2016-11-15T12:50:05-06:00 2015-12-31 ERNST & YOUNG US LLP 155 N WACKER DR Chicago IL 60606 990 2015-01-01 362801392 Presence Nazarethville % JAMES H KELLEY PRES 6309142791 300 North River Road Des Plaines IL 60016 JAMES H KELLEY TREASURER 2016-11-14 true JACOB J ZEHNDER P01564049 3128792000 2015 2017-02-10 21:41:12Z X Sister Maryann McKeogh 300 N River Road Des Plaines IL 60016 6482266 false 0928 X WWW.PRESENCEHEALTH.ORG X 1974 IL SEE SCHEDULE O X 14 11 0 10 0 194996 27775 5755569 6411526 423 1429 38132 41536 5989120 6482266 0 0 0 0 3278908 3591495 0 0 0 2320833 2323861 5599741 5915356 389379 566910 2209450 0 2969405 0 -759955 0 X SEE SCHEDULE O false false 5379030 6453062 PRESENCE NAZARETHVILLE IS A 68 BED LICENSED NURSING HOME IN DES PLAINES, ILLINOIS. FOUNDED BY THE SISTERS OF HOLY FAMILY OF NAZARETH, PRESENCE NAZARETHVILLE PROVIDES 24 HOUR NURSING CARE AND PHYSICAL THERAPY TO INTERMEDIATE AND SHELTERED CARE RESIDENTS. 5379030 true true false false false false false false false false false false false false false 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 true false false true true false false false true X 0 0 0 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 false X JAMES H KELLEY 3123083972 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 PRO TOP ROOFING INC 2625 American LN UNIT D ELK GROVE VILLAGE IL 60007 ROOF REPLACEMENT 177980 UNIDINE CORP 1000 WASHINGTON STREET STE 510 BOSTON MA 02118 FOOD SERVICE 120917 2 0 27775 0 27775 NURSING CARE FACILITIES 623110 6411526 6411526 0 0 6411526 1429 1429 0 0 0 0 0 0 0 0 0 LAUNDRY 812300 25162 25162 0 0 MISCELLANEOUS 900099 9622 9622 0 0 VISITOR MEALS 722514 6752 6752 0 0 41536 6482266 6453062 0 1429 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2775170 2775170 0 0 185729 185729 0 0 418907 418907 0 0 211689 211689 0 0 536326 0 536326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523815 523815 698 698 0 0 65991 65991 0 0 0 0 0 0 0 0 0 0 135602 135602 0 0 1081 1081 0 0 0 0 0 0 0 0 0 0 15385 15385 0 0 0 0 0 0 143934 143934 0 0 57674 57674 0 0 Bad Debt Expense -101918 -101918 0 0 Drugs 317660 317660 0 0 MEDICAL SUPPLIES 61411 61411 0 0 Non Patient Supplies 251552 251552 0 0 314650 314650 5915356 5379030 536326 0 0 X 750790 0 0 0 0 0 840483 0 0 0 0 0 0 0 28113 0 7010 0 0 0 581875 0 0 0 1179 0 0 0 0 0 0 0 2209450 0 107217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2862188 0 2969405 0 X -759955 0 0 0 0 0 -759955 0 2209450 0 X 566910 0 0 0 0 193045 X X false true X true false X 1307008 269257 71 194996 27775 1799107 4144845 4438264 4948657 5755569 6411526 25698861 14628 29748 47370 38132 41536 171414 0 0 5466481 4737269 4996098 5988697 6480837 27669382 0 0 0 27669382 875 2874 25354 423 1429 30955 0 875 2874 25354 423 1429 30955 0 0 5467356 4740143 5021452 5989120 6482266 27700337 0.99888 0.99867 0.00112 0.00133 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 X ASC 740-10 FOOTNOTE 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 THAT 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 CORPORATION'S SOLE MEMBER, 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 CASH 2015-12-31 45354 BOOK VALUE 237061646 PRESENCE RHC SENIOR SERVICES 100 NORTH RIVER ROAD DES PLAINES IL 60016 501(C)(3) NET ACCOUNTS RECEIVABLE 2015-12-31 515831 BOOK