ASCENSION LIVING ALEXIAN VILLAGE TENNESEE: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ASCENSION LIVING ALEXIAN VILLAGE TENNESEE (EIN 62-1136742)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-16
IRS object ID
201601379349311155
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-16T20:30:40-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN621136742EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Alexian Village of TennesseeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALEXBusinessNameControlTxt
Phone4238860100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1437 Alexian WayAddressLine1Txt
CitySignal MountainCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37377ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMichael E HambleyPersonNm
Person TitlePRESIDENT AND CEOPersonTitleTxt
Signature2016-05-16SignatureDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Robin BaschnagelBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1437 Alexian WayAddressLine1Txt
CitySignal MountainCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37377ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$25,591,982GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.alexianbrothershealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionTo provide skilled nursing services to those in our Continuing Care Retirement community for the short term or long term..ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee295TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$360,563PYContributionsGrantsAmt
CY Contributions Grants$136,770CYContributionsGrantsAmt
PY Program Service Revenue$24,231,171PYProgramServiceRevenueAmt
CY Program Service Revenue$24,697,284CYProgramServiceRevenueAmt
PY Investment Income$43,989PYInvestmentIncomeAmt
CY Investment Income$187,922CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$570,006CYOtherRevenueAmt
PY Total Revenue$24,635,723PYTotalRevenueAmt
CY Total Revenue$25,591,982CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,577,237PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,731,000CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,757,816PYOtherExpensesAmt
CY Other Expenses$17,245,000CYOtherExpensesAmt
PY Total Expenses$23,335,053PYTotalExpensesAmt
CY Total Expenses$25,976,000CYTotalExpensesAmt
PY Revenues Less Expenses$1,300,670PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$384,018CYRevenuesLessExpensesAmt
Total Assets BOY$74,392,458TotalAssetsBOYAmt
Total Assets EOY$87,682,964TotalAssetsEOYAmt
Total Liabilities BOY$30,711,171TotalLiabilitiesBOYAmt
Total Liabilities EOY$43,684,210TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$43,681,287NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,998,754NetAssetsOrFundBalancesEOYAmt
MissionAlecian Village of Tennessee ("AVT") carries out the healing mission of the Catholic Church whose corporate Member is Ascension Health Senior Care. Our Mission calls for us to provide spiritually centered, holistic care which sustains and improves the health of individuals and communities, of all faiths, races, and socio-economic backgrounds, particularly those most in need. We commit ourselves to identifying and developing effective responses to the health and housing needs of all persons we are called to serve with special attention to those who are poor and vulnerable.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$16,813,000ExpenseAmt
Revenue$22,369,919RevenueAmt
DescALEXIAN VILLAGE OF TENNESSEE ("AVT") PROVIDES A CONTINUUM OF SERVICES TO RESIDENTS OF AVT (102,498 RESIDENT DAYS SERVED), ASSISTED LIVING SERVICES TO RESIDENTS OF ALEXIAN INN (7,208 DAYS SERVED), RESIDENTS OF MEMORY CARE (3,973 DAYS SERVED), AND RESIDENTS OF THE HEALTH CARE CENTER (36,044 DAYS SERVED) THAT MAXIMIZES DIGNITY AND INDEPENDENCE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY FOR THE CONTINUUM OF SERVICES, AS A CHARITABLE ORGANIZATION, IT IS RECOGNIZED THAT NOT ALL PERSONS SERVED POSSESS THE ABILITY TO PURCHASE ESSENTIAL SERVICES NEEDED FOR CARE AND OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES. IN 2015, OVER $33,500 WAS PROVIDED IN CHARITABLE CARE AT COST. AVT ALSO SERVES THE COMMUNITIES OF SIGNAL MOUNTAIN AND CHATTANOOGA BY PROVIDING PROGRAMS THROUGHOUT THE YEAR. MEETING ROOMS ARE PROVIDED AT NO COSTS TO LOCAL CHARITABLE ORGANIZATIONS AND COMMUNITY GROUPS. AS A RELIGIOUS ORGANIZATION, AVT ALSO EMPLOYS STAFF TO PROVIDE CHAPLAINCY SERVICES. THERE ARE MULTIPLE CHAPELS AT AVT, WHICH HAVE DAILY INTERDENOMINATIONAL SERVICES & PROGRAMS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,216,000ExpenseAmt
