 , 870.

26 Other salaries and wages , , , , , . 28 265 610 866 . 230 994 336. 34 , 616 , 530.

27 Pension plan contributions , , , .. 27 13 397 002 . 10 435 349. 2 961 . 653.

28 Other employee benefits ...... 28 32 938 784 . 28 159 062. 4 , 779 , 722.

29 Payroll taxes . . ....... . . .. 29 17 364 621 . 15 054 769. 2 , 309 , 852.

30 Professional fundraising fees , , , , , 30

31 Accounting fees .. ..... ... . 31 400 733 . 400 , 733.

32 Legal fees .............. 32 12 617 767 . 12 , 617 , 767.

33 Supplies ............... 33 145 674 331. 144 283 236 . 1 1 391 , 095.

34 Telephone .............. 34 2 , 930 , 584 . 1 , 136 , 902

-

1 , 793 , 682.

35 Postage and shipping ........ , 35 1 , 673 , 965. 1 , 04 5 289. 628 676.

36 Occupancy 36 12 474 449. 10 106 281. 2 , 368 , 168.

37 Equipment rental and maintenance . 37 7 , 864 , 362. 6 1 930 , 606. 933 756.

38 Printing and publications ....... 3839 Travel ... ... .. ... .. . ... . 39 715 763 . 274 685. 441 078.

40 Conferences , conventions , and meetings , 40 801 536 . 392 067 . 409 469.

41 Interest ................. 41 9 , 567 , 576. 9 , 567 , 576.

42 Depreciation , depletion , etc (attach schedule).. 42 76 688 717. 47 163 940. 29 524 777. STMT 5.1

43 Other expenaesnotcovered above (Urnize)STMT _6_ 3a 186 611 025. 163 048 367. 23 562 658.

b ------------------------3b

c--

------------------------3c

d--

------------------------3d

e--

3e

44 Total functional expenses (add lines 22 through 431

Ume talsro lln 3 5 .. M-P),cary , 44 809 , 909 745. 676 838 683. 133 071 062.

Joint Costs . Check ► L_j you are following SOP 98-2.Are any joint costs from a combined educational campaign and fundraising solicitation reported In (B) Program services? ..... ► Yes aX No

If "Yes," enter (i) the aggregate amount of these joint costs $ ; ( ii) the amount allocated to Program serAces $

(ii) the amount allocated to Management and general $ ; and (iv) the amount allocated to Fundraising $Statement of Program Service Accomplishments (See page 25 of the instruction s.)

What Is the organization's primary exempt purpose? ► PATIENT CARE--------------- ---------------------

-- program serviceExpenses

All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number (Required for 501(c)(3) and

of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) (4) orgs., and 4 fa (1)trusts; but opfionalonal for

organizations and 4947(a)( 1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) others.)

a PATIENT -CARE ---SEE -PART -VIII - - --RELATIONSHIP OF-ACTIVITIES-----------------------------------------------------------------

TO THE ACCOMPLISI NT OF_EXEMPT PURPOSES.-------------------------------------

---------------------------------------------------------------------------( Grants and allocations $15,930,294.) 67638 , 68

b---------------------------------

-------------------------------------(Grants and allocations $ )

G ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

(Grants and allocations $

d ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Grants and allocations $

e Other program services (attach schedule ) (Grants and allocations $

f Total of Program Service Expenses (should equal line 44, column (B), Program services). .. ► 676,838,683.

4EIo20 1 000 Form 990 (2004)

016969 533P 08/10/2006 14:05:41 V04-8 4

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36-2167060Form 990 (2004) Page 3

Balance Sheets (See page 25 of the instructions.)Note : Where required, attached schedules and amounts within the description (A) (e

column should be for end-of-year amounts only. Beginning of year End of year

45 Cash - non-interest-bearing ... ........................ 37 343 109. 45 25 200 203.

46 Savings and temporary cash investments .................... 46

47a Accounts receivable 47a 160 , 481 , 75 0................

Nf,<b Less : allowance for doubtful accounts ..... 47b 857 296 .26 122 440 609. 47c 133 624 454.

KAF u'4.048a Pledges receivable ........ . 48a

.

Nom :b Less : allowance for doubtful accounts ...... 48b NO 5 , 365 , 185. 48c NONE

49 Grants receivable ..................... . ......... 49

50 Receivables from officers , directors , trustees, and key employees

(attach schedule ) ................................ 50

51a Other notes and loans receivable (attach

schedule ) 51 a ,„

b Less: allowance for doubtful accounts .... 51 b 51 c

52 Inventories for sale or use , , , , , . . . .......... . ... 10 223 652. 52 11 , 949 , 506.

53 Prepaid expenses and deferred charges ......... ... STMT. 7. 12 086 729 . 53 12 914 220.

54 Investments - securities (attach schedule ) s ,8, ►E]Cost ® FMV 1 299 078 135. 54 1 , 384 , 798 , 232.

55a Investments - land, buildings , and55aequipment : basis , , , , , , th4 k, , , , ,

b Less : accumulated depreciation (attachschedule ) .... .................. 5 5 b 55C

56 Investments - other (attach schedule ) .. . ... . . . .. . . . .. Ste. 9 . NO 56 85 640 201.

57a Land , buildings, and equipment basis ...... 57a 1 208 390 487.

b Less : accumulated depreciation (attachschedule STMT 5.1 , , , , , , 57b 639 423 962. 573 412 087. Sic 568 966 525.

58 Other assets (describe ► STMT 10 ) 19 , 11 4 326. 58 30 , 949 , 706.

59 Total assets (add lines 45 through 58) (must equal line 74) .......... 2 079 063 832. 59 2 . 253 943 047.

60 Accounts payable and accrued expenses .......... ......... 91 397 049 . 60 8-9 , 275 , 226.

61 Grants payable ................................. 6162 Deferred revenue ................... ............. 6263 Loans from officers , directors , trustees , and key employees (attach

schedule ) ....................... ............ .. 63' 64a Tax-exempt bond liabilities ( attach schedule ) . . .. .... . ... .. . . . 627 300 000. 64a 617 , 300 , 000.

b Mortgages and other notes payable (attach schedule ) , , , , , , , , , , , , , 64b65 Other liabilities ( describe ► STMT 11 ) 248 969 693 . 65 428 097 163.

66 Total liabilities ( add lines 60 through 65) .... . .. . . . ..... . . . . . 967 666 742 . 66 1 , 134 , 672 , 389.

Organizations that follow SFAS 117, check here ► X and complete lines

67 through 69 and lines 73 and 74. x,; yA

w 67 Unrestricted . ......................... ........ 1 034 430 636. 67 1 118 161 064.

68 Temporarily restricted ......................... 49 484 326. 68 1 , 109 , 594.

-a 69 Permanently restricted ...... ............ ......... 27 482 128 . 69 NONEto

Organizations that do not follow SFAS 117, check here ► LI and ucomplete lines 70 through 74.

U.0 70 Capital stock , trust principal, or current funds ................ . 70

71 Paid-in or capital surplus, or land , building , and equipment fund ........ 71h 72 Retained earnings, endowment, accumulated income , or other funds .... 72a 73 Total net assets or fund balances ( add lines 67 through 69 or lines

70 through 72;column (A) must equal line 19 ; column ( B) must equal line 21 ) . . . ... , 1 111 397 090. 73 1 119 270 658 .

74 Total liabilities and net assets I fund balances ( add lines 66 and 73) . 2 079 063 832. 74 2 , 253 , 943 , 047.

Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about aparticular organization. How the public perceives an organization in such cases may be determined by the information presentedon its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part Ill, the organization'sprograms and accomplishments.

JS%4E1030 1.000

016969 533P 08/10/2006 11:38:34 V04-8 5

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Form 990 (2004)

Reconci l iation of Revenue p r AUMeTFinancial Statements with Revenue perReturn (See page 27 of the instructions.)

a Total revenue, gains, and other support ,per audited financial statements ► a 831,153

b Amounts included on line a but not on

line 12, Form 990:

(1) Net unrealized gains -

on Investments • • t

36-2167060

off,PIM Reconciliation of ExpenseFinancial Statements wiltReturn

a Total expenses and losses peraudited financial statements , , , , ►

b Amounts included on line a but noton line 17, Form 990:

(1) Donated services

and use of facilities $

Page 4

per

759,72:

(2) Donated services (2) Prior year adjustments -

and use of facilities $ reported on line 20,

(3) Recoveries of prior Form 990 , , , • • $

year grants . . . . $ (3) Losses reported on -

(4) Other (specify): line 20, Form 990 S

(4) Other (specify):

STMT 12 $ 468,664.

Add amounts on lines (1) through (4) ► b 468 664. STMT 14 $ 468,664. - -

Add amounts on lines (1) through (4). . ► b 468 , 664.

c Linea minus line b ......... ► c 830 684 862. c Linea minus line b .. ► c 779 291 057.

d Amounts included on line 12, d Amounts included on line 17, -

Form 990 but not on line a: Form 990 but not on line a: l

(1) Investment expenses (1) Investment expenses ,

not Included on line not Included on line

6b, Form 990 6b, Form 990 , , , $

STMT 13 $ 22,006,439. STMT 15 $ 30,618,688.

Add amounts on lines (1) and (2). . ► d 22 006 439. Add amounts on lines (1) and (2) . , ► d 30 6 88 688.

e Total revenue per line 12, Form 990 e Total expenses per line 17, Form! 90

line c plus lined • • • • • • • • • ► e 852 691 301. line c plus lined • • • e 809 909 , 745.

FJTMW List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated; see page 27 ofthe instructiens_1

(A) Name and address(B) Title and average

hours per weekdevoted to position

(C) Compensation(If not paid, enter

4,

(D) Contributlons toemployee benefit plans &dstsrcs compsmation

(E) EVenseaccount and other

allowances

SEE STATEMENT 16 -Y 19 6 , 647 , 370 1 , 185 , 857 NONE

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your

organization and all related organizations , of which more than $ 10,000 was provided by the related organizations? ► [Yes q No

If "Yes; attach schedule - see page 28 of the instructions . SEE STATEMENT 21

JSA4E10401000

016969 533P 08/10/2006 11:38:34 V04-8

Form 990 (2004)

6

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Other Information (See page 28 of the instructions. Yes No76 Did the organization engage in any activity not previously reported to the IRS? If "Yes; attach a detailed description of each activity 76 X77 Were any changes made in the organizing or governing documents but not reported to the IRS? ....... ........... . 77 X

If "Yes; attach a conformed copy of the changes.

78 a Did the organization have unrelated business gross Income of $1,000 or more during the year covered by this return? ... .. ... . 78a X

b If "Yes." has it filed a tax return on Form 990-T for this year? ..... ........ . . .. . .... ... . . ..... ..... 78b X79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement ... ... . . 79 X

80 a Is the organization related (other than by association with a statewide or nationwide organization) through common

membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? . . _ . . .... ...... . 80a X

b If "Yes," enter the name of the organization. STMT 22

and check whether k Is exempt or nonexempt.

81 a Enter direct and Indirect political expenditures. See line 81 Instructions........ .... . .. 81 a

b Did the organization file Form 1120-POL for this year? .............. .. ... . ....... .......... . . 81 b N

82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge

or at substantially less than fair rental value? ...... . .. ........... . ... ..... ... . . ........ . . 82a X

b If "Yes; you may Indicate the value of these items here. Do not include this amount

as revenue In Part 1 or as an expense In Part 11. (See Instructions In Part 111.) ....... . .. ... 82b 1 , 232 , 490.

