2015-09-14T12:13:26-05:00 2014-10-31 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2014-01-01 370661234 Saint Anthony's Health Center % MICHAEL L NELSON SAIN 6184652571 ONE SAINT ANTHONYS WAY PO BOX 3 Suite ALTON IL 620020340 AJAY PATHAK PRESIDENT 6184652571 2015-09-09 true Donna J Larson P00043751 3142315544 2014 2016-04-25 22:37:26Z X AJAY PATHAK SAINT ANTHONYS WAY PO BOX 340 ALTON IL 62002 61118504 false 0928 X HTTPS://WWW.OSFHEALTHCARE.ORG/SAINT-ANTHONYS/ X 1925 IL SEE SCHEDULE O X 21 17 781 94 0 0 669404 369515 79337812 59739657 1932133 352483 1385964 642283 83325313 61103938 6200 13024 0 0 34416015 27893867 0 0 0 43099707 38105598 77521922 66012489 5803391 -4908551 53676571 0 40326770 0 13349801 0 X SPONSORED BY THE SISTERS OF ST. FRANCIS OF THE MARTYR ST. GEORGE, SAINT ANTHONY'S HEALTH CENTER IS A TWO-CAMPUS SYSTEM WITH A MISSION OF MAKING CHRIST'S MERCIFUL LOVE VISIBLE BY PROVIDING QUALITY HEALTH CARE. false false 26442863 13024 29630393 INPATIENT SERVICES: SAINT ANTHONY'S HEALTH CENTER IS A TWO-CAMPUS, 203-BED ACUTE CARE FACILITY LOCATED IN ALTON, ILLINOIS. COMPRISED OF THE SAINT ANTHONY'S HEALTH CENTER CAMPUS AND SAINT CLARE'S HOSPITAL, THE ORGANIZATION OFFERS THE LATEST IN TECHNOLOGY AND STATE-OF-THE-ART MEDICINE ADMINISTERED WITH COMPASSION AND SKILL. INPATIENT SERVICES BASED AT THE SAINT ANTHONY'S CAMPUS INCLUDE MEDICAL, SURGICAL, AND OBSTETRICS. WE PROVIDE ADDITIONAL SERVICES TO OUR INPATIENTS INCLUDING: PAIN MANAGEMENT, SURGICAL SERVICES, GASTROENTEROLOGY, LABORATORY SERVICES, CARDIOLOGY, STRESS LAB, DIAGNOSTIC RADIOLOGY SERVICES, CARDIOVASCULAR SERVICES, RADIATION THERAPY, ONCOLOGY SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY. INPATIENT SERVICES AT SAINT CLARE'S HOSPITAL INCLUDE REHABILITATION SERVICES AND A SKILLED NURSING FACILITY. SAINT ANTHONY'S HEALTH CENTER PROVIDES PRIVATE ROOMS TO THEIR INPATIENTS. DURING 2014, SAINT ANTHONY'S HEALTH CENTER HAD 3,058 ADMISSIONS, 17,423 PATIENT DAYS, 242 BIRTHS, AND 492 SURGERIES. 20531067 21806389 OUTPATIENT SERVICES: SAINT ANTHONY'S HEALTH CENTER IS A TWO-CAMPUS, 203-BED ACUTE CARE FACILITY LOCATED IN ALTON, ILLINOIS. COMPRISED OF THE SAINT ANTHONY'S HEALTH CENTER CAMPUS AND SAINT CLARE'S HOSPITAL, THE ORGANIZATION OFFERS THE LATEST IN TECHNOLOGY AND STATE-OF-THE-ART MEDICINE ADMINISTERED WITH COMPASSION AND SKILL. OUTPATIENT SERVICES INCLUDE: CENTER FOR WOUND HEALING AND HYPERBARIC MEDICINE, SURGICAL SERVICES, DIABETES SERVICES, HOME-HEALTH SERVICES, CANCER CENTER OF EXCELLENCE, RADIATION ONCOLOGY, CHEMOTHERAPY, ADULT DAY SERVICES PSYCHOLOGICAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, GASTROENTEROLOGY, PAIN MANAGEMENT, CARDIOVASCULAR LAB, DIAGNOSTIC RADIOLOGY, SLEEP STUDIES AND RESPIRATORY CARE SERVICES. DURING 2014, WE PERFORMED 1,439 OUTPATIENT SURGERIES, 98,558 OUTPATIENT REGISTRATIONS, AND 15,869 HOME HEALTH VISITS. 