2015-05-19T12:41:54-05:00 2014-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 2000 INDIANAPOLIS IN 462045108 990 2013-07-01 352057801 ST MARY'S HEALTH INC STMA 8124854178 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 JOHN L ZABROWSKI CHIEF FINANCIAL OFFICER 8124854178 2015-05-19 1 SHAWNA M JIMENEZ P01222873 3174648600 2015-05-01 2013 2016-02-25 16:41:14Z KEITH JEWELL 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 110553119 0 X WWW.STMARYS.ORG X 1998 IN INTEGRATED HEALTH CARE SYSTEM SERVING SOUTHWESTERN INDIANA. 18 13 0 13 0 0 6003498 53452567 16665846 55296452 696551 1469135 0 334965 23365895 110553119 28000 17563053 0 0 10677455 21495156 0 0 0 10177042 35356809 20882497 74415018 2483398 36138101 29810973 57569821 17816841 6983954 11994132 50585867 X INTEGRATED HEALTH CARE SYSTEM SERVING SOUTHWESTERN INDIANA. 0 0 74415018 17563053 55631417 ST. MARY'S HEALTH, INC. ACTS AS THE PARENT CORPORATION FOR AN INTEGRATED HEALTH CARE DELIVERY NETWORK. AS THE PARENT CORPORATION OF THIS HEALTH SYSTEM, ST. MARY'S HEALTH, INC. HAS DEVELOPED SYSTEM-LEVEL POLICIES, INTEGRATED STRATEGIC PLANNING AND FINANCIAL REPORTING PRACTICES, IMPLEMENTED QUALITY INITIATIVES AND SHARED BEST PRACTICES AMONG THE SYSTEM COMPONENT OPERATIONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 74415018 1 1 0 0 0 0 0 0 0 0 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 1 1 1 1 0 0 1 41 0 1 0 0 0 0 0 0 0 0 0 0 0 X 18 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 IN X JOHN L ZABROWSKI 8124854178 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 DANIEL SCHENK BOARD MEMBER 1.00 0.00 X 0 0 0 GREG DONALDSON BOARD MEMBER 1.00 0.00 X 0 0 0 JOSEPH MURDOCK BOARD MEMBER 1.00 40.20 X 0 464830 39890 KARL SASH MD BOARD MEMBER 1.00 56.00 X 0 653364 94682 KEITH JEWELL CEO/PRESIDENT 1.00 69.00 X X 0 10096 0 LAURENCE STEENBERG VICE CHAIR 1.00 2.00 X X 0 0 0 LAWRENCE KREMER BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL HERRELL MD SECRETARY 1.00 5.00 X X 0 0 0 MICHAEL HINTON BOARD MEMBER 1.00 1.00 X 0 0 0 NADINE COUDRET BOARD MEMBER 1.00 1.00 X 0 0 0 PHILLIP STIVER MD BOARD MEMBER 1.00 1.00 X 0 0 0 RONALD ROMAIN TREASURER 1.00 1.00 X X 0 0 0 SHARON KAZEE BOARD MEMBER 1.00 1.00 X 0 0 0 SISTER SHARON RICHARDT BOARD MEMBER 1.00 1.00 X 0 0 0 SISTER XAVIER BALLANCE CHAIR 1.00 4.00 X X 0 0 0 SUSAN HARDWICK BOARD MEMBER 1.00 0.00 X 0 0 0 TERRENCE KEATING BOARD MEMBER 1.00 2.00 X 0 0 0 TIMOTHY FLESCH THRU 122013 CEO/PRESIDENT 1.00 70.20 X X 0 1661825 23492 VINCENT CAPONI BOARD MEMBER 1.00 40.40 X 0 2102774 55508 0 4892889 213572 0 0 1 0 HALL RENDER KILLIAN 39778 TREASURY CENTER CHICAGO IL 60694 LEGAL SERVICES 498752 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 19182 CONSULTING SERVICES 362129 CLINICAL PATH CONSULTING LLC 1000 N WATER STREET SUITE 950 MILWAUKEE WI 53202 CONSULTING SERVICES 239358 CHAPMAN CONSULTING LLC 4 OCEANS WEST BOULEVARD UNIT 202C DAYTONA BEACH FL 32118 CONSULTING SERVICES 217651 CRIMSON PO BOX 79461 BALTIMORE MD 21279 CONSULTING SERVICES 155527 12 53452567 53452567 ADMIN SVCS FOR MMBR ENTITIES 561000 55107286 55107286 WELLNESS SVC AND FITNESS CTR 713940 189166 189166 55296452 1469135 1469135 PURCHASE DISCOUNTS 900099 163962 163962 TELECOMMUNICATIONS 900099 71525 71525 QUALITY INITIATIVES 900099 59326 59326 40152 40152 334965 110553119 55631417 0 1469135 17563053 17563053 15948130 15948130 4454767 4454767 1092259 1092259 2552651 2552651 489986 489986 719235 719235 77410 77410 1966060 1966060 1454170 1454170 20103440 20103440 649667 649667 