2016-11-15T12:28:23-06:00 2015-12-31 ERNST & YOUNG US LLP 155 N WACKER DR Chicago IL 60606 990 2015-01-01 362841358 Arthur Merkle-Clara Knipprath Nursing Home % JAMES H KELLEY ARTH 6309142791 1190 E 2900 N ROAD CLIFTON IL 60927 JAMES H KELLEY TREASURER 2016-11-14 true JACOB J ZEHNDER P01564049 3128792000 2015 2017-02-10 21:41:12Z SEE SCHEDULE O MICHAEL ENGLEHART 200 SOUTH WACKER DRIVE CHICAGO IL 60606 5028971 false X www.presencehealth.org X 1975 IL SEE SCHEDULE O 14 11 0 77 0 16898 13917 3675065 4744850 -12858 1668 246159 143315 3925264 4903750 0 0 0 0 2126971 2341753 0 0 0 1978156 2824387 4105127 5166140 -179863 -262390 11529822 5968216 5791893 492357 5737929 5475859 X SEE SCHEDULE O false false 5009412 4761828 The Organization provides senior living in a faith-based, mission driven community. The Organization operates 90 beds and also offers short-stay rehabilitation, skilled nursing care and short-term respite care. 5009412 true true false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true X 0 0 true 0 true false false false false false false false false false false X 14 11 false false false false true true true true true false false false true true true true true false false true true X JAMES H KELLEY 3123083289 200 S WACKER DRIVE CHICAGO IL 60606 JEAN BLAKE DIRECTOR EX-OFFICIO/SYSTEM CEO 1.0 40.0 X X 0 376276 65416 JOSEPH G HUGAR CEO/DIRECTOR EX-OFFICIO 1.0 49.0 X X 0 459242 103593 LAWRENCE PANKAU MD DIRECTOR 1.0 40.0 X 0 306907 29776 NANCY DOWD DIRECTOR 1.0 6.0 X 0 0 0 DR JAMES HAGEN DIRECTOR 1.0 6.0 X 0 0 0 LUCIA JONES DIRECTOR 1.0 6.0 X 0 0 0 THERESA KWIATKOWSKI DIRECTOR 1.0 6.0 X 0 0 0 FLORIDA FREEMAN DIRECTOR 1.0 6.0 X 0 0 0 JOHN LARSON DIRECTOR 1.0 6.0 X 0 0 0 SISTER MARIE MASON SSCM CHAIR/DIRECTOR 1.0 6.0 X X 0 0 0 SALLIE MILLER VICE CHAIR/DIRECTOR 1.0 6.0 X X 0 0 0 PHYLLIS NICHOLS DIRECTOR 1.0 6.0 X 0 0 0 TIM PHILLIPPE DIRECTOR 1.0 6.0 X 0 0 0 TOM SMITH DIRECTOR 1.0 6.0 X 0 0 0 ANTHONY J FILER TREASURER 1.0 62.0 X 0 1401909 1209330 JEANNIE C FREY SECRETARY 1.0 63.0 X 0 577236 125759 PATRICK QUINN ASSISTANT TREASURER 1.0 61.0 X 0 328224 71480 JULIE ROKNICH ASSISTANT SECRETARY 1.0 60.0 X 0 217095 30640 0 3666889 1635994 0 false true false UNIDINE CORP 1000 WASHINGTON STREET STE 510 BOSTON MA 02118 FOOD SERVICE 129036 1 0 13917 0 13917 OPERATION OF NURSING HOME 623110 4744850 4744850 0 0 4744850 1668 1668 0 0 251558 125221 126337 0 126337 126337 0 0 0 0 CAFETERIA 900099 8063 8063 0 0 OTHER INCOME 900099 8915 8915 0 0 16978 4903750 4761828 0 128005 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1779491 1779491 0 0 106368 106368 0 0 320810 320810 0 0 135084 135084 0 0 156178 0 156178 0 550 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 927822 927822 3822 3822 0 0 257409 257409 0 0 884 884 0 0 0 0 0 0 126255 126255 0 0 4097 4097 0 0 0 0 0 0 977 977 0 0 0 0 0 0 0 0 0 0 315958 315958 0 0 0 0 0 0 REPAIRS & MAINTENANCE 56985 56985 0 0 BAD DEBT EXPENSE 457977 457977 0 0 MEDICAL SUPPLIES 309379 309379 0 0 OTHER TAXES & ASSESSMENTS 158602 158602 0 0 47492 47492 5166140 5009412 156728 0 0 0 741035 8038962 0 0 0 1041482 1050608 0 0 0 0 0 0 19849 21036 5317 8041 6729677 2582181 2424212 4147496 0 0 0 0 0 0 0 0 0 0 11529822 5968216 0 23812 0 0 16085 18025 0 0 0 0 0 0 0 0 0 0 5775808 450520 5791893 492357 X 5737929 5469988 0 