6715788 8302875 EMERGENCY SERVICES: SERVING THE COMMUNITY WITH ADVANCED TECHNOLOGY AND COMPASSIONATE CARE LOCATED ON THE CAMPUS OF SAINT ANTHONY'S HOSPITAL, OUR EMERGENCY DEPARTMENT USES THE LATEST TECHNOLOGY TO EVALUATE MINOR TO MORE SERIOUS, LIFE-THREATENING EMERGENCY NEEDS, WITH 24-HOUR AVAILABILITY OF OPERATING ROOMS, EQUIPMENT, DIAGNOSTIC SERVICES AND STAFFING. SAINT ANTHONY'S EMERGENCY DEPARTMENT USES A MULTI-LEVEL TRIAGE SYSTEM TO PRIORITIZE TRUE EMERGENCIES TO ENSURE IMMEDIATE CARE, FOR ENHANCED PATIENT FLOW, AND SHORTER PATIENT WAIT TIMES. WE OFFER QUALITY PATIENT CARE, BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS, PHYSICIAN'S ASSISTANTS, NURSES, NURSE PRACTITIONERS, AND TECHNICIANS. SAINT ANTHONY'S IS ALSO A DESIGNATED EMERGENCY FACILITY APPROVED FOR PEDIATRICS BY THE STATE OF ILLINOIS PROVIDING SPECIALIZED EMERGENCY CARE FOR CHILDREN - DAY OR NIGHT. SAINT ANTHONY'S HEALTH CENTER IS DESIGNATED AS A PRIMARY STROKE CENTER AND BECAME THE FIRST HOSPITAL IN ILLINOIS TO OFFER TELEMEDICINE FOR NEUROLOGIC EMERGENCIES. DURING 2014, WE HAD 19,712 VISITS TO OUR EMERGENCY ROOM. 53689718 true true false true false false false false false true false false false false false false true true false false false false false false false false true true false false true true false true false false false false false false true false false false true false true true false false false true 78 0 true 781 true false false false false false false false false false false X 21 17 true false true false true true true true true false false false true true true true true true true true false X MICHAEL L NELSON 6184635616 815 EAST FIFTH STREET SUITE 401 ALTON IL 62002 X BEISER REPRESENTATIVE DANIEL DIRECTOR 1.0 0.0 X 0 0 0 BELONGEA SR M ANSELMA CHIEF OPERATING OFFICER 40.0 2.0 X 0 0 0 BLAIR DR EDWARD DIRECTOR 1.0 40.0 X 1500 200428 11066 CHAPMAN DALE DIRECTOR 1.0 1.0 X 0 0 0 COURY MOTHER M REGINA PACIS DIRECTOR 1.0 2.0 X 0 0 0 CROWDER SR M CHRISTINE DIRECTOR 1.0 1.0 X 0 0 0 FLANAGAN SR M ISIDORIS DIRECTOR 1.0 1.0 X 0 0 0 HAWLEY SR M KATERI DIRECTOR 1.0 2.0 X 0 0 0 HUDSON DR JAMES DIRECTOR 1.0 0.0 X 0 0 0 KRATSCHMER MARK DIRECTOR 1.0 0.0 X 0 0 0 LABBE SR M AGNES DIRECTOR 1.0 0.0 X 0 0 0 MAHER SR M ANASTASIA SEC/DIR OF ST CLARE'S VILLA 40.0 3.0 X X 0 0 0 MEIDL SR M MIKELA PRESIDENT & CEO 40.0 3.0 X X 0 0 0 MORRISON SR M ALEXANDRA DIRECTOR 1.0 0.0 X 0 0 0 NELSON ELIZABETH DIRECTOR 1.0 1.0 X 0 0 0 NORTON DONALD DIRECTOR 1.0 0.0 X 0 0 0 PIEPHOFF DR JAMES DIRECTOR 1.0 40.0 X 9900 567912 13195 SHEPPARD JOAN DIRECTOR 1.0 0.0 X 0 0 0 SPELLS DR KENNETH DIRECTOR 1.0 0.0 X 0 0 0 WERTS DWIGHT DIRECTOR 1.0 0.0 X 0 0 0 ZENKER DR STEVEN DIRECTOR 1.0 0.0 X 0 0 0 KUIPER EVERT PRESIDENT & CEO 40.0 3.0 X X 210533 0 34256 NELSON