2019-05-15T12:37:59-05:00 2018-06-30 990 2017-07-01 364251846 St Alexius Medical Center STAL 3147338000 1555 Barrington Road Hoffman Estates IL 601691099 Tonya Mershon Tax Officer 2019-05-15 2017 2019-02-21 02:37:17Z Len Wilk 1555 Barrington Road Hoffman Estates IL 601691099 353188636 false 0928 X https://www.amitahealth.org/locations/hospitals/hoffman-estates X 1998 IL To improve the health and well-being of all people in the communities we serve. 9 6 2047 463 50288 0 312104 148025 356873482 349041753 232470 728360 2077764 2234724 359495820 352152862 0 0 0 0 118676925 119573452 0 0 0 196408292 195621695 315085217 315195147 44410603 36957715 327697242 394453094 107449906 107560159 220247336 286892935 St. Alexius Medical Center carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health and housing needs of the those we are called to serve. false false 261443597 0 349042412 St. Alexius Medical Center is a 318-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, St. Alexius Medical Center treated 16,613 adults and children for a total of 71,031 patient days of service. The hospital also provided services for 263,545 outpatient visits, which included 6,421 outpatient surgeries and 61,479 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 261443597 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true true false true 305 0 true 2047 true true true false false false false false true false false false X 9 6 false false true false true true true true true false false false true true true true true false false true true IL X Jeannie Justie 2242730515 2601 Navistar Dr Bld 4 FL 2-Finance Lisle IL 60532 BRUCE WOLFE CHAIRPERSON 1.0 2.0 X X 0 0 0 KATHLEEN GILMER VICE CHAIRPERSON 1.0 2.0 X X 0 0 0 LEN WILK CEO, ST. ALEXIUS 49.0 1.0 X X 0 553717 20475 CALVIN H FISCHER DO DIRECTOR 1.0 49.0 X 0 264437 41830 JOANNE LESKI EDD RN CNE DIRECTOR 1.0 2.0 X 0 0 0 MARIJO LETIZIA PHD DIRECTOR 1.0 2.0 X 0 0 0 THOMAS R PALMER JD DIRECTOR 1.0 2.0 X 0 0 0 JUDGE JOHN D TOURTELOT DIRECTOR 1.0 2.0 X 0 0 0 MICHAEL HANDLER MD DIRECTOR; CMO ABMC & SAMC 25.0 25.0 X 0 394182 34049 MARK FREY CEO, AMITA HEALTH 0.0 0.0 X 0 1730719 47458 DONNA GAUTHIER ASSISTANT SECRETARY 1.0 39.0 X 0 90398 24526 DIANA WOYTKO SECRETARY; CQO, AMITA HEALTH 1.0 49.0 X 0 383399 58496 HENRY ZEISEL TREASURER; CFO, ABMC & SAMC 25.0 25.0 X 0 285379 25862 LAURENCE R DRY III CHIEF OPERATING OFFICER 25.0 25.0 X 0 341806 35388 ANSHUL AGGARWAL MD CARDIOLOGY 50.0 0 X 1051926 0 23340 BRYAN BERTOGLIO MD NEUROSURGERY 50.0 0 X 1215131 0 36122 KOGAN NEPHTALI MD CARDIOLOGY 50.0 0 X 858555 0 46053 SCOTT E TOMASIK MD CARDIOLOGY 50.0 0 X 951097 0 46173 SANJAY YADLA MD NEUROSURGEON 50.0 0 X 810391 0 34293 4887101 4044036 474064 138 false true false OBHG ILLINOIS SC 10 CENTIMETERS DR MAULDIN SC 29662 MEDICAL SERVICES 1005730 SUBURBAN LUNG ASSOCIATES SC 800 BIESTERFIELD RD STE 510 ELK GROVE VILLAGE IL 60007 MEDICAL SERVICES 752285 POWER CONSTRUCTION COMPANY LLC 8750 W BRYN MAWR AVE STE 500 CHICAGO IL 60631 CONSTRUCTION SERVICES 502917 PULMONARY EXCHANGE LTD 9840 SOUTHWEST HIGHWAY OAK LAWN IL 60453 MEDICAL SERVICES 294274 COMPASS HEALTHCARE CONSULTING LLC 3400 DUNDEE RD STE 200 NORTHBROOK IL 60062 CONSULTING SERVICES 260392 14 X 0 0 0 148025 0 0 148025 Net Patient Service Revenue 621990 346685124 346685124 Income from Joint Ventures 621990 985000 985000 Rental Income from Affiliates 531120 886775 886775 Services to Affiliates 561000 434566 434566 Laboratory Services 621500 50288 50288 0 0 0 0 349041753 725740 725740 0 0 0 0 1318404 0 1030554 287850 0 287850 287850 0 7840 5220 0 2620 2620 2620 0 0 0 0 393318 0 393318 393318 Cafeteria/Vending Revenue 722514 1477571 1477571 Medical Records Fees 900099 9754 9754 Childbirth Education 616000 50947 50947 15284 0 0 15284 1553556 352152862 349042412 50288 2912137 98434149 92624354 5809795 2014243 1895358 118885 11907553 11204744 702809 7217507 6791514 425993 16218 16218 10672 10672 1614 1614 7667932 7319491 348441 0 159802 -68463 228265 779140 341726 437414 43801 40007 3794 5531491 640035 4891456 54402 48172 6230 145911 119616 26295 8960496 8960496 15660247 3338941 12321306 2852640 2852640 Professional Fee to Affiliate 61461765 61461765 Medical Supplies 45559883 45688451 -128568 Purchased Services 18263924 2327814 15936110 Provider Tax 15455850 15455850 12995907 12214222 781685 0 315195147 261443597 53751550 0 496 11271 0 2327 0 0 60633377 56200385 0 0 0 0 0 0 4716728 5485212 167744 292402 333126071 91525367 247517182 241600704 0 0 0 1309975 1258996 121431 235523 13230309 89366274 327697242 394453094 20353429 19444258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87096477 88115901 107449906 107560159 X 220247336 286892935 0 0 0 0 220247336 286892935 327697242 394453094 X 36957715 29687884 X false true X true false X false false false false false false false false true 1614 1614 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Alexius Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Alexius Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 12220000 12220000 250729551 54105644 196623907 8423594 4832931 3590663 56793803 32531595 24262208 4959123 55197 4903926 241600704 Other Current Assets 99682 Due from Affiliates 86269107 Other Receivables 331472 Estimated 3rd Party Payor Settlements 2666013 Adj-Debt Issuance Costs #193425 - N/R Other 89366274 50000 Due to Affiliates 37153973 Other Current Liabilities 1854869 Estimated 3rd Party Payor Settlement 47700539 Recovery Tail Liability 574433 Accrued Tax Liability 782087 88115901 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true X true X true X 600 true true false true true 4617185 0 4617185 0.0146 69683475 68945926 737549 0.0023 0 0.0 0 0 74300660 68945926 5354734 0.0170 108217 428247 2690 425557 0.0014 1244 1063906 1063906 0.0034 339 1009980 1009980 0.0032 0 0.0 1 3720 3720 0.0000 0 109801 2505853 2690 2503163 0.0079 0 109801 76806513 68948616 7857897 0.0249 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 0 0 0 0 0.0 false 4790203 479020 91889822 109119682 -17229860 X true true HOFFMAN ESTATES SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.4 0.6 1 1 ST ALEXIUS MEDICAL CENTER 1555 BARRINGTON ROAD HOFFMAN ESTATES IL 60169 https://www.amitahealth.org/locations/hospitals/hoffman-estates 0004994 X X X X ST ALEXIUS MEDICAL CENTER 1 false false true X X X X X X X X 15 true true false true X www.amitahealth.org/about-us/community-benefit/st-alexius-hoffman-estates X true 16 true www.amitahealth.org/about-us/community-benefit/st-alexius-hoffman-estates false true X 200.0 600.0 X X X X X true true X X X true X https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance X https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance X https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST ALEXIUS MEDICAL CENTER. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY HOSPITALS PARTICIPATING IN THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL (MCHC) LED HOSPITAL COALITION; AND INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK AS WELL AS THE COMMUNITY OVERALL. TWENTY-NINE AGENCIES/INDIVIDUALS PROVIDED COMMENT. INPUT FROM THE FOLLOWING ORGANIZATIONS WAS GATHERED DURING THE PERIOD AUGUST TO OCTOBER 2016 : A SAFE HAVEN FOUNDATION ANTOICH AREA HEALTHCARE ACCESSIBILITY ALLIANCE AUSTIN CHILDCARE PROVIDERS NETWORK CHICAGO DEPARTMENT OF PUBLIC HEALTH DUPAGE COUNTY HEALTH DEPARTMENT DUPAGE FEDERATION ON HUMAN SERVICES REFORM ELMHURST CUSD 205 ENLACE CHICAGO ERIE FAMILY HEALTH CENTER/ERIE HEALTHREACH WAUKEGAN HEALTHCARE FOUNDATION OF NORTHERN LAKE COUNTY ILLINOIS DEPARTMENT OF PUBLIC HEALTH, BELLWOOD REG OFFICE LAKE COUNTY FOREST PRESERVES LAKE COUNTY HEALTH DEPARTMENT LAKE COUNTY COMMUNITY HEALTH CENTER LORETTO HOSPITAL METROPOLITAN CHICAGO HEALTHCARE COUNCIL NAPERVILLE SCHOOL DISTRICT 203 NEW MOMS, INC. NORTHWEST COMMUNITY HEALTHCARE NORTHWEST COMPASS, INC. NORTHWESTERN LAKE FOREST HOSPITAL PCC COMMUNITY WELLNESS CENTER PEOPLE'S RESOURCE CENTER ST. JOSEPH SERVICES UNITED WAY OF METROPOLITAN CHICAGO VILLAGE OF ADDISON VILLAGE OF ARLINGTON HEIGHTS WEST HUMBOLDT PARK DEVELOPMENT COUNCIL WHEELING TOWNSHIP GENERAL ASSISTANCE OFFICE THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS (INCLUDING AFRICAN-AMERICAN, ARABIC, ASIAN, AUTISTIC CHILDREN, THE DISABLED, EASTERN EUROPEAN, ELDERLY, ETHNIC MINORITIES, HISPANIC, THE HOMELESS, IMMIGRANTS, INDIAN, JAPANESE, LGBT POPULATION, LOW-INCOME RESIDENTS, MULTILINGUAL, MULTIRACIAL, NON-ENGLISH SPEAKING, POLISH, RUSSIAN, SOUTH AMERICAN, UNDOCUMENTED, UNINSURED/UNDERINSURED, WOMEN, YOUTH), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING AFRICAN-AMERICAN, THE DISABLED, ELDERLY, EX-OFFENDERS, FREE CARE, HISPANIC, THE HOMELESS, IMMIGRANTS, LGBT COMMUNITY, LOW-INCOME, MEDICAID/MEDICARE, THE MENTALLY ILL, NONENGLISH SPEAKING ADULTS, PREGNANT TEENS, SUBSTANCE ABUSERS, UNDOCUMENTED, UNINSURED/UNDERINSURED, VETERANS, YOUNG ADULTS, YOUTH). Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ST ALEXIUS MEDICAL CENTER. THE OTHER HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL CONDUCTED ITS CHNA INCLUDE: ADVENTIST LAGRANGE MEMORIAL HOSPITAL ALEXIAN BROTHERS MEDICAL CENTER ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL FRANCISCAN ST. JAMES HEALTH INGALLS MEMORIAL HOSPITAL LITTLE COMPANY OF MARY HOSPITAL AND HEALTH CARE CENTERS LORETTO HOSPITAL NORTHWEST COMMUNITY HEALTHCARE NORTHWESTERN MEMORIAL HOSPITAL PALOS COMMUNITY HOSPITAL RUSH OAK PARK HOSPITAL RUSH UNIVERSITY MEDICAL CENTER SAINT ANTHONY HOSPITAL ST. BERNARD HOSPITAL AND HEALTH CARE CENTER SWEDISH COVENANT HOSPITAL THE UNIVERSITY OF CHICAGO MEDICINE THOREK MEMORIAL HOSPITAL ADVENTIST GLEN OAKS HOSPITAL ADVENTIST HINSDALE HOSPITAL EDWARD HOSPITAL & HEALTH SERVICES ELMHURST MEMORIAL HEALTHCARE CENTRAL DUPAGE HOSPITAL NORTHWESTERN LAKE FOREST HOSPITAL ADVENTIST BOLINGBROOK HOSPITAL Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. ALEXIUS MEDICAL CENTER - PART I. ISSUE: CANCER SAMC ALONG WITH ITS MEMBER HOSPITAL, ABMC, RUNS A COMPREHENSIVE CANCER INSTITUTE IN THEIR RESPECTIVE IMMEDIATE SERVICE AREAS. FREE SUPPORT GROUPS THAT FOCUS ON EDUCATION, SUPPORT AND POSITIVE COPING WERE PROVIDED TO PATIENTS AND COMMUNITY MEMBERS. THE SUPPORT GROUPS WERE LED BY LICENSED PROFESSIONALS THAT FACILITATE THE SESSIONS, WHICH WERE DESIGNED TO PROVIDE AN OPEN, SAFE AND ENCOURAGING ENVIRONMENT FOR THE SHARING OF COMMON EXPERIENCES, TIPS AND LAUGHTER. SUPPORT GROUPS WERE FOCUSED ON THE FOLLOWING: -YOUNG WOMEN'S SUPPORT GROUP (50 & YOUNGER) - IN THIS PHASE OF LIFE, WOMEN'S ROLES INCLUDE BEING SINGLE YOUNG WOMEN, YOUNG WIVES, MOTHERS, AND BEGINNING OR SOLIDIFYING THEIR CAREERS. IN THIS GROUP, WOMEN RECEIVE EMOTIONAL SUPPORT FROM OTHER WOMEN WHO CAN SHARE THEIR PAST EXPERIENCES. -EXPRESS YOURSELF! - A MONTHLY WORKSHOP USING VARIOUS ART MATERIALS TO CREATE BEAUTIFUL SYMBOLS OF STRENGTH AND VITALITY. -FIT CLUB TO FIGHT CANCER - A FITNESS AND CANCER WORKOUT PROGRAM. -TAI CHI-QIGONG MEDITATION - TRADITIONAL CHINESE METHODS ARE TAUGHT TO STRENGTHEN THE HEALTH OF THE BODY, MIND, AND SPIRIT. - HEALING TOUCH - SPECIALIZED THERAPY DESIGNED TO ALLEVIATE CANCER TREATMENT'S PAIN, STRESS AND SIDE EFFECTS. -ENERGY THERAPY - HELPS TO EASE FATIGUE, PAIN AND STRESS WITH A 45-MINUTE MASSAGE. -MASSAGE THERAPY - A 30-MINUTE MASSAGE WITH A CERTIFIED THERAPIST. - GENTLE YOGA - AN INTRODUCTION TO YOGA FOR CANCER PATIENTS, WHO CAN PRACTICE FROM THE MAT OR CHAIR. -CANCER GENETICS RISK ASSESSMENT - CERTIFIED HIGH-RISK GENETIC EDUCATORS OFFER GENETIC EDUCATION/COUNSELING AND TESTING FOR HEREDITARY CANCERS. ISSUE: CHRONIC KIDNEY DISEASE OUR EFFORTS AT ADDRESSING CHRONIC KIDNEY DISEASE CONTINUE TO BE INCLUDED IN ALL OF OUR EDUCATION, PREVENTION, SCREENING AND TREATMENT OF TYPE II DIABETES. ISSUE: HIV/AIDS ABHS, CORPORATE MEMBER OF SAMC, CONTINUES TO BE A PERMANENT, VOTING MEMBER OF THE CATHOLIC CHARITIES HIV/AIDS TASK FORCE FOR THE CHICAGO ARCHDIOCESE AND IS AN HIV/AIDS PROGRAM SERVICES ADVISORY COMMITTEE. THIS TASK FORCE COLLABORATES WITH AGENCIES,INSTITUTIONS AND INDIVIDUALS WHO PROVIDE HIV/AIDS SERVICES, EDUCATION AND MINISTRY IN THE CHICAGO AREA TO CARRY OUT THE HEALING MISSION OF THE CATHOLIC CHURCH. THIS APPROACH BEGINS WITH HOUSING, THE CORNERSTONE OF HEALTHCARE AND AN INTEGRAL PART OF ABHS. STABLE HOUSING PROVIDES A FOUNDATION FOR PEOPLE TO GET A FRESH START. IT PROVIDES A PLACE TO RECEIVE COUNSELING, CARE, AND TO RECONNECT WITH FAMILY. IT'S A PLACE TO BE PART OF A SUPPORTIVE COMMUNITY THAT OFFERS COMPREHENSIVE SERVICES. ABHS OFFERS CLIENTS A WIDE ARRAY OF SUPPORTIVE SERVICES. INDIVIDUAL SESSIONS AND GROUP SERVICES WERE PROVIDED IN ALL AREAS, INCLUDING SPIRITUAL CARE, LIFE SKILLS, AND PSYCHOSOCIAL SUPPORT GROUPS SUCH AS