Revenue$2,005,251RevenueAmt
DescALEXIAN VILLAGE OF TENNESSEE, D/B/A ALEXIAN BROTHERS VALLEY RESIDENCE ("ABVR") IS A SEPARATE AND DISTINCT DIVISION OF AVT. IT EXISTS TO PROVIDE A SECURE ENVIRONMENT TO THOSE SUFFERING FROM DEMENTIA OR ALZHEIMER'S DISEASE. ON AVERAGE, 37.7 RESIDENTS WERE SERVED EACH DAY OF FY2015. SUCH SERVICES INCLUDE NURSING ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, RECREATIONAL ACTIVITIES, MEAL PREPARATION AND DINING, AND SPIRITUAL WELLNESS. IN ADDITION, ABVR PROVIDES SHORT TERM RESPITE CARE AND AN ADULT DAY CARE PROGRAM, ALSO TO SERVE THOSE SUFFERING FROM DEMENTIA OR ALZHEIMER'S DISEASE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$602,000ExpenseAmt
Revenue$893,963RevenueAmt
DescALEXIAN VILLAGE OF TENNESSEE, D/B/A ALEXIAN GROVE IS A SEPARATE AND DISTINCT DIVISION OF THE AVT ORGANIZATION. IT EXISTS TO PROVIDE INDEPENDENT, RESIDENTIAL RETIREMENT LIVING WHILE PROMOTING THE WELL-BEING OF ALL THOSE SERVED THROUGH A DELIVERY OF QUALITY SERVICES. ALEXIAN GROVE IS HOME TO OVER 35 SENIOR CITIZENS IN INDEPENDENT APARTMENTS (ON AVERAGE 35 PERSONS SERVED EACH DAY). IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF CHATTANOOGA AND THE SURROUNDING COMMUNITY, FREE OR SUBSIDIZED CARE AND OTHER ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY AT LARGE ARE CONSIDERED AND PROVIDED WHEN APPROPRIATE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$18,631,000TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document91IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee295EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Tim BoothBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4237553437PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 East 10th StreetAddressLine1Txt
CityChattanoogaCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37402ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROBIN T BASCHNAGEL
EX-OFFICIO MEMBER & PRESIDENT & CEO50.001.00Yes (X)Yes (X)$0$183,636$3,551
LINDA BENNETT
DIRECTOR & SECRETARY/TREASURER1.000Yes (X)Yes (X)$0$0$0
ROBERT MAIN
DIRECTOR & VICE CHAIRPERSON1.000Yes (X)Yes (X)$0$0$0
KATHLEEN PURI RN MSN
DIRECTOR & CHAIRPERSON1.000Yes (X)Yes (X)$0$0$0
MIKE HAMBLEY
EX-OFFICIO MEMBER & PRESIDENT & CEO50.000Yes (X)Yes (X)$0$0$0
JOSEPH BLASS
DIRECTOR1.000Yes (X)$0$0$0
MARK FREY
TRUSTEE (END 4/15)1.0062.00Yes (X)$0$1,938,610$40,093
BROTHER ANDREW THOME CFA
DIRECTOR1.000Yes (X)$0$0$0
TIM BOOTH
DIRECTOR OF FINANCE17.0034.00Yes (X)$0$134,323$13,811
JOE GIRARDI
CHIEF FINANCIAL OFFICER1.0068.00Yes (X)$0$139,916$3,997
GARY MOHN
DIRECTOR1.0043.00Yes (X)$0$295,169$22,681
ROBERT K NORRIS
DIRECTOR OF NURSING40.000$103,410$0$1,233Yes (X)
GEORGE S NORTON
ADMINISTRATOR40.000$124,545$0$1,263Yes (X)
JIM LEWANDOWSKI
FORMER KEY EMPLOYEE0.000.00$0$136,675$21,163Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$227,956TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,828,329TotReportableCompRltdOrgAmt
Total Other Compensation$107,793TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
THE WESTON GROUP
2222 SULLIVAN TRAILEASTONPA18040THERAPY SERVICE CONTRACTOR$912,160
Lawler-Wood LLC
900 S Gay StreetKnoxvilleTN37902General Contractor Services$141,5971600 Riverview Tower
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$136,770AllOtherContributionsAmt
Total Contributions$136,770TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Lifecare & Independent623000$13,506,424$13,506,424
Skilled Nursing & Rehab623000$8,128,928$8,128,928
Assisted Living Care623000$2,965,499$2,965,499
Adult Day Care624100$55,622$55,622

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,811TotalRevenueColumnAmt
Related Or Exempt Func Income$40,811RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$24,697,284TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$186,079TotalRevenueColumnAmt
Exclusion$186,079ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,843OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$1,843OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,843TotalRevenueColumnAmt
Exclusion$1,843ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Beauty Shop900099$150,450$150,450
Dietary900099$93,000$93,000
Therapy900099$10,070$10,070

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$316,486TotalRevenueColumnAmt
Related Or Exempt Func Income$316,486RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$570,006OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,591,982TotalRevenueColumnAmt
Related Or Exempt Func Income$25,267,290RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$187,922ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,800,000TotalAmt
