2020-12-16T16:21:19-06:00 2020-01-31 420714325 RSM US LLP 1 S Wacker Drive Ste 800 Chicago IL 60606 990 2019-07-01 363383867 Little Company of Mary Affiliated Services LITT 7082295111 2800 West 95th Street Evergreen Park IL 60805 Michael Allen Chief Financial Officer 7082295100 2020-12-15 1 Rebekuh Eley P01247672 3126343400 2020-12-15 2019 2022-09-23 18:48:47Z X John Hanlon 2800 West 95th Street Evergreen Park IL 60805 10997108 0 0928 X osfhealthcare.org/little-company-of-mary/ X 1984 IL Provide medical care to patients. X 8 6 265 10 24987 -9385 0 0 16403858 9756164 229834 832 2243391 1240112 18877083 10997108 0 0 0 0 22792843 13250746 0 0 0 10630134 6280915 33422977 19531661 -14545894 -8534553 39507527 0 20597015 0 18910512 0 X In Solidarity with the Sisters of the Little Company of Mary, we are entrusted to serve the community through our ministry of Catholic Health Care. We are the empowered laity - the greater Company of Mary. Rooted in a deep heritage of prayerful support of the sick and dying, we strive to enhance the sacredness of life and human dignity. 0 1 13400983 7889303 Little Company of Mary Affiliated Services provides ambulatory healthcare services for the community at a variety of locations. It accomplishes this program by employing over 35 employed physicians, nurse practitioners, and a midwife. Each individual physician office provides clinical excellence above and beyond traditional medicine in a peaceful, clean, and caring environment. The office utilizes the best information and state-of-the-art technology to deliver and manage care and improve the health of the community. 1809703 1230112 Operated and maintained healthcare buildings for physicians and immediate care centers. 663384 1866861 Little Company of Mary Affiliated Services maintains additional services for patients and employees in order to further promote quality health care and a healthy work environment. For example, Little Company of Mary Affiliated Services purchased and maintains an Electronic Medical Record (EMR) system. The EMR system provides physicians with the most up-to-date information concerning their patients, which increases the safety and quality of the healthcare services provided to the community. 15874070 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 11 0 1 265 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 6 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X Timothy Kelleher 7082295111 2800 West 95th Street Evergreen Park IL 60805 John Hanlon MD President 1.00 41.00 X X 0 771917 28846 Bassel Atassi Physician 40.00 0.00 X 755561 0 35712 Sujal Desai DO Physician 40.00 0.00 X 669422 0 38506 Robert Bonaminio DO Physician 40.00 0.00 X 510961 0 38380 David Butler Physician 40.00 0.00 X 512358 0 28637 Ramsey Ellis Physician 40.00 0.00 X 451267 0 6549 Heidi Ruhe Secretary 1.00 40.00 X X 0 224876 30908 Thomas Fahey Chairperson 1.00 1.00 X X 0 0 0 Ken Herlin Treasurer 1.00 0.00 X X 0 0 0 James Miller MD Director (Until 8/9/19) 1.00 0.00 X 0 0 0 Kent Armbruster MD Director 1.00 0.00 X 0 0 0 Violet Clark Director 1.00 1.00 X 0 0 0 Irv Fold Director 1.00 0.00 X 0 0 0 Marie Ruff Director 1.00 0.00 X 0 0 0 2899569 996793 207538 46 0 1 0 UIC Department of Surgery 840 S Wood Street Suite 619 Chicago IL 60612 Physician Services 861654 GDI Services Inc 4952 W 128th Place Alsip IL 60803 Facility Maintenance Services 290433 Loyola University Medical Center 2160 S First Avenue Maywood IL 60153 Physician Services 127186 3 Patient Revenue 621110 8946025 8946025 Other Operating Rev. 561000 810139 785152 24987 9756164 832 832 1230112 0 1230112 1230112 1230112 Real Estate Tax Refund 900099 10000 10000 10000 10997108 10961289 24987 10832 11175350 9461718 1713632 150529 127447 23082 1298900 1099726 199174 625967 529981 95986 31600 31600 1302323 556206 746117 169957 169957 412874 289012 123862 237795 190236 47559 943543 802012 141531 4365 4365 16760 15085 1675 860872 688698 172174 -227554 -243935 16381 Medical Supplies 1048662 1048662 Contracted Physicians 716316 716316 Bad Debt Expense 499293 499293 LCM Management Service 170496 170496 93613 93613 19531661 15874070 3657591 0 1754 