HIV SUPPORT AND SUBSTANCE USE COUNSELING. THE PROGRAMS WERE FOCUSED ON TREATING THE WHOLE INDIVIDUAL, THROUGH A HOLISTIC RANGE OF SERVICES FOCUSED ON RECOVERY AND SUPPORT. THESE INCLUDE THE FOLLOWING: COMPREHENSIVE CASE MANAGEMENT; SUBSTANCE USE COUNSELING; OCCUPATIONAL THERAPY; SPIRITUAL CARE; AND, AFTER CARE. ABHS REPRESENTS CHICAGO DEPARTMENT OF PUBLIC HEALTH (CDPH) ON ISSUES RELATED TO HIV/AIDS. ISSUE:IMMUNIZATION AND INFECTIOUS DISEASES SAMC HOSTED CHILD IMMUNIZATION CLINICS WITH LOCAL MUNICIPALITIES FOR A NOMINAL FEE. SAMC PROVIDES EVERY PATIENT UPON DISCHARGE THE OPPORTUNITY TO RECEIVE A FLU VACCINE. SAMC REQUIRES EVERY EMPLOYEE TO HAVE A FLU VACCINE FOR THE PROTECTION OF OUR PATIENTS UNLESS THEY WERE MEDICALLY EXCUSED. THE EMPLOYED PHYSICIAN GROUP SERVING SAMC URGES EVERY PATIENT TO HAVE A FLU VACCINATION. ABHS, CORPORATE MEMBER OF SAMC, PROVIDES A FREE IMMUNIZATION CLINIC EACH QUARTER TO ANY MEMBER OF THE COMMUNITY. ISSUE: INFANT HEALTH AND FAMILY PLANNING THROUGH THE WOMEN'S HEALTH INSTITUTE, A VARIETY OF FREE PROGRAMS WERE OFFERED TO PATIENTS, FAMILY AND CAREGIVERS AT NO CHARGE OR FOR A NOMINAL FEE. THEY INCLUDE: -TWO-PART, IN-DEPTH CLASSES FOR EXPECTED COUPLES WHO WANT TO LEARN MORE ABOUT BREASTFEEDING. -PREGNANCY CENTRAL, AN ONLINE RESOURCE FOR INFORMATION AND QUESTIONS DURING PREGNANCY. -BREASTFEEDING CLASSES. -PREPARED CHILDBIRTH CLASSES PROVIDED TO NEW PARENTS THAT COVERS LABOR AND DELIVERY, OBSTETRIC INTERVENTIONS, MEDICATIONS, CESAREAN DELIVERY, NEWBORN CARE AND FEELINGS. -TWO-SESSIONS, FOUR-HOUR CLASSES ARE OFFERED TO PREPARE PARENTS NAVIGATE THEIR FIRST WEEKS AT HOME. -WEEKEND PREPARED CHILDBIRTH CLASSES WHICH FOCUSES ON ONE-WEEKEND WITH COMPACT COURSES FOR EXPECTED PARENTS. SAMC HAS ADOPTED THE MARCH OF DIMES "HEALTHY BABIES ARE WORTH THE WAIT" INITIATIVE TO EDUCATE CONSUMERS AND PROFESSIONALS ABOUT PREVENTABLE PRETERM BIRTH, WHICH WAS ADOPTED BY ALL OBSTETRICIANS ON THE MEDICAL STAFF AND COMMUNICATED TO ALL PATIENTS. ISSUES: INJURY AND VIOLENCE, POTENTIALLY DISABLING CONDITIONS SAMC IS DETERMINED TO ADDRESS FAMILY VIOLENCE BY PARTNERING WITH THE WINGS PROGRAM. WINGS PROVIDES A PATHWAY TO INDEPENDENCE FOR ADULTS AND CHILDREN WHO WERE ESCAPING DOMESTIC VIOLENCE AND ABUSE. SAMC PROVIDES AT NO CHARGE AN OFFICE FOR WINGS AT SAMC THAT IS STAFFED BY A FULL-TIME WINGS SOCIAL WORKER WHO MEETS WITH CLIENTS AND PROVIDES SCREENING AND OTHER SUPPORT SERVICES. THROUGH THE PARTNERSHIP WITH WINGS, SAMC DEVELOPED AN INDESTRUCTIBLE BUSINESS CARD WITH HELPLINE PHONE NUMBER AND HAS IMPLEMENTED A PROCESS IN IDENTIFYING AND OFFERING HELP IN BOTH ENGLISH AND SPANISH. SAMC HAS BEEN PROVIDING CONTINUING EDUCATION FOR EMERGENCY MEDICAL PERSONNEL. THESE NURSES WORK WITH THE REGIONAL EMERGENCY SERVICES COORDINATOR TO TEACH, TRAIN AND TEST EVERY FIRST RESPONDER ON A CONTINUAL BASIS. EMERGENCY ROOMS AT SAMC HAVE BEEN TRAINED ON IDENTIFYING AND SUPPORTING HUMAN TRAFFICKING SURVIVORS. A SURVEY CONDUCTED BY THE COALITION TO ABOLISH SLAVERY & TRAFFICKING (CAST) FOUND OVER HALF OF LABOR AND SEX TRAFFICKING SURVIVORS SURVEYED HAD ACCESSED HEALTH CARE AT LEAST ONCE WHILE BEING TRAFFICKED. THIS SHOWS AN OPPORTUNITY FOR EMERGENCY DEPARTMENTS, FIRST RESPONDERS AND EMT STAFF TO DETECT POTENTIAL SITUATIONS. THROUGH THE WOMEN'S HEALTH INSTITUTE FAMILY AND FRIENDS INFANT CPR CLASSES ARE OFFERED, WHICH TEACHES THE LIFESAVING SKILLS OF CPR AND RELIEF OF CHOKING. THE SENIOR & COMMUNITY RESOURCE CENTER OFFERS FREE OSTEOPOROSIS AND MEMORY SCREENINGS. ISSUES: MENTAL HEALTH, SUBSTANCE ABUSE SAMC CREATED A 3-YEAR PARTNERSHIP WITH THE ECKER CENTER FOR MENTAL HEALTH TO OFFER PSYCHIATRIC SERVICES TO THE UNDERINSURED. THE FUNDING FROM SAMC GIVES THE ECKER CENTER FOR MENTAL HEALTH THE ABILITY TO ENROLL 15 NEW CHILDREN INTO THE PSYCHIATRIC DEPARTMENT, BUT THE ENROLLMENT EXCEEDED GOALS AND ENROLLED 60 ADOLESCENTS INSTEAD DURING THE 2018 FISCAL YEAR. PATIENTS RATED THE EFFICACY OF TREATMENT AND SATISFACTION AT 90%. MOST MENTAL HEALTH COMMUNITY PROGRAMMING IS DISSEMINATED THROUGH ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL, A HOSPITAL AFFILIATED WITH SAMC. ISSUE: NUTRITION, PHYSICAL ACTIVITY AND WEIGHT SAMC ALONG WITH ITS MEMBER HOSPITAL, ABMC, OFFER THE GONOODLE PROGRAMMING TO THE SCHAUMBURG AND ELGIN AREA SCHOOL DISTRICTS. GONOODLE IS AN ONLINE SUITE OF PROGRAMS DESIGNED TO IMPROVE CHILDREN'S PHYSICAL ACTIVITY AND NUTRITION. THIS INCLUDES OVER 50 SCHOOLS WITH AN AVERAGE OF 14,000 STUDENTS PARTICIPATING IN GONOODLE ACTIVITIES ON A MONTHLY BASIS. GONOODLE CREATES AN ENGAGING AND FUN ENVIRONMENT WHERE CHILDREN MOVE AROUND THE CLASSROOM, INCREASING THEIR PHYSICAL ACTIVITY TIME WHILE LEARNING THEIR CURRICULUM MATERIAL. NATIONALLY, THE UTILIZATION OF GONOODLE SHOWED 23% GREATER IMPROVEMENT IN READING SCORES, 50% GREATER IMPROVEMENT IN MATH SCORES AND 13% IMPROVEMENT IN CHILDHOOD WEIGHT (AS MEASURED BY BMI) COMPARED TO CHILDREN WHO DIDN'T PLAY GONOODLE. ISSUES: TYPE II DIABETES, HEART DISEASE AND STROKE SAMC ALONG WITH ITS MEMBER HOSPITAL, ABMC, PARTNERED WITH GOLDEN CORRIDOR FAMILY YMCA IN ELGIN AND SCHAUMBURG TO LAUNCH THE DIABETES PREVENTION PROGRAM (DPP) FOR THE AT-RISK POPULATION AND THOSE WHO WERE UNDERINSURED. THE GOAL OF THE DPP PROGRAM IS FOR PARTICIPANTS TO LOSE 5-7% OF BODY WEIGHT (2% BMI DECREASE) DURING THE PROGRAM AND MAINTAIN THE WEIGHT AFTER THE PROGRAM. THE PROGRAM ALSO AIMS TO INCREASE PHYSICAL ACTIVITY OF PARTICIPANTS TO 150 MINUTES PER WEEK. BOTH HOSPITALS OFFER FINANCIAL SUPPORT IN INITIATING THE DPP PROGRAM WHILE OFFERING FINANCIAL AID TO THE PARTICIPANTS THUS TARGETING PARTICIPANTS WHOM WERE UNDERINSURED. OFFERING DIABETES CARE AND CHRONIC MANAGEMENT SERVICES IN THE COMMUNITIES BATTLING HIGH RATES OF THESE DISEASES IMPROVES ACCESS TO HEALTH CARE. SAMC LED DIABETES EDUCATIONAL PROGRAMMING THROUGH A MENTOR PROGRAM MEET AND GREET, AND OFFERED DIABETES 101 CLASS TO SCHOOL NURSES AND STAFF THROUGHOUT FY2018. SAMC COORDINATES FREE BI-MONTHLY BLOOD PRESSURE SCREENINGS TO PREVENT HYPERTENSION RELATED HEALTH RISKS TO THE COMMUNITY. THE HOSPITAL PROVIDED BLOOD PRESSURE SCREENING TO HUNDREDS OF PEOPLE IN THE COMMUNITY. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - ST. ALEXIUS MEDICAL CENTER - PART II. THE SENIOR & COMMUNITY RESOURCE CENTER OFFERS FREE EVENTS/PROGRAMS THAT SUPPORT HEALTH LIFESTYLES. THOSE EVENTS INCLUDE CHOLESTEROL AND BLOOD PRESSURE SCREENINGS; FOREVER YOUNG YOGA CLASSES, AND HEATLY COOKING CLASSES. ISSUE: RESPIRATORY DISEASES A NEW ALEXIAN SLEEP HEALTH CENTER IS BEING CONSTRUCTED IN SAMC TO SERVE THE COMMUNITY IN THE IMMEDIATE SERVICE AREAS. THE CENTER IS PREMIER IN THE CHICAGOLAND AREA IN BOTH QUALITY AND QUANTITY. THE SLEEP STAFF INCLUDES A NATIONALLY RECOGNIZED PEDIATRIC SLEEP SPECIALIST WHO HAS ALLOWED THE PROGRAM TO DEVELOP HIGH QUALITY SERVICE IN THE IMPORTANT AND UNDERSERVED AREA OF PEDIATRIC SLEEP. THE ALEXIAN SLEEP HEALTH CENTER WAS FOUNDED TO HELP PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS DIAGNOSE AND TREAT PATIENTS WITH SLEEP DISORDERS INCLUDING SLEEP APNEA, NARCOLEPSY, RESTLESS LEGS SYNDROME AND INSOMNIA. AT THE TIME OF THIS REPORT, ABMC IS IN THE PLANNING STAGES OF AN ASTHMA PROGRAM WITH OTHER COMMUNITY STAKEHOLDERS. ISSUE: SEXUALLY TRANSMITTED DISEASES SAMC DOES NOT PROVIDE SPECIFIC PROGRAMMING FOR THIS ISSUE BUT PROVIDES REFERRALS TO PRIMARY CARE FOR ANY COMMUNITY MEMBER NEEDING ASSISTANCE. ALL IDENTIFIED NEEDS ARE BEING ADDRESSED BY ALEXIAN BROTHERS MEDICAL CENTER, ST. ALEXIUS MEDICAL CENTER AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL AS DESCRIBED. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - ST ALEXIUS MEDICAL CENTER. ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY. THE FRONT OF OUR STATEMENT INCLUDES THIS MESSAGE: "IF YOU ARE AN UNINSURED ILLINOIS RESIDENT AND MEET CERTAIN INCOME REQUIREMENTS, YOU MAY QUALIFY FOR A DISCOUNT THROUGH OUR ALEXIAN ASSISTANCE PROGRAM IN ACCORDANCE WITH THE STATE OF ILLINOIS, HOSPITAL UNINSURED PATIENT DISCOUNT ACT (EFFECTIVE APRIL 1, 2009). FOR ADDITIONAL INFORMATION, PLEASE CONTACT US AT 866-690-3370 OR ALEXIANASSISTANCE@ALEXIAN.NET". THE BACK OF OUR STATEMENT INCLUDES THIS MESSAGE: "IF PAYING THIS BILL PRESENTS A FINANCIAL HARDSHIP, YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALEXIAN BROTHERS HOSPITAL NETWORK PROVIDES ASSISTANCE TO PATIENTS IN NEED OF FINANCIAL AID TO HELP PAY FOR HIS/HER HOSPITAL BILLS. YOU MAY OBTAIN AN APPLICATION BY CALLING OUR STAFF AT THE NUMBER BELOW OR YOU MAY DOWNLOAD THE FORMS FROM THE INTERNET AT WWW.ALEXIANBROTHERSHEALTH.ORG". IN ADDITION, ALL UNINSURED PATIENTS RECEIVE A LETTER FROM OUR PATIENT FINANCIAL SERVICES DEPARTMENT ONCE WE COMPLETE A PROCESS OF ATTEMPTING TO IDENTIFY ALTERNATIVE COVERAGE FOR UNINSURED PATIENTS. THIS LETTER IS SENT AT THE BEGINNING OF OUR STATEMENT CYCLE FOR EACH UNINSURED PATIENT. THE TEXT OF THE LETTER IS: "THANK YOU FOR CHOOSING [HOSPITAL NAME] AS YOUR HEALTHCARE PROVIDER. YOUR ACCOUNT CURRENTLY HAS A BALANCE OF $XX; ADDITIONAL CHARGES MAY BE PENDING. WE HAVE NO RECORD THAT YOU HAVE HEALTH INSURANCE TO HELP IN PAYING YOUR BILL. IF YOU HAVE INSURANCE, PLEASE PROVIDE THE NECESSARY INFORMATION BY FILLING OUT THE STUB ABOVE AND FAXING A COPY OF YOUR INSURANCE CARD TO 847-483-7058, ATTN: CORRESPONDENCE TEAM. IF YOU HAD INSURANCE THAT ENDED WITHIN THE LAST 60 DAYS, YOU MAY BE ELIGIBLE FOR COBRA COVERAGE FROM A FORMER EMPLOYER. PLEASE CONTACT YOUR FORMER EMPLOYER TO DETERMINE IF YOU ARE ELIGIBLE." ST. ALEXIUS USES MULTIPLE METHODS OF COMMUNICATING ITS MISSION OF PROVIDING CARE TO ALL WHO NEED IT REGARDLESS OF ABILITY TO PAY. SIGNS POSTED AT REGISTRATION CLEARLY POINT OUT THAT CHARITY CARE OR FINANCIAL ASSISTANCE IS AVAILABLE. ALEXIAN BROTHERS HEALTH SYSTEM'S (ABHS) WEBSITE, THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ALEXIUS, FEATURES INFORMATION ON HOW TO APPLY FOR CHARITY CARE ON-LINE. IN THE HOSPITAL SETTING, WE EMPLOY TWO FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY. 2 ST ALEXIUS OUTPATIENT CENTER 347 W GOLF ROAD SCHAUMBURG IL 60195 DIAGNOSTIC IMAGING SERVICES AND PHYSICAL THERAPY REHABILITATION SERVICES ST ALEXIUS BREAST CARE CENTER 864 W STEARNS ROAD BARTLETT IL 60103 MAMMOGRAPHY AND DEXA BONE SCAN IMAGING Schedule H, Part VI, Line 7 STATE OF FILING COMMUNITY BENEFIT ALEXIAN BROTHERS HOSPITAL NETWORK("ABHN") PREPARES AND FILES THE ANNUAL NON-PROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS REPORT IS PREPARED ON A CONSOLIDATED BASIS AND INCLUDES DATA FOR ALEXIAN BROTHERS MEDICAL CENTER ("ABMC"), ST. ALEXIUS MEDICAL CENTER ("SAMC") AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL ("ABBHH"). Schedule H, Part I, Line 3c FAP ELIGIBILTY PATIENTS WITH INCOME LESS THAN OR EQUAL TO 250% OF THE FEDERAL POVERTY LEVEL ("FPL") WILL BE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF ON THAT PORTION OF THE CHARGES FOR SERVICES FOR WHICH THE PATIENT IS RESPONSIBLE FOLLOWING PAYMENT BY AN INSURER, IF ANY. AT A MINIMUM, PATIENTS WITH INCOMES ABOVE 250% OF THE FPL BUT NOT EXCEEDING 400% OF THE FPL WILL RECEIVE A SLIDING SCALE DISCOUNT ON THAT PORTION OF THE CHARGES FOR SERVICES PROVIDED FOR WHICH THE PATIENT IS RESPONSIBLE FOLLOWING PAYMENT BY AN INSURER, IF ANY. A PATIENT ELIGIBLE FOR THE SLIDING SCALE DISCOUNT WILL NOT BE CHARGED MORE THAN THE CALCULATED AGB CHARGES. PATIENTS WITH DEMONSTRATED FINANCIAL NEEDS WITH INCOME GREATER THAN 400% OF THE FPL (INSURED) AND GREATER THAN 600% FPL (UNINSURED) MAY BE ELIGIBLE FOR CONSIDERATION UNDER A "MEANS TEST" FOR SOME DISCOUNT OF THEIR CHARGES FOR SERVICES FROM THE ORGANIZATION BASED ON A SUBSTANTIVE ASSESSMENT OF THEIR ABILITY TO PAY. CATASTROPHIC LOSS - YEARLY MAXIMUM FAMILY RESPONSIBILITY ON BALANCES WILL NOT EXCEED 25% OF THE ANNUAL GROSS FAMILY INCOME. A PATIENT ELIGIBLE FOR THE "MEANS TEST" DISCOUNT WILL NOT BE CHARGED MORE THAN THE CALCULATED AGB CHARGES. Schedule H, Part I, Line 6a NAME OF THE ORGANIZATION THAT PREPARED THE COMMUNITY BENEFIT REPORT ALEXIAN BROTHERS HOSPITAL NETWORK (ABHN), EIN: 36-3276552, PREPARES AND FILES THE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS REPORT IS PREPARED ON A CONSOLIDATED BASIS AND INCLUDES DATA FOR ALEXIAN BROTHERS MEDICAL CENTER (ABMC), ST. ALEXIUS MEDICAL CENTER (SAMC) AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL (ABBHH). Schedule H, Part V, Section B, Line 17 BILLING AND COLLECTION POLICY DURING TAX YEAR 2017, THE ORGANIZATION LEARNED VIA VERBAL COMMENTS OF IRS AGENTS AT PUBLIC EVENTS THAT THE IRS INTENDS THAT THE "READILY OBTAINABLE" STANDARD IN THE 501(R) REGULATIONS FOR THE AGB CALCULATION AND BILLING AND COLLECTION POLICY IS ONLY MET IF THOSE ITEMS ARE POSTED TO THE ORGANIZATION'S WEB SITE. THE ORGANIZATION HAD INTERPRETED THAT WEB POSTING