5871 0 0 5737929 5475859 11529822 5968216 X -262390 0 0 0 0 320 X X false true X true false X 25271 18600 32546 16898 13917 107232 2926890 3112221 3260472 3675065 4744850 17719498 0 0 0 2952161 3130821 3293018 3691963 4758767 17826730 0 0 0 17826730 50262 35511 -12858 253226 326141 0 50262 35511 -12858 253226 326141 0 246159 16978 263137 3002423 3166332 3293018 3925264 5028971 18416008 0.96800 0.97680 0.01771 0.00860 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 408291 408291 0 4333036 2394703 1938333 0 1498678 24675 1474003 0 489672 162803 326869 4147496 0 DUE TO AFFILIATES 450520 450520 X SCHEDULE D, PART X, LINE 2 PRESENCE HEALTH RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF DECEMBER 31, 2015 AND 2014, PRESENCE HEALTH DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS. true true false false false false false JEAN BLAKE DIRECTOR EX-OFFICIO/SYSTEM CEO 0 294461 0 67403 0 14412 0 46040 0 19376 0 441692 0 0 JOSEPH G HUGAR CEO/DIRECTOR EX-OFFICIO 0 403172 0 45413 0 10657 0 80601 0 22992 0 562835 0 0 LAWRENCE PANKAU MD DIRECTOR 0 249621 0 5951 0 51335 0 15900 0 13876 0 336683 0 0 ANTHONY J FILER TREASURER 0 658477 0 161537 0 581895 0 1185735 0 23595 0 2611239 0 377532 JEANNIE C FREY SECRETARY 0 446640 0 105384 0 25212 0 102389 0 23370 0 702995 0 0 PATRICK QUINN ASSISTANT TREASURER 0 234711 0 62409 0 31104 0 49265 0 22215 0 399704 0 18512 JULIE ROKNICH ASSISTANT SECRETARY 0 189526 0 27407 0 162 0 9850 0 20790 0 247735 0 0 DETERMINATION OF COMPENSATION OF ORGANIZATION'S CEO/EXECUTIVE DIRECTOR SCHEDULE J, PART I, LINE 3 COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION AND THE CORPORATIONS ULTIMATE PARENT, PRESENCE HEALTH NETWORK. SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF PRESENCE HEALTH NETWORK, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. PRESENCE HEALTH NETWORK USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE BOARD. SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A PRESENCE HAS THREE SEVERANCE PLANS DEPENDING UPON LEVEL. THESE PLANS ALLOW INDIVIDUALS WHOSE JOBS HAVE BEEN ELIMINATED AND WHO HAVE NOT BEEN ABLE TO FIND A SIMILAR POSITION WITHIN THE SYSTEM TIME TO TRANSITION. THE NUMBER OF WEEKS OF WAGE CONTINUATION ARE BASED UPON LENGTH OF SERVICE. THE PLANS ARE NOT FUNDED. NO INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR YEAR 2015. THE CORPORATION ALSO ACCRUED DEFERRED SEVERANCE FOR THE FOLLOWING INDIVIDUAL, WHICH WILL VEST IN A LATER YEAR: ANTHONY J. FILER $1,169,835 PAYMENTS FROM A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, QUESTION 4B IN ORDER TO ENHANCE THE ABILITY OF PRESENCE HEALTH TO ATTRACT AND RETAIN QUALIFIED MANAGEMENT PERSONNEL BY PROVIDING ELIGIBLE EXECUTIVES WITH ADDITIONAL RETIREMENT BENEFITS ON A DEFERRED BASIS, PRESENCE HEALTH NETWORK MAINTAINS AN UNFUNDED SUPPLEMENTAL RETIREMENT PLAN (THE "PLAN") FOR A SELECT GROUP OF MANAGEMENT, WHICH IS INTENDED TO COMPLY WITH SECTION 457(F), AND SECTION 409A OF THE INTERNAL REVENUE CODE. THE PLAN, PRESENCE HEALTH NETWORK CREDITS TO SUCH ELIGIBLE EXECUTIVE'S RETIREMENT ACCOUNT AN AMOUNT BASED ON A PERCENTAGE OF SALARY. EARNINGS AND/OR LOSSES ON INVESTMENTS ARE CREDITED AT A RATE EQUAL TO THE RATE OF RETURN OVER THE SAME PERIOD ON INVESTMENT OPTIONS SELECTED BY THE ELIGIBLE EXECUTIVE. ELIGIBLE EXECUTIVES ARE ENTITLED TO RECEIVE BENEFITS ON THE EARLIEST OF (I) JANUARY 1 OF THE THIRD CALENDAR YEAR BEGINNING AFTER THE YEAR IN WHICH SUCH CONTRIBUTION IS CREDITED, (II) ATTAINING AGE 62, OR (III) ATTAINING THE AGE OF 60 IF THE ELIGIBLE EXECUTIVE HAS COMPLETED TEN (10) YEARS OF SERVICE. THE FOLLOWING LISTED INDIVIDUALS BECAME VESTED IN SUPPLEMENTAL RETIREMENT BENEFITS UNDER THE SERP, AND THEREFORE HAD BENEFITS INCLUDED IN THEIR TAXABLE INCOME: PATRICK QUINN $21,921 ANTHONY J. FILER $558,075 ALSO IN RESPONSE TO QUESTION 4B, THE FOLLOWING LISTED INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S SECTION 457(F) PLAN AND EARNED UNVESTED BENEFITS DURING 2015 WHICH ARE REPORTED IN COLUMN (C): PATRICK QUINN $24,076 JEAN BLAKE $33,555 JOSEPH G. HUGAR $68,202 JEANNIE C. FREY $86,489 FORM 990, BOX C DOING BUSINESS AS/ASSUMED NAMES ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME ALSO OPERATES UNDER THE FOLLOWING ASSUMED NAMES: - PRESENCE MERKLE-KNIPPRATH COUNTRYSIDE - COUNTRYSIDE VILLAS, INC. Form 990, Part I, Line 1 ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES UNDER THE ADMINISTRATION OF THE FRANCISCAN MISSIONARY BROTHERS THE FACILITY'S FIRST CONCERN IS TO CONVEY AND PROVIDE A CONCEPT OF CARE THAT RECOGNIZES THE DIGNITY OF THE PERSON WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX OR NATIONAL ORIGIN. CARE AT THE FACILITY IS DESIGNED TO HELP THE RESIDENT REACH HIS or HER GREATEST POTENTIAL IN SPITE OF HIS or HER DISABILITY OR INFIRMITY. THE FACILITY PERMITS THE RESIDENT TO RETAIN HIS or Her OWN IDENTITY AND EXERCISE HIS or Her TALENTS AND ABILITIES AS BEST HE or she CAN, AND ATTEMPTS TO MEET NOT ONLY HIS or her PHYSICAL BUT SOCIAL, PSYCHOLOGICAL AND SPIRITUAL NEEDS. FORM 990, PART III, QUESTION 1 - MISSION STATEMENT THE CORPORATION IS PART OF THE PRESENCE HEALTH SYSTEM AND ACTS IN ACCORDANCE WITH THE PRESENCE HEALTH MISSION, WHICH IS AS FOLLOWS: INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST AND AS PART OF PRESENCE HEALTH, A CATHOLIC HEALTH SYSTEM, ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME PROVIDES HEALTHCARE SERVICES IN A COMPASSIONATE, HOLISTIC MANNER IN THE SPIRIT OF HEALING AND HOPE. FORM 990, PART I, QUESTION 5, AND PART V, QUESTION 2 COMPENSATION AND FORM W-3 TRANSMITTAL OF WAGES AND TAX STATEMENT ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME (THE "CORPORATION") REPORTS 0 EMPLOYEES ON FORM 990, PART I, QUESTION 5 AND FORM 990, PART V, QUESTION 2A AS IT IS NOT REQUIRED TO FILE FORM W-3, TRANSMITTAL OF WAGES AND TAX STATEMENT. THE CORPORATIONS COMPENSATION IS PAID BY PRESENCE CARE TRANSFORMATION CORPORATION ("PCTC"), WHICH ISSUES THE FORMS W-2 AND W-3, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PCTC. FORM 990, PART V, QUESTION 1A FORM 1096 TRANSMITTAL OF U.S. INFORMATION RETURNS ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME (THE "CORPORATION") REPORTS 0 ON FORM 990, PART V, QUESTION 1A AS IT IS NOT REQUIRED TO FILE FORM 1096, TRANSMITTAL OF U.S. INFORMATION RETURNS. ALL OF THE CORPORATIONS ACCOUNTS PAYABLE REPORTABLE ON FORM 1096 ARE PAID BY PRESENCE CARE TRANSFORMATION CORPORATION ("PCTC"), WHICH ISSUES ALL FORMS 1099, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PCTC. FORM 990, PART VI, QUESTION 6 MEMBERS OR SHAREHOLDERS ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME HAS ONE MEMBER, PRESENCE LIFE CONNECTIONS. FORM 990, PART VI, QUESTION 7A PERSONS WITH AUTHORITY TO ELECT MEMBERS OF THE GOVERNING BODY THE CORPORATIONS SOLE MEMBER, PRESENCE LIFE CONNECTIONS, HAS THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY, OTHER THAN EX-OFFICIO DIRECTORS. FORM 990, PART VI, QUESTION 7B DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS PRESENCE LIFE CONNECTIONS (THE "MEMBER"), THROUGH ITS BOARD OF DIRECTORS, HAS CERTAIN GENERAL AND RESERVED POWERS WITH RESPECT TO THE FOLLOWING. GENERAL POWERS: THE MEMBER SHALL PROVIDE OVERSIGHT AND SUPPORT FOR THE ACTIVITIES OF THE CORPORATION, FOR THE PURPOSE OF ASSURING THAT ALL ACTIONS OF THE CORPORATION ARE CONSISTENT WITH THE MISSION AND VALUES OF THE SYSTEM; THE PURPOSES OF THE CORPORATION; THE ETHICAL AND RELIGIOUS DIRECTIVES; THE PRESENCE HEALTH SYSTEM STRATEGIC PLAN; AND BEST PRACTICES. EXCLUSIVE POWERS: IN FURTHERANCE OF THE EXERCISE OF ITS GENERAL POWERS AND RESPONSIBILITIES, THE MEMBER SHALL HAVE THE SOLE POWER TO TAKE THE ACTIONS SPECIFIED BELOW WITH RESPECT TO THE FOLLOWING MATTERS: A) AMEND OR REPEAL THE BYLAWS OF THE CORPORATION. B) APPOINT AND REMOVE ALL OFFICERS OF THE CORPORATION AND ALL DIRECTORS OF THE CORPORATION, OTHER THAN ANY EX-OFFICIO DIRECTORS. C) APPROVAL CAPITAL AND OPERATING BUDGETS, AND LONG-TERM CAPITAL EQUIPMENT PLANS FOR THE CORPORATION. D) APPROVE UNBUDGETED EXPENDITURES IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. E) APPROVE ANY BORROWING OR SIGNIFICANT INCURRENCE OF DEBT BY THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME, OR ANY SALE, PURCHASE, ALIENATION, EXCHANGE, SIGNIFICANT LEASES (OTHER THAN IN THE ORDINARY COURSE) OR ENCUMBRANCES OF THE CORPORATIONS REAL PROPERTY, EXCEPT THOSE MADE PURSUANT TO APPROVED BUDGETS. F) APPROVE EXECUTION OF ANY DEEDS, MORTGAGES, BONDS, OR MAJOR EQUIPMENT LEASES, EXCEPT THOSE MADE PURSUANT TO APPROVED BUDGETS. G) APPROVE ANY OTHER SIGNIFICANT AND UNBUDGETED SALE, PURCHASE, EXCHANGE, LEASE (OTHER THAN IN THE ORDINARY COURSE) TRANSFER, LITIGATION OR LEGAL SETTLEMENT, BENEFITS PACKAGES, ENCUMBRANCE OR OTHER DISPOSITION OR OTHER SIGNIFICANT TRANSACTION INVOLVING THE NON-REAL-ESTATE ASSETS OF THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. H) APPROVE MATERIAL CHANGES IN THE KIND OF SERVICES RENDERED, SUCH AS THE ADDITION OR DISCONTINUATION OF ANY MAJOR SERVICE LINE (E.G., OBSTETRICS) OR CHANGE IN THE FUNDAMENTAL NATURE OF SERVICES PROVIDED BY THE CORPORATION (E.G., A CHANGE REQUIRING A DIFFERENT KIND OF LICENSE). I) APPROVE STRATEGIC PLANS FOR THE CORPORATION CONSISTENT WITH AN IN FURTHERANCE OF SYSTEM MISSION AND VALUES, AND RESPONSIVE TO THE NEEDS OF THE COMMUNITIES SERVED BY THE CORPORATION AND SUPPORT THE ABILITY OF THE CORPORATION AND ITS AFFILIATES TO PROVIDE HIGH-QUALITY CARE AND SERVICES. J) APPROVE ANY CONTRACT FOR THE MANAGEMENT OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION OR ANY HEALTH CARE FACILITIES OWNED BY THE CORPORATION. K) APPROVE ANY SELECTION OR MODIFICATION OF THE BUSINESS NAME OR LOGO OF THE CORPORATION OR ANY PROGRAM OR DIVISION OF THE CORPORATION, OR THE USE OF ANY CORPORATE OR BUSINESS NAME OF THE CORPORATION BY AN ENTITY OTHER THAN THE MEMBER OR AN AFFILIATE. L) PROVIDE OR ASSURE THE PROVISION OF APPROPRIATE INSURANCE