MICHAEL EVP/CFO 40.0 1.0 X 250007 0 166865 FISCHER PATRICIA VP OF PHYSICIAN SERVICES 13.0 27.0 X 130302 0 73036 SCHUETTE DIANE AVP, MARKETING & DEVELOPMENT 30.0 10.0 X 100636 0 56545 PEIPERT JOHN DIRECTOR OF EMERGENCY SERVICES 40.0 0.0 X 112552 0 8737 WENDLE MARY PHARMACY DIRECTOR 40.0 0.0 X 104226 0 121103 BOETTGER DENISE AVP, PCS OPERATIONS 40.0 0.0 X 111771 0 79877 1031427 768340 564680 11 false true false CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DR CHICAGO IL 60693 EVS/ENG/BIOMED SRVS 3018092 CONIFER HEALTH SOLUTIONS 1500 SOUTH DOUGLASS ROAD ANAHEIM CA 92806 BILLING SERVICES 1206738 SISTERS OF ST FRANCIS OF THE MARTYR 1 FRANCISCAN WAY ALTON IL 62002 ADMIN/NURSING SRVS 1086145 THOMPSON COBURN 721 LOCUST ST ST LOUIS MO 63101 LEGAL SERVICES 674067 LEGATUS EMERGENCY SERVICES S IL PO BOX 790126 DEPT 30535 ST LOUIS MO 63179 EMERGENCY SERVICES 520594 21 158951 159561 51003 369515 NET PATIENT REVENUE 621110 58892748 58892748 EHR INCENTIVE PAYMENT 621110 846909 846909 59739657 165431 165431 0 0 0 0 0 193034 8584 14566 193034 -5982 187052 187052 0 0 0 CAFETERIA SALES 722514 346498 346498 MANAGEMENT FEE 561000 208330 208330 PHARM SALES - EMPLOYEE 446110 2420 2420 85035 85035 642283 61103938 59739657 994766 X 13024 13024 0 0 0 673060 673060 0 56738 56738 22850033 19885992 2964041 578244 503236 75008 2037395 1773110 264285 1698397 1435794 262603 94804 94804 1084494 1084494 115078 115078 0 0 0 8401369 6502694 1898675 660097 660097 13273675 12922683 350992 1512878 222316 1290562 0 1360648 1330648 30000 122452 108504 13948 0 24574 764 23810 380902 380902 0 3205294 2675565 529729 1311436 1311436 DPA PROVIDER TAX 3558119 3558119 BAD DEBT EXPENSE 1670839 1670839 DUES & SUBSCRIPTIONS 392030 71928 320102 PROPERTY TAXES 107781 107781 829128 469081 360047 66012489 53689718 12322771 0 3378 0 7163075 0 0 0 9709428 0 0 0 0 0 3499969 0 1802080 0 417002 0 0 0 24912698 0 4138973 0 0 0 1492197 0 0 0 537771 0 53676571 0 7685935 0 0 0 0 0 6222379 0 0 0 0 0 2122459 0 0 0 24295997 0 40326770 0 X 12023592 0 1326209 0 0 0 13349801 0 53676571 0 X -4908551 -54531 -8386719 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 35762 true 384 false false 36146 false SCHEDULE C, PART II-B, LINES 1F & 1G THE AMOUNT REPORTED FOR LOBBYING EXPENSES ON LINE 1F IS ATTRIBUTABLE TO A PORTION OF MEMBERSHIP DUES PAID TO ORGANIZATIONS FOR LOBBYING EXPENSES. THE AMOUNT REPORTED ON LINE 1G IS ATTRIBUTABLE TO DIRECT MEETINGS WITH SENATORS AND CONGRESSMEN IN THEIR OFFICES. 