Program Services$5,569,000ProgramServicesAmt
Management And General$1,231,000ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$102,000TotalAmt
Management And General$102,000ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,358,000TotalAmt
Program Services$3,000ProgramServicesAmt
Management And General$1,355,000ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$471,000TotalAmt
Program Services$401,000ProgramServicesAmt
Management And General$70,000ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,591,000TotalAmt
Management And General$2,591,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$8,000TotalAmt
Management And General$8,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$26,000TotalAmt
Management And General$26,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,706,000TotalAmt
Program Services$6,438,000ProgramServicesAmt
Management And General$268,000ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$814,000TotalAmt
Program Services$762,000ProgramServicesAmt
Management And General$52,000ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,089,000TotalAmt
Program Services$2,262,000ProgramServicesAmt
Management And General$827,000ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$40,000TotalAmt
Program Services$6,000ProgramServicesAmt
Management And General$34,000ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$50,000TotalAmt
Management And General$50,000ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,036,000TotalAmt
Program Services$3,036,000ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$165,000TotalAmt
Management And General$165,000ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescOtherDesc
Total$720,000TotalAmt
Program Services$154,000ProgramServicesAmt
Management And General$566,000ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,976,000TotalAmt
Program Services$18,631,000ProgramServicesAmt
Management And General$7,345,000ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$42,724BOYAmt
EOY$32,213EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$981,372BOYAmt
EOY$802,253EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$81,036BOYAmt
EOY$90,251EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$84,976BOYAmt
EOY$110,555EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$81,946,878LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,692,912LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$69,823,314BOYAmt
EOY$74,253,966EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$198,725BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,180,311BOYAmt
EOY$12,393,726EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$74,392,458BOYAmt
EOY$87,682,964EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,791,328BOYAmt
EOY$1,842,397EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,919,843BOYAmt
EOY$41,841,813EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,711,171BOYAmt
EOY$43,684,210EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$41,369,240BOYAmt
EOY$41,555,894EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,853,231BOYAmt
EOY$1,984,044EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$458,816BOYAmt
EOY$458,816EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,681,287BOYAmt
EOY$43,998,754EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$74,392,458BOYAmt
EOY$87,682,964EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$384,018ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$338,641NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,040,126OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$78,402CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64,503CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$542,841CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$360,563CurrentTaxYearMinus1YearAmt
Current Tax Year$136,770CurrentTaxYearAmt
Total$1,183,079TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,598,336CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,453,410CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,454,998CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,231,171CurrentTaxYearMinus1YearAmt
Current Tax Year$25,269,133CurrentTaxYearAmt
Total$106,007,048TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,676,738CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,517,913CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,997,839CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,591,734CurrentTaxYearMinus1YearAmt
Current Tax Year$25,405,903CurrentTaxYearAmt