0 1724052 0 0 2031795 0 0 0 0 312968 0 53638 0 0 0 23207989 0 0 0 0 0 12175331 0 39507527 0 3834095 0 16762920 0 20597015 0 X 18910512 0 18910512 0 39507527 0 X -8534553 672056 -11048015 X 0 0 0 X 19402638 19124512 16791312 18502165 10961289 84781916 19402638 19124512 16791312 18502165 10961289 84781916 0 0 0 84781916 521967 701631 361541 258106 832 1844077 521967 701631 361541 258106 832 1844077 179892 90022 1421 1006 10000 282341 20104497 19916165 17154274 18761277 10972121 86908334 0.97550 0.97510 0.02120 0.02170 X Schedule A, Part III, Line 12, Explanation of Other Income: Miscellaneous - 2017 Amount: $ 306. Real Estate Tax Refund - 2015 Amount: $ 179,892. 2016 Amount: $ 90,022. 2017 Amount: $ 1,115. 2018 Amount: $ 1,006. 2019 Amount: $ 10,000. Schedule A, Part III: Column (e): 2019 is a short-year. 0 0 0 0 0 0 0 0 0 John Hanlon MD President 0 641373 0 125000 0 5544 0 5500 0 23346 0 800763 0 0 Bassel Atassi Physician 521859 0 233200 0 502 0 2650 0 33062 0 791273 0 0 0 Sujal Desai DO Physician 613703 0 55060 0 659 0 5600 0 32906 0 707928 0 0 0 Robert Bonaminio DO Physician 452296 0 57119 0 1546 0 5600 0 32780 0 549341 0 0 0 David Butler Physician 503794 0 5000 0 3564 0 5600 0 23037 0 540995 0 0 0 Ramsey Ellis Physician 450547 0 0 0 720 0 5600 0 949 0 457816 0 0 0 Heidi Ruhe Secretary 0 223241 0 0 0 1635 0 4569 0 26339 0 255784 0 0 Part I, Line 3 The Board Executive Committee of Little Company of Mary Hospital, Inc. annually reviews external benchmark compensation drafts and determines compensation adjustments based on market data and internal performance results for the Secretary and Treasurer positions. The Hospital uses an outside consultant and outside surveys to determine appropriateness of executive pay. The process of determining executive compensation is documented and retained by the CEO of the Hospital. For other top management positions, the compensation committee is comprised of the CEO, CFO, and COO of the Hospital. Cash 2020-01-31 2772397 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) Net Accounts Receivable 2020-01-31 1690310 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) Inventory for Sale or Use 2020-01-31 213297 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) Prepaid Expenses 2020-01-31 62742 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) Property, Plant and Equipment 2020-01-31 23420085 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) Other Assets 2020-01-31 12409461 Book Value 383852646 OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 501(c)(3) 0 1 0 1 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: The following directors, officers, and key employees all became employees of OSF Multi-Specialty Group: John Hanlon, Heidi Ruhe, and Kent Armbruster. Part I, Line 2e: Explanation of Involvement: Executives of Little Company of Mary Affiliated Services were offered severance compensation as a result of the merger with OSF Multi-Specialty Group. The following officers and key employees became entitled to severance compensation:-John Hanlon-Heidi Ruhe Part I, Line 5: As part of the merger agreement and in accordance with state laws, OSF Multi-Specialty Group assumed all of the debts and liabilities of Little Company of Mary Affiliated Services. Schedule N, Part I: After approval of both organizations' Board of Directors and all regulatory agencies, Little Company of Mary Affiliated Services, an Illinois not for profit corporation, merged into OSF Multi-Specialty Group, an Illinois not for profit corporation. OSF Multi-Specialty Group assumed all assets and obligations of Little Company of Mary Affiliated Services. The merger was effective February 1, 2020. Form 990, Part III, line 3 After approval of both organizations' Board of Directors and all regulatory agencies, Little Company of Mary Affiliated Services, an Illinois not for profit corporation, merged into OSF Multi-Specialty Group, an Illinois not for profit corporation. OSF Multi-Specialty Group assumed all assets and obligations of Little Company of Mary Affiliated Services. The merger was effective February 1, 2020. Form 990, Part VI, Section A, line 4 After approval of both organizations' Board of Directors and all regulatory agencies, Little Company of Mary Affiliated Services, an Illinois not for profit corporation, merged into OSF Multi-Specialty Group, an Illinois not for profit corporation. OSF Multi-Specialty Group assumed all assets and obligations of Little Company of Mary Affiliated Services. The merger was effective February 1, 2020. Form 990, Part VI, Section A, line 6 The sole member of the organization is Little Company of Mary Health Systems of Evergreen Park, an Illinois not-for-profit corporation. Form 990, Part VI, Section A, line 7a Little Company of Mary Health Systems of Evergreen Park has the power to appoint members of the governing body. Form 990, Part VI, Section A, line 7b The sole corporate member retains reserved powers to approve, among other things, Affiliated Services' annual budget, election of Directors, and the incurrence of debt or transfer of property in excess of certain limits. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the Director of Finance, Controller, and CFO prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Each director, principal officer, key employee and member of a committee with Board delegated powers shall annually sign a Conflict of Interest Statement which affirms that such person has received, read, understood, and agreed to comply with the directive. All conflict of interest statements are reviewed annually by the CEO and the Corporate Compliance Officer and the results are presented to the Corporate Compliance Committee. The results and any recommendations are reported at the next Board of Directors' meeting. If a conflict is deemed to exist, such person shall not vote on, nor use his or her personal influence on, nor participate (other than to present factual information or to respond to questions) in the discussions or deliberations with respect to such contract or transaction. Such person may not be counted in determining the existence of a quorum at any meeting where the contract or transaction is under discussion or is being voted upon. The minutes of the meeting shall reflect the disclosures made, the vote thereon and, where applicable, the abstention from voting and participation, and whether a quorum was present. Form 990, Part VI, Section B, line 15 The Board Executive Committee of Little Company of Mary Hospital, Inc. annually reviews external benchmark compensation drafts and determines compensation adjustments based on market data and internal performance results for the President position. The Hospital uses an outside consultant and outside surveys to determine appropriateness of executive pay. The process of determining executive compensation is documented and retained by the CEO of the Hospital. For other top management positions, the compensation committee is comprised of the Hospital's CEO, CFO, and COO. Form 990, Part VI, Section C, line 19 The conflict of interest policy is available by request. Form 990, Part XI, line 9: Transfer to OSF Multi-Specialty Group -11,026,583. FASB 158 Pension Adjustment -21,432. Little Company of Mary Hospital Inc 2800 West 95th Street Evergreen Park IL 60805 362246719 Health Servcies IL 501(c)(3) Line 3 Little Company of Mary Sisters - USA 0 Little Company of Mary Health Systems 2800 West 95th Street Evergreen Park IL 60805 363823627 Health Services IL 501(c)(3) Line 1 Little Company of Mary Sisters - USA 0 Little Company of Mary Hospital Foundation 2800 West 95th Street Evergreen Park IL 60805 363993337 Supporting Organization IL 501(c)(3) Line 12a, I Little Company of Mary Hospital 1 Little Company of Mary Sisters - USA 2800 West 95th Street Evergreen Park IL 60805 237294648 Religious IL 501(c)(3) Line 1 N/A 0 LCHM-UCMC Radiation Oncology Joint Venture LLC 2800 West 95th Street Evergreen Park IL 60805 Health Services IL N/A N/A 0 0 Southwest Health Systems Inc 2800 West 95th Street Evergreen Park IL 60805 363425870 Managed Care IL N/A C 1 Mary Cap Insurance Inc 76 St Paul Street Suite 500 Burlington VT 50401 030304812 Captive Insurance VT N/A C 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1