VALUE 237061646 PRESENCE RHC SENIOR SERVICES 100 NORTH RIVER ROAD DES PLAINES IL 60016 501(C)(3) INVENTORY 2015-12-31 33800 BOOK VALUE 237061646 PRESENCE RHC SENIOR SERVICES 100 NORTH RIVER ROAD DES PLAINES IL 60016 501(C)(3) PREPAID EXPENSES AND DEFERRED CHARGES 2015-12-31 6037 BOOK VALUE 237061646 PRESENCE RHC SENIOR SERVICES 100 NORTH RIVER ROAD DES PLAINES IL 60016 501(C)(3) LAND, BUILDINGS, AND EQUIPMENT - NET 2015-12-31 1565625 BOOK VALUE 237061646 PRESENCE RHC SENIOR SERVICES 100 NORTH RIVER ROAD DES PLAINES IL 60016 501(C)(3) true false false false true true true true false LEGAL EXPENSES FORM 990, SCHEDULE N, PART I, LINE 1 In house Legal staff was used to prepare the documents for this transaction. In house legal costs are paid for as a part of the Corporate overhead allocation and therefore the expense attributable to this transaction could not specifically be determined. LIABILITIES DISCLOSURE FORM 990, SCHEDULE N, PART I, LINES 1 AND 5 The liabilities of Presence Nazarethville were transferred to Presence RHC Senior Services as a part of this transaction. The liabilities transferred include: Accounts Payable and Accrued Expenses $61,885 Due to Parent & Affiliate Corporations $865,926 DIRECTOR OR TRUSTEE OF SUCCESSOR OR TRANSFEREE ORGANIZATION FORM 990, SCHEDULE N, PART I, LINE 2A The officers, directors, and trustees of Presence Nazarethville have historically been the same as Presence RHC Senior Services the successor organization. FINAL RETURN FORM 990, BOX B ON DECEMBER 31, 2015, THE CORPORATION MERGED WITH PRESENCE SENIOR SERVICES - CHICAGOLAND (FKA, "PRESENCE RHC SENIOR SERVICES"), AN ILLINOIS NOT-FOR-PROFIT CORPORATION, EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A RESULT, THIS WILL BE THE CORPORATIONS FINAL RETURN. SEE ATTACHED ARTICLES OF MERGER. SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1 WE FOSTER A HOLISTIC APPROACH IN OUR SERVICES TO THE AGING, MINDFUL OF EACH RESIDENT'S WELL-BEING, WHILE ENCOURAGING MAXIMUM INDEPENDENCE. MISSION STATEMENT FORM 990, PART III, QUESTION 1 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, PRESENCE NAZARETHVILLE PROVIDES HEALTHCARE SERVICES IN A COMPASSIONATE, HOLISTIC MANNER IN THE SPIRIT OF HEALING AND HOPE. COMPENSATION AND FORM W-3 TRANSMITTAL OF WAGES AND TAX STATEMENT FORM 990, PART I, QUESTION 5, AND PART V, QUESTION 2 PRESENCE NAZARETHVILLE (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 1096 TRANSMITTAL OF U.S. INFORMATION RETURNS FORM 990, PART V, QUESTION 1A PRESENCE NAZARETHVILLE (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. MEMBERS OR SHAREHOLDERS FORM 990, PART VI, QUESTION 6 THE CORPORATION HAS ONE MEMBER, PRESENCE SENIOR SERVICES CHICAGOLAND. PERSONS WITH AUTHORITY TO ELECT MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, QUESTION 7A THE CORPORATIONS SOLE MEMBER, PRESENCE SENIOR SERVICES CHICAGOLAND, HAS THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY, OTHER THAN EX-OFFICIO DIRECTORS. PRESENCE NAZARETHVILLE MERGED INTO PRESENCE SENIOR SERVICES CHICAGOLAND AS OF 12/31/2015 AND ITS ASSETS WERE SUBSEQUENTLY SUBJECT TO THE PROVISIONS OF THAT CORPORATIONS ARTICLES OF INCORPORATION AND BYLAWS. DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS FORM 990, PART VI, QUESTION 7B PRESENCE SENIOR SERVICES