104245 104245 21378 21378 100382 100382 NON RECURRING EXPENSES 3484454 3484454 PURCHASED SERVICES 1215664 1215664 CORPORATE EXPENSE 684863 684863 DUES 250889 250889 1482315 1482315 74415018 74415018 0 0 125658 3022134 709553 328351 456563 39890 0 416673 28921 28975762 53773742 29810973 57569821 17412854 6582213 403987 401741 17816841 6983954 X 11994132 50585867 11994132 50585867 29810973 57569821 X 36138101 1971972 481662 X 0 1 X 1 0 X X X 0 0 0 ST MARY'S MEDICAL CENTER OF EVANSVILLE 350869065 3 1 1 1 4712941 ST MARY'S WARRICK HOSPITAL INC 351343019 3 1 1 1 2446720 2 7159661 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 456563 39890 416673 416673 DEFERRED COMPENSATION 332528 CAA & CERP MUTUAL FUND 69213 OTHER RECEIVABLES 59853 INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE 51861065 DUE FROM ST. MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE, INC. 20884 DUE FROM ST.VINCENT HEALTH, INC. 686022 DUE FROM ST.VINCENT HOSPITAL AND HEALTH CARE CENTER, INC. 177 DUE FROM ASCENSION HEALTH MINISTRY SERVICE CENTER 744000 53773742 DEFERRED COMPENSATION 332528 EXECUTIVE LIFE INSURANCE 69213 401741 X PART X, LINE 2: THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2014. 1 ST MARY'S HEALTH SERVICES INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 351679526 501(C)(3) 233710 OPERATING SUPPORT ST MARY'S AT HOME INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 351899560 501(C)(3) 1143990 OPERATING SUPPORT ST MARY'S BUILDING CORPORATION 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 237248362 501(C)(3) 74141 OPERATING SUPPORT ST MARY'S MEDICAL CENTER OF EVANSVILLE INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 350869065 501(C)(3) 4712941 OPERATING SUPPORT ST MARY'S MEDICAL GROUP LLC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 261356310 501(C)(3) 8194103 OPERATING SUPPORT ST MARY'S WARRICK HOSPITAL INC 1116 MILLIS AVENUE BOONVILLE IN 47601 351343019 501(C)(3) 2446720 OPERATING SUPPORT ST MARY'S CARE PARTNERS INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 351899562 501(C)(3) 36409 OPERATING SUPPORT ST MARY'S MEDICAL GROUP INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 352076827 721038 OPERATING SUPPORT 7 1 PART I, LINE 2: ONE PERSON OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC., IS RESPONSIBLE FOR RESEARCHING AND COORDINATING GRANT PROPOSALS. THIS PERSON IS ALSO RESPONSIBLE FOR ENSURING THAT TIMELY REPORTS ARE SENT TO THE GRANTOR. THE CHIEF EXECUTIVE OF THE ENTITY OPERATIONS REVIEWS AND APPROVES ALL THE EXPENDITURES FROM THE GRANT FUNDS, ENSURING THEY ARE WITHIN THE GUIDELINES OF THE GRANT. 0 1 0 0 0 0 0 0 0 JOSEPH MURDOCK BOARD MEMBER 0 404766 0 0 0 60064 0 20275 0 19615 0 504720 0 0 KARL SASH MD BOARD MEMBER 0 327829 0 284404 0 41131 0 60223 0 34459 0 748046 0 39996 TIMOTHY FLESCH THRU 122013 CEO/PRESIDENT 0 895586 0 742747 0 23492 0 5000 0 18492 0 1685317 0 2 VINCENT CAPONI BOARD MEMBER 0 906862 0 1166965 0 28947 0 37247 0 18261 0 2158282 0 0 PART I, LINE 3: ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S HEALTH, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSTION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B: ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS OF: TIMOTHY FLESCH $2 KARL SASH, MD $39,996 FORM 990, PART VI, SECTION A, LINE 2 TIMOTHY FLESCH (CEO/PRESIDENT) AND DANIEL SCHENK (BOARD MEMBER) ALSO SERVE ON THE BOARD OF DIRECTORS OF FIRST FEDERAL SAVINGS BANK. FORM 990, PART VI, SECTION A, LINE 6 ST. MARY'S HEALTH, INC. HAS A SINGLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A ST. MARY'S HEALTH, INC. HAS A SINGLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S HEALTH, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11 ST. MARY'S HEALTH, INC.'S FINANCE COMMITTEE REVIEWS THE FORM 990 IN MARCH UPON RECEIVING DIRECTION FROM ITS TAX PREPARER. THE FORM 990 IS THEN SENT TO THE GOVERNING BODY IN APRIL TO ALLOW FOR A THOROUGH REVIEW BY THE GOVERNING BODY PRIOR TO THE FILING DATE OF MAY 15TH. THE GOVERNING BODY WILL REVIEW THE FORM 990 VIA A SECURE WEB-BASED PORTAL AND ASK ANY QUESTIONS REGARDING THE FORM 990. ANY QUESTIONS AND RESPONSES WILL BE POSTED TO THE WEB-BASED PORTAL BEFORE THE RETURN IS FILED. ALL QUESTIONS AND RESPONSES WILL BE REVIEWED AND DISCLOSED IN THE MEETING MINUTES OF THE NEXT BOARD MEETING FOLLOWING THE REVIEW OF THE FORM 990. 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, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. FORM 990, PART VI, SECTION B, LINE 15B IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S HEALTH, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. COMPENSATION DETERMINATIONS OF ST. MARY'S HEALTH, INC.'S OTHER OFFICERS OR KEY EMPLOYEES ARE MADE BY ST. MARY'S HEALTH, INC.'S MANAGEMENT. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS 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 OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME POSITION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER WITH ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. 481,662. FORM 990, PART III, LINE 4A: OUR MISSION, VISION AND VALUES PROVIDE A STRONG FOUNDATION FOR THE WORK WE DO--A FRAMEWORK THAT EXPRESSES OUR PRIORITIES IN WHAT WE WILL ACHIEVE AND HOW WE WILL ACHIEVE THEM. OUR MISSION ROOTED IN THE LOVING MINISTRY OF JESUS AS A HEALER, WE COMMIT OURSELVES TO SERVING ALL PERSONS WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. OUR CATHOLIC HEALTH MINISTRY IS DEDICATED TO SPIRITUALLY CENTERED, HOLISTIC CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE ARE ADVOCATES FOR A COMPASSIONATE AND JUST SOCIETY THROUGH OUR ACTIONS AND OUR WORDS. OUR VISION WE ENVISION A STRONG, VIBRANT, CATHOLIC MINISTRY IN THE UNITED STATES WHICH WILL LEAD TO THE TRANSFORMATION OF HEALTHCARE. WE WILL ENSURE SERVICE THAT IS COMMITTED TO HEALTH AND WELL-BEING FOR OUR COMMUNITIES AND THAT RESPONDS TO THE NEEDS OF INDIVIDUALS THROUGHOUT THE LIFE CYCLE. WE WILL EXPAND THE ROLE OF THE LAITY, IN BOTH LEADERSHIP AND SPONSORSHIP, TO ENSURE A CATHOLIC HEALTH MINISTRY OF THE FUTURE. VALUES WE ARE CALLED TO: SERVICE OF THE POOR - GENEROSITY OF SPIRIT, ESPECIALLY FOR PERSONS MOST IN NEED REVERENCE - RESPECT AND COMPASSION FOR THE DIGNITY AND DIVERSITY OF LIFE INTEGRITY - INSPIRING TRUST THROUGH PERSONAL LEADERSHIP WISDOM - INTEGRATING EXCELLENCE AND STEWARDSHIP CREATIVITY - COURAGEOUS INNOVATION DEDICATION - AFFIRMING THE HOPE AND JOY OF OUR MINISTRY ST MARY'S MEDICAL GROUP OF EVANSVILLE LLC 3700 WASHINGTON AVENUE EVANSVILLE IN 47714 DORMANT IN 0 0 ST MARY'S HEALTH INC ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(C)(3) 11A, I N/A 0 ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(C)(3) 11A, I ASCENSION HEALTH ALLIANCE 0 CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC 2001 W 86TH STREET INDIANAPOLIS IN 46260 351869951 FREESTANDING OUTPATIENT CENTER IN 501(C)(3) 11C, III-FI STVINCENT HOSPITAL & HEALTH CARE CENTER INC 1 REHABILITATION HOSPITAL OF INDIANA INC 4141 SHORE 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