2015-05-13T09:36:26-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 202961579 St John Hospital Foundation STJO 5865827500 22101 Moross Road Moross Office Building No 102 Detroit MI 48236 Susan Burns President 5865827500 2015-05-13 1 Alicia Janisch P00741382 5137847100 2015-05-09 2013 2016-03-07 17:11:31Z Susan Burns 22101 Moross Road Moross Office Building No Detroit MI 48236 11827302 0 X www.stjohnprovidence.org X 2005 MI To raise funds to benefit St. John Hospital & Medical Center. 28 23 0 130 0 0 5467085 10909424 0 0 871832 917871 0 0 6338917 11827295 3428153 2773495 0 0 1791083 1714977 0 0 1971840 750624 722949 5969860 5211421 369057 6615874 26336359 32258312 993123 447495 25343236 31810817 X St. John Hospital Foundation, as a Catholic Health Ministry, is committed to raise funds to benefit St. John Hospital & Medical Center. 0 0 2773495 2773495 To solicit and invest contributions, gifts and bequests for the benefit of St. John Hospital & Medical Center. This funding is used to provide delivery of patient services, care to the elderly and indigent, and health awareness programs.See community benefit report on Schedule O. 2773495 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 28 23 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Debbie Solem 5867530094 28000 Dequindre Warren MI 48092 X Eugene Lovasco Chairperson 2.00 0.00 X X 0 0 0 Peter Cracchiolo Vice Chair 2.00 3.00 X X 0 0 0 Jane Nugent Secretary 2.00 0.00 X X 0 0 0 Daniel Roma Treasurer 2.00 0.00 X X 0 0 0 Susan Burns Sch O President 2.00 52.00 X X 0 394013 19517 John Adamo Board Member 2.00 0.00 X 0 0 0 Peter Ahee Start 314 Board Member 2.00 0.00 X 0 0 0 Darrene Baer Start 1213 Board Member 2.00 0.00 X 0 0 0 Doug Blatt Board Member 2.00 3.00 X 0 0 0 David Brooks Sch O Board Member 2.00 52.00 X 0 612619 14969 Dana Camphous-Peterson Board Member 2.00 0.00 X 0 0 0 Matthew Casey Board Member 2.00 0.00 X 0 0 0 Sean Cotton Board Member 2.00 0.00 X 0 0 0 Amy Danna Board Member 2.00 0.00 X 0 0 0 Joan Gehrke Board Member 2.00 0.00 X 0 0 0 Kevin Grady MD Sch O Board Member 2.00 50.00 X 0 368807 19366 Sr Betty Granger CSJ Sch O Board Member 2.00 4.00 X 0 0 0 Thomas LaLonde Board Member 2.00 0.00 X 0 0 0 Robert Liggett Jr Board Member 2.00 0.00 X 0 0 0 Jeffrey Littmann Board Member 2.00 0.00 X 0 0 0 Steven Minnick MD Sch O Board Member 2.00 52.00 X 0 222234 16702 John Nicholson Start 314 Board Member 2.00 0.00 X 0 0 0 Peter Ronan Board Member 2.00 0.00 X 0 0 0 Lou Saravolatz Sch O Board Member 2.00 50.00 X 0 512888 19517 Terence Thomas Board Member 2.00 0.00 X 0 0 0 Lisa Vallee-Smith Board Member 2.00 0.00 X 0 0 0 Sandra Vandenberghe Board Member 2.00 0.00 X 0 0 0 William Zweng Board Member 2.00 0.00 X 0 0 0 0 2110561 90071 0 0 1 0 0 738940 10170484 10909424 917878 917878 7 -7 -7 -7 11827295 0 0 917871 2773495 2773495 1383562 402228 981334 32547 32547 208493 208493 90375 90375 59333 59333 95681 95681 18313 18313 27373 27373 32037 32037 18172 18172 Purchased Services 335223 335223 Cultivation 55761 55761 Supplies 49572 49572 Dues 17676 17676 13808 13808 5211421 2773495 466086 1971840 1150859 1834765 5575603 3881515 432217 342822 119216 89395 2216 0 19488465 26452637 26336359 32258312 206918 192625 786205 254870 993123 447495 X 2939046 4696113 11912566 12985715 10491624 14128989 25343236 31810817 26336359 32258312 X 6615874 1550030 -1698323 X 0 1 X 1 0 X 8776517 9532385 6494598 5467085 10909424 41180009 8776517 9532385 6494598 5467085 10909424 41180009 15750727 25429282 1421032 1626737 791756 871794 917878 5629197 46809206 0.54330 0.58670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10491624 4912288 706349 442809 15667452 10103422 184358 516190 312346 10491624 9006464 1051513 464076 418631 10103422 7960242 704845 419703 78326 9006464 7648026 437229 387196 512209 7960242 0.90180 0.09820 0 1 1 138874 58195 80679 293343 284627 8716 89395 Interest in Investments held by Ascension Health Alliance 25142478 Advances to Affiliates 1310159 26452637 Intercompany Debt with Ascension Health Alliance 254870 254870 X Part V, Line 4: Endowment funds are created to support the healthcare ministry of St. John Health System Hospitals. The distributions from an endowment provide a dependable source of income each year to help St. John continue to meet the community's healthcare needs. Part X, Line 2: From the consolidated audited financial statements of St. John Providence Health System ("SJPHS") (which include the activity of St. John Hospital Foundation): The member health care entities of SJPHS are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). SJPHS accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. 0 St John Hospital & Medical Center 28000 Dequindre Warren MI 48092 381359063 Section 501(c)(3) 2773495 0 To support health care ministries. 1 0 Part I, Line 2: The Foundation requires potential applicants (i.e., the Hospital's departments) to complete an actual application. There are various levels of review that subsequently take place prior to the final approval decision. The ultimate decision on every applicant is formally documented. All funds are disbursed to the hospital, but the foundation still requires an application process for the various departments requesting the funds. 