83 a Did the organization comply with the public Inspection requirements for returns and exemption applications? . . . ....... .. 83a X

b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? ..... ........... . 83 b

84 a Did the organization solicit any contributions or gifts that were not tax deductible? . . .... ..... ... ........... . 84a NI-k

b If "Yes," did the organization Include with every solicitation an express statement that such contributions

or gifts were not tax deductible? , , , , _ , _ - - - - - , , ... . . 84b N1 k85 501(c) (4), (5), or (6) organizatons. a Were substantially all dues nondeductible by members? , , , , , , , , , , , , , , , ,, , , , , 86a NI IL

b Did the organization make only In-house lobbying expenditures of $2,000 or less? 85b N

If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization

received a waiver for proxy tax owed for the prior year.

c Dues, assessments, and similar amounts from members 85c N/A

d Section 162(e) lobbying and political expenditures . ... ..... ........ . ... ... 86d N/A

.

e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices ...... . . ... ... 85e N/A

f Taxable amount of lobbying and political expenditures (line 85d less 85e) , , , , , , . , , . 85f N/A

g Does the organization elect to pay the section 6033(e) tax on the amount on line 851`7 , , , , , , , , , , , . , , , , , , , , ! n6 N

h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 851 to its reasonable

estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?.. ..... ...... . 85h N1 k86 501(c)(7) orgs. Enter a Initiation fees and capital contributions Included on line 12 , . , , . , 86a N/A

b Gross receipts, Included on line 12, for public use of club facilities , , , , , , , , , , , , , , , , , , 86b N/A87 501(c)(12) orgs. Enter a Gross income from members or shareholders 87a H/A

b Gross Income from other sources. (Do not net amounts due or paid to other

sources against amounts due or received from them.) . . .. 87b N/A88 At any time during the year, did the organization own a 50% or greater Interest In a taxable corporation or

.

partnership, or an entity disregarded as separate from the organization under Regulations sections

301.7701-2 and 301.7701-3? If "Yes," complete Part IX .. .. . - ..... 88

89 a 501(c)(3) organizations. Enter. Amount of tax Imposed on the organization during the year under

section 4911 ► NONE section 4912 ► NONE ; section 4955 ► NO

b 501(c)(3) and 501(c)(4) orgs. Did the organization engage in any section 4958 excess benefit transaction

during the year or did It become aware of an excess benefit transaction from a prior year? If "Yes," attach

a statement explaining each transaction .. . ..... . . . . ........ . .... .... . ... .. ... . . .. . . 89b X

c Enter. Amount of tax Imposed on the organization managers or disqualified persons during the year under

sections 4912, 4955, and 4958. _ - . . . . ... . . . .... ► NONE

d Enter. Amount of tax on line 89c, above, reimbursed by the organization ....... . ... . ....... ..... .... ► NONE

90 a List the states with which a copy of this return is filed .ILLINOIS

b Number of employees employed In the pay period that Includes March 12, 2004 (See instructions.) sTK 22.1

, , , , , 190b 15383

91 The books are in careof lo- EVANSTON NW HC,GARY GEPHART Telephone no. ► 847 570-5053

Locatedat,. 2650 RIDGE AVENUE,, EVANSTON, IL ZIP +4 ► 60201

92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Fonn 1041- Check here , ►and enter the amount of tax-exempt Interest received or accrued during the tax year . .... . ... . ... . . . ► 192 I N/A

JSA4EI041 1.000

Form 990 (2004)

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Analysis of Income-Producing Activities (see page 33 of the instrucuons.)

Note : Enter gross hmounts unless otherwise Unrelated business Income Excluded by section 512, 513, or 514 (E)

Indicated.(B) (C) (p) Related or

• (A)

A A ount exempt function93 Program service revenue:

atmui code mount ^ocn„wn ood• mIncome

a PATIENT REVENUE 923 . 6:

b THIRD PARTY CONTR. -379 , 6!

c OTHER ALLOWANCES -8 11

d

e

f Medicare/Medicald payments. . . . . . . 230 3

p Fees and contracts from government agencies .

94 Membership dues and assessments . . g

9 6 Interest an awlnpe and ternponry ash bwssbn•nts 14 613 7 5

99 Dividends and Interest from securities 14 16 , 383 , 098.

97 Net rental Income or (loss) from real estate:

a debt-financed property .... ... .

b not debt-financed property ...... 16 1 , 576 , 543. 2 , 1

98 Not rental Income or (loss) from personal prop"

99 Other Investment Income ... ... .

•100 Gain or(Toss)fmmsaiss orsssets other than hvntory 18 42 073 949.

101 Net Income or (loss) from special events

102 Gross profit or (loss) from sales of Inventory . 02 355 , 854.

103 Other revenue: a

b 6 1 362 . 203. 3 , 984 , 747. 3 . 191 . 9:

e

d

e

104 Subtotal (add columns (B), (D), and (Q). 6 , 362 , 203 . . 64 987 906. 771 1 8 '

0

106 Total (add line 104, columns (B), (D), and (E)) ..... . .. ... ... . .. . . . . . . . .. . ... ► 843,167,410*

Note: Une 105 plus fine Id, Part 1, should equal the amount on line 12, Part 1.

MMILTAIM Relationshipof Activities to the Accomplishment of Exempt Purposes (See page 34 of the instructions.)

Line No. Explain how each activity for which income is reported In column (E) of Part VII contributed Importantly to the accomplishment

y of the organization's exempt purposes (other than byproviding funds for such purposes).

idol" .

8"b 23.2

JiE3M Information Regarding Taxable Subsidiaries and Dis regarded Entities (See page 34 of the instructions.)(A)

Name, address,

;M=

on,partnershi p,

(B)Percentage of

ownership Interest

CNature

ofactivities Totalncome E ar

STUT 24 % NONE 1-0 , 93-6 , 222.

- R Information Reaardina Transfers Ass%

ociated with Personal Benefit Contracts (See pane 34 of the instructions.)

(a) Did the organization, during the year, receive any funds, din

(b) Did the organization , during the year, pay pre

Note: If'Yes* to tb), file FAn6 8870 and 4pnn 4720

and bel121

c ire

PleaseSign / S, stir o ole,Here k

T4pe not name and title.

Paid slgnahM OF/if

Preparer's Firm's name (or iUse Only if selfemployed),

address , and ZIP + 4

Indirectly, to pay premiums on a personal benefit contract? . , ,

,s, directly or indirectly, on a personal benefit contract,?*

of preparer

Ile

Yes X NoYes X No

JM481000 1.000

016969 533P 08/10/2006 11:38:34 V04-8

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SCHEDULE A(Form 990 or 990-EZ)

Department of the Treasury

Name of the organization

Organization Exempt Under Section 501(c)(3)(Except Private Foundation ) and Section 501(e ), 601(f), 601(k),

501(n), or Section 4947(a)(1) Nonexempt Charitable Trust

Supplementary Information - (See separate instructions.)ST be completed by the above organizations and attached to their Form 990 or 1

OMB No. 1545-0047

2004

EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 136-2167060

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees(See page 1 of the instructions . List each one. If there are none , enter "None.")

(a) Name and address of each employee paid more (b) Title and averagehours per week (c) Compensation

(d) Contributions toemployee benefit plans &

(e) Egenseaccount and other

than E50 , 000 devoted toposition deferred compensation allowances

RONALD- SPAETH-----------------------

FORMR AMEN OFF CER

2650 RIDGE AVENUE

EVANSTON , IL 40 HRS /WK 2 , 520 , 085. 57 , 152. NONE

THOMAS- SMITH---------------------- CIO

2650 RIDGE AVENUE

EVANSTON , IL 40 HRS /WK 617 730 . 82 , 310. NONE

WILLIAM LUEHRS-------------------- Ci¢t0

2650 RIDGE AVENUE

EVANSTON , IL 40 HRS WK 614 322. 117 057. NONE

JESSE-PETERSON-HALL

---------------------------------EXEC VP-EH -

2650 RIDGE AVENUE

EVANSTON , IL 40 HRS /WK 2-6-3 , 798 . 44 , 546 NONE

HARRY- L_JONES---------------------- CCO s SVP

2650 RIDGE AVENUE

EVANSTON , IL 40 HRS/WK 260 568 . 62 512. NONE

Total number of other employees paid over

$50,000 .1819 -

Compensation of the Five Highest Paid Independent Contractors for Professional Services(See page 2 of the instructions. List each one (whether individuals or firms). If there are none, enter "None.")

(a) Name and address of each Independent contractor paid more than $50,000 (b) Type of service (c) Compensation

WINSTON &-STRAWN-----------------------------------------------

CHICAGO IL 60694 ATTORNEY 13127523.

CRA INTERNATIONAL INC---------------------------

BOSTON , MA 02241 CONSULTANT 6 , 581 , 676.

BAIN & COMPANY-INC------------------------------------

BOSTON MA 02211 CONSULTANT 1 , 121 , 250.

RECALL TOTAL INFO- MGMT- INC------------------------------

ATLANTA GA 30392 CONSULTANT 963 562.

HEALTHCOM PARTNERS- LLC--------------------------------------------

CHICAGO IL 60678 CONSULTANT 802 580.

Total number of others receiving over $50,000 forprofessional services 35

For Paperwork Reduction Act Notice, see the Instructions for Form 890 and Form 990..

JSA

Schedule A (Form 990 or 990-EZ) 2004

4E12101 000

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Schedule A (Form 990 or 990-EZ) 2004 36-2167060 Page 2

Statements About Activities (See page 2 of the instructions. ) Yes No1 During the year, has the organization attempted to Influence national, state, or local legislation, Including any

attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid

or incurred In connection with the lobbying activities ► $ (Must equal amounts on line 38,

Part VI-A, or line i of Part VI-8.) . .... . . ..... ... . . . .. ..... . ... ... 1 X... ... . . .

Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other

organizations checking "Yes," must complete Part VI-B AND attach a statement giving a detailed description of

the lobbying activities.

2 During the year, has the organization, either directly or Indirectly, engaged In any of the following acts with any

substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or

with any taxable organization with which any such person Is affiliated as an officer, director, trustee, majority

owner, or principal beneficiary? (if the answer to any question Is 'yes,' attach a detailed statement explaining

the transactions.)

a Sale, exchange, or leasing of property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a X

b Lending of money or other extension of credit? ...... .. .... .... ... . ... ...... ......... 2b X

c Furnishing of goods, services, or facilities? .... .... .. ........... . .... ..... .....BUNT . 2$ 2c X

d Payment of compensation (or payment or reimbursement of expenses If more than $1,000)? . S) . Q9.0. - , E71iX. V . 2d X

e Transfer of any part of its Income or assets? ... .... .. .... ........ . .. . .... . ... . .. .. . 2e X

3a Do you make grants for scholarships, fellowships, student loans, etc.? Of "Yes," attach an explanation of how

you determine that recipients qualify to receive payments.) .. .... ... . ... . . .. . .... . .. .. .gTNT.2C; 3a X

b Do you have a section 403(b) annuity plan for your employees? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 b X

4a Did you maintain any separate account for participating donors where donors have the right to provide advice

on the use or distribution of funds? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a X

b Do you provide credit counseling, debt management , credit repair , or debt negotiation services? 4b X

17M1 Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions.)

The or anization is not a private foundation because it is: (Please check only ONE applicable box.)

6 A church, convention of churches , or association of churches . Section 170(b)(1)(A)(i).

6 A school . Section 170(b)(1)(A)(0). (Also complete Part V.)

7 X A hospital or a cooperative hospital service organization . Section 170(b)(1)(A)(ii).

8 A Federal , state , or local government or governmental unit. Section 170(b)(1)(A)(v).

9 A medical research organization operated in conjunction with a hospital . Section 170(b)(1)(A)(lii). Enter the hospitars name, city,

and state ►

10 q An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv).

(Also complete the Support Schedule in Part N-A.)

11 a q An organization that normally receives a substantial part of its support from a governmental unit or from the general public . Section

170(b)( 1)(A)(vl). (Also complete the Support Schedule In Part N-A.)

11 b A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule In Part N-A.)

12 An organization that normally receives: (1 ) more than 33 1 /3% of its support from contributions , membership fees, and gross

receipts from activities related to its charitable , etc., functions - subject to certain exceptions, and (2 ) no more than 33 1/3% of

its support from gross investment Income and unrelated business taxable income (less section 511 tax) from businesses acquired

by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule In Part IV-A.)

13 q An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations

described in: (1) lines 5 through 12 above; or (2) section 501 (c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See

section 509(a)(3).)

Provide the following information about the supported organizations . (See page 5 of the Instructions

(a) Name (s) of supported organization (s)(b) Line numberfrom above

14 11 An organizat ion organized and operated to test for public safety . Section 509(a)(4). (See page 5 of the instructions.)

4E1220 1 000 Schedule A (Form 990 or 99042Z) 2004

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Schedule A (Form 990 or 990-EZ) 2004 36-2167060 Page 3

Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method ofaccounting.Note: You may use'the worksheet in the instructions for converfina from the accrual to the cash method ofaccountino e%rn aen. .rran•.a

Calendar year (or fiscal year beginning In) (a) 2003 (b) 2002 c 2001 (d) 2000 a Total15 Gifts , grants , and contributions received. (Do

not Include unusual grants . See One 28.) .

16 Membership fees received .

.17 Gross receipts from admissions , merchandise

sold or services performed , or furnishing of

facilities In any activity that is related to the

organization' s charitable , etc., purpose .

18 Gross Income from interest , dividends,

amounts received from payments on securities

loans (section 512(a)(5)), rents , royalties, and

unrelated business taxable income (less

section 511 taxes) from businesses acquired

by the organization after June 30, 197519 Net Income from unrelated business

activities not Included In line 18

20 Tax revenues levied for the organization's

benefit and either paid to It or expended on

its behalf

21 The value of services or facilities furnished to

the organization by a governmental unit

without charge . Do not include the value of

services or facilities generally furnished to the

public without charge ..............

22 Other Income . Attach a schedule. Do not

Include gain or (loss) from sale of capital assets

23 Total of lines 15 through 22 .

24 Line 23 minus line 17 ..............

25 Enter 1% of line 23 ...............

26 Organizations described on lines 10 or 11: a Enter 2% of amount In column (e), One 24 15QT. "1?"C4%$1:0F , , , ► 26a

b Prepare a list for your records to show the name of and amount contributed by each person (other than a

governmental unit or publicly supported organization) whose total gifts for 2000 through 2003 exceeded the

amount shown In line 26a . Do not file this list with your return . Enter the total of all these excess amounts ► 26b

c Total support for section 509(a)(1) test : Enter line 24, column (e) . . .... ... . .. . . . . . . . . ... .. .. ► 26cd Add: Amounts from column (e) for lines: 18 19

22 26b . .. . .. ...... ► 26de Public support (line 26c minus line 26d total) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ► 26e

f Public support percenta ge (line 26e (numerator) divided by line 26c (denominator)) . ► 26f %zi organizations aescnoea on line ix: a i-or amounts mciuaea in lines 15, lb, and it that were received trom a °alsquaunea

person," prepare a list for your records to show the name of, and total amounts received In each year from, each "disqualified person."Do not file this list with your return. Enter the sum of such amounts for each year.

(2003) ________________ (2002) ___________________ (2001) ___ NOT APPLICABLE _ (2000)

b For any amount included in line 17 that was received from each person (other than "disqualified persons"), prepare a list for your records toshow the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000.(include In the list organizations described in lines 5 through 11, as well as individuals.) Do not file this list with your return. After computingthe difference between the amount received and the larger amount described In (1) or (2), enter the sum of these differences (the excessamounts) for each year.

(2003)---------------- (2002) ------------------- (2001)

------------------- (2000)---------------

c Add: Amounts from column (e) for lines: 15 16

17 20 21

d Add: Line 27a total and line 27b total , ,

e Public support (line 27c total minus line 27d total) ... ... .... . ... . ... .

f Total support for section 509(a)(2) test Enter amount from line 23, column (e) . . .. . .

g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) . .

............ ►

............ ►

............ ►. ►l27f

............... ►

28 Unusual Grants: Far an organization described in line 10, 11, or 12 that received any unusual grants during 2000 through 2003,. . .prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a briefdescription of the nature of the grant. Do not file this list with your return. Do not Include these grants In line 15.

Schedule A (Form 990 or 990-EZ) 2004JSA4E1221 1 000

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36-2167060Schedule A (Form 990 or 990-EZ) 2004 Page 4

Private School Questionnaire (See page 7 of the instructions.) NOT APPLICABLE(To be completed ONLY by schools that checked the box on line 6 in Part IV)

29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, Yes No

other governing instrument, or in a resolution of its governing body? ...... ....... . 29........ .. .30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its

brochures, catalogues , and other written communications with the public dealing with student admissions,programs , and scholarships? . . . . _ . . 30. . . . , .. , , , . . . . . _ . . ._ . . . , . . . .. . . . . . .

31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media duringthe period of solicitation for students , or during the registration period if it has no solicitation program, in a way

that makes the policy known to all parts of the general community it serves? 31, .............

If "Yes," please describe ; if "No," please explain. (If you need more space, attach a separate statement)

-----------------------------------------------------------------------------

-----------------------------------------------------------------------------

- -

----------------------------------------------------------------------------------------------------------------------------------------------------------

32 Does the organization maintain the following: .a Records indicating the racial composition of the student body, faculty, and administrative staff? 2ab Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory

basis? 2 b

c Copies of all catalogues, brochures, announcements, and other written communications to the public dealingwith student admissions, programs, and scholarships? 2c

d Copies of all material used by the organization or on its behalf to solicit contributions?

.

If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement)

-----------------------------------------------------------------------------

33 Does the organization discriminate by race in any way with respect to:

a Students' rights or privileges?

b Admissions policies?

c Employment of faculty or administrative staff?

d Scholarships or other financial assistance?

e Educational policies?

f Use of facilities?

g Athletic programs?

h Other extracurricular activities?

If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement)

--------------------------------------------------------------------------------------------------------------------------------------------------------

34 a Does the organization receive any financial aid or assistance from a governmental agency? .

b Has the organization's right to such aid ever been revoked or suspended? ......................If you answered "Yes" to either 34a or b, please explain using an attached statement

35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If "No," attach an explanation

JSA4E 1230 1.000

016969 533P 08/10/2006 11:38:34 V04-8

Schedule A (Form 990 or 9904M 2004

12

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Schedule A Form 990 or 990-F1 2004 36 -2167060 Page a

I:Frg Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions.)

o be completed ONLY by an eligible organization that filed Form 5768) NOT APPLICABLECheck ► a It the organization belon gs to an affiliated group . Check ► b It you checked "a" and "limited control" p rovisions apply,

Limits on Lobbying Expendituresa

Affiliated groupb

To be completedtotals for ALL electing

(The term "expenditures" means amounts paid or incurred.) organizations

36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 36

37 Total lobbying expenditures to Influence a legislative body (direct lobbying) 37....

38 Total lobbying expenditures (add lines 38 and 37) 38, , , , , , , , , , , , , , , , ,,

39 Other exempt purpose expenditures 39, ,, ,

40 Total exempt purpose expenditures (add lines 38 and 39) 40. , ........table -41 Lobbying nontaxable amount Enter the amount from the following

If the amount on line 40 Is - The lobbying nontaxable amount Is - -

Not over $500,000 . . . . . . . , . . .. 20% of the amount on One 40 . . . . . . . . - -

Over $500,000 but not over $1 , 000,000 $100,000 plus 15% of the excess over $500,000 = - ,

000 $ 175,000 plus 10% of the excess over $1,000,000000 but not over $1,500Over $1 000 41, ,,

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 , , , , , , . , . . . . .

42 Grassroots nontaxable amount (enter 25% of line 41) 42, , , , , , , ,

43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 43

44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 44

Caution : If there Is an amount on either line 43 or line 44, you must file Form 4720.

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 instructions for lines 45 throunh 50 on page 11 of the Instructions.)

Lobbying Expenditures During 4-Year Averaging Period

Calendar year (or fiscal (a) (b) (c) (d) (e)

year beg inning In) ► 2004 2003 2002 2001 Total

Lobbying nontaxable

45 amountLobbying ceiling amount -

4 6 1 S0% of line 45(a))

47 Total lobb expenditures

Grassroots nontaxable

48 amount

Grassroots ceiling amount

49 150% of line 48 e

Grassroots lobbying

5 0 expenditures . .

Lobbying Activity by Nonelecting Public Charities

(For re portin g only by organizations that did not complete Part VI-A (See page 1 i or me Insuuctions.

During the year, did the organization attempt to Influence national , state or local legislation , Including anyYes No Amount

attempt to Influence public opinion on a legislative matter or referendum, through the use of:

a Volunteers x........ ...... ......... .. .. ...b Paid staff or management (Include compensation in expenses reported on lines c through h.) , , x

c Media advertisements .. . ................................

d Mailings to members, legislators, or the public . . . . . . . . . . . . ............... . x

e Publications, or published or broadcast statements . . . ......... ....... ...... . x

t Grants to other organizations for lobbying purposes , , .. . . .... . ......... . x

g Direct contact with legislators, their staffs, government officials, or a legislative body , , , , , , , , x

h Rallies , demonstrations, seminars, conventions, speeches, lectures, or any other means x

I Total lobbying expenditures (Add lines c through h.),,,,,, , , , , , , , , , , , , , , ,

If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.JSA Schedule A (Form 990 or 990-EZ) 2004

4E1240 1.000

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Schedule A Form 990 or 99D-EZ) 2004 36-2167060Information Regarding Transfers To and Transactions and Relationships With NoncharitableExempt Organizations (See page 11 of the instructions.)

Page 6

51 Did the reporting organization directly or Indirectly engage in any of the following with any other organization described in section501(c) of the Code (other than section 501(c)(3) organizations) or In section 527, relating to political organizations?

a Transfers from the reporting organization to a noncharitable exempt organization of Yas No

(I) Cash.. .................................................... alal(II) Other assets ................... .................. .... ....... .... +1 II X

b Other transactions:(I) Sales or exchanges of assets with a noncharitable exempt organization , , , , , , , , , , , , , , , , , , , , b ( I ) X(II) Purchases of assets from a noncharitable exempt organization , , , , , , , , , , , , , , , , , , , , , , , , Mi l l

(ill) Rental of facilities, equipment, or other assets . . . . . . . . . . . . . . . ........ ........... b(I I I ) X(Iv) Reimbursement arrangements ...... . . . . . . . . . ........................... b iv X(v) Loans or loan guarantees,,,, , , , , , v(vi) Performance of services or membership or fundraising solicitations , b vl

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees , , , , , , , , , , , , , , , , , , , cd If the answer to any of the above Is "Yes," complete the following schedule. Column (b) should always show the fair market value of the

goods, other assets, or services given by the reporting organization. If the organization received less than fair market value In any

transaction or sharing arrangement, show In column (d) the value of the goods, other assets, or services received:

(a) (b) (a) (d)Line no. Amount Involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements

52a Is the organization directly or Indirectly affiliated with, or related to, one or more tax-exempt organizations

described in section 501 ( c) of the Code (other than section 501 (c)(3)) or in section 527? .......... ►Q Yes Q No

016969 533P 08/10/2006 11:38:34 V04-8 14

JsASchedule A (Form 990 or 990-EZ) 2004

4E 1200 1.000

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART I - GROSS SALES LESS RETURNS AND ALLOWANCES

DESCRIPTION AMOUNT----------- ------

EVANSTON HOSPITAL GIFT SHOP 399,295.

GLENBROOK HOSPITAL GIFT SHOP 425,223.------------

TOTAL 824,518.

STATEMENT 1

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PART I - LINE 8(A) - GROSS AMOUNTS RECEIVED FROM SALE OF ASSETSEVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON, ILLINOIS

Year Ended September 30, 2005

SalesProceeds Other Basis Gain(Loss)

36-2617060

Investments in Securities 2,137,901,634 2,095,827,685 42,073,949

See Note

Note: The Hospital's investments in securities are managed

by outside trustees.

STAT824ENT 1.1

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PART I - LINE 8( B) - GROSS AMOUNTS RECEIVED FROM DISPOSAL OF ASSETSEVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON, ILLINOIS

Year Ended September 30, 2005

36-2167060

Sales Original Accumulated AdjustedProceeds Cost Basis Deare:ciation Basis Gain(Loss)

Buildings & Equipment - 28,526,063 (28,526,063) - -

sTAT T 1.2

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EVANSTON NOR1*ESTEtai HEALTHCASE CORPORATION

POEM 990, PART I - COST 08 GOODS SOLD

36-2167060

MINUS:BEGINNING SALARIES ENDING COST OF

DESCRIPTION fl VSNT0[OC A = AM MAGES OTHER COSTS DIVENTO GOODS SOLD

----------- ------- ----------

EV STON HOSPITAL GIFT SHOP 205 , 004. 205,004.

GLENBR00K HOSPITAL GIFT SHOP 263 , 660. 263,660.

-------- ------- -------

TO468,664. 468,664.

016969 533P 08/10/2006 11:38:34 V04-8 1 9 32A1CH T 2

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, PART I - OTHER INCREASES IN FUND BALANCES

DESCRIPTION

NET UNREALIZED GAIN ON INVESTMENTS

36-2167060

AMOUNT

49,692,107.------------

TOTAL 49,692,107.

016969 533P 08/10/2006 11:38:34 V04-8

STATEMENT 3

20

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, PART I - OTHER DECREASES IN FUND BALANCES

DESCRIPTION

ENH FNDN START UP SUPPORTADDITIONAL MINIMUM PENSION BENEFIT

36-2167060

AMOUNT

80,261,732.4,338,363.

------------

TOTAL 84,600,095.

016969 533P 08/10/2006 11:38:34 V04-8

STATEMENT 4

21

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, PART II - GRANTS AND ALLOCATIONS PA#D DURING THE YEAR

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR

AND

RECIPIENT NAME AIM ADDRESS FOUNDATION STATUS OF RECIPIENT

-------------------------- ------------------------------

GRANTS PAID

ENH RESEARCH INSTITUTE

1301 CENTRAL STREET

EVANSTON, IL 60201

ENH FACULTY PRACTICE ASSOC

1301 CENTRAL STREET

EVANSTON, IL 60201

EVANSTON NORTHWESTERN HEALTHCARE FOUNDATION

1301 CENTRAL ST

EVANSTON, IL 60201

NONE

501(C)(3)

NONE

501(C) (3)

NONE

501(C)(3)

36-2167060

PURPOSE OF GRANT OR CONTRIBUTION

--------------------------------

PAYMENT FOR MEDICAL EDUCATION AND RESEARCH

PAYMENT FOR MEDICAL EDUCATION AND RESEARCH

PAYMENT FOR EDUCATION AND RESEARCH

TOTAL CONTRIBUTIONS PAID

AMOUNT

4,092,477.

11,810,874.

26,943.

------------

15,930,294.

016969 533P 08/10/2006 11:38:34 V04-8 22 STATEMENT 5

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PART II - LINE 42 - DEPRECIATIONPART IV - LINE 57 - LAND , BUILDINGS AND EQUIPMENT

EVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON, ILLINOISYEAR ENDED SEPTEMBER 30, 2005

36-2167060

COSTS ALLOWANCES FOR DEPRECIATION NET CARRYINGBALANCE TRANSFERS BALANCE BALANCE TRANSFERS BALANCE AMOUNT10/1/2004 ADDITIONS DISPOSALS (DEDUCTIONS) 9/30/2005 10/1/2004 PROVISION DISPOSALS (DEDUCTIONS) /9 30/2005 9/30/2005

LAND & IMPROVEMENTS 27,319 ,991 - - 690 , 286 28,010,277 8 , 790,739 852 ,441 - - 9,643,180 18,367,097

BUILDINGS & IMPROVEMENTS 727,986 ,711 - (4,975,048 ) 72,658 , 979 795 , 670,642 338 , 184,462 33 , 819.996 (4,975,048) 2,154,460 369,183,870 426,486,772

EQUIPMENT 347,229 ,020 3 , 799,201 (23,551 , 015) 33 , 633,216 361 , 110,422 242 , 109,121 42,016 ,280 (23 ,551,015 ) 22,526 260,596,912 100 , 513,510

CONSTRUCTION IN PROGRESS 59,960 ,887 67 ,206,219 - (103,567,760) 23 ,599,146 - - - - 23,599,146

TOTAL LINE 57 1,162 ,496,409 71 ,005,420 (28,526 , 063) 3 ,414,721 1,208,390,487 589,084 , 322 76,688,717 ( 28,526 , 063) 2 , 176,986 639 , 423,962 588 , 966,525

to

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, PART II - OTHER EXPENSES

DESCRIPTION TOTAL----------- -----

INSURANCE 53,246,331.MANAGEMENT FEES 34,975,234.PURCHASED SERVICES 14,736,194.CONSULTING/COLLECTION FEES 3,865,738.INTERNS/RESIDENTS SERVICES 9,143,713.MAINTENANCE CONTRACTS 15,588,382.PROV FOR UNCOLLECTED ACCTS 17,944,000.AMORTIZATION 179,708.LAUNDRY SERVICES 2,767,073.MISCELLANEOUS EXPENSES 728,816.DUES-INSTITUTIONAL 203,024.ADVERTISING 3,332,358.CHARITY CARE 13,595,894.MEDICAID TAX 16,304,560.

TOTALS 186,611,025.

36-2167060

PROGRAMSERVICES

51,943,468.31,230,787.9,146,733.

378,260.9,143,713.6,937,683.

17,944,000.25,000.

2,767,073.298,838.

3,332,358.13,595,894.16,304,560.

---------------163,048,367.

MANAGEMENTAND GENERAL

1,302,863.3,744,447.5,589,461.3,487,478.

8,650,699.

154,708.

429,978.203,024.

---------------23,562,658.

016969 533P 08/10/2006 11:38:34 V04-8 23 STATEMENT 6

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990,-PART IV - PREPAID EXPENSES AND DEFERRED CHARGES

DESCRIPTION

PREPAID EXPENSES

TOTALS

BEGINNINGBOOK VALUE

12,086,729.---------------

12,086,729.

ENDINGBOOK VALUE----------

12,914,220----------------

12,914,220.

STATEMENT 7

016969 533P 08/10/2006 11:38:34 V04-8 24

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990 , PART IV - INVESTMENTS - SECURITIES

BEGINNING ENDING

DESCRIPTION-----------

BOOK VALUE----------

BOOK VALUE----------

MARKET VALUE

CASH FLOW 15,152,281. 10,257,585.MISCELLANEOUS 1,260,927. 300,109.

WILLIAM BLAIR 41,431,651. 43,663,564.

NTQA INDEX 233,787,329. 235,191,737.BANK OF IRELAND 23,459,680.

CAPITAL GUARDIAN 47,423,892. 55,684,607.NTQA BOND 95,521,415.PIMCO 179,877,187. 160,608,331.JACOBS LEVY 88,883 ,303. 99,900,423.IRIDIAN 35,103,546.GOLDMAN SACHS 31,452,139. 41,023,273.BRANDES 52,114,780. 59,479,870.HARRIS ASSOCIATES 42,631,680. 49,153,297.ABBOTT CAPITAL 2,476,139. 4,817,497.

ADAMS STREET 4,903,027. 6,395,695.JP MORGAN BOND INVESTMENTS 401,954,293. 402,849,451.

SERP FUNDING TRUST-HP 612,196. 692,772.

SERP FUNDING TRUST 10'. 10.

PROFESSIONAL STAFF 1,032,660. 1,109,594'.

JULIUS BAER 28,021,633.T. ROWE 40,316,950.W. ASSET CORE BD PLUS 100,157,034.

W. ASSET GLOBAL-FOREIGN 45,174,800.- ----

TOTALS---------------1,299,078,135.

------ --- -1,384,798,232.

STATEMENT 8

016969 533P 08/10/2006 11:38:34 V04-8 25

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990,'PART IV - INVESTMENTS - OTHER

DESCRIPTION

BEGINNING

BOOK VALUE

SECURITES LENDING PRGM NONE---------------

TOTALS NONE

016969 533P 08/10/2006 11:38:34 V04-8

36-2167060

ENDINGBOOK VALUE

85,640,201.---------------

85,640,201.

STATEMENT 9

26

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, 'PART IV - OTHER ASSETS

DESCRIPTION

BEGINNINGBOOK VALUE

PREACQUISITION COSTSMISCELLANEOUS RECEIVABLES

LT RECEIVABLESANNUITIES, TRUST, & OTHER

650,080.7,453,253.2,090,000.8,920,993.

---------------

TOTALS 19,114,326.

36-2167060

ENDING

BOOK VALUE

747,802.3,824,867.5,361,048.

21,015,989.

30,949,706.

STATEMENT 10

016969 533P 08/10/2006 11:38:34 V04-8 27

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990, -PART IV - OTHER,LIABILITIES

DESCRIPTION

RESERVE FOR MALPRACTICE LOSSES

DEFERRED PENSION COSTDEFERRED COMPENSATIONMARK TO MARKET LIABILITY

DUE TO AFFILIATESDUE TO 3RD PARTIES

CURRENT MATURITY OF LT DEBT

SECURITIES LENDING PRGM LIAB

TOTALS

BEGINNING

BOOK VALUE

129,000,000.25,501,895.13,245,754.12,254,681.44,086,886-24,880,477.

---------------

248,969,693.

36-2167060

ENDINGBOOK VALUE

176,200,000.31,689,580.22,038,003.11,206,969.71,715,616.19,606,794.10,000,000.85,640,201.

---------------

428,097,163.

STATEMENT 11

016969 533P 08/10/2006 11:38:34 V04-8 28

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990,-PART IV-A. - OTHER REVENUE ON BOOKS BUT NOT ON RETURN

DESCRIPTION AMOUNT----------- ------

COST OF GOODS SOLD (LINE 10B ) 468,664.---------------

TOTAL 468,664.

STATEMENT 12

016969 533P 08/10/2006 11:38:34 V04-8 29

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990,-PART IV-A. - OTHER REVENUE ON RETURN BUT NOT ON BOOKS

DESCRIPTION AMOUNT

----------- ------

TRFS FR ENH RESEARCH INSTITUTE 2,362,865.

TRFS FR ENH FACULTY PRACT ASSO 349,466.

TRFS FR ENH FOUNDATION 5;208,503.

TRFS FR RADIATION MED INST 95,114.

PROFESSIONAL STAFF 394,597.

CHARITY CARE 13,595,894.

TOTAL 22,006,439.

STATEMENT 13

016969 533P 08/10/2006 11:38:34 V04-8 30

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990,'PART IV-B - OTHER EXPENSES ON BOOKS BUT NOT ON RETURN

DESCRIPTION AMOUNT-----------

COST OF GOODS SOLD (LINE 10B) 468,664.---------------

TOTAL 468,664.

STATEMENT 14

016969 533P 08/10/2006 11:38:34 V04-8 31

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990,'PART IV-B - OTHER EXPENSES ON RETURN BUT NOT ON BOOKS

DESCRIPTION AMOUNT

----------- ------

TRFS TO ENH RESEARCH INSTITUTE 4,092,477.

TRFS TO ENH FACULTY PRACT ASSO 11,810,874.

TRFS TO ENH FOUNDATION 793,506.

PROFESSIONAL STAFF 325,937.

CHARITY CARE 13,595,894.

TOTAL 30, 618,688.

STATEMENT 15

016969 533P 08/10/2006 11: 38:34 V04-8 32

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

CONTRIBUTIONSTITLE AND TIME TO EMPLOYEE

NAME AND ADDRESS DEVOTED TO POSITION COMPENSATION BENEFIT PLANS---------------- ------------------- ------------ -------------

PERCY L BERGER DIRECTOR NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

JOHN L. CARL DIRECTOR NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

WILLIAM L. DAVIS CHAIRMAN NONE2650 RIDGE AVENUE .25 HRS/WK

EVANSTON, IL 60201

CONNIE K. DUCKWORTH DIRECTOR NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

RAYMOND GRADY PRES-HOSP&CLINICS 832,709.2650 RIDGE AVENUE 40 HRS/WKEVANSTON, IL 60201

JEFFREY H. HILLEBRAND COO 869,439.2650 RIDGE AVENUE 40 HRS/WKEVANSTON, IL 60201

MICHELE J. HOOPER DIRECTOR NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

JANARDAN D. KHANDEKAR,• M.D.- DIRECTOR/PHYSICIAN 956,389.2650 RIDGE AVENUE 35 HRS/WKEVANSTON, IL 60201

Amounts reported as "Compensation" irk the current year may include the payment of deferred

compensation that was reported in a prior year. In accordance with IRS requirements, amounts

reported as "Compensation and Benefits" in the current year include deferred compensation

amounts that are not vested and have not been paid to plan participants.

016969 533P 08/10/2006 11:38:34 V04-8 33

NONE

NONE

NONE

NONE

125,253.

105,419.

NONE

56,528.

EXPENSE ACCTAND OTHZRALLOWANCES

NONE

NONE

NONE

NONE

NONE

NONE

NONE

NONE

STATEMENT 16

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

TITLE AND TIME

NAME AND ADDRESS----------------

DEVOTED TO POSITION-------------------

COMPENSATION------------

LESTER B. KNIGHT, III DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

HARRY M. JANSEN KRAEMER, JR. DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

HOMER J. LIVINGSTON, JR. DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WK

EVANSTON, IL 60201

MILES L. MARSH DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

HARVEY N. MEDVIN DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WK

EVANSTON, IL 60201

MARK R. NEAMAN DIR,PRES&CEO 958,505.

2650 RIDGE AVENUE 40 HRS/WK

EVANSTON, IL 60201

JERRY K. PERLMAN DIRECTOR NONE

2650 RIDGE AVENUE .25 HRS/WK

EVANSTON, IL 60201

DOUGLAS M. SILVERSTEIN PRES GLENBROOK HOSP 603,085.

2650 RIDGE AVENUE 40 HRS/WK

EVANSTON, IL 60201

Amounts reported as "Compensation" in the current year may include the payment of deferredcompensation that was reported in a prior year. In accordance with IRS requirements, amounts

reported as "Compensation and Benefits" in the current year include deferred compensationamounts that are not vested and have not been paid to plan participants.

Vlbyby o33P 08/10/2006 11:38:34 V04-8 34

CONTRIBUTIONSTO EMPLOYEE

BENEFIT PLANS-------------

NONE

NONE

NONE

NONE

NONE

614,794.

NONE

90,246.

NONE

NONE

NONE

NONE

NONE

NONE

NONE

STATEMENT 17

EXPENSE ACCTAND OTHERALLOWANCES

NONE

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

CONTRIBUTIONS EXPENSE ACCTTITLE AND TIME TO EMPLOYEE AND OTHER

NAME AND ADDRESS----------------

DEVOTED TO POSITION COMPENSATION------------------- ------------

BENEFIT PLANS-------------

ALLOWANCES *----------

NEELE E. STEARNS, JR. DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

J. MIKESELL THOMAS SECRETARY NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

JOHN R. WALTER DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

DAVID P. WINCHESTER, M.D. DIRECTOR/PHYSICIAN 779,787. 34,505. NONE2650 RIDGE AVENUE 21 HRS/WKEVANSTON, IL 60201

WILLIAM J. WHITE DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

WILLIAM WRIGLEY, JR. DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

THOMAS H. HODGES EXEC VP/TREASURER 946,587. 65,050. NONE2650 RIDGE AVENUE 40 HRS/WKEVANSTON, IL 60201

A. STEVEN CROWN DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

Amounts reported as "Compensation" in the current year may include the payment of deferredcompensation that was reported i n a prior year. In accordance with IRS requirements, amountsreported as "Compensation and Benefits" in the current year include deferred compensationamounts that are not vested and have not been paid to plan participants.

016969 53 P 08110/2006 11:38:34 V04-8 35 STATEMENT 18

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

CONTRIBUTIONS EXPENSE ACCTTITLE AND TIME TO EMPLOYEE AND OTHER

NAME AND ADDRESS----------------

DEVOTED TO POSITION-------------------

COMPENSATION------------

BENEFIT PLANS-------------

ALLOWANCES----------

RUSSELL M. FLAUM DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

SAMUEL M. MENCOFF DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

MARY O'BRIEN PRESIDENT,HIGHLAND P 553,545. 52,705. NONE2650 RIDGE AVENUE 40 HRS/WKEVANSTON, IL 60201

DAVID KUO, M.D. DIRECTOR/PHYSICIAN 147,324. 41,357. NONE2650 RIDGE AVENUE 40 HRS/WKEVANSTON, IL 60201

M. JUDE REYES DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

JONATHAN P. WARD DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

ROBERT L. LEVY, MD DIRECTOR NONE NONE NONE2650 RIDGE AVENUE .25 HRS/WKEVANSTON, IL 60201

GRAND TOTALS

-------------- -6,647,370.

------------- -1,185,857.

-------------NONE

Amounts reported as "Compensation" in the current year may include the payment of deferredcompensation that was reported in a prior year. In accordance with IRS requirements, amountsreported as "Compensation and Benefits" in the current year include deferred compensationamounts that are not vested and have not been paid to plan participants.

016969 533P 08/10/2006 14:05:41 V04-8 36 STATEMENT 19

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART V - COMPENSATION PROVIDED BY RELATED ORGANIZATION

CONTRIBUTIONS EXPENSE ACCT-TO EMPLOYEE AND OTHER

NAME AND ADDRESS COMPENSATION BENEFIT PLANS ALLOWANCES---------------- ------------ ------------- ----------

ENH FACULTY PRACTICE ASSOCIATES36-3738206

JANARDAN D. KHANDEKAR, M.D. 144,174. 8,522. NONE2650 RIDGE AVENUEEVANSTON, IL 60201

ENH FACULY PRACTICE ASSOCIATES36-3738206

DAVID P. WINCHESTER, M.D. 677,759. 29,991. NONE2650 RIDGE AVENUEEVANSTON, IL 60201

-------------- -------------- --------------GRAND TOTALS 821,933. 38,513. NONE

Amounts reported as "Compensation" in the current year may include the payment of deferred

compensation that was reported in a prior year. In accordance with IRS requirements, amounts

reported as "Compensation and Benefits" in the current year include deferred compensationamounts that are not vested and have not been paid to plan participants.

016969 533P 08/10/2006 11:38:34 V04-8 38 STATEMENT 21

r

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART VI - NAMES OF RELATED ORGANIZATIONS

ENH FACULTY PRACTICE ASSOCIATES EXEMPT

RADIATION MEDICINE INSTITUTE EXEMPT

ENH RESEARCH INSTITUTE EXEMPT

ENH VISITING NURSES ASSOCIATION EXEMPT

ENH VNA HOME SERVICES EXEMPT

EVANSTON NORTHWESTERN HC FNDN EXEMPT

ENH INSURANCE INTERNATIONAL NON-EXEMPT

ENH MEDICAL GROUP, INC. NON-EXEMPT

STATEMENT 22

016969 533P 08/10/2006 11:38:34 V04-8 39

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36-2617060PART VI - LINE 90b - NUMBER OF EMPLOYEES

EVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON, ILLINOISYear Ended September 30, 2005

Evanston Northwestern Healthcare Corporation

ENH Faculty Practice Associates

Radiation Medicine Institute

ENH Research Institute

Evanston Northwestern Healthcare Foundation

ENH Visiting Nurses Association

ENH VNA Home Services

Total

' Number of Employees in the payperiodthat includes 3/12/04.

" All employees Form 941 filed underTax ID number 36-2167060.

Numberof Employees*

5,383

1,194

9

258

75

50

69

7,038

STATffi NT 22.1

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION

FORM 990 , PART VII - OTHER REVENUE

DESCRIPTION

PHYSICIAN BILLINGOFFSITE PHARMACIESSPECIALTY LAB TESTOUTREACH PROGRAMTUITIONCOMPUTER TRAININGCAFETERIAPARKING LOT

VALET PARKINGPAYPHONE COMMISSN

APPLICATION FEES

MISCELLANEOUS

TOTALS

BUSINESS EXCLUSIONCODE----

AMOUNT CODE------ ----

541900446110 6,033,739.541380 320,964.

541519 7,500.

------------

6,362,203.

36-2167060

RELATED OR EXEMPTAMOUNT FUNCTION INCOME------ ---------------

2,423,610.

188,301.580,004.

03 3,433,898.03 499,531.03 4,697.03 6,336.03 40,250.01 35.

------------

3,984,747.

------------

3,191,915.

016969 533P 08/10/2006 11:38:34 V04-8 40 STATEMENT 23

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PART VIH - RELATIONSHIP OF ACTIVITIES TO THE ACCOMPLISHMENTOF EXEMPT PURPOSESEVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON,ILLINOISYEAR-ENDED SEPTEMBER 30, 2005

Lines 93(A) - (C), 94, 103 (C)

The Evanston Northwestern Healthcare Corporation (ENH) (consisting of the Evanston,Glenbrook, and Highland Park Hospitals) is being operated exclusively for charitable,educational, and scientific purposes within the meaning of section 501(c)(3) of the InternalRevenue Code of 1986, as amended (the "Code"). This includes the conducting of healthcare andhealthcare-related activities which support and benefit the operation of health care facilities inEvanston, Glenview, Northbrook, Vernon Hills, Lincolnwood, and Highland Park, Illinois andcommunities adjacent, in which treatment of patients, together with educational and researchactivities ancillary therefore, is provided in accordance with professional standards which areconsistent with reasonably attainable goals and for the benefit of the communities in which theseactivities occur.

The Evanston Northwestern Healthcare Corporation provides quality care across the fullspectrum of service from physician offices, through outpatient services, inpatient care, and eveninto people's homes and throughout the communities. Services are provided to all individualswithout regard to personal financial resources. Our quality has been nationally recognized in thepast eleven years as being named by Solucient among the "Top 15 Major Teaching Hospitals"and "Top 100 U.S. Hospitals" in the country. Additionally, Evanston Northwestern Healthcarehas received accreditation by the Joint Commission on Accreditation of Healthcare Organization.

Activities of the organization are structured to fulfill the corporate mission:

The core mission ofEvanston Northwestern Healthcare is to preserve and improvehuman life. This mission will be achieved through the provision ofsuperior clinical care,academic excellence, and innovative research.

Evanston Northwestern Healthcare is a not-for-profit corporation principallyformed toprovide quality healthcare servicesfor the communities it serves. The delivery ofhealthcare services is provided in a wide range ofinpatient and ambulatory healthcaresettings, community-wide, employing modern technology and expertise. Supportforqualified residents who may not be able to pay the entire cost oftheir care is a part oftheorganization's commitment. The organization's primary service area includes Chicago's"north shore, " northern suburbs, and its environs. In support ofits primary mission ofpatient care, the corporation engages in a wide range ofacademic activities in medicaleducation and research, and does so largely by way ofits affiliation with NorthwesternUniversity.

The programs and services offered by Evanston Northwestern Healthcare professionals at ourthree hospitals and other ancillary sites provide many community benefits. Individuals from

STATEMENT 23.1

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metropolitan Chicago, northern Cook and Lake Counties, and southeastern Wisconsin havebenefited from our community outreach efforts.

Evanston Northwestern Healthcare has a Charity Care and Financial Assistance Program thatoffers both free and discounted care to all patients who meet policy guidelines. A team offinancial counselors at each of our hospitals and many medical office sites work collaborativelywith patients experiencing financial hardship to enroll them into our charity care and financialassistance program. Evanston Northwestern Healthcare does not file liens against patientsincapable of paying healthcare expenses. The charity care program provides the following:

• Free Care to qualifying patients who are at or below 200 percent of the Federal PovertyLevel Guidelines, which is twice the recommended Federal Poverty Level Guidelines.

• Discounted care to qualifying patients who are above 200 percent of the Federal PovertyLevel using a sliding scale with discounts ranging from 10 percent to 85 percent

• Financial counseling support

Customer service representatives are available weekdays from 8 a.m. to 6 p.m. to assist with

questions on hospital physician bills. Patients can also e-mail questions regarding their bills and

receive a prompt response.

Evanston Northwestern Healthcare communicates its Charity Care Policy in both Spanish and

English to patients through its employees, postings in key hospital access points such as the

Emergency Room, the corporate website, and on the back of each patient bill. Evanston

Northwestern Healthcare employees and medical staff have been informed of the Charity Care

Policy through newsletters and department meetings.