1326209 369515 8657 407839 1296542 1312169 669404 79037 734401 1326209 2735465 3199311 96972 4719579 1312169 2899164 1290200 -9337 0 1444562 0 2735465 2679513 291592 45651 0 117592 0 2899164 0.98000 0.02000 true false 59327896 -54531 375420 320889 59007007 103562 1993369 2096931 61103938 64252654 14566 14566 64238088 103562 1670839 1774401 66012489 SCHEDULE D, PART V, LINE 4 THESE FUNDS ARE TO BE USED FOR FUTURE CAPITAL IMPROVEMENTS AND OPERATING EXPENSES. SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D LOSS FROM SALE OF ASSETS 14,566 NET ASSETS RELEASED FROM RESTRICTION 360,854 -------- 375,420 SCHEDULE D, PART XI, LINE 4B RESTRICTED CONTRIBUTION REVENUE 322,530 BAD DEBT EXPENSE 1,670,839 ---------- 1,993,369 SCHEDULE D, PART XII, LINE 2D LOSS FROM SALE OF ASSETS 14,566 SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE 1,670,839 true true X true X true true true true false true false 1810000 1810000 0.02800 14324417 12011439 2312978 0.03600 16134417 12011439 4122978 0.06400 13753 368812 12183 356629 0.00600 250 312818 312818 0.00500 2568 3463984 2244913 1219071 0.01900 67288 67288 16571 4212902 2257096 1955806 0.03000 16571 20347319 14268535 6078784 0.09400 true 311444 6229 32533102 23600577 8932525 X true true 2 1 SAINT ANTHONY'S HEALTH CENTER ONE SAINT ANTHONYS WAY ALTON IL 62002 WWW.OSFHEALTHCARE.ORG/SAINT-ANTHONYS/ 2287 X X X 2 SAINT CLARE'S HOSPITAL 915 EAST 5TH STREET ALTON IL 62002 WWW.OSFHEALTHCARE.ORG/SAINT-ANTHONYS/ 4218 X ACUTE INPATIENT PHYSICAL REHABILITATION SAINT ANTHONY'S HEALTH CENTER 1 false false true X X X X X X X X X 13 true true false true X SEE PART V, SECTION C X true 13 true SEE PART V, SECTION C false false true X 200. 600. X X X X true true X X X true X X X X X X X true X false X X X X true X false false SAINT CLARE'S HOSPITAL 2 false false true X X X X X X X X X 13 true true false true X SEE PART V, SECTION C X true 13 true SEE PART V, SECTION C false false true X 200. 600. X X X X true true X X X true X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY 1 & 2 KEY STAKEHOLDERS WHO WOULD HAVE SPECIFIC INSIGHTS INTO THE HEALTHCARE NEEDS OF THE AREA WERE INVITED TO PARTICIPATE IN THE CHNA, REPRESENTING ETHNIC AND PATIENT-TYPE GROUPS. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY 1 & 2 THE CHNA WAS CONDUCTED BY SAINT ANTHONY'S HEALTH CENTER, SAINT CLARE'S HOSPITAL AND ALTON MEMORIAL HOSPITAL. SCHEDULE H, PART V, SECTION B, LINES 7A & 10A FACILITY 1 WWW.OSFHEALTHCARE.ORG/SAINT-ANTHONYS/ABOUT/COMMUNITY-HEALTH/ HTTP://WWW.SAHC.ORG/UPLOADEDFILES/COMMUNITYHEALTHNEEDSASSESSMENT-SAHC.PDFT THE IMPLEMENTATION STRATEGY HAS BEEN INCLUDED WITH THE CHNA. FACILITY 2 SAME AS ABOVE HTTP://WWW.SAHC.ORG/UPLOADEDFILES/COMMUNITYHEALTHNEEDSASSESSMENT-SCH.PDF THE IMPLEMENTATION STRATEGY HAS BEEN INCLUDED WITH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY 1 & 2 DENTAL CARE WAS NOT ADDRESSED AS OUR CARE MANAGEMENT TEAM REFERS PATIENTS NEEDING DENTAL CARE TO THE SIU SCHOOL OF DENTAL MEDICINE AND AREA DENTISTS. THE DENTAL SCHOOL IS A MEDICAID PROVIDER. REPRODUCTIVE HEALTH - FOR PERSONAL HEALTH ISSUES, MADISON COUNTY HEALTH DEPARTMENT OFFERS CLINