Form 1 Annual Operating Report (AOR) Form

Health Professions Student Loan (HPSL) Program and Nursing Student Loan (NSL) Program: Administrative Requirements (Regulations & Policy)

AOR Form

Health Professions Student Loan (HPSL) Program and Nursing Student Loan (NSL) Program: Administrative Requirements (Regs. & Policy)

OMB: 0915-0047

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FINANCIAL DATA
1. Federal Agency and Organization Element to Which Report is Submitted	2. Federal Grant or Other Identifying Number Assigned by Federal Agency	3a. DUNS #		4. Reporting Period End Date
Health Resources and Services Administration (HRSA)	Grant #: Submission Tracking #: OPSID:	3b. EIN		06/30/2013
PAGE 1A - STUDENT BORROWER DATA SECTION
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1A-1. Number of Loans for the Dentistry discipline			(New Only)
1A-2. Total Dollar Amount of Loans Awarded for the Dentistry discipline
1A-3. Total Full-time Enrollment for the Dentistry discipline for the academic year (both non-LDS recipients and LDS recipients)
1A-4. Total number of Defaulted Loans for the Dentistry discipline
1A-5. Total Original Defaulted Principal Loaned for the Dentistry discipline
1A-6a. Total Number of Students who dropped out of the Dentistry discipline
1A-6b. Of the number above, how many of them were LDS student borrowers
1A-7a. Total Number of LDS Borrowers for the Dentistry discipline
1A-7b. Of the number of LDS borrowers for the Dentistry discipline above, number of Active and Non Retired/Defaulted Borrowers
1A-8. Total Number of LDS Students including those who graduated during the reporting period for the Dentistry discipline			(Age and Gender details)
1A-9. Total Graduates (LDS-Dentistry only)
1A-10. Number of LDS students including those who graduated during this reporting period that indicate an intention to serve in a medic ally underserved community
1A-11. Number of LDS students including those that graduated during this reporting period that indicate an intention to practice in primary c are
1A-12. Number of LDS students including those who graduated during this reporting period that are from rural backgrounds

Current Years Graduate Special Data Number of Graduates
1A-13. Total number of full time graduates (LDS loan recipients and Non-LDS) at your school during the current reporting period
1A-13a. Of the total number in question 1A-13, how many are URM graduates
1A-13b. Of the total number in question 1A-13, how many are non- URM graduates
1A-14. Total number of full time LDS graduates during the current reporting period who indicate intent to serve in a rural area

Prior Years Graduate Special Data Number of Graduates
1A-15a. Total Number of LDS - Dentistry Loan Recipients who graduated in academic year 2011-2012
1A-15b. Of the Total Graduates reported in question 1A-15a, the Number of Full-Time LDS - Dentistry Graduates in academic year 2011-2012 serving in Medic ally Underserved Communities
1A-15c . Of the Total Graduates reported in question 1A-15a, the Number of Full-Time LDS - Dentistry Graduates in academic year 2011-2012 serving in Primary Care
1A-15d. Of the Total Graduates reported in question 1A-15a, the Number of Full-Time LDS - Dentistry Graduates in academic year 2011-2012 who entered the field for which they received the degree
1A-15e. Of the Total Graduates in question 1A-15a, the Number of Full-Time LDS - Dentistry Graduates in academic year 2011-2012 who entered service in a rural area?

Student Special Data (For LDS programs Only)

*1A-16. Please indicate the recruitment activities for disadvantaged students your school uses for the LDS program by checking all box(s) that apply.

(Recruitme nt de tails )

*1A-17a. Please indicate the retention and/or mentoring activities for disadvantaged students that your school uses for the LDS program by checking all boxes that apply.

(Retention details)

*1A-17b. Please indicate the type of retention and/or mentoring activities for disadvantaged students your school uses for the LDS program by checking all boxes that apply.

(Type of Re tention Activitie s de tails)

*1A-18. Please share in the box below any success stories about LDS recipients. (Maximum 250 characters)

*1A-19. How many LDS students received pipeline training from other HRSA programs (i.e., Health Careers Opportunity Program (HCOP) Centers of Excellence (COE) at any period of time? (Data collection period starts July 1, 2012).