STANDARD TO BE A SAFE HARBOR AFTER CONSULTING WITH EXTERNAL COUNSEL AND TAX ADVISORS, AND TIMELY TOOK OTHER STEPS TO MAKE THE INFORMATION READILY OBTAINABLE. CONSEQUENTLY, THE ORGANIZATION DOES NOT BELIEVE ITS DECISION TO NOT POST THESE DOCUMENTS TO ITS WEB SITE RISES TO THE LEVEL OF A FAILURE, NOR DOES IT BELIEVE THE CIRCUMSTANCES WERE EITHER WILLFUL OR EGREGIOUS, HAVING OTHERWISE TIMELY TAKEN THE STEPS NECESSARY TO ATTAIN AND CONTINUE TO MAINTAIN COMPLIANCE WITH THE OTHER REQUIREMENTS RELATED TO THE BILLING AND COLLECTION POLICY AND THE AGB, AS PART OF ITS POLICIES AND PROCEDURES FOR ENSURING COMPLIANCE WITH ALL ASPECTS OF 501(R). HOWEVER, THE ORGANIZATION IS MAKING THIS VOLUNTARY DISCLOSURE IN ORDER TO COMMUNICATE TO THE IRS THE CHANGES IT IS UNDERTAKING IN RESPONSE TO THE RECENT IRS INFORMAL GUIDANCE ON THIS SPECIFIC POINT CONCERNING THE "READILY OBTAINABLE" STANDARD, AND THE FACT THAT THE ORGANIZATION HAS STARTED THE WORK NECESSARY TO POST ITS AGB INFORMATION AND BILLING AND COLLECTION POLICY TO ITS WEB SITE AND WILL COMPLETE THOSE ADDITIONAL POSTINGS AS SOON AS REASONABLY POSSIBLE. THE OTHER WEB POSTINGS REQUIRED UNDER 501(R) (I.E., THOSE RELATED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE FINANCIAL ASSISTANCE POLICY) WERE TIMELY COMPLETED AND CONTINUE TO REMAIN IN PLACE AS REQUIRED. THE ORGANIZATION BELIEVES ITS SAFEGUARDS WORKED AS INTENDED IN THIS CASE (I.E., THE ORGANIZATION HAS REGULAR COMMUNICATIONS WITH A NUMBER OF EXTERNAL LAW FIRMS AND TAX CONSULTANTS AND THE TIMELY ATTENTION TO THE RECENT GUIDANCE WAS SUPPORTED BY THE FRAMEWORK OF REGULAR ACCESS TO SUBJECT MATTER EXPERTS). THESE CHANGES ARE IN THE PROCESS OF BEING INCORPORATED INTO CORPORATE POLICIES AND PROCEDURES THAT APPLY TO THE ORGANIZATION. Schedule H, Part I, Line 7g Subsidized Health Services ST. ALEXIUS HAS NOT INCLUDED COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS PART OF SUBSIDIZED HEALTH SERVICES. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE FOLLOWING COSTING METHODOLOGIES WERE USED: -CHARITY AT COST - A COST TO CHARGE METHODOLOGY BASED ON THE FILED 2018 MEDICARE COST REPORT WAS USED TO CALCULATE COSTS. -UNREIMBURSED MEDICAID - COSTS ARE CALCULATED USING THE 2018 FILED MEDICAID COST REPORT. -OTHER BENEFITS - COSTS ARE DETERMINED BY ACTIVITY REPORTED IN ACCORDANCE WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION; COSTS COULD INCLUDE THE VALUE OF HOURLY WAGES, COSTS OF MATERIALS, VALUE OF SPACE LOANED TO COMMUNITY GROUPS FOR MEETINGS, AND INDIRECT COSTS WHERE APPLICABLE. Schedule H, Part II Community Building Activities THE COMMUNITY BUILDING EFFORTS INCLUDE ECONOMIC DEVELOPMENT OPPORTUNITIES WITH CHAMBERS OF COMMERCE; PROVIDING INTERNSHIPS AND SCHOLARSHIPS TO LOCAL COLLEGES; AND SPONSORING FUND RAISERS FOR COMMUNITY ORGANIZATIONS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE ST ALEXIUS MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE ABHN HOSPITALS, INCLUDING ST. ALEXIUS, PROACTIVELY WORK TO PRESUMPTIVELY ASSESS AND GRANT CHARITY TO ALL UNINSURED PATIENTS PRIOR TO SENDING THESE PATIENTS THEIR FIRST STATEMENT. WE SCREEN ALL UNINSURED PATIENTS AGAINST CREDIT SCORE DATA IN ORDER TO PRESUMPTIVELY APPLY OUR CHARITY POLICY.WE ESTIMATE THAT APPROXIMATELY 10% OF OUR CURRENT BAD DEBT PLACEMENTS WOULD BE ELIGIBLE FOR ADDITIONAL CHARITY IF WE HAD A FULL PRESUMPTIVE CHARITY PROCESS ACROSS 100% OF OUR SELFPAY AFTER INSURANCE ACCOUNTS. DISCOUNTS AND PAYMENTS ARE NOT INCLUDED IN BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS FOR ST. ALEXIUS UNLESS THE PAYMENT IS A RECOVERY OF AMOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT. RECOVERIES ARE CLASSIFIED AS A DECREASE TO BAD DEBT EXPENSE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE (WHICH INCLUDE THE ACTIVITY OF ST ALEXIUS MEDICAL CENTER): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IT IS THE POLICY OF ABHS, INCLUDING ST. ALEXIUS, TO OFFER PATIENTS A PAYMENT PLAN AND/OR CHARITY ASSISTANCE WHEN IT BECOMES KNOWN OR EVEN SUSPECTED THAT A PATIENT NEEDS FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS ARE NOTIFIED AND EVERY ATTEMPT IS MADE TO CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM COMPLETE AN APPLICATION WITH COMPASSION AND DIGNITY. FINANCIAL COUNSELORS WORK WITH PATIENTS TO HELP DETERMINE IF THERE ARE ANY THIRD PARTY PAYERS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. WE WORK WITH THE PATIENT TO DETERMINE IF THEY ARE ELIGIBLE FOR FEDERAL PROGRAMS INCLUDING MEDICAID, STATE FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION AND OR OTHER SPECIALIZED GRANT PROGRAMS SUCH AS OUR MAMMOGRAPHY GRANT PROGRAM FOR LOW INCOME WOMEN. IN THE EVENT NO THIRD PARTY PROGRAMS ARE IDENTIFIED, WE THEN WORK WITH THE PATIENT TO HELP THEM APPLY FOR CHARITY DISCOUNTS AND PAYMENT PLANS.IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY. Schedule H, Part V, Section B, Line 16a FAP website - ST ALEXIUS MEDICAL CENTER: Line 16a URL: https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - ST ALEXIUS MEDICAL CENTER: Line 16b URL: https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST ALEXIUS MEDICAL CENTER: Line 16c URL: https://www.amitahealth.org/patient-resources/pay-your-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment EXISTING SECONDARY DATA SOURCES WERE CONSULTED TO COMPLEMENT THE RESEARCH QUALITY OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT. DATA WERE OBTAINED FROM THE FOLLOWING SOURCES: *CENTER FOR APPLIED RESEARCH AND ENVIRONMENTAL SYSTEMS (CARES) *CENTERS FOR DISEASE CONTROL & PREVENTION, OFFICE OF INFECTIOUS DISEASE, NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION *CENTERS FOR DISEASE CONTROL & PREVENTION, OFFICE OF PUBLIC HEALTH SCIENCE SERVICES, CENTER FOR SURVEILLANCE, EPIDEMIOLOGY AND LABORATORY SERVICES, DIVISION OF HEALTH INFORMATICS AND SURVEILLANCE (DHIS) *CENTERS FOR DISEASE CONTROL & PREVENTION, OFFICE OF PUBLIC HEALTH SCIENCE SERVICES, NATIONAL CENTER FOR HEALTH STATISTICS *COMMUNITY COMMONS *CONNECTICUT DEPARTMENT OF PUBLIC HEALTH *ESRI ARCGIS MAP GALLERY *NATIONAL CANCER INSTITUTE, STATE CANCER PROFILES *OPENSTREETMAP (OSM) *US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY *US CENSUS BUREAU, COUNTY BUSINESS PATTERNS *US CENSUS BUREAU, DECENNIAL CENSUS *US DEPARTMENT OF AGRICULTURE, ECONOMIC RESEARCH SERVICE *US DEPARTMENT OF HEALTH & HUMAN