CHICAGOLAND (THE "MEMBER"), THROUGH ITS BOARD OF DIRECTORS, HAS CERTAIN RESERVE POWERS WITH RESPECT TO THE FOLLOWING. GENERAL POWERS AND RESPONSIBILITIES: 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. MEMBER RESERVED 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, SUBJECT TO ANY NOTICES OR FURTHER APPROVALS REQUIRED BY APPLICABLE CIVIL OR CANON LAW, OR THE MEMBERS BYLAWS: A) BYLAWS. AMEND OR REPEAL THE BYLAWS OF THE CORPORATION. B) OFFICERS AND DIRECTORS. APPOINT AND REMOVE ALL OFFICERS OF THE CORPORATION AND ALL DIRECTORS OF THE CORPORATION, OTHER THAN ANY EX-OFFICIO DIRECTORS. C) BUDGETS. APPROVE CAPITAL AND OPERATING BUDGETS, AND LONG-TERM CAPITAL EQUIPMENT PLANS FOR THE CORPORATION. D) UNBUDGETED EXPENDITURES. APPROVE UNBUDGETED EXPENDITURES IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. E) DEBT, SALE, LEASE AND OTHER REAL PROPERTY TRANSACTIONS. 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) REAL ESTATE DOCUMENTS, EQUIPMENT LEASES. APPROVE EXECUTION OF ANY DEEDS, MORTGAGES, BONDS, OR MAJOR EQUIPMENT LEASES, EXCEPT THOSE ENTERED INTO PURSUANT TO APPROVED BUDGETS. G) SIGNIFICANT UNBUDGETED TRANSACTIONS. 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) MATERIAL CHANGES IN SERVICES. 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) STRATEGIC PLAN. APPROVE STRATEGIC PLANS FOR THE CORPORATION CONSISTENT WITH AND 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) MANAGEMENT CONTRACTS. APPROVE ANY CONTRACT FOR THE MANAGEMENT OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION OR ANY HEALTH CARE FACILITIES OWNED BY THE CORPORATION. K) BUSINESS NAME, LOGO. 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) ADMINISTRATIVE SERVICES. 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) SIGNIFICANT JOINT VENTURES. APPROVE THE ESTABLISHMENT, TERMINATION, OR SALE OF ANY SIGNIFICANT JOINT VENTURE RELATIONSHIP BY THE CORPORATION. N) UNRELATED BUSINESS ACTIVITY. APPROVE THE ACQUISITION OR DEVELOPMENT OF ANY BUSINESS OR ACTIVITY UNRELATED TO THE PROVISION OF HEALTH CARE SERVICES. O) NEW AFFILIATES. APPROVE THE CREATION OF ANY NEW AFFILIATE TO BE OWNED OR CONTROLLED BY THE CORPORATION. P) CONTRIBUTIONS TO MEMBER. 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) CONTRIBUTION ACCEPTANCE. 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) BANKING. 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) AUDITORS. SELECT INDEPENDENT AUDITORS FOR THE CORPORATION, IN CONNECTION WITH THE CONSOLIDATED AUDIT OF ALL SYSTEM ENTITIES. T) REGISTERED AGENT. APPROVE OR CHANGE THE CORPORATIONS REGISTERED AGENT OR REGISTERED OFFICE, AS APPROPRIATE FROM TIME TO TIME. U) TAX-EXEMPTION. 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 REVIEW PROCESS FORM 990, PART VI, QUESTION 11B 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. PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C 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. COMPENSATION AND APPROVAL PROCESS FOR OFFICERS AND KEY EMPLOYEES FORM 990 PART VI, QUESTIONS 15A AND 15B, AND PART V, QUESTION 2A 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. 