0 1 0 0 0 0 0 0 0 Susan Burns Sch O President 0 286998 0 93512 0 13503 0 7650 0 11867 0 413530 0 12510 David Brooks Sch O Board Member 0 516200 0 96419 0 0 0 3102 0 11867 0 627588 0 0 Kevin Grady MD Sch O Board Member 0 182040 0 0 0 186767 0 7499 0 11867 0 388173 0 0 Steven Minnick MD Sch O Board Member 0 198709 0 0 0 23525 0 4835 0 11867 0 238936 0 0 Lou Saravolatz Sch O Board Member 0 457185 0 46221 0 9482 0 7650 0 11867 0 532405 0 0 Part I, Line 3 St. John Health, a related organization of St. John Hospital Foundation, uses the following to establish the compensation of the organization's President: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Part I, Line 4b Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk for forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990, Schedule J, Part II, Column B(i) in the year paid. 457(f) Payments made: - Susan Burns - $12,510 Form 990, Part III: St. John Hospital & Medical Center Community Benefit Report Fiscal Year Ended June 30, 2014 This report illustrates the significant degree to which St. John Hospital & Medical Center contributes to the positive health status of the community it serves. As a member of Ascension Health, the nation's largest Catholic Healthcare System, St. John Hospital & Medical Center continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and society as a whole. The goal of St. John Hospital and Medical Center is to perpetuate the healing mission of the church. St. John Hospital & Medical Center furthers this goal through delivery of patient services, care to the elderly and indigent, patient education, health awareness programs for the community and medical research. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status or ability to pay. In order to portray the full breadth of our contribution, our community benefit information is described below. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT St. John Hospital & Medical Center is a regional referral teaching hospital with 772 licensed beds, a 1300+ member medical staff and more than 50 medical and surgical specialties. As the largest acute care provider on Detroit's east side, St. John Hospital and Medical Center is also an active participant in community health initiatives through its community-based partnerships with churches, schools, and civic organizations. St. John Hospital & Medical Center: 1. Operates an emergency room that is open to all persons regardless of ability to pay. 2. Has on open medical staff with privileges available to all qualified physicians in the area. 3. Has a governing body in which independent persons representative of the community compromise a majority. 4. Engages in medical or scientific research programs. 5. Engages in the training and education of health care professionals. 6. Participates in Medicaid, Medicare, Champus, Triage and/or other government-sponsored health care programs. MEDICAL RESEARCH St. John Hospital & Medical Center furthers its mission by contributing funds and personnel to support research that has helped advance medical care. Research projects include various cardiac and interventional cardiac research projects, oncology, pediatric hematology and oncology, internal medicine, obstetrics and gynecology, nephrology, radiology and infectious disease research. St. John Hospital & Medical Center has a wide array of surgical specialties and sub-specialties. Our operating rooms and post-anesthesia units are open 24 hours a day, seven days a week for scheduled and emergency procedures. St. John Hospital & Medical Center seeks to improve the physical, mental, social, and spiritual health status of its surrounding community and has long been known for its excellence in medical care. Our clinical excellence includes: - More than 50 medical and surgical specialties - A Level Two Trauma Center - An Accredited Chest Pain Center - Excellence in maternal/child services - Many minimally invasive and robotic surgery options - Comprehensive cardiac care - Quality neurosciences - A network of oncology specialties - Comprehensive bone and joint care - A thriving medical education program MEDICAL EDUCATION & SPECIALTY AREAS St. John Hospital & Medical Center believes that in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Numerous seminars and classes and continuing education programs are provided to medical residents and staff and are posted on our website www.stjohnprovidence.org/medical professionals/medical education. Along with providing care and treatment in a wide range of areas, St. John Hospital & Medical Center is known for the following specialty areas: - Audiology - Bariatric Surgery - Bone & Joint Center - Childbirth Services - Cracchiolo Inpatient Rehabilitation Center - Emergency - Heart and Vascular Care - The Holley Institute - Minimally Invasive Surgery - Neurosciences - Parkinson's Disease Clinic - Physical Rehabilitation and Therapy - Post-Polio Clinic - St. John Center for Wound and Hyperbaric Medicine - Stroke - Transplant Specialty Center - Trauma Center - Valade Healing Arts Center - Van Elslander Cancer Center - Women's Health Some of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. EXPANDING AWARENESS, EDUCATION AND HEALTH PROMOTION St. John Hospital & Medical Center believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life and has invested significantly in unique, top quality health education and materials to accomplish its goals. Various classes provided to the community are as follows: - Labyrinth walk - Open arms grief counseling - Prenatal and breastfeeding classes - Bereavement support group - Oncology bereavement support - Non-oncology bereavement support - Breast cancer support group - Individual counseling for cancer patients - Pediatric cancer parent support group - Cardiac rehabilitation program - Carelink education classes for senior adults - Clinical trials - Diabetes education program - Injury prevention classes to numerous schools and community groups - Free pediatric obesity program - Screenings for oral cancer - Hip and knee pain seminar - Hypnotherapy for smoking cessation - Lap band support group - Transplant support group Education material also is provided via our website at www.stjohnprovidence.org. ACCESS TO CARE PROGRAMS St. John Hospital & Medical Center operates many public health clinics. Public clinics range from specialty clinics such as pediatrics to general internal medicine clinics. Our public health clinics provide care for all community residents, regardless of their ability to pay. Services include the full range of preventive and primary health and dental care for adults and children, prenatal care, AIDS/HIV education and management of chronic diseases such as asthma, diabetes and heart disease. St. John Hospital provides clothing and food pantries both in the Van Elslander Cancer Center and various units within the hospital. Our associates have had departmental bake sales and other benefits for individual patients in need. Educating the younger generation is a hallmark of St. John Hospital & Medical Center. To give underserved children an opportunity to learn a healthcare career, our human resources department participates with local Detroit school Del Cristo Rey to provide employment to students as part of their normal school week. Our emergency department hosts students in the emergency center for several hours of learning and instructional hands-on education. Our physicians and leaders participate regularly in career days for local schools in which they have partnerships. Our medical education department organizes physician speakers for the Grosse Pointe schools advanced medicine classes. COMMUNITY OUTREACH SERVICE St. John Hospital & Medical Center provides charitable contributions to a number of community organizations. St. John Hospital & Medical Center has contributed funds for sponsorship in the community by volunteering and giving support to community organizations, parades, neighborhood advocacy and clean-up groups, community orchestras, health walks and marathons, health expos and health fairs, American Red Cross blood drives, churches, schools, career fairs at schools, police office benefits and community foundation outings. St. John Hospital & Medical Center is an active supporting member in community events and partners with many organizations to improve community health, such as American Red Cross, American Heart Association, Multiple Sclerosis Society, Eagle Sports, Soar tutoring program, American Cancer Society . Community service is an important part of our existence. To that end, St. John Hospital & Medical Center provides a Christmas store each year for up to 600 children, giving each child a toy, outfit and gift bag for the family that includes a $50 food gift certificate. The mission spirituality team at the hospital also supports the Salem Memorial Lutheran church food pantry with weekly donations and counseling from our spiritual care team for those attending. CHARITY CARE St. John Hospital & Medical Center offers a wide variety of health and wellness programs that meet diverse needs, regardless of economic status and physical condition. The uninsured are more likely to seek care in hospital emergency rooms. St. John Hospital and Medical Center had 123,003 emergency department visits in fiscal 2014. Increasingly, patients are experiencing limited abilities to pay for health care services or qualify for state and federally Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related St. John Providence Health System entity boards. Form 990, Part VI, Section A, line 6 St. John Hospital Foundation has a single corporate member, St. John Health. Form 990, Part VI, Section A, line 7a St. John Hospital Foundation has a single corporate member, St. John Health, who has the ability to elect members to the governing body of St. John Hospital Foundation. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. John Hospital Foundation financial information or corporation as a whole are subject to approval by its sole corporate member, St. John Health. Form 990, Part VI, Section B, line 11 Management, 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 questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy; has read and understands the policy; has agreed to comply with the policy; and understands that the organization is charitable and, in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's President, the process, performed by St. John Health, a related organization of St. John Hospital Foundation, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. Management reviewed and approved the compensation. In the review of the compensation, the President was compared to individuals at other organizations in the area who hold the same title. Wage bands are adjusted annually and wages paid for all positions are within those bands. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Individual was not present when her compensation was decided. Form 990, Part VI, Line 15b is more appropriately answered as not applicable as St. John Hospital Foundation does not compensate any other officers or key employees. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A: Where noted with a "(Sch O)" reference, the compensation listed is for services provided to this organization or a related organization in an employee capacity and not for participation in this organization's board. Amounts paid for the services of Sister Betty Granger are paid directly to her religious province; Therefore, her compensation on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees is zero. Form 990, Part XI, line 9: Transfers to Affiliates -4,236. Change in Pledge Receivable Balance Non-Cash Related -1,694,087. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St John Health 28000 Dequindre Road Warren MI 48092 382244034 Parent MI Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Brighton Hospital 12851 Grand River Brighton MI 48116 381576680 Hospital MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 Eastwood Community Clinics 28000 Dequindre Road Warren MI 48092 381958763 Health Care MI Section 501(c)(3) Schedule A, Line 9 St John Health 1 Father Murray Nursing Center 28000 Dequindre Road Warren MI 48092 382601348 Health Care MI Section 501(c)(3) Schedule A, Line 9 St John Health 1 Medical Resources Group 43800 Garfield Clinton Township MI 48038 383494637 Health Care MI Section 501(c)(3) Schedule A, Line 9 St John Health 1 Providence Health Foundation 22101 Moross Detroit MI 48236 383526629 Fundraising MI Section 501(c)(3) Schedule A, Line 11c St John Health 1 Providence Hospital 16001 West Nine Mile Road Southfield MI 48037 381358212 Hospital MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 Seton Health Corp of SE Michigan 16001 West Nine Mile Road Southfield MI 48037 382820107 Health Care MI Section 501(c)(3) Schedule A, Line 11c St John Health 1 St John Community Health Investment Corp 28000 Dequindre Road Warren MI 48092 382262856 Health Care MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 St John Hospital & Medical Center 28000 Dequindre Road Warren MI 48092 381359063 Health Care MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 St John Hospital Guild 28000 Dequindre Road Warren MI 48092 386091110 Fundraising MI Section 501(c)(3) Schedule A, Line 11c St John Hospital & Medical Center 0 St John River District Hospital 4100 River Road East China MI 48054 383160564 Hospital MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 St John Senior Community 28000 Dequindre Road Warren MI 48092 382631907 Health Care MI Section 501(c)(3) Schedule A, Line 9 St John Health 1 St John Macomb-Oakland Hospital 28000 Dequindre Road Warren MI 48092 383322109 Hospital MI Section 501(c)(3) Schedule A, Line 3 St John Health 1 Fontbonne Auxiliary of St John Hospital 28000 Dequindre Road Warren MI 48092 386082173 Fundraising MI Section 501(c)(3) Schedule A, Line 11c St John Hospital & Medical Center 0 Advent Partners LP 28000 Dequindre Road Warren MI 48092 383494197 Rental Real Estate MI N/A Open MRI of Michigan 28000 Dequindre Road Warren MI 48092 383544539 Diagnostic Imaging Center MI N/A Advent Inc 28000 Dequindre Warren MI 48092 382971743 Real Estate Development MI N/A C 0 Affiliated Health Services Inc 28000 Dequindre Warren MI 48092 382292922 Medical Services MI N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 St John Macomb-Oakland Hospital R 1128485 Actual Amount Paid St John Macomb-Oakland Hospital Q 101918 Actual Amount Paid St John Macomb-Oakland Hospital R 2011979 Actual Amount Paid Providence Health Foundation S 3396784 Actual Amount Paid Providence Health Foundation Q 761287 Actual Amount Paid Providence Health Foundation R 3336538 Actual Amount Paid St John River District Hospital C 137412 Actual Amount Paid St John River District Hospital R 145776 Actual Amount Paid St John Health P 3809703 Actual Amount Paid St John Health R 3518326 Actual Amount Paid St John Hospital & Medical Center B 2773495 Actual Amount Paid St John Hospital & Medical Center Q 2652505 Actual Amount Paid St John Hospital & Medical Center R 2431917 Actual Amount Paid Fontbonne Auxiliary of St John Hospital C 285865 Actual Amount Paid Macomb Hospital Center Auxiliary C 350000 Actual Amount Paid