Total$107,190,127TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$107,190,127PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$181,137CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$153,636CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$85,477CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$43,989CurrentTaxYearMinus1YearAmt
Current Tax Year$186,079CurrentTaxYearAmt
Total$650,318TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$181,137CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$153,636CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$85,477CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$43,989CurrentTaxYearMinus1YearAmt
Current Tax Year$186,079CurrentTaxYearAmt
Total$650,318TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,857,875CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,671,549CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,083,316CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,635,723CurrentTaxYearMinus1YearAmt
Current Tax Year$25,591,982CurrentTaxYearAmt
Total$107,840,445TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9940PublicSupportCY509Pct
Public Support PY5090.9929PublicSupportPY509Pct
Investment Income CY0.0060InvestmentIncomeCYPct
Investment Income PY0.0070InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part IIIFormAndLineReferenceDesc
ExplanationFor the year ended 6/30/12, the organization filed a short period return due to a change of accounting period. Thus, the amounts in column 2011 of Schedule A reflect the tax year 1/1/2012 - 6/30/2012 activity.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$458,816BeginningYearBalanceAmt
Investment Earnings Or Losses$53,240InvestmentEarningsOrLossesAmt
End Year Balance$512,056EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$458,816BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$458,816EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$465,192BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses-$6,376InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$458,816EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$464,231BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$961InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$465,192EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$511,922BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$2,309InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$50,000OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$464,231EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.0PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,930,000OtherCostOrOtherBasisAmt
Book Value$1,930,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$67,401,557OtherCostOrOtherBasisAmt
Depreciation$5,975,693DepreciationAmt
Book Value$61,425,864BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,343,702OtherCostOrOtherBasisAmt
Depreciation$1,212,717DepreciationAmt
Book Value$6,130,985BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,271,619OtherCostOrOtherBasisAmt
Depreciation$504,502DepreciationAmt
Book Value$4,767,117BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$74,253,966TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Other Assets
Assets under Bond Agreements$190,886
Restricted Funds$2,442,860
Other Long term Investments$9,759,980
FieldValueIRS element (for citing)
Total Book Value Other Assets$12,393,726TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Unamortized life entry fees$27,730,959
Resident Security Fees
Reserve for outstanding insurance losses$40,791
Resident personal funds
Intercompany Debt with Ascension Health Alliance$12,917,443
Other$1,152,620
FieldValueIRS element (for citing)
Total Liability$41,841,813TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationFrom the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Alexian Village of Tennessee: The System accounts for uncertainty in income tax provisions 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, 2015.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBIN T BASCHNAGEL
EX-OFFICIO MEMBER & PRESIDENT & CEO$0$156,759$0$26,877$0$0$0$0$0$3,551$0$187,187$0$0
MARK FREY
TRUSTEE (END 4/15)$0$715,750$0$1,205,360$0$17,500$0$19,895$0$20,198$0$1,978,703$0$0
GARY MOHN
DIRECTOR$0$234,987$0$36,718$0$23,464$0$17,500$0$5,181$0$317,850$0$0
JIM LEWANDOWSKI
FORMER KEY EMPLOYEE$0$0$0$0$0$136,675$0$0$0$21,163$0$157,838$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationAlexian Brothers Health System, a related organization of Alexian Village of Tennessee through June 30, 2014 , uses the following methods to establish the compensation of the organization's CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Alexian Village of Tennessee TRANSFERRED MEMBERSHIP TO ASCENSION HEALTH SENIOR CARE d.b.a. ASCENSION SENIOR LIVING EFFECTIVE 7/1/14. ASCENSION SENIOR LIVING USES THE FOLLOWING METHODS. - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4a Severance or change-of-control paymentThe following individual listed in Schedule J received the referenced amount of change in control payments in calendar 2014. The payments under a change-of-control arrangement are made in connection with retirement that changed the terms of employment resulting from a change in control of the organization: Jim Lewandowski - $136,675
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planASCENSION HEALTH SENIOR CARE, D.B.A. ASCENSION SENIOR LIVING, OFFERS A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN TO ALL EMPLOYEES WHO PARTICIPATE IN THE EXECUTIVE BENEFITS PROGRAM AND WHOSE COMPENSATION EXCEEDS THE IRS ALLOWABLE LIMIT FOR A QUALIFIED PENSION PLAN. THE PURPOSE OF THE PLAN IS TO RESTORE RETIREMENT BENEFITS THAT ARE RESTRICTED BECAUSE OF COMPENSATION LIMITS FOR THE EXECUTIVES. NEITHER CONTRIBUTIONS TO NOR DISTRIBUTIONS FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WERE MADE IN THE CURRENT YEAR.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15 Process for Determining CompensationIN DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL THE PROCESS PERFORMED BY ASCENSION HEALTH SENIOR CARE, A RELATED ORGANIZATION, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. IN THE REVIEW OF THE COMPENSATION, THE TOP MANAGEMENT OFFICIAL 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 BOARD MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OF THE ORGANIZATION, THE PROCESS PERFORMED BY ASCENSION HEALTH SENIOR CARE, A RELATED ORGANIZATION, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OF THE ORGANIZATION WERE 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 BOARD MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsMany of the persons listed in Part VII, Section A have a "business relationship" with each other by virtue of employment by Ascension Senior Living related entities - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersAlexian Village of Tennessee has a SINGLE CORPORATE MEMBER, ASCENSION HEALTH SENIOR CARE (AHSC).
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyAlexian Village of Tennessee HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH SENIOR CARE, WHO HAS THE AUTHORITY TO APPOINT AND REMOVE DIRECTORS AND EXECUTIVE OFFICERS OF Alexian Village of Tennessee.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersASCENSION HEALTH SENIOR CARE, D.B.A. ASCENSION SENIOR LIVING, HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY IN THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE: NEW ORGANIZATIONS & MAJOR TRANSACTIONS; GOVERNING DOCUMENTS; APPOINTMENTS/REMOVALS' EVALUATION DEBT LIMITS; STRATEGIC & FINANCIAL PLANS; ASSETS; SYSTEM POLICIES & PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION PER THE SYSTEM AUTHORITY MATRIX.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyManagement, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board Member's questions.
Form 990, Part VI, Line 12c Conflict of interest policyThe organization's Conflict of Interest Policy is monitored as part of the system-wide procedures and not at the organizational level. The system-wide procedures are as follows: 1. At time of appointment and annually thereafter, all interested persons, including board and committee members, complete a disclosure statement which addresses actual or potential conflicts of interest. 2. The disclosure statement is done electronically and the return of the completed statement is a condition of continued appointment, employment, or participation with the organization. 3. All actual conflicts are investigated, and resolved by the chief governance officer and the corporate responsibility officer, with the results shared with the chief executive of the organization. 4. Periodic reviews are conducted by governance, compliance, and internal audit to ensure the organization is operating consistent with the policy and enforcing the policy's terms.
Form 990, Part VI, Line 19 Required documents available to the publicTHE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
Form 990, Part VII, Section B, Line 1 Explanation of Compensation paid to New Blue ConstructionNew Blue Construction provided construction services. The payments made to New Blue Construction included both materials and labor.
Form 990, Part VIII, Line 2f Other Program Service RevenueOther Resident Services - Total Revenue: 40811, Related or Exempt Function Revenue: 40811, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueTransportation - Total Revenue: 3556, Related or Exempt Function Revenue: 3556, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other - Total Revenue: 312930, Related or Exempt Function Revenue: 312930, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other FeesPhysician Fees - Total Expense: 39000, Program Service Expense: 36000, Management and General Expenses: 3000, Fundraising Expenses: ; Professional Fees - Total Expense: 1378000, Program Service Expense: 1334000, Management and General Expenses: 44000, Fundraising Expenses: ; Purchased Services - Total Expense: 5289000, Program Service Expense: 5068000, Management and General Expenses: 221000, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesEquity Transfer - 1040126;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (22 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Ascension Health Alliance
PO BOX 45998ST LOUISMO63145453358926NATIONAL HEALTH SYSTEMMO501(c)(3Type INAfalse
Ascension Health
PO BOX 45998ST LOUISMO63145311662309NATIONAL HEALTH SYSTEMMO501(c)(3Type IASCENSION HEALTH ALLIANCEfalse
Ascension Health Senior Care
12250 Weber Hill RoadST LOUISMO63127431227406PARENT COMPANYMO501(c)(3Type IAscension Healthfalse
Alexian Village of Milwaukee Inc
9301 N 76th StreetMilwaukeeWI53223391351584Continuing care retirement communityWI501(c)(39Ascension Health Senior CareYes (true)
Alexian Brothers Senior Neighbors
250 East 10th StreetChattanoogaTN37402620646376Supports the provision of community services for senior citizensTN501(c)(37Ascension Health Senior CareYes (true)
Alexian Brothers Lansdowne Village
4624 LansdowneSt LouisMO63116431470362Skilled nursing facilityMO501(c)(39Ascension Health Senior CareYes (true)
Seton Manor Inc
1000 Seton DriveOrwigsburgPA17961232960726Skilled nursing facilityPA501(c)(39Ascension Health Senior CareYes (true)
Alexian Brothers Sherbrooke Village
4005 Ripa AvenueSt LouisMO63125431592502Skilled nursing facilityMO501(c)(39Ascension Health Senior CareYes (true)
Alexian Brothers Community Services
425 CUMBERLAND ST SUITE 110ChattanoogaTN37404364344423PACE- Comprehensive & Coordinated Community Based ServicesTN501(c)(39Ascension Health Senior CareYes (true)
Borgess Nursing Home Inc
3057 Gull RoadKalamazooMI49048382555589Skilled nursing facilityMI501(c)(39Ascension Health Senior CareYes (true)
St Joseph's Ministries Inc
331 S Seton AvenueEmmitsburgMD21727521835288Skilled nursing facilityMD501(c)(39Ascension Health Senior CareYes (true)
Carondelet Long-Term Care Facilities Inc
621 Carondelet DriveKansas CityMO64114742505427Skilled nursing facilityMO501(c)(39Ascension Health Senior CareYes (true)
St Catherine's Laboure Manor
1750 Stockton StreetJacksonvilleFL32204591878316Skilled nursing facilityFL501(c)(39Ascension Health Senior CareYes (true)
Via Christi Healthcare Outreach Program for Elders Inc
2622 W Centra Suite 100WichitaKS67203481236589PACE (SNF)KS501(c)(39Via Christi Villages IncYes (true)
Via Christi Village Ponca City Inc
1601 Academy RoadPonca CityOK74604731153337Retirement CommunityOK501(c)(39Via Christi Villages IncYes (true)
Via Christi Village Hays Inc
2225 Canterbury DriveHaysKS67601202828680Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
Via Christi Village Manhattan Inc
2800 Willow Grove RoadManhattanKS66502481078862Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
Via Christi Village McLean Inc
777 N McLean BlvdMcLeanKS67203481247723Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
Via Christi Village Pittsburg Inc
1502 E Centennial DrivePittsburgKS66762743070971Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
Cornerstone Assisted Living Inc
2622 W Centra Suite 100WichitaKS67203481241079Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
Via Christi Villages Inc
2622 W Centra Suite 100WichitaKS67203480559086Management CompanyKS501(c)(3Type IAscension Health Senior CareYes (true)
Via Christi Village Georgetown Inc
1655 S GeorgetownGeorgetownKS67218481129325Retirement CommunityKS501(c)(39Via Christi Villages IncYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Live at Home
Q$477,256FMV
ALEXIAN BROTHERS COMMUNITY SERVICES
Q$543,385FMV

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