SERVICES *US DEPARTMENT OF HEALTH & HUMAN SERVICES, HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) *US DEPARTMENT OF JUSTICE, FEDERAL BUREAU OF INVESTIGATION *US DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS SECONDARY DATA INDICATORS REFLECT COUNTY-LEVEL DATA FOR COOK, LAKE, AND DUPAGE COUNTIES. WHILE THIS ASSESSMENT IS QUITE COMPREHENSIVE, IT CANNOT MEASURE ALL POSSIBLE ASPECTS OF HEALTH IN THE COMMUNITY, NOR CAN IT ADEQUATELY REPRESENT ALL POSSIBLE POPULATIONS OF INTEREST. IT MUST BE RECOGNIZED THAT THESE INFORMATION GAPS MIGHT IN SOME WAYS LIMIT THE ABILITY TO ASSESS ALL OF THE COMMUNITY'S HEALTH NEEDS. FOR EXAMPLE, CERTAIN POPULATION GROUPS - SUCH AS THE HOMELESS, INSTITUTIONALIZED PERSONS, OR THOSE WHO ONLY SPEAK A LANGUAGE OTHER THAN ENGLISH OR SPANISH - ARE NOT REPRESENTED IN THE SURVEY DATA. OTHER POPULATION GROUPS - FOR EXAMPLE, PREGNANT WOMEN, LESBIAN/GAY/BISEXUAL/TRANSGENDER RESIDENTS, UNDOCUMENTED RESIDENTS, AND MEMBERS OF CERTAIN RACIAL/ETHNIC OR IMMIGRANT GROUPS - MIGHT NOT BE IDENTIFIABLE OR MIGHT NOT BE REPRESENTED IN NUMBERS SUFFICIENT FOR INDEPENDENT ANALYSES. IN TERMS OF CONTENT, THIS ASSESSMENT WAS DESIGNED TO PROVIDE A COMPREHENSIVE AND BROAD PICTURE OF THE HEALTH OF THE OVERALL COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance MULTIPLE METHODS ARE USED AT ST. ALEXIUS TO COMMUNICATE ITS MISSION OF PROVIDING CARE TO ALL WHO NEED IT REGARDLESS OF ABILITY TO PAY. SIGNS POSTED AT REGISTRATION CLEARLY POINT OUT THAT CHARITY CARE OR FINANCIAL ASSISTANCE IS AVAILABLE. ALEXIAN BROTHERS HEALTH SYSTEM'S (ABHS) WEBSITE, THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ALEXIUS, FEATURES INFORMATION ON HOW TO APPLY FOR CHARITY CARE ON-LINE. IN THE HOSPITAL SETTING, WE EMPLOY FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY. Schedule H, Part VI, Line 4 Community information IN THE SAMC SERVICE AREA, THE POPULATION IS SLIGHTLY OLDER WITH 15.4% OF RESIDENTS OVER AGE 65 AS COMPARED TO 13.9% IN ILLINOIS. 19.2% OF THE POPULATION IS HISPANIC, A HIGHER PERCENTAGE AS COMPARED TO 16.7% IN ILLINOIS AND 17.4% IN THE US. THE COMMUNITY'S SOCIAL DETERMINANTS ARE FAIRLY AVERAGE, EXCEPT THAT THERE ARE 7.6% OF RESIDENTS THAT IS CONSIDERED "LINGUISTICALLY ISOLATED" IE DO NOT SPEAK ENGLISH. NEARLY 15% OF THE POPULATION LIVES AT OR BELOW 100% OF THE POVERTY LEVEL AND 32.3% ARE AT OR BELOW THE 200% OF THE POVERTY LEVEL, REPRESENTING 2,174,865 INDIVIDUALS. IN THE ASSESSMENT, IT IS MOST OFTEN THESE INDIVIDUALS THAT HAVE DIFFICULTY ACCESSING SERVICES AND HAVE POORER OVERALL HEALTH, AND SO OUR EFFORTS TO PROVIDE THE COMMUNITY WITH NEEDED SERVICES SHOULD BE DIRECTED IN MOST CASES TOWARDS THIS POPULATION. Schedule H, Part VI, Line 5 Promotion of community health SAMC'S GOVERNING BODY IS THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REPORT UP THROUGH THE ALEXIAN BROTHERS HEALTH SYSTEM BOARD OF GOVERNORS. THE MAJORITY OF THE BOARD OF DIRECTORS MEMBERS LIVE AND WORK IN THE COMMUNITY AND SERVE TO SUPPORT THE MISSION AND VALUES OF THE ALEXIAN BROTHERS. SAMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY AND ENDEAVORS TO PROVIDE THEM WITH THE SAFEST AND MOST TECHNOLOGICALLY ADVANCED ENVIRONMENT POSSIBLE THROUGH THE EFFECTIVE USE OF SURPLUS FUNDS. SOME OF OUR SURPLUS FUNDS HAVE BEEN USED TO PURCHASE TECHNOLOGY FOR NON-INVASIVE BRAIN MAPPING AND NONINVASIVE TECHNOLOGY FOR TREATING BRAIN TUMORS IN PRIOR YEARS. AS NECESSARY, SAMC RECRUITS MEDICAL SPECIALISTS AND SUBSPECIALISTS WHO PROVIDE THE EXPERTISE FOR EMERGING TECHNOLOGIES THAT ADVANCE PATIENT CARE. SAMC STRIVES TO FULLY SERVE THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS AND TRICARE. SAMC ALSO PARTICIPATES IN RESEARCH AND EDUCATION. COMMUNITY MEMBERS ALSO USE SAMC AS A CONDUIT FOR VOLUNTEERING AS EVIDENCED BY OVER 400 VOLUNTEERS (COMPRISING ALMOST 71,000 HOURS OF SERVICE) WHO ASSIST WITH NON- MEDICAL PATIENT SERVICES, ADMINISTRATION AND THE GIFT SHOP Schedule H, Part VI, Line 6 Affiliated health care system St Alexius Medical Center, d/b/a AMITA Health St Alexius Medical Center, Hoffman Estates, is a member hospital of Alexian Brothers Health System (ABHS), a comprehensive and diversified healthcare organization located in Arlington Heights, Illinois, a community in Chicago's northwestern suburbs. A ministry organization of Ascension, the largest Catholic health system in the nation, ABHS consists of two acute-care hospitals, three specialty hospitals, a community mental health center, clinical institutes, diagnostic imaging facilities and the Alexian Brothers Ambulatory Group, d/b/a Alexian Brothers Medical Group, which is part of the AMITA Health Medical Group. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ASCENSION (WWW.ASCENSION.ORG) IS A FAITH-BASED HEALTHCARE ORGANIZATION DEDICATED TO TRANSFORMATION THROUGH INNOVATION ACROSS THE CONTINUUM OF CARE. AS THE LARGEST NON-PROFIT HEALTH SYSTEM IN THE U.S. AND THE WORLD'S LARGEST CATHOLIC HEALTH SYSTEM, ASCENSION IS COMMITTED TO DELIVERING COMPASSIONATE, PERSONALIZED CARE TO ALL, WITH SPECIAL ATTENTION TO PERSONS LIVING IN POVERTY AND THOSE MOST VULNERABLE. IN FY2018, ASCENSION PROVIDED MORE THAN $2.0 BILLION IN CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. ASCENSION INCLUDES APPROXIMATELY 156,000 ASSOCIATES AND 34,000 ALIGNED PROVIDERS. ASCENSION'S HEALTHCARE DIVISION OPERATES MORE THAN 2,600 SITES OF CARE - INCLUDING 151 HOSPITALS AND MORE THAN 50 SENIOR LIVING FACILITIES - IN 21 STATES AND THE DISTRICT OF COLUMBIA, WHILE ITS SOLUTIONS DIVISION PROVIDES A VARIETY OF SERVICES AND SOLUTIONS INCLUDING PHYSICIAN PRACTICE MANAGEMENT, VENTURE CAPITAL INVESTING, INVESTMENT MANAGEMENT, BIOMEDICAL ENGINEERING, FACILITIES MANAGEMENT, CLINICAL CARE MANAGEMENT, INFORMATION SERVICES, RISK MANAGEMENT, AND CONTRACTING THROUGH ASCENSION'S OWN GROUP PURCHASING ORGANIZATION. AMITA HEALTH (WWW.AMITAHEALTH.ORG) IS A JOINT OPERATING COMPANY FORMED BY ASCENSION HEALTH AND ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION OF WHICH ADVENTIST MIDWEST HEALTH, AND ALEXIAN BROTHERS HEALTH SYSTEM, ARE THE MEMBERS. AMITA HEALTH WELCOMED PRESENCE HEALTH TO THE ORGANIZATION IN MARCH 2018, MAKING AMITA HEALTH THE LARGEST HEALTH SYSTEM IN ILLINIOS. THROUGH ITS MEMBERS, AMITA HEALTH HAS OVER 25,000 ASSOCIATES COMMITTED TO DELIVERING THE MOST EFFICIENT, HIGHEST QUALITY, FAITH-BASED CARE AT NINETEEN ACUTE AND SPECIALTY CARE HOSPITALS AND AT MORE THAN 200 AMBULATORY/CLINIC LOCATIONS. AMITA HEALTH HAS AN EXTENSIVE PROVIDER NETWORK OF OVER 7,000 HOSPITAL-AFFILIATED PHYSICIANS, AND THE AMITA HEALTH MEDICAL GROUP CONSISTS OF OVER 800 MULTI-SPECIALTY EMPLOYED PHYSICIANS AND ASSOCIATE PRACTITIONERS, RANKING IT AMONG THE LARGEST REGIONAL MEDICAL GROUPS. AMITA HEALTH'S MISSION IS TO EXTEND THE HEALING MINISTRY OF JESUS BY RESPECTING THE FAITH TRADITIONS OF THE MANY INDIVIDUALS AND FAMILIES IT SERVES ACROSS SUBURBAN CHICAGO. WITH A SACRED MISSION OF EXTENDING THE HEALING MINISTRY OF CHRIST, ADVENTHEALTH (WWW.ADVENTHEALTH.COM) IS A CONNECTED SYSTEM OF CARE FOR EVERY STAGE OF LIFE AND HEALTH. MORE THAN 80,000 SKILLED AND COMPASSIONATE CAREGIVERS IN PHYSICIAN PRACTICES, HOSPITALS, OUTPATIENT CLINICS, SKILLED NURSING FACILITIES, HOME HEALTH AGENCIES AND HOSPICE CENTERS PROVIDE INDIVIDUALIZED, WHOLISTIC CARE. A CHRISTIAN MISSION, SHARED VISION, COMMON VALUES, FOCUS ON WHOLE-PERSON HEALTH AND COMMITMENT TO MAKING COMMUNITIES HEALTHIER UNIFY THE SYSTEM'S 45 HOSPITAL CAMPUSES AND HUNDREDS OF CARE SITES IN DIVERSE MARKETS THROUGHOUT NINE STATES. THE COVERED AFFILIATES WITHIN AMITA HEALTH PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES AND ACCESS TO THE MOST ADVANCED MEDICAL TECHNOLOGY. THEIR HEALTHCARE PROFESSIONALS ARE PASSIONATE ABOUT DELIVERING EXCEPTIONAL HEALTHCARE AND ARE PROUD OF THE POWERFUL, CUTTING-EDGE TECHNOLOGY OFFERED BY THE SYSTEM. THE COVERED AFFILIATES WITHIN AMITA HEALTH ALSO OFFER A WIDE RANGE OF COMMUNITY HEALTH SERVICES, CORPORATE WELLNESS PROGRAMS, PREVENTIVE CARE AND EDUCATION. AS CHARITABLE ORGANIZATIONS, THEY RECOGNIZE THAT NOT EVERYONE CAN AFFORD ESSENTIAL MEDICAL SERVICES AND THAT THEIR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH AMITA HEALTH'S COMMITMENT TO SERVING ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT OR BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY ARE CONSIDERED AND PROVIDED WHEN APPROPRIATE. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY AND MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES INCLUDING, BUT NOT LIMITED TO, EDUCATIONAL AFFILIATIONS, HEALTH SCREENINGS, COUNSELING PROGRAMS, CONTINUING MEDICAL EDUCATION (CME) PROGRAMS AND DONATIONS TO COMMUNITY GROUPS. Schedule H, Part VI, Line 7 State filing of community benefit report IL false true false false false false false false false LEN WILK CEO, ST. ALEXIUS 0 407879 0 107545 0 38293 0 0 0 20475 0 574192 0 36307 CALVIN H FISCHER DO DIRECTOR 0 233224 0 31213 0 0 0 19301 0 22529 0 306267 0 0 MICHAEL HANDLER MD DIRECTOR; CMO ABMC & SAMC 0 357959 0 20000 0 16223 0 11077 0 22972 0 428230 0 0 MARK FREY CEO, AMITA HEALTH 0 912487 0 678307 0 139925 0 25948 0 21510 0 1778177 0 0 DIANA WOYTKO SECRETARY; CQO, AMITA HEALTH 0 244210 0 104096 0 35093 0 42582 0 15915 0 441895 0 27399 HENRY ZEISEL TREASURER; CFO, ABMC & SAMC 0 271055 0 13468 0 855 0 0 0 25862 0 311241 0 0 LAURENCE R DRY III CHIEF OPERATING OFFICER 0 290516 0 13560 0 37731 0 12337 0 23050 0 377194 0 36338 ANSHUL AGGARWAL MD CARDIOLOGY 691247 0 243000 0 117679 0 0 0 23340 0 1075266 0 0 0 BRYAN BERTOGLIO MD NEUROSURGERY 887483 0 327649 0 0 0 4993 0 31129 0 1251253 0 0 0 KOGAN NEPHTALI MD CARDIOLOGY 564220 0 189000 0 105335 0 20766 0 25287 0 904608 0 0 0 SCOTT E TOMASIK MD CARDIOLOGY 620628 0 239000 0 91469 0 23005 0 23168 0 997270 0 0 0 SANJAY YADLA MD NEUROSURGEON 663017 0 147374 0 0 0 10105 0 24188 0 844684 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Alexian Brothers-AHS Midwest Region Health Co., a related organization of St. Alexius Medical Center, uses the following methods to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Compensation survey or study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment(s) from the supplemental nonqualified retirement plan during the calendar year: LEN WILK - $36,307 DIANA WOYTKO - $27,399 LAURENCE R DRY, III - $36,338 Form 990, Part IV, Line 20b EXPLANATION OF FINANCIAL STATEMENTS THE ACTIVITY OF ST. ALEXIUS MEDICAL CENTER IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ST. ALEXIUS MEDICAL CENTER IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ST. ALEXIUS MEDICAL CENTER. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER, THE PROCESS, PERFORMED BY ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO., A RELATED ORGANIZATION OF ST. ALEXIUS MEDICAL CENTER, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO. COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES, THE PROCESS PERFORMED BY ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO., A RELATED ORGANIZATION OF ST. ALEXIUS MEDICAL CENTER, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 4 Significant changes to organizational documents DIRECTORS SHALL BE APPOINTED BY THE ASCENSION CLASS DIRECTORS OF THE MINISTRY MARKET CORPORATION (THE CORPORATE MEMBER) AND SHALL SERVE FOR THREE (3) THREE-YEAR TERMS AND UNTIL SUCCESSORS ARE DULY APPOINTED AND QUALIFIED UNLESS THEY SHALL SOONER RESIGN OR BE REMOVED. EXCEPT AS OTHERWISE DETERMINED BY THE ASCENSION CLASS DIRECTORS OF THE MINISTRY MARKET CORPORATION, NO PERSON SHALL BE ELIGIBLE FOR APPOINTMENT FOR MORE THAN THREE SUCCESSIVE THREE-YEAR TERMS. FORMERLY, DIRECTORS WOULD SERVE FOR ONE YEAR AND WERE ELIGIBLE FOR EIGHT CONSECUTIVE APPOINTMENTS. THE CORPORATE MEMBER NAME CHANGED AND WORDING WAS EDITED TO READ AS FOLLOWS: THE CORPORATION SHALL HAVE ONE MEMBER: ALEXIAN BROTHERS HEALTH SYSTEM D/B/A PRESENCE ALEXIAN BROTHERS HEALTH SYSTEM, AN ILLINOIS NOT-FOR PROFIT CORPORATION. ADDITIONALLY, RIGHTS OF ASCENSION, ASCENSION HEALTH AND THE JOINT OPERATING COMPANY WERE ADDED TO THE BYLAWS AS FOLLOWS: DECISION MAKING RIGHTS OF ASCENSION SUBJECT TO THE AMITA AFFILIATION AGREEMENT, THE FOLLOWING MATTERS SHALL BE DECIDED BY ASCENSION: MAJOR TRANSACTIONS INVOLVING CORPORATION OR A CORPORATION SUBSIDIARY THAT IS A CREDIT GROUP MEMBER; AND THE INCURRENCE OF DEBT BY CORPORATION OR ANY CORPORATION SUBSIDIARY. DECISION MAKING RIGHTS OF ASCENSION HEALTH SUBJECT TO THE AMITA AFFILIATION AGREEMENT, THE FOLLOWING MATTERS SHALL BE DECIDED BY ASCENSION HEALTH: THE APPOINTMENT, REMOVAL AND PERFORMANCE EVALUATION OF THE PRESIDENT OF THE CORPORATION; CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION WHERE SUCH CHANGES ARE NOT CONSISTENT WITH SYSTEM POLICY; THE APPOINTMENT, REMOVAL, AND PERFORMANCE EVALUATION OF THE CORPORATION PRESIDENT; THE FORMATION OF A CORPORATION SUBSIDIARY; AND MAJOR TRANSACTIONS INVOLVING ANY CORPORATION SUBSIDIARY THAT IS NOT A CREDIT GROUP MEMBER. THE DISTRIBUTION OF ASSETS UPON DISSOLUTION WAS AMENDED WHERE FORMERLY ALL ASSETS REMAINING AFTER THE PAYMENT OF ALL LIABILITIES OF THE CORPORATION WOULD BE DISTRIBUTED TO THE CORPORATE MEMBER OR OTHER SUCH EXEMPT ORGANIZATION(S) UNDER SECTION 501(C)(3) OF THE CODE AS DETERMINED BY THE CORPORATE MEMBER, NOW THE BYLAWS STATE: UPON THE DISSOLUTION OF THE CORPORATION, THE DISPOSITION OF ALL THE ASSETS OF THE CORPORATION SHALL BE IN A MANNER AS PROVIDE BY THE BOARD (SUBJECT TO THE PRIOR APPROVAL OF ASCENSION HEALTH) AND IN ACCORDANCE WITH THE FOLLOWING: THE PAYING, OR THE MAKING PROVISION, OF THE PAYMENT OF ALL OF THE LIABILITIES, DIRECT OR INDIRECT, CONTINGENT OR OTHERWISE, INCLUDING WITHOUT LIMITATION, ALL LIABILITIES EVIDENCED IN ALL OUTSTANDING LOAN AGREEMENTS, CREDIT AGREEMENTS, MASTER INDENTURES AND OTHER SIMILAR DOCUMENTS. SUBJECT TO COMPLIANCE WITH THE DISSOLUTION PRINCIPLES OF ASCENSION HEALTH, ALL ASSETS REMAINING AFTER THE PAYMENT OF ALL OF THE LIABILITIES OF THE CORPORATION SHALL BE DISTRIBUTED TO ASCENSION HEALTH OR SUCH OTHER EXEMPT ORGANIZATION(S) UNDER SECTION 501(C)(3) OF THE CODE AS SHALL BE DETERMINED BY ASCENSION. ANY OTHER ASSETS NOT SO DISPOSED OF SHALL BE DISTRIBUTED FOR ONE OR MORE EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE, OR SHALL BE DISTRIBUTED TO THE FEDERAL GOVERNMENT, OR TO A STATE OR LOCAL GOVERNMENT, FOR A PUBLIC PURPOSE. ANY SUCH ASSETS NOT SO DISPOSED OF SHALL BE DISPOSED OF BY A COURT OF COMPETENT JURISDICTION OF THE COUNTY IN WHICH THE PRINCIPAL OFFICE OF THE CORPORATION IS THEN LOCATED, EXCLUSIVELY FOR SUCH PURPOSES OR TO SUCH ORGANIZATION OR ORGANIZATIONS, AS SAID COURT SHALL DETERMINE, WHICH ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR SUCH PURPOSES. Form 990, Part VI, Line 6 Classes of members or stockholders EFFECTIVE AS OF 3/1/2018, ST. ALEXIUS MEDICAL CENTER HAS ONE CORPORATE MEMBER - ALEXIAN BROTHERS HEALTH SYSTEM IS THE CORPORATE MEMBER OF EACH OF ITS SUBSIDIARIES. THE INSTITUTE MEMBER OF ALEXIAN BROTHERS HEALTH SYSTEM IS ASCENSION HEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Subject to the ratification of the board of Alexian Brothers-AHS Midwest Region Health Co., Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of St. Alexius Medical Center. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. ALEXIUS MEDICAL CENTER FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY THE CORPORATE MEMBER, ALEXIAN BROTHERS HEALTH SYSTEM, SUBJECT TO THE APPROVAL OF ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A Related Entities The organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Miscellaneous Revenue - Total Revenue: 15284, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 15284; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers with ALPHA - -XXX-XX-XXXX; Transfers with Affiliates - XXX-XX-XXXX; Form 990, Part XII, Line 2c OVERSIGHT OF AUDIT OR SELECTION OF INDEPENDENT ACCOUNTANT ST. ALEXIUS MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. THE FINANCE AND AUDIT COMMITTEE OF ASCENSION HEALTH ALLIANCE'S BOARD ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED ORGANIZATION AS A WHOLE. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO 501(c)(3) Type I NA false Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO 501(c)(3) Type I Ascension Health Alliance false Alexian Brothers - AHS Midwest Region Health Co 2601 Navistar Drive Lisle IL 60532 472360513 Joint Operating Company IL 501(c)(3) Type II NA false Alexian Brothers Health System 200 South Wacker Drive Chicago IL 60606 363260495 Supports the provision of healthcare services for related corporations for which it is a member IL 501(c)(3) Type III-FI Ascension Health false Alexian Brothers Bonaventure House dba Alexian Brothers The Harbor and Alex ian Brothers Housing and Health Alliance 825 Wellington Avenue Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL 501(c)(3) 10 Alexian Brothers Health System true Alexian Brothers of San Jose Inc 2601 Navistar Drive Lisle IL 60532 941530037 Acute care 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363330928 HEALTH CARE IL 501(c)(3) 10 Presence Care Transformation Corporation true RAINBOW HOSPICE AND PALLIATIVE CARE 1550 BISHOP COURT MOUNT PROSPECT IL 60056 363296367 HEALTH CARE IL 501(c)(3) 10 Presence Care Transformation Corporation true MEDICARE VALUE PARTNERS 100 NORTH RIVER ROAD DES PLAINES IL 60016 363495969 HEALTH CARE IL 501(c)(3) 10 Presence Health Partners Services true PRESENCE HOME CARE 18927 HICKORY CREEK DR 300 MOKENA IL 60448 460483581 HEALTH CARE IL 501(c)(3) 10 PRESENCE CARE TRANSFORMATION CORPORATION true PRESENCE CARE HOME 18927 HICKORY CREEK DR 300 MOKENA IL 60448 460483587 HEALTH CARE IL 501(c)(3) 10 PRESENCE CARE TRANSFORMATION CORPORATION true ALVERNO PROVENA HOSPITAL LABORATORIES INC 2434 Interstate Plaza Drive Hammond IN 46234 203238867 HEALTH CARE IN 501(c)(3) 3 Presence Central & Suburban Hospitals Network AND PRESENCE CHICAGO HOSPITAL S NETWORK true Alexian Rehabilitation Services LLC 935 Beisner Elk Grove Village IL 60007 300221481 Rehabilitation hospital IL NA N/A Bonaventure Medical Foundation LLC 2601 Navistar Drive Lisle IL 60532 363978153 Manages managed care contracts DE NA N/A St Alexius Center for Sleep Health LLC 1300 S Main Street Lombard IL 60148 205876371 Operation of sleep lab IL ST ALEXIUS MEDICAL CENTER Related -2671 0 false true BELMONTHARLEM SURGERY CENTER LLC 3101 NORTH HARLEM CHICAGO IL 60634 412237162 MEDICAL SERVICE IL NA N/A ALVERNO CLINICAL LABORATORIES LLC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 203240648 MEDICAL SERVICE IN NA N/A Presence Lakeshore Gastroenterology LLC 150 N River Road Suite 210 Des Plaines IL 60016 811750563 Medical Service IL NA N/A PROFESSIONAL CLINICAL LABORATORIES LLC 113 E 4TH ST MICHIGAN CITY IN 46360 300711211 MEDICAL SERVICES IN NA N/A Thelen Corporation 2601 Navistar Drive Lisle IL 60532 363266316 Owns/ leases property; joint venture partner IL NA C Corporation true Alexian Brothers Health Providers Association Inc 2601 Navistar Drive Lisle IL 60532 363853286 Messenger 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