Evanston Northwestern Healthcare has aligned its community benefits program with the guidingprinciples outlined in Advancing the State ofthe Art ofCommunity Benefit for nonprofithospitals , which provides a set of uniform standards to increase accountability and aligngovernance , management , and operations to return benefit to local communities . The fiveguiding principles are: 1 ) disproportionate unmet health-related needs, 2) primary prevention 3)seamless continuum of care, 4) build community capacity, and 5) community collaboration.Highlights of programs and services offered this year by Evanston Northwestern Healthcare andrelationship to the guiding principles include , but are not limited to the following:

2 STATEMENT 23.1

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activities for Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing Evanston Hospital Outpatient Access to healthcare for Treated 9,360 adult and Q Disproportionate UnmetDepartment provides medical care to adults the medically underserved. 10,304 adolescent Health-Related Needsand children who lack private medical patients. 0 Primary Preventioninsurance. Medical services include, but are Access to healthcare. Lf Seamless Continuum ofnot limited to: obstetrics/gynecology, Caregeneral surgery, orthopedics, diabetes Information about Q Build Communityeducation and podiatry. Evanston Northwestern Capacity

Healthcare services. ECommunity Collaboration

Ongoing Emergency Departments within Evanston Access to healthcare. Provided care to 92,767 Q Disproportionate UnmetNorthwestern Healthcare are staffed 24/7 individuals at the Health-Related Needswith physicians, nurses and technicians who Evanston, Glenbrook and q Primary Preventionare trained to respond up to level 2 trauma Highland Park Hospital 0 Seamless Continuum ofmedical emergencies. emergency departments. Care

q Build Community

Capacityq Community Collaboration

Ongoing The Eye and Vision Center hosts Access to healthcare. Treated 563 patients who Disproportionate Unmetophthalmology clinics for medically received charity care. Health-Related Needsunderserved clients referred through the Access to healthcare for 0 Primary Preventionoutpatient clinic at Evanston Hospital, the medically underserved. El Seamless Continuum ofproviding a spectrum of pediatric and adult Carevision services. q Build Community

Capacityq Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

D"at" ttit ' ' ef

^w.o ,=Gn2- T ? • Htr

:^e e s Arl t

. - nuiT a y aµr, Tw v

u^°'ltdressed,

ON 111"(4

Ongoing Family Care Center at Glenbrook Hospital Access to healthcare. From June 2004 - June I Disproportionate Unmetprovides comprehensive care for people of 2005 12 residents were Health-Related Needsall ages and serves as a training site for Access to healthcare for trained through the El Primary PreventionFamily Medicine resident physicians and the medically underserved. Family Care Centers. 0 Seamless Continuum ofmedical students from Northwestern CareUniversity's Feinberg School of Medicine. Provide teaching Q Build Community

opportunities for medical Capacitystudents and residents. Collaboration

Ongoing The Dental Center at Evanston Hospital Dental care. The Dental Center had Q Disproportionate Unmetprovides all primary care services and 2,435 patient encounters Health-Related Needsspecial consultations for medically Access to healthcare for who received 45%-75% Q Primary Preventionunderserved patients, pre-screenings for the medically underserved. discounts for their 0 Seamless Continuum ofcardiovascular patients, management for oral services. Carecomplications in oncology patients and Access to healthcare. q Build Communityrefractory dental problems. Capacity

q Communi Collaboration

Ongoing Started in 1996, Evanston Township High Access to healthcare. For the 2004-2005 0 Disproportionate UnmetSchool Health Center is a school based academic year there were Health-Related Needshealth clinic, funded by Evanston Access to healthcare for 3,075 student encounters Q Primary PreventionNorthwestern Healthcare for approximately the medically underserved. with 887 students 0 Seamless Continuum of$340,000 and provides: physical exams, receiving treatment. Careimmunizations, treatment of acute and Coordinate services/create ICJ Build Communitychronic illnesses, individual counseling, partnerships. Capacityhealth education, gynecological care and Q Community Collaborationsupport groups to students whose parents Community outreach.allow them to enroll in the health center.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing Since 1985, Evanston Township High Community outreach. The number of students q Disproportionate UnmetSchool (ETHS) and Evanston Hospital have participating in the Health-Related Needspartnered to offer students participation in Coordinate services/create program averages 40 q Primary Preventionthe ETHS Health Sciences Rotation partnerships. students per year. q Seamless Continuum ofProgram (HSRP), which affords students Carean opportunity to explore healthcare careers 0 Build Communityup front and personal. Designed for junior Capacityand senior students, this program combines 0 Community Collaborationclassroom instruction with job shadowingrotations among different hospitaldepartments. HSRP is a yearlong course,which students can earn four semestercredits, two science and two applied science.

Ongoing Interpretive Services are provided for Community outreach. Provided 6,176 hours of q Disproportionate Unmetpatients and family members receiving written, verbal and sign Health-Related Needsmedical treatment at any of its sites via language interpretive q Primary Prevention"Language Line," Cross Cultural services. 0 Seamless Continuum ofInterpreting Services and services for the Carehearing impaired. 0 guild Community

Approximately $60,000 Capacitywas directed for Language q Community CollaborationLine services andapproximately $260,000was directed for CrossCultural InterpretiveServices.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing Provide financial support to community Access to healthcare for Over $600,000 was Q Disproportionate Unmetorganizations that embrace Evanston the medically underserved. provided to support 37 Health-Related NeedsNorthwestern Healthcare's mission to organizations. Q Primary Preventionpreserve and improve human life, as well as Access to healthcare. Q Seamless Continuum ofto help Evanston Northwestern Healthcare Careconnect with the communities it serves. The Community outreach. Q Build Communitylist of the 37 organizations receiving Capacitycontributions is listed in the Evanston Coordinate services/create Q Community CollaborationNorthwestern Healthcare annual community partnerships.benefits re ort.

Ongoing The Community Relations Department Access to healthcare for Each Evanston 0 Disproportionate Unmetwas established in 2005 to manage and the medically underserved. Northwestern Healthcare Health-Related Needscoordinate community benefits activities hospital has a full-time Q Primary Preventionthat improve community health and to serve Access to healthcare. community relations 0 Seamless Continuum ofas a liaison to Evanston Northwestern manager. CareHealthcare communities. Community outreach. El Build Community

CapacityCoordinate services/create 0 Community Collaborationpartnerships.

Information aboutEvanston NorthwesternHealthcare services.

Impact public olicy .

AK I'

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing Mobile Meals/Meals at Home programs Diet/nutrition/obesityprovide meals for homebound individuals.

Food and NutritionServices at EvanstonHospital prepared 7,198meals and Food andNutrition Services atGlenbrook Hospitalprepared 12,511 meals forthe Meals at Homeprograms in Evanston andGlenbrook service areas.

q Disproportionate UnmetHealth-Related Needs

q Primary Preventionq Seamless Continuum ofCareQ Build CommunityCapacityQ Community Collaboration

Senior services.

Community outreach.

Mobile Meals of HighlandPark Hospital provided10,187 meals to

approximately 45recipients per month.Meal deliveries weredelivered by hospitalvolunteers and accountedfor 4,575 volunteer hours.

Ongoing Cancer Wellness Center, Northbrook is a Cancer. Kellogg Cancer Care q Disproportionate Unmetnot-for-profit organization that provides Centers offered 12 Health-Related Needspsychosocial support to cancer patients and Access to healthcare. educational programs and Q Primary Preventiontheir families by physicians and professional Evanston Northwestern Q Seamless Continuum of

staff from Evanston Northwestern Coordinate services/create Healthcare contributed Care

Healthcare's Kellogg Cancer Care Centers. partnerships. $5,000 to the Center. Q Build CommunityCapacity

EWAVIAML=0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

u,al 1 t 've _ a

e d . d" resse "^. i 'L. c ff ^^y 4 i

dafresse {n

Ongoing Highland Park Hospital and Lake County Access to healthcare. 90 children received 232 El Disproportionate UnmetHealth Department make up the Lake vaccines at Highland Park Health-Related NeedsCounty Community Health Partnership Access to healthcare for Hospital. 0 Primary Prevention

Immunization Clinic which provides the medically underserved. q Seamless Continuum ofmonthly childhood immunization clinics. Care

Youth health. 0 Build CommunityCapacity

Community outreach. 0 Community Collaboration

Coordinate services/createartnershi s.

Ongoing Health education programs are offered at Health information. 392 health education q Disproportionate Unmet

Evanston Northwestern Healthcare sites . classes were offered at Health-Related NeedsCommunity outreach. Evanston Northwestern Q Primary Prevention

Healthcare to 7,854 q Seamless Continuum ofInformation about participants. CareEvanston Northwestern q Build CommunityHealthcare services. Capacity

El Community Collaboration

Ongoing Experts from Evanston Northwestern Health information. 120 presentations were q Disproportionate Unmet

Healthcare's Speakers ' Bureau are provided to 3,147 Health-Related Needsavailable to organizations throughout the Community outreach. participants. El Primary Prevention

Evanston Northwestern Healthcare service q Seamless Continuum of

area. Information about 52 OASIS (senior CareEvanston Northwestern organization) events were q Build CommunityHealthcare services. offered to 2,308 Capacity

participants. Q Community CollaborationSenior Services.

IWOt^ '

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Access to healthcare.

Access to healthcare forthe medically underserved.

Information aboutEvanston NorthwesternHealthcare services.

Q Disproportionate UnmetHealth-Related Needs

Q Primary Preventionq Seamless Continuum ofCareQ Build CommunityCapacity0 Community Collaboration

Ongoing Health Screenings are offered at Evanston Community outreach. 291 screening events were Q Disproportionate UnmetNorthwestern Healthcare sites on a monthly offered at Evanston Health-Related Needs

basis as well as in the community by Health information. Northwestern Healthcare Q Primary Preventionrequest. to 2,291 individuals. q Seamless Continuum of

Access to healthcare. Care71 screenings were Q Build Community

Access to healthcare for provided to 3,066 Capacitythe medically underserved. individuals in the El Community Collaboration

Information aboutEvanston Northwestern

community.

Healthcare services.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

developmentally Capacityappropriate advice to q Community Collaborationparents about readingaloud with their child.

Ongoing Mental health services for adults, Mental health. Evanston Northwestern q Disproportionate Unmetadolescents and children are offered along a Healthcare's "Access Health-Related Needscontinuum of care including group, Access to healthcare. Center" offers 24-hour Q Primary Preventionindividual and family outpatient services, crisis intervention that 0 Seamless Continuum of

intensive outpatient and day hospital Community outreach. fielded 50 crises calls per Careprograms, inpatient centers for both adults month and received and Q Build Communityand adolescents. Evanston Northwestern fielded approximately 500 CapacityHealthcare is the only hospital along theNorth Shore to the Wisconsin border thatprovides a full continuum of mental health

mental health referral Q Community Collaborationcalls per month.

services.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing Perinatal Depression Program identifies Mental Health. The program collected q Disproportionate Unmetwomen who are suffering from perinatal 2,838 screens on 2,311 Health-Related Needsdepression and offers referrals for women Community Outreach. women and the hotline (l Primary Preventionwho may need additional help. The program received 307 calls. 0 Seamless Continuum ofscreens women for perinatal depression Careduring and after their pregnancy and offers a q Build Community24/7 crisis hotline for women and their Capacityfamily members who may find themselves 0 Community Collaborationin an emergent situation. All services areprovided free of charge. (This program isadministered at Evanston Hospital and made

available throughout all ENH communities)

Ongoing The Healthy Evanston Initiative was ' Community outreach. The Initiative gives the J Disproportionate Unmet

launched as part of a coordinated effort to community a voice in Health-Related Needsimprove the health of Evanston. Evanston Coordinate services/create how to improve its health. 121 Primary PreventionNorthwestern Healthcare contributed partnerships. 0 Seamless Continuum of$10,000 to the Evanston Community CareFoundation (ECF) to establish the Initiative. Health information. Q Build CommunityThe ECF's first step is to convene a task Capacityforce to identify opportunities and resources (1 Community Collaboration

to romote communi health.11Ongoing Evanston Northwestern Healthcare Community outreach. Over 50 employees q Disproportionate Unmet

employees are encouraged and recognized provided information Health-Related Needsfor their involvement in their communities. Coordinate services/create about their service in q Primary PreventionOur Leaders in the Community share their partnerships. leadership roles in q Seamless Continuum of

time and talents to serve on local civic, not- volunteer organizations. Care

for-profit, advocacy and/or governmental Q Build Communityorganizations. Capacity

0 Communi Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Ongoing / As a result of budget cuts to District 65's Youth health. 522 or 24% of the 0 Disproportionate UnmetSchool after school athletic program, Evanston students participate in the Health-Related NeedsYear Northwestern Healthcare's contribution of Community outreach. program. Q Primary Prevention

$5,000 to the McGaw YMCA/District q Seamless Continuum of65/Evanston Northwestern Healthcare Coordinate services/create CareAfter-School Athletic Program helps make partnerships. 0 Build Communityit possible for every child who wants to Capacityparticipate to pla. El Community Collaboration

Ongoing The year long Healthy Highland Community outreach. 160 residents registered 0 Disproportionate UnmetPark/Highwood pilot program provides free for the year long project. Health-Related Needshealth screenings 3 times per year and Coordinate services/create 0 Primary Preventioneducational programs to Highland Park and partnerships. 0 Seamless Continuum ofHighwood residents in an effort to provide Careparticipants with tools to make healthy Health information. 0 Build Communitylifestyle changes. The pilot program is Capacitypossible through grant funds from the 0 Community CollaborationHealthcare Foundation of Highland Park.

Ongoing Quit Now smoking cessation cards were Smoking. 3,000 cards were q Disproportionate Unmetprovided to individuals that smoke. The distributed at Evanston Health-Related Needscards provide a 1-800-Quit-Now number to Health information. Northwestern Healthcare Q Primary Preventioncall for support. sites and at community q Seamless Continuum of

Community outreach. events. CareQ Build Community

Coordinate services/create Capacitypartnerships. 0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

f ^^esse ^; ddres a, ^ ^

Ongoing Meeting room space is made available free Community outreach. Evanston Northwestern q Disproportionate Unmetof charge at Evanston Northwestern Healthcare met 577 Health-Related NeedsHealthcare sites to community Coordinate services/create requests for meeting room q Primary Preventionorganizations. partnerships. space from community q Seamless Continuum of

organizations. CareQ Build CommunityCapacityQ Community Collaboration

Sept. Evanston Northwestern Healthcare provided Community outreach. 40 individuals were Cpl Disproportionate Unmet

through medical services in various capacities to treated at Evanston Health-Related NeedsDec. 2005 individuals displaced from the Gulf Region Access to healthcare. Northwestern Healthcare Q Primary Prevention

after Hurricane Katrina . sites. q Seamless Continuum ofAccess to healthcare for Carethe medically underserved. q Build Community

CapacityQ Communi Collaboration

January 22 The Glen Health Fair Health information. Provided screenings and q Disproportionate Unmethealth information to Health-Related Needs

Community outreach. Glenview residents. 0 Primary Preventionq Seamless Continuum of

Information about CareEvanston Northwestern El Build CommunityHealthcare services. Capacity

0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

February Health Fair at19 Evanston

Baptist Church Health information.

Community outreach.

Information aboutEvanston NorthwesternHealthcare services.

Provided screenings andhealth information tochurch members.

q Disproportionate UnmetHealth-Related Needs

Q Primary Preventionq Seamless Continuum ofCareQ Build CommunityCapacityQ Community Collaboration

March 31 Addressed Evanston 71Ward on City of Community outreach. Addressed approximately q Disproportionate UnmetEvanston's Hospital Charity Care 40 residents. Health-Related NeedsReferendum related to St. Francis Hospital. Information about q Primary Prevention

Evanston Northwestern q Seamless Continuum ofHealthcare services. Care

q Build Community

CapacityEl Communi Collaboration

May 10 Community Leaders' Forums at Evanston Community outreach. Addressed approximately q Disproportionate UnmetMay 16 Hospital offered community leaders an 25 community leaders. Health-Related Needs

opportunity to learn about Evanston Coordinate services/create q Primary Prevention

Hospital's Community Benefits as well as partnerships. q Seamless Continuum ofan opportunity to comment on the Hospital's Careinvolvement in the community and where it Information about C Build Communitymight be able to increase partnership Evanston Northwestern Capacityopportunities. Healthcare services. 0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

May 18 Allstate Employee Health Fair Health information. Provided screenings and q Disproportionate Unmethealth information to Health-Related Needs

Community outreach. Allstate employees. Q Primary Preventionq Seamless Continuum of

Information about CareEvanston Northwestern El Build CommunityHealthcare services. Capacity

El Community Collaboration

May 19 Glenview Community Health Fair at Park Health information. Evanston Northwestern q Disproportionate Unmet

Center Healthcare sponsored this Health-Related NeedsCommunity outreach. community event and C! Primary Prevention

provided screenings and q Seamless Continuum ofInformation about health information to CareEvanston Northwestern Glenview residents. Q Build Community

Healthcare services. CapacityL1 Community Collaboration

Summer Partnership for the Future assists Community outreach. Hired two Evanston q Disproportionate UnmetMonths motivated high school students to make Township High School Health-Related Needs

successful transition to college. Evanston Coordinate services/create students and provided q Primary PreventionHospital hired two Evanston Township High partnerships. $1,000 in scholarship q Seamless Continuum ofSchool students and at the completion of money. Careeach summer made a $1,000 contribution for Job training. R1 Build Community

the student's college fund. Capacity0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

Summer Evanston Hospital hired four Evanston

Months Township High School students for theMayor' s Summer Youth Job Program.

Community outreach.

Coordinate services/createpartnerships.

Job training.

Four students were able towork in a professionalsetting and gain valuablework experience.

q Disproportionate UnmetHealth-Related Needs

q Primary Preventionq Seamless Continuum ofCareQ Build CommunityCapacityQ Community Collaboration

June 3-4 Glenview Relay for Life is an American Community outreach. Glenbrook Hospital's q Disproportionate UnmetCancer Society advocacy and fundraising Food and Nutrition Health-Related Needsevent designed to raise money to help fun Cancer. services donated, prepared q Primary Preventioncancer research and programs sponsored by and served food to feed q Seamless Continuum ofthe American Cancer Society. Coordinate services/create approximately 1,000 Care

partnerships. participants in the event 0 Build Community

Capacity0 Community Collaboration

June 8 Highland Park Hospital Ambulatory Care Community outreach. The Open House included q Disproportionate UnmetCenter Open House tours, screenings and Health-Related Needs

Cancer. information on services q Primary Preventionavailable at the q Seamless Continuum of

Coordinate services/create Ambulatory Care Center. Carepartnerships. Cd Build Community

CapacityInformation about 0 Community CollaborationEvanston NorthwesternHealthcare services.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

June 19 Evanston Northwestern Healthcare is a Community outreach. Approximately 3,000 q Disproportionate Unmetsponsor of The Ricky Byrdsong Memorial participated in the race. Health-Related NeedsRace Against Hate Coordinate services/create q Primary Prevention

partnerships. q Seamless Continuum ofCareEl Build CommunityCapacityQ Community Collaboration

June 14 Community Leaders' Forums at Community outreach. Addressed approximately q Disproportionate UnmetJune 30 Glenbrook Hospital offered community 30 community leaders. Health-Related Needs

leaders an opportunity to learn about Coordinate services/create q Primary PreventionGlenbrook Hospital's Community Benefits partnerships. q Seamless Continuum ofas well as an opportunity to comment on the CareHospital's involvement in the community Information about Q Build Community

and where it might be able to increase Evanston Northwestern Capacityartnershi o ortunities. Healthcare services. El Communi Collaboration

June 25 Northbrook Days is an all day community- Community outreach. Provided blood pressure q Disproportionate Unmetwide event offering various resources screenings and health Health-Related Needsavailable to community members in an Information about information to El Primary Preventionoutdoor sidewalk setting. Evanston Northwestern approximately 300 q Seamless Continuum of

Healthcare services. residents. CareQ Build CommunityCapacity0 Community Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activities for Fiscal Year 2005October 1, 2004 - September 30, 2005

July 16 District 112 and 113 Back to School Community outreach

Health FairYouth health.

Access to healthcare forthe medically underserved

Provided lead and glucosescreenings,immunizations, as well asschool and sportsphysicals to 75 medicallyunderserved students.

Q Disproportionate UnmetHealth-Related Needs

Q Primary PreventionQ Seamless Continuum ofCareQ Build CommunityCapacity

Coordinate services/create Q Community Collaborationpartnerships.

July 19 Community Benefits Presentation to the Community outreach. Addressed approximately q Disproportionate Unmet

Evanston Kiwanis Club 25 members of the Health-Related NeedsInformation about Kiwanis Club of q Primary Prevention

Evanston Northwestern Evanston. q Seamless Continuum of

Healthcare services. Care

Q Build CommunityCapacityEl Community Collaboration

1-1-11-1 d.August 6 Latino Health Fair at McGaw YMCA Health information. Provided health q Disproportionate Unmet

screenings and health Health-Related Needs

Community outreach. information to Evanston Q Primary PreventionLatino residents. q Seamless Continuum of

Information about CareEvanston Northwestern Q Build CommunityHealthcare services. Capacity

0 Communi Collaboration

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activities for Fiscal Year 2005October 1, 2004 - September 30, 2005

r r ^d ess v. LL Gt^dintirlr^tipler

August 8 Community Benefits Presentation to the Community outreach. Addressed 14 members of q Disproportionate Unmet

Highland Park City Council city council. Health-Related NeedsInformation about q Primary PreventionEvanston Northwestern q Seamless Continuum ofHealthcare services. Care

Cd Build CommunityCapacityEl Community Collaboration

August 22 Health Fair at Loyola Academy Health information. Provided health q Disproportionate Unmetinformation to students Health-Related Needs

Community outreach. and staff of Loyola 0 Primary PreventionAcademy in Wilmette. q Seamless Continuum of

Information about CareEvanston Northwestern El Build Community

Healthcare services. Capacity0 Community Collaboration

August 27 Highland Park Relay for Life. Highland Community outreach. 32 teams raised more than q Disproportionate UnmetPark Hospital sponsorpd the first annual

i$61,000. Health-Related Needs

Relay for Life-a fundr sing event for the Cancer. Q Primary PreventionAmerican Cancer Society. q Seamless Continuum of

Coordinate services/create Carepartnerships. El Build Community

CapacityHealth information. Q Community Collaboration

Information aboutEvanston NorthwesternHealthcare services.

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EVANSTON NORTHWESTERN HEALTHCARECommunity Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

August 28 Evanston Community Picnic Health information. Provided health q Disproportionate Unmetscreenings and health Health-Related Needs

Community outreach. information for Q Primary Preventionindividuals attending the q Seamless Continuum of

Information about picnic. CareEvanston Northwestern El Build CommunityHealthcare services. Capacity

El Community Collaboration

August 30 Sports Physicals were provided by Access to healthcare for Provided physicals for 29 0 Disproportionate UnmetEvanston Northwestern Healthcare the medically underserved. students. Health-Related Needsphysicians and medical residents for El Primary PreventionGlenview District 34 middle school children Youth health. q Seamless Continuum ofon financial assistance , who otherwise Carewould not have been able to participate in Community outreach. Q Build Community

extracurricular sports programs. CapacityCoordinate services/create El Community Collaborationpartnerships.

September Community Benefits Presentation to the Community outreach. Addressed approximately q Disproportionate Unmet6 Evanston Lighthouse Rotary Club 50 members of the Health-Related Needs

Information about Evanston Lighthouse q Primary PreventionEvanston Northwestern Rotary Club. q Seamless Continuum ofHealthcare services. Care

0 Build CommunityCapacity0 Communi Collaboration

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EVANSTON NORTHWESTERN HEALTHCARE

Community Benefits Program Tracking & Evaluation

Activitiesfor Fiscal Year 2005October 1, 2004 - September 30, 2005

September African-American Health Ministry Community outreach

24 Coalition Spiritual WalkCoordinate services/createpartnerships.

Information about

Provided healthscreenings forapproximately 50individuals, healthinformation andinformation about

Q Disproportionate UnmetHealth-Related Needs

q Primary Preventionq Seamless Continuum ofCareEl Build Community

Evanston Northwestern Evanston Northwestern CapacityHealthcare services. Healthcare services. 0 Community Collaboration

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Mission of Training and TeachingEvanston Northwestern Healthcare also has a well established tradition of medical student andresident teaching dating back to 1930 when Evanston Hospital began its formal affiliation withNorthwestern University. Core rotations for the Evanston Northwestern Healthcare residencyprogram are at Evanston and Glenbrook Hospitals. These teaching hospitals offer the latesttreatments, which have been evaluated for effectiveness in research studies led by clinicians withfaculty appointments at Northwestern University.

Evanston Northwestern Healthcare (ENH) supports the training and education of physicians.This is most evident through our direct support of residents and fellows across a variety ofprograms in different disciplines. Several of these programs are based within ENH while othersrotate through our hospitals within different specialties while on rotation fro the NorthwesternUniversity Feinberg School of Medicine. The following statistics provide an overview of ENH'sGraduate Medical Education Programs.

Residents FellowsEBH Based programs 96.0 4.7NU Feinberg School of Medicine 69.4 8.1

ENH Based Programs include:Internal MedicinePreliminary Medicine (intern year)Family PracticePathologyTransitional Medicine (1s` year prior to specialization)General DentistryDiagnostic Imaging (Radiology Fellows)Otology - NeurotologyUrogynecology

ENH participated in resident training through the Northwestern University McGaw MedicalCenter. McGaw is the parent corporation for its member hospitals that include EvanstonNorthwestern Healthcare, Northwestern Memorial Hospital, Children's Memorial Hospital, andthe Rehabilitation Institute of Chicago.

The Evanston Northwestern Healthcare School of Anesthesia operates out of Evanston Hospital.The program has full accreditation from the Council of Accreditation ofNurse AnesthesiaEducational Programs. The mission of the school is to prepare qualified professional registerednurses for the advanced practice of nurse anesthesia in a variety of practice settings. Thegraduate nurse anesthetist demonstrates the knowledge, skills, and attitude necessary to take onleadership roles in the practice of nurse anesthesia. In Fiscal year 2005, over 50 studentsparticipated in the program.

ENH also provides clinical training for student nurses and allied health technicians through

collaborative relationships with Loyola University, UIC, North Park University, Oakton

Community College, Harper College, and the College of Lake County. During the 2005academic year, over 400 students participate in clinical rotation at Evanston NorthwesternHealthcare.

STATEMENT 23.1

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i

Mission of ResearchEvanston Northwestern Healthcare has become one of the nation's premier independent researchinstitutions, attracting the best and brightest physician-scientists. ENH is ranked 22nd out of themulti-specialty independent research institutions that receive funding from the National Institutesof Health. Nearly 30 of ENH's researchers have been awarded NIH grants of $1 million ormore.

The collaboration between Northwestern University' s scientists and ENH physicians has createdan ideal model for advancing medical research and bringing new therapies to patients who needthem most: Scientists in our labs and at NU lay the foundation and ENH physician-scientiststhen figure out how to put their discoveries into practice.

Furthermore, ENH physician-scientists are able to offer patients access to over 160 externallyfunded clinical trials in a variety of medical/surgical disciplines.

Volunteer Community AuxiliariesThe Auxiliary of Evanston Northwestern Healthcare and the Auxiliary of Highland Park Hospitalcomprise more than 800 community volunteers and members who financially support thehealthcare system's clinical services and programs. These groups raised over $575,000 tosupport research and treatment of Inflammatory Bowel Disease, $450,000 for breast cancerresearch, supported purchase of two mammography machines at the Highland Park AmbulatoryCare Center, and contributed other support for educational programming for parents who havelost a child and providing nursing scholarships.

STATEMENT 23.1

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J I

36-2167060

PART VII - LINE 103(A)-(C) - OTHER REVENUEEVANSTON NORTHWESTERN HEALTHCARE CORPORATION - EVANSTON, ILLINOIS

Year Ended September 30, 2005

Physician Billing Services Evanston Northwestern Healthcare performs billing,collection and accounts receivable management services for the employed physicians.The charges are based on industry and market averages.

Specialty Lab Testing Evanston Northwestern Healthcare processes certaintechnologically advanced facilities, which enable it to perform tests that can not beperformed at other medical laboratories in the area.

Outreach Program Evanston Northwestern Healthcare provides nurses to corporateclients to promote health of employees through education and counseling. Additionallythey provide medical monitoring and direct patient care for minor injuries and illnesses.

School of Anesthesia Evanston Northwestern Healthcare operates the accredited NurseAnesthesia Educational Program to prepare qualified professional registered nurses for theadvanced practice of nurse anesthesia.

EMS Training Evanston Northwestern Healthcare provides paramedic trainingto the personnel of local fire departments.

Laboratory Training Evanston Northwestern Healthcare is the clinical site for theaccredited laboratory training program offered at National-Louis University. This is a one yearprogram which provides education through lectures and rotations through our variouslaboratories.

Fitness Centers Evanston Northwestern Healthcare collects for services such ashealth assessments, health awareness and nutrition classes, massage therapy,etc.

Computer Training Evanston Northwestern Healthcare provides consultation servicesand training materials to other institutions in the development of Epic medical billing computersystem.

STATEMENT 23.2

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-2167060

FORM 990, PART IX - INFORMATION REGARDING TAXABLE SUBSIDIARIES

PERCENTAGE NATURE OF

NAME AND ADDRESS OWNERSHIP BUSINESS TOTAL ENDING

EMPLOYER IDENTIFICATION NUMBER INTEREST ACTIVITIES INCOME ASSETS

------------------------------ -------- ---------- ------ ------

ENH INSURANCE INTERNATIONAL INSURANCE NONE 10,936,222.

P.O. BOX 1061

GEORGETOWN, GRAND CAYMAN BWI98-0419452

TOTAL INCOME NONE 10,936,222.

016969 533P 08/10/2006 11:38:34 V04-8 41 STATEMENT 24

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-21670'tG

SCHEDULE A, PART III - EXPLANATION FOR LINE 2C

EVANSTON NORTHWESTERN HEALTHCARE CORPORATION MAY ENGAGE IN CERTAIN

TRANSACTIONS WITH ORGANIZATIONS THAT MAY EMPLOY ITS DIRECTORS, OFFICER

CREATORS, KEY EMPLOYEES, OR MEMBERS OF THEIR FAMILIES, OR WITH ANY

TAXABLE ORGANIZATION WITH WHICH ANY PERSON IS AFFILIATED AS AN OFFICER

DIRECTOR, TRUSTEE, MAJORITY OWNER, OR PRINCIPAL BENIFICIARY FOR THE

PURCHASE OF GOODS OR SERVICES (E.G. BANKING, PROFESSIONAL SERVICES,

MEDICAL SUPPLIES AND PHARMACEUTICALS). ALL SUCH TRANSACTIONS ARE

SUBJECT TO CONFLICTS OF INTEREST DISCLOSURES AND ARE CONDUCTED AT ARM'

LENGTH.

STATEMENT 25

016969 533P 08/10/2006 11:38:34 V04-8 42

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EVANSTON NORTHWESTERN HEALTHCARE CORPORATION 36-216704t7'

SCHEDULE A, PART III - EXPLANATION FOR LINE 3A

THE ORGANIZATION MAINTAINS INTERNAL CONTROL PROCEDURES. TO INSURE THAT

INDIVIDUALS OR ORGANIZATIONS RECEIVING DISBURSEMENTS, IN FURTHERANCE

OF ITS EXEMPT PROGRAMS, ARE QUALIFYING RECIPIENTS. ALL GRANTS ARE

AWARDED ON A NON-DISCRIMINATORY BASIS.

STATEMENT 26

016969 533P 08/10/2006 11:38:34 V04-8 43

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Form 8868 Application for Extension of Time To File an(Rev December 2004) Exempt Organization Return OMB No. 1545-1709

Department of the Treasurylip- File a separate application for each return.

Internal Revenue Service

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box . . . . . . . . ► l• If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form).Do not complete Part 11 unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.

Automatic 3-Month Extension of Time-Only submit original (no copies needed)

Form 990-T corporations requesting an automatic 6-month extension-check this box and complete Part I only . . . ► q

All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns.Partnerships, REMICs, and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041.

Electronic Filing (e-file). Form 8868 can be filed electronically if you want a 3-month automatic extension of time to file one of thereturns noted below (6 months for corporate Form 990-T filers). However, you cannot file it electronically if you want the additional(not automatic) 3-month extension, instead you must submit the fully completed signed page 2 (Part II) of Form 8868. For moredetails on the electronic filing of this form, visit www.irs.gov/efile.

Type or Name of Exempt Organization Employer identification number

print Evanston Northwestern Healthcare Corporation 36:2167060

File by the Number, street, and room or suite no. If a P.O. box, see instructions.due date forfiling your 1301 Central Street 2nd Floorreturn. Seeinstructions City, town or post office, state, and ZIP code. For a foreign address, see instructions.

Evanston, IL 60201

Check type of return to be filed (file a separate application for each return):

0 Form 990 q Form 990-T (corporation) q Form 4720q Form 990-BL q Form 990-T (sec. 401(a) or 408(a) trust) q Form 5227q Form 990-EZ q Form 990-T (trust other than above) q Form 6069q Form 990-PF q Form 1041-A q Form 8870

• The books are in the care of Gephart Assistant Vice-President and Controller----------------------------------------------------------

Telephone No. ► (__847 ) 570-5053 ___ ___ FAX No. - S___84?___) 570-5240

• If the organization does not have an office or place of business in the United States, check this box . . . . . . ► q

• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If thisis for the whole group, check this box ► q . If it is for part of the group, check this box ► and attach a list with thenames and EINs of all members the extension will cover.

I I request an automatic 3-month (6-months for a Form 990-T corporation) extension of time until _May 15 20 06,

to file the exempt organization return for the organization named above. The extension is for the organization's return for:

► q calendar year 20 ... or

0- 0 tax year beginning ..........October 1 20 04 and ending ......... Sepetmber 30 2005.

2 If this tax year is for less than 12 months, check reason: q Initial return q Final return q Change in accounting period

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less anynonrefundable credits. See instructions . . . . . . . . . . . . . . . . . . . . . . $

b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax paymentsmade. Include any prior year overpayment allowed as a credit . . . . . . . . . . . . . . $

Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, depositwith FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). Seeinstructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EOfor payment instructions

For Privacy Act and Paperwork Reduction Act Notice, see Instructions. Cat No. 279160 Form 8868 (Rev. 12-2004)

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Form 8868 (Rev. 12-2004) Page 2

• If you are filing for an Additional (not automatic) 3-Month Extension , complete only Part II and check this box . . ► 0

Note . Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.• If you are filing for an Automatic 3-Month Extension , complete only Part I (on page 1).

FU.WM Additional (not automatic) 3-Month Extension of Time-Must File Orig in I and One Copy,

Type or Name of Exempt Organization ^°? '` Employer Identification number

print Evanston Northwestern Healthcare Corporation 36 : 2167060

File by the Number, street , and room or suite no . If a P.O. box, see Instructions . For IRS use onlyextended 1301 Central Street 2nd Floordue date for =-, ,-filing the City, town or post office , state, and ZIP code. For a foreign address, see instructions. M^^M11Inswctio s. Evanston , IL 60201

Check type of return to be filed (File a separate application for each return):

® Form 990 q Form 990-T (sec. 401(a) or 408(a) trust) q Form 5227q Form 990-BL q Form 990-T (trust other than above) q Form 6069q Form 990-EZ q Form 1041-A q Form 8870q Form 990-PF q Form 4720

STOP: Do not complete Part 11 if you were not already granted an automatic 3-month extension on a previously filed Form 8868.

• The books are in the care of ► _Gary Gephart, Assistant Vice-President and Controller

Telephone No. ► _ _ 847 ) 570-5053 FAX No. 10- ?_ _) 570-5240

• If the organization does not have an office or place of business in the United States, check this box . . . . . . ► q

• If this is for a Group Return , enter the organization's four digit Group Exemption Number (GEN) If this isfor the whole group, check this box ► q . If it is for part of the group, check this box ► q and attach a list with thenames and EINs of all members the extension is for.

4 I request an additional 3-month extension of_Sime until August 15 20 06----------------- - -

5 For calendar year -------- or other tax year beginning ...... October l_ 04 September302005

------

, 20_---., and ending .. . .

6 If this tax year is for less than 12 months, check reason: q Initial return q final return q Change in accounting period

7 State in detail why you need the extension fin order to-prepare a complete and accurate return , an extension of three-----------------------------------

months is respectively requested ----------------------- -----------------------------------------•---------------•---

----•-------------------- ------------------ -----•-•-----------•---------------•-------•-•-----------------------------•------- ------------8a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any

NO TAXnonrefundable credits. See instructions . . . . . . . . . . . . . . . . . . . . . . $

b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimatedtax payments made. Include any prior year overpayment allowed as a credit and any amount paidpreviously with Form 8868 . . . . . . . . . . . . . . . . . . . . . . . . . . $ NO TAX

c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, depositwith FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions. $ NO TAX

Signature and VerificationUnder penalties of perjury, I declare that I have examined this form , Including accompanying schedules and statements , and to the best of my knowledge and belief,it is true, correct , complete, and tha I am a ad to prepare this form.

Signature ► dr-C-1.^ Title ► Date ► 0 1

41" - / (j Notice to Applicant-To Be Completed by the IRS

We have approved this application . Please attach this form to the organization 's return.

We have not approved this application . However, we have granted a 10-day grace period from the later of the date shown below or the duedate of the organization ' s return (including any prior extensions). This grace period is considered to be a valid extension of time for electionsotherwise required to be made on a timely return . Please attach this form to the organization 's return.

q We have not approved this application . After considering the reasons stated in item 7, we cannot grant your request for an extension of timeto file . We are not granting a 10-day grace period.

q We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested.

q Other ..-----•-------••------------------------•-----------------------

DirectorBY

Date

Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3-month extensionreturned to an address different than the one entered above.

Name

Gary Gephart Assistant Vice-President and Controller Evanston Norlhwesiem-Health `

Type or Number and street (include suite , room, or apt. no.) or a P.p„bgft - rif',rc t1''f =--IVV--y

print 1301 Central Street 2nd Floor ^1^i ^-^ -

City or town, province or state, and country (including postal or

Evanston , IL 60201 70 12 2006(Rev. 12-2004)