Cumulative

(Includes current year)

Current

(New LDS Recipients)

HCOP:

COE:

Other:

Other Program Titles:

HCOP:

COE:

Other:

Other Program Titles:

* Please provide the name of at least one health clinic that provides services to a significant number of individuals who are from disadvantaged backgrounds including members of minority groups, that your school uses to provide students with experience in providing clinical services to such individuals.(Maximum 100 characters)

Clinic 1:

Clinic 2:

Clinic 3:

FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 1b - Student Race/Ethnicity Data Section	FOR HRSA USE ONLY
	Institution						Program
	MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC						LDS - Osteopathic Medicine
	Submission Tracking Number		OPSID		Grant Number		Reporting Period
	AORE3600012785/1		68822012(Active)		E36HP21719		07/01/2012 - 06/30/2013
1. Hispanic or Latino Students
Did your BHPr funded program have students of "Hispanic or Latino ethnicity" betw een 7/1/2012 and 6/30/2013? Y es, I can provide some of the counts by race but not all.
Hispanic or Latino Students by Race		Enrollment of Discipline (A)	New Student Recipients (B)	Recipients Other Than New W ho Did Not Graduate (C)		Recipients Other Than New W ho Graduated (D)		Total Recipients (B+C+D)
A. American Indian or Alaska Native
B. Asian - All (including underrepresented)
B1. Asian - underrepresented, if Know n
C. Black or African American
D. Native Haw aiian or Other Pacific Islander
E. W hite
F. More than one race (Race co mbinatio ns)
TOTAL (A + B + C + D + E + F)
Hispanic or Latino Students All Races		Enrollment of Discipline (A)	New Student Recipients (B)	Recipients Other Than New W ho Did Not Graduate (C)		Recipients Other Than New W ho Graduated (D)		Total Recipients (B+C+D)
G. All races

2. Non-Hispanic or Non-Latino Students
Did your BHPr funded program have students of "Non-Hispanic or Non-Latino ethnicity" betw een 7/1/2012 and 6/30/2013? Y es, I can provide some of the counts by race but not all.
Non-Hispanic or Non-Latino Students by Race	Enrollment of Discipline (A)	New Student Recipients (B)	Recipients Other Than New W ho Did Not Graduate (C)	Recipients Other Than New W ho Graduated (D)	Total Recipients (B+C+D)
A. American Indian or Alaska Native
B. Asian - All (including underrepresented)
B1. Asian - underrepresented, if know n
C. Black or African American
D. Native Haw aiian or Other Pacific Islander
E. W hite
F. More than one race (Race co mbinatio ns)
TOTAL (A + B + C + D + E + F)
Non-Hispanic or Non-Latino Students All Races	Enrollment of Discipline (A)	New Student Recipients (B)	Recipients Other Than New W ho Did Not Graduate (C)	Recipients Other Than New W ho Graduated (D)	Total Recipients (B+C+D)
G. All races

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 2 - PROGRAMS ACCOUNT SECTION			FOR HRSA USE ONLY
			Institution					Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC					LDS - Osteopathic Medicine
			Submission Tracking Number	OPSID		Grant Number		Reporting Period
			AORE3600012785/1	68822012(Active)		E36HP21719		07/01/2012 - 06/30/2013
Program Accounts					Cumulative (includes current year)		Current Y ear
A.	FEDERAL FUNDS AWARDED
B.	C ASH BALANC E - START OF REPORT PERIOD
C.	CASH RECEIPTS
	1.	Federal Funds Received/Receivable
	2.	Institutional C ontributions Deposited
	3.	Transferred from Scholarship Fund
	4.	Loan Principal C ollected
	5.	Interest Income C ollected on Loans
	6.	Penalty C harges C ollected on Loans
	7.	Investment Income
	8.	Institutional Repayments of Bad Debts, Principal
	9.	Institutional Repayments of Bad Debts, Interest
	10.	Institutional Repayments of Bad Debts, Penalty C harges
	11.	Cash Receipts Total (sum of C.1 through C.10)
D.	C ASH DISBURSEMENTS
	1.	Loaned to Students
	2.	Transferred to Scholarship Fund
	3.	Repayments to Federal Government, Principal
	4.	Repayments to Federal Government, Interest
	5.	Repayments to Federal Government, Other Income
	6.	Repayments to Institution, Principal
	7.	Repayments to Institution, Interest
	8.	Repayments to Institution, Other Income
	9.	C ollection Agent C osts, Principal
	10.	C ollection Agent C osts, Interest
	11.	Litigation C osts, Principal
	12.	Litigation C osts, Interest
	13.	C redit Bureau Fees
	14.	Other C osts
	15.	C ash Disbursements Total (sum of D.1 through D.14)
E.	C ASH BALANC E - END OF REPORT PERIOD (C ASH BALANC E START OF REPORT PERIOD + C ASH REC EIPTS - C ASH DISBURSEMENTS)