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. DOCUMENT AVAILABILITY FORM 990, PART VI, LINE 19 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. STATUTORY EMPLOYER FORM 990, PART VII, SECTIONS A & B 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. NEGATIVE BAD DEBT EXPENSE IN 2015 AND ALL OTHER EXPENSES FORM 990, PART IX, LINE 24A NEGATIVE BAD DEBT EXPENSE IN 2015 ILLINOIS, AS A RESULT IN CHANGES WITH THE AFFORDABLE CARE ACT, EXPANDED ITS ELIGIBILITY FOR MEDICAID AND PRESENCE NAZARETHVILLE WAS ACTIVE IN ASSISTING THIS NEWLY ELIGIBLE POPULATION TO REGISTER. WITH MORE INDIVIDUALS QUALIFYING FOR MEDICAID RESERVES SHIFTED FROM BAD DEBT TO CONTRACTUAL ALLOWANCES, RESULTING IN A DECREASE IN BAD DEBT EXPENSE DURING THE YEAR. PRESENCE NAZARETHVILLE ALSO EXPANDED THE ELIGIBILITY IN ITS FINANCIAL ASSISTANCE POLICY FOR INDIVIDUALS TO QUALIFY FOR PRESUMPTIVE FINANCIAL ASSISTANCE. THE PRIMARY IMPACT RESULTED IN MORE INDIVIDUALS WHO WILL QUALIFY FOR FINANCIAL ASSISTANCE AND ACCOUNTS WERE WRITTEN OFF MORE QUICKLY. AS PART OF THIS CHANGE, ACCOUNTS WRITTEN OFF TO BAD DEBT IN 2014 WERE ALSO EVALUATED TO SEE IF THEY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE NEW STANDARDS. AS A RESULT OF THESE TWO CHANGES, PRESENCE NAZARETHVILLE RECORDED A NEGATIVE BAD DEBT EXPENSE IN 2015. PART IX, LINE 24, E ALL OTHER EXPENSES TAXES AND ASSESSMENTS $231,795 SUBSCRIPTIONS AND MEMBERSHIPS $24,545 REPAIRS AND MAINTENANCE $41,922 OTHER EXPENSES $16,388 AUDITED FINANCIAL STATEMENTS FORM 990, PART XII, LINE 2B 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. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 TRANSFER NET ASSETS TO PRHCSS DUE TO MERGER: ($1,238,836) INTERCOMPANY TRUE UP RELATED TO MERGER: $1,431,881 -------------- TOTAL: $193,045 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 Arthur Merkle - Clara Knipprath Nursing 1190 E 2900 N Road Clifton IL 60927 362841358 Health Care IL 501(C)(3) 9 PLC 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 Bel Harlem Surg Ctr 3101 North Harlem Chicago IL 60634 412237162 Medical Service IL na RH Sleep Ctr - NW 665 W North Ave 500 Lombard IL 60148 261519627 Medical Service IL na RH Sleep Ctr - Evan 665 W North Ave 500 Lombard IL 60148 261519556 Medical Service IL na RH Sleep Ctr - LP 665 W North Ave 500 Lombard IL 60148 261519667 Medical Service IL na RH Sleep Ctr - RF 665 W North Ave 500 Lombard IL 60148 262189763 Medical Service IL na Alverno Clinic Lab 2434 Interstate Pl Dr Hammond IN 46324 203240648 Medical Service IN na Prof Clinic Lab LLC 113 E 4th St Michigan City IN 46360 300711211 Medical Service IN NA 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 PR Med Ctr 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 true false false false false false false false false false false false false false false false PRESENCE HEALTH FOUNDATION BOARD OF TRUSTEES c 27775 CASH REIMBURSEMENTS FOR SHARED SERVICES PRESENCE CARE TRANSFORMATION CORPORATION (FKA PRESENCE PRV HEALTH) (FEIN: 36-3366652) PAYS ALL OF THE COMPENSATION AND ACCOUNTS PAYABLE FOR ALL ENTITIES UNDER THE PRESENCE HEALTH SYSTEM AS THE DESIGNATED PAYMENT AGENT FOR SUCH ENTITIES. CASH IS DEPOSITED INTO AN ACCOUNT BY PRESENCE HEALTH ENTITIES AND SWEPT ON A MONTHLY BASIS TO REIMBURSE PRESENCE CARE TRANSFORMATION CORPORATION FOR THESE EXPENSES AT COST. THE AMOUNTS REPORTED ON PART V OF SCHEDULE R REFLECT THE TOTAL CASH TRANSFERS TO/FROM PRESENCE CARE TRANSFORMATION CORPORATION.