COVERAGE, STANDARDIZED EMPLOYEE BENEFITS, INFORMATION SYSTEMS AND TECHNOLOGY, FINANCIAL MANAGEMENT SERVICES, LEGAL, MARKETING, RISK MANAGEMENT AND OTHER ADMINISTRATIVE SERVICES NECESSARY TO SUPPORT THE CORPORATIONS OPERATIONS. M) APPROVE THE ESTABLISHMENT, TERMINATION, OR SALE OF ANY SIGNIFICANT JOINT VENTURE RELATIONSHIP BY THE CORPORATION. N) APPROVE THE ACQUISITION OR DEVELOPMENT OF ANY BUSINESS OR ACTIVITY UNRELATED TO THE PROVISION OF HEALTH CARE SERVICES. O) APPROVE THE CREATION OF ANY NEW AFFILIATE TO BE OWNED OR CONTROLLED BY THE CORPORATION. P) DIRECT AND APPROVE ANY CONTRIBUTIONS, DONATIONS OR OTHER ASSET TRANSFERS WITHOUT CONSIDERATION TO THE MEMBER OR ANY AFFILIATE, IN FURTHERANCE OF THE MISSION AND VALUES. Q) APPROVE ACCEPTANCE OF A CONTRIBUTION THAT IMPOSES A MATERIAL OBLIGATION ON THE CORPORATION, IF APPROVED BY THE CORPORATIONS APPLICABLE FOUNDATION OR FUNDRAISING AFFILIATE AS CONSISTENT WITH THE CORPORATIONS AND SYSTEMS MISSION AND GOALS. R) DEFINE THE CRITERIA FOR THE SELECTION OF BANKS AND OTHER FINANCIAL DEPOSITORIES TO BE USED BY THE CORPORATION, AND AUTHORIZE THE PROCESS BY WHICH SIGNATORIES ON ALL BANK AND SIMILAR ACCOUNTS OF THE CORPORATION ARE APPROVED. S) SELECT INDEPENDENT AUDITORS FOR THE CORPORATION, IN CONNECTION WITH THE CONSOLIDATED AUDIT OF ALL SYSTEM ENTITIES. T) APPROVE OR CHANGE THE CORPORATIONS REGISTERED AGENT OR REGISTERED OFFICE, AS APPROPRIATE FROM TIME TO TIME. U) APPROVE ANY VOLUNTARY CHANGE TO THE CORPORATIONS STATUS OF AN ORGANIZATION EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED FROM TIME TO TIME. APPROVAL AND RECOMMENDATION POWERS: TO BE EFFECTIVE, THE ACTIONS SET FORTH BELOW MUST BE APPROVED BY BOTH THE CORPORATIONS BOARD OF DIRECTORS AND THE MEMBER. SUCH ACTIONS MAY BE INITIATED EITHER BY THE MEMBER OR THE CORPORATIONS BOARD. A) ADOPTION, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION B) ADOPTION OF ANY PLAN OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, QUESTION 11B FORM 990 REVIEW PROCESS THE CORPORATION PROVIDES A COMPLETE COPY OF ITS FORM 990 TO ALL MEMBERS OF THE GOVERNING BODY OF ITS ULTIMATE PARENT CORPORATION, PRESENCE HEALTH NETWORK, FOR REVIEW PRIOR TO FILING WITH THE IRS. THE BOARD OF DIRECTORS OF THE CORPORATION AND OTHER SUBSIDIARY ORGANIZATIONS WITHIN THE PRESENCE HEALTH SYSTEM ARE INTERNAL LIMITED FIDUCIARY BOARDS WHICH DO NOT RECEIVE A COMPLETED COPY OF THE FORM 990 PRIOR TO FILING. AS A RESULT, THE CORPORATION ANSWERS "NO", TO FORM 990, PART VI, LINE 11A. FORM 990, PART VI, LINE 12C PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF PRESENCE HEALTH NETWORK AND ALL OF ITS AFFILIATED MINISTRIES (COLLECTIVELY "PRESENCE HEALTH") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY DIRECTOR, TRUSTEE, OFFICER, CORPORATE MEMBER APPOINTEE, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SENIOR LEADERS, AND OTHERS IN A RECENT POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PRESENCE HEALTH ("INTERESTED PERSONS"), AND CLARIFY THE STANDARDS OF CONDUCT, DUTIES AND OBLIGATIONS OF INTERESTED PERSONS IN THE CONTEXT OF POTENTIAL CONFLICTS OF INTEREST BY PROVIDING A METHOD FOR DISCLOSING AND RESOLVING SUCH POTENTIAL CONFLICTS. NO PRESENCE HEALTH ENTITY WILL ENGAGE IN ANY CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS DISINTERESTED MEMBERS OF THE APPLICABLE BOARD OF DIRECTORS OR OTHER GOVERNING BODY DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF PRESENCE HEALTH HAVE BEEN IMPLEMENTED. TO FACILITATE THIS POLICY, ALL INTERESTED PERSONS HAVE A CONTINUING OBLIGATION TO PROMPTLY DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE. ALL DISCLOSURES MUST BE PROVIDED TO THE SYSTEM COMPLIANCE OFFICER AND GENERAL COUNSEL IN A WRITTEN DESCRIPTION OF THE MATERIAL FACTS. DISCLOSURE SHALL BE ON A CONFLICTS OF INTEREST QUESTIONNAIRE OR SIMILAR FORMAT AS DESCRIBED IN THE CONFLICTS OF INTEREST POLICY. ALL INTERESTED PERSONS SHALL ALSO COMPLETE A QUESTIONNAIRE BASED ON THE ASSUMPTION OF THE BOARD (OR OTHER RELEVANT) POSITION, AND THEREAFTER ON AT LEAST AN ANNUAL BASIS OR WHEN AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT ARISES. AT ANY TIME THAT AN ACTUAL, APPARENT OR A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE CORPORATIONS BOARD OF DIRECTORS, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A DISCLOSURE STATEMENT BY AN INTERESTED PERSON, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE SUBJECT INTERESTED PERSON, THE CORPORATIONS BOARD OR APPLICABLE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, ONLY DISINTERESTED DIRECTORS/COMMITTEE MEMBERS VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT IS FOUND TO EXIST THE INTERESTED PERSON WILL GENERALLY BE REQUIRED TO RECUSE HIM OR HERSELF DURING ANY MEETING IN WHICH THE BOARD OF DIRECTORS OR APPLICABLE COMMITTEE CONDUCTS THE EVALUATION OF THE SUBJECT TRANSACTION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. TO ENSURE THAT THE PRESENCE HEALTH OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS EXEMPT STATUS, TRANSACTIONS INVOLVING INTERESTED PERSONS ARE ONLY APPROVED IF, AFTER EXERCISING REASONABLE DUE DILIGENCE, THE BOARD DETERMINES THEY ARE FAIR AND REASONABLE, TAKING INTO ACCOUNT FACTORS SUCH AS WHETHER PRESENCE HEALTH COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT. HOWEVER, LENDING MONEY OR GUARANTYING AN OBLIGATION OF A DIRECTOR, OFFICER, OR EMPLOYEE OF PRESENCE HEALTH (EXCLUSIVE OF CUSTOMARY INSURANCE COVERAGE FOR ACTS DONE IN CONNECTION WITH SUCH INDIVIDUALS SERVICE TO OR EMPLOYMENT BY PRESENCE HEALTH) IS STRICTLY PROHIBITED. FORM 990 PART VI, QUESTIONS 15A AND 15B, AND PART V, QUESTION 2A COMPENSATION AND APPROVAL PROCESS FOR OFFICERS AND KEY EMPLOYEES COMPENSATION FOR THE CORPORATIONS CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF PRESENCE HEALTH NETWORK, THE SYSTEM PARENT CORPORATION WHICH SHARES A MIRROR BOARD WITH PRESENCE CARE TRANSFORMATION CORPORATION (PCTC) AND PRESENCE CHICAGO HOSPITALS NETWORK (PCHN). SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF THE SYSTEM PARENT CORPORATION, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. THE SYSTEM PARENT CORPORATION USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE SYSTEM PARENTS HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION AND APPROVES ALL COMPONENTS OF EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE SYSTEM PARENTS BOARD. THE CORPORATION ANSWERS "NO" TO FORM 990, PART VI, QUESTION 15A AND 15B PER THE FORM 990 INSTRUCTIONS AS ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION, PRESENCE CARE TRANSFORMATION CORPORATION, THE SYSTEMS STATUTORY EMPLOYER. FORM 990, PART VI, LINE 19 DOCUMENT AVAILABILITY THE CORPORATIONS ARTICLES OF INCORPORATION ARE ON FILE WITH THE STATE OF ILLINOIS. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE CORPORATION, TOGETHER WITH ITS AFFILIATES, ARE AVAILABLE FROM THE NATIONAL DISSEMINATION AGENT AS REQUIRED BY PRESENCE HEALTH SYSTEMS BOND DOCUMENTS. CONFLICTS OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE PUBLIC; HOWEVER A SUMMARY OF THE CURRENT POLICY IS ANNUALLY INCLUDED IN SCHEDULE O OF THE CORPORATIONS FORM 990. FORM 990, PART VII, SECTIONS A & B STATUTORY EMPLOYER PRESENCE CARE TRANSFORMATION CORPORATION ("PCTC") (FEIN 36-3366652) ACTS AS THE AGENT FOR THE CORPORATION. CASH IS SWEPT FROM THE CORPORATION ON A DAILY BASIS TO PCTC AND PCTC ISSUES ALL PAYROLL AND ACCOUNTS PAYABLE CHECKS ON BEHALF OF AND AS AGENT FOR THE CORPORATION AND THE APPROPRIATE ACCOUNTING ENTRIES ARE RECORDED. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OF FUND BALANCES INCREASES IN TEMPORARILY RESTRICTED ASSETS $320 FORM 990, PART XII, LINE 2B AUDITED FINANCIAL STATEMENTS AN INDEPENDENT ACCOUNTANT ANNUALLY AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF PRESENCE HEALTH NETWORK AND ITS AFFILIATES. THE AUDIT OPINION IS ISSUED ON THE CONSOLIDATED FINANCIAL STATEMENTS AND EACH AFFILIATE IS NOT SEPARATELY AUDITED. FORM 990 PART IX LINE 11G DESCRIPTION:TEMP LABOR TOTAL FEES:6954 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:12000 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:25707 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:883161 Presence Health Network 200 South Wacker Drive Chicago IL 60606 361649520 Parent Corp IL 501(C)(3) 11c III FI na false Medicare Value Partners 100 North River Road Des Plaines IL 60016 363495969 Health Care IL 501(C)(3) 3 PCHN false Presence Holy Family Medical Center 100 North River Road Des Plaines IL 60016 362439318 Health Care IL 501(C)(3) 3 PCHN false Mount Loretto Nursing Home Inc 302 Swart Hill Road Amsterdam NY 12010 141363014 Health Care NY 501(C)(3) 3 RM New York true Presence Health Partners Services 2380 E Dempster Ave Ste 236 Des Plaines IL 60016 362644178 Health Care IL 501(C)(3) 3 PCHN false Presence Care Home 18927 Hickory Creek Drive 300 Mokena IL 60448 460483587 Health Care IL 501(C)(3) 9 PLC true Presence Care Transformation Corp 1000 Remington Blvd Ste 100 Bolingbrook IL 60440 363366652 Mgmt Support IL 501(C)(3) 11c III FI PHN false Presence Home Care 18927 Hickory Creek Drive 300 Mokena IL 60448 460483581 Health Care IL 501(C)(3) 9 PLC true Presence Central and Suburban Hosp 1000 Remington Blvd Ste 100 Bolingbrook IL 60440 364195126 Health Care IL 501(C)(3) 3 PCTC false Laverna Terrace Housing Corporation 18927 Hickory Creek Drive 300 Mokena IL 60448 363438977 Senior Living IL 501(C)(3) 9 PCTC false Provena Self-Insurance Trust 1000 Remington Blvd Suite 100 Bolingbrook IL 60440 362987310 Insurance IL 501(C)(3) 11c III FI na false Presence Life Connections 18927 Hickory Creek Drive 300 Mokena IL 60448 371127787 Health Care IL 501(C)(3) 9 PCTC false Presence Behavioral Health 1820 South 25th Avenue Broadview IL 60155 362709982 Health Care IL 501(C)(3) 3 PHS true Presence Ambulatory Services 100 North River Road Des Plaines IL 60016 364286236 Health Care IL 501(C)(3) 9 PCHN false Presence Health Fdn Board of Trustees 200 South Wacker Drive Chicago IL 60606 363330929 Fundraising IL 501(C)(3) 7 PCHN false Presence Chicago Hospitals Network 200 South Wacker Drive Chicago IL 60606 362235165 Mgmt Support IL 501(C)(3) 11c III FI PHN false Presence Home Care Services 5747 West Dempster Morton Grove IL 60053 362893936 Home Care IL 501(C)(3) 3 PCHN false Presence Resurrection Medical Center 7435 West Talcott Avenue Chicago IL 60631 363330926 Health Care IL 501(C)(3) 3 PCHN false Resurrection Nursing Home Inc 90 North Main Street Castleton NY 12033 141348691 Health Care NY 501(C)(3) 3 RM New York true Presence Senior Srvcs - Chicagoland 100 North River Road Des Plaines IL 60016 237061646 Health Care IL 501(C)(3) 3 PCHN false Presence Healthcare Services 100 North River Road Des Plaines IL 60016 363330928 Health Care IL 501(C)(3) 3 PCHN false Presence Saint Francis Hospital 355 Ridge Avenue Evanston IL 60202 362167800 Health Care IL 501(C)(3) 3 PCHN false Presence St Mary and Elizabeth Med Cntr 2233 West Division Street Chicago IL 60622 362171079 Health Care IL 501(C)(3) 3 PCHN false Presence Saint Joseph Hospital Chicago 2900 North Lake Shore Drive Chicago IL 60657 363200170 Health Care IL 501(C)(3) 3 PCHN false Presence Nazarethville 300 North River Road Des Plaines IL 60016 362801392 Health Care IL 501(C)(3) 9 PSSC true Rainbow Hospice and Palliative Care 1550 Bishop Court Mount Prospect IL 60056 363296367 Health Care IL 501(C)(3) 9 PHCS true Resurrection University 1431 N Claremont Chicago IL 60622 362182170 Education IL 501(C)(3) 2 PCHN false RH Sleep Ctr - NW 26-1519627 665 W North Ave 500 IL 60148 LOMBARD IL 60148 MEDICAL SERV. IL N/A false RH Sleep Ctr - Evan 26-1519556 665 W North Ave 500 IL 60148 LOMBARD IL 60148 MEDICAL SERV. IL N/A false RH Sleep Ctr - LP 26-1519667 665 W North Ave 500 IL 60148 LOMBARD IL 60148 MEDICAL SERV. IL N/A false RH Sleep Ctr - RF 26-2189763 665 W North Ave 500 IL 60148 LOMBARD IL 60148 MEDICAL SERV. IL N/A false ALVERNO clinic LAB 20-3240648 2434 Interstate Pl DrIN 46324 HAMMOND IN 46324 LAB SERV IN N/A false PROF CLINICAL LAB LLC 30-0711211 113 E 4th St IN 46360 MICHIGAN IN 46360 MEDICAL SERV. IN N/A false Bel Harlem Surg Ctr 41-2237162 3101 North Harlem IL 60634 CHICAGO IL 60634 MEDICAL SERV. IL N/A false L Gilbraith Insurance SPC LTD 68 W Bay Road PO Box 1109 Grand Cayman CJ 000000000 Insurance CJ PCHN Foreign Company false Provena Health Assurance SPC 23 Lime Tree Bay Ave PO Box 1051 Grand Cayman CJ 980420054 Insurance CJ PCTC Foreign Company false Presence Properties Inc 100 North River Road Des Plaines IL 60016 363520630 Medical IL PV C Corp true Presence Service Corporation 2380 E Dempster Street Des Plaines IL 60016 364314354 Medical IL PCSHN C Corp true Presence Ventures Inc 100 North River Road Des Plaines IL 60016 371168085 Medical IL PCTC C Corp false Resurrection Medical Center Auxiliary 7435 West Talcott Avenue Chicago IL 60631 366109825 Fundraising IL PRMC C Corp true Resurrection Ministries of New York 90 North Main Street Castleton NY 12033 141720818 Parent Corp NY PCHN C Corp false Presence Health Care Preferred 100 North River Road Des Plaines IL 60016 363974620 MGD Care Contract IL PCHN C Corp false false false false false false false false false false false false false false false false true true false false