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 3 - PROGRAMS ACCOUNT SECTION (Continued)			FOR HRSA USE ONLY
			Institution						Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC						LDS - Osteopathic Medicine
			Submission Tracking Number		OPSID		Grant Number		Reporting Period
			AORE3600012785/1		68822012(Active)		E36HP21719		07/01/2012 - 06/30/2013
Program Accounts (Continued)			Cumulative (includes current year)			Current Y ear
F.	LOAN CANCELLATIONS TO BORROW ERS		Number of Borrow ers	Principal	Interest	Number of Borrow ers		Principal		Interest
	1.	Professional Practice
		a. HP Practice-Shortage (10%)
		b. HP Practice-Rural Shortage (15%)
		c. Total (Sum of 1.a and 1.b)
	2.	Nursing Employment
		a. Nursing Employment (10%)
		b. Nursing Employment (15%)
		c. Nursing Employment (20%)
		d. Nursing Employment (15%) on or after 03/23/2011
		e. Nursing Employment (20%) on or after 03/23/2011
		f. Nursing Employment (Other) on or after 03/23/2011
		g. Total (sum of 2.a through 2.f)
	3.	Death
		a. On PC L Loans made on or after 10/22/85
		b. On Loans except those reported in F.3.a
		c. Total (Sum of 3.a and 3.b)
	4.	Permanent & Total Disability Approved by HHS
		a. On PC L Loans made on or after 10/22/85
		b. On Loans except those reported in F.4.a
		c. Total (Sum of 4.a and 4.b)

PROGRAM ACCOUNTS (Continued)

Cumulative

(includes current year)

Current Y ear

BAD DEBTS APPROVED FOR W RITE-OFF BY HHS

Number of

Borrow ers

Principal

Interest

Penalty

Charges

Number of

Borrow ers

Principal

Interest

Penalty

Charges

Total Approved

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 4 - EXCESS CASH WORKSHEET			FOR HRSA USE ONLY
			Institution			Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC			LDS - Osteopathic Medicine
			Submission Tracking Number	OPSID	Grant Number	Reporting Period
			AORE3600012785/1	68822012(Active)	E36HP21719	07/01/2012 - 06/30/2013
A.	General Ledger Cash Balance as of 6/30/2012
B.	Actual Collections for 7/1/2012 - 6/30/2013
	1.	Principal
	2.	Interest
	3.	Investment Income and Penalty Charges
	4.	Institutional Repayments of Bad Debts (Principal, Interest & Penalty Charges)
C.	Federal Funds Received/Receivable 7/1/2012 - 6/30/2013
D.	Institutional Contribution for 7/1/2012 - 6/30/2013
E.	Projected Collections for 7/1/2013 - 6/30/2013
	1.	Principal
	2.	Interest
	3.	Investment Income and Penalty Charges
F.	Projected Funds Available as of 6/30/2013 (A + B + C + D + E)
G.	Actual Expenditures for 7/1/2012 - 6/30/2013
	1.	Loans to Students
	2.	Costs(Collection, Litigation, Credit Bureau and Other)
	3.	Repayments to Federal Government and Institution (Principal, Interest and Other Income)
H.	Projected Expenditures for 7/1/2013 - 6/30/2013
	1.	Loans to Students
	2.	Costs(Collection, Litigation and Credit Bureau)
I.	Projected Expenditures as of 6/30/2013 (G + H)
J.	Projected Cash Balance as of 6/30/2013 (F - I)
K.	Less Projected Expenditures for 7/1/2013 - 6/30/2015
L.	Excess Cash (J - K)
M.	General Ledger Ending Cash Balance as of 6/30/2013

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 5 - PROGRAMS ACCOUNT SECTION (Continued)			FOR HRSA USE ONLY
			Institution				Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC				LDS - Osteopathic Medicine
			Submission Tracking Number	OPSID	Grant Number		Reporting Period
			AORE3600012785/1	68822012(Active)	E36HP21719		07/01/2012 - 06/30/2013
Program Accounts (Continued)
H.	FROM WORKSHEET C ALC ULATIONS
	1.	Default Rate
	FOR AC TIVE SC HOOLS
	2.	Excess C ash from report page 4 that was or will be returned to PMS
	3.	Excess C ash from report page 4 that was or will be returned to the Division of Financial Operations
	FOR C LOSING SC HOOLS
	4.	Amount of cash determined to be due the Federal Government and remitted separately to the Division of Financial Operations
I.	CHEC K LIST/QUESTIONS
	1.	W hat is the total amount of interest that is past due?
	AUDITS
	2.	Does your institution provide for a biennial audit of the loan and/or scholarship funds by a qualified independent auditor?
		a. Period of last audit				Fro m : / To : /
		b. Date audit submitted to Regional Audit Agency				/

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 6a - BORROWER ACCOUNTS WORKSHEET			FOR HRSA USE ONLY
			Institution						Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC						LDS - Osteopathic Medicine
			Submission Tracking Number		OPSID		Grant Number		Reporting Period
			AORE3600012785/1		68822012(Active)		E36HP21719		07/01/2012 - 06/30/2013
Borrower Accounts				Number of Borrowers (1)		Principal Loaned (2)		Principal Repaid (3)
1.	FULLY RETIRED
	A.	Repayment/Prof Pract/C ancel
	B.	C ancellation/Death
	C.	C ancellation/Disability
	D.	Discharged in Bankruptcy
	E.	HHS Approved Write-off
	F.	Uncollectible per P.L. 100-607
	G.	Total (sum of 1.A through 1.F)
2.	CURRENT
	A.	Student Status
	B.	Grace Period
	C.	Deferment Status
	D.	Postponement/C ancellation
	E.	Repayment - Not Past Due
	F.	Past Due 1-119 Days
	G.	Total (sum of 2.A through 2.F)
3.	IN BANKRUPTCY
	A.	Pending Discharge/Wage Earners Agreement
4.	IN DEFAULT
	A.	120 Days and Over
5.	FORBEARANCE
	A.	Forbearance
	TOTAL

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 6b - BORROWER ACCOUNTS WORKSHEET			FOR HRSA USE ONLY
			Institution						Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC						LDS - Osteopathic Medicine
			Submission Tracking Number		OPSID		Grant Number		Reporting Period
			AORE3600012785/1		68822012(Active)		E36HP21719		07/01/2012 - 06/30/2013
Borrower Accounts				PRINCIPAL CANCELED
				Employment/ Prof Pract (4)		Death/ Disability (5)		Principal Delinquent (6)
1.	FULLY RETIRED
	A.	Repayment/Prof Pract/C ancel
	B.	C ancellation/Death
	C.	C ancellation/Disability
	D.	Discharged in Bankruptcy
	E.	HHS Approved Write-off
	F.	Uncollectible per P.L. 100-607
	G.	Total (sum of 1.A through 1.F)
2.	CURRENT
	A.	Student Status
	B.	Grace Period
	C.	Deferment Status
	D.	Postponement/C ancellation
	E.	Repayment - Not Past Due
	F.	Past Due 1-119 Days
	G.	Total (sum of 2.A through 2.F)
3.	IN BANKRUPTCY
	A.	Pending Discharge/Wage Earners Agreement
4.	IN DEFAULT
	A.	120 Days and Over
5.	FORBEARANCE
	A.	Forbearance
	TOTAL

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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FINANCIAL DATA
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration BUREAU OF HEALTH PROFESSIONS Annual Operating Report Page 6c - BORROWER ACCOUNTS WORKSHEET			FOR HRSA USE ONLY
			Institution				Program
			MIDWESTERN UNIVERSITY DOWNERS GROVE - CHICAGO COLLEGE OF OSTEOPATHIC				LDS - Osteopathic Medicine
			Submission Tracking Number		OPSID	Grant Number	Reporting Period
			AORE3600012785/1		68822012(Active)	E36HP21719	07/01/2012 - 06/30/2013
Borrower Accounts				Principal Uncollectible Not Past Due (7)	Principal Outstanding but Not Due (8)	Principal Written Off (9)		Capitalized Interest (10)
1.	FULLY RETIRED
	A.	Repayment/Prof Pract/C ancel
	B.	C ancellation/Death
	C.	C ancellation/Disability
	D.	Discharged in Bankruptcy
	E.	HHS Approved Write-off
	F.	Uncollectible per P.L. 100-607
	G.	Total (sum of 1.A through 1.F)
2.	CURRENT
	A.	Student Status
	B.	Grace Period
	C.	Deferment Status
	D.	Postponement/C ancellation
	E.	Repayment - Not Past Due
	F.	Past Due 1-119 Days
	G.	Total (sum of 2.A through 2.F)
3.	IN BANKRUPTCY
	A.	Pending Discharge/Wage Earners Agreement
4.	IN DEFAULT
	A.	120 Days and Over
5.	Forbearance
	A.	Forbearance
	TOTAL

OMB No.: 0915-0044

Expiration Date: 07/31/2015

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File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	AORE3100012041 - REVIEW
Author	abalasubramanian
File Modified	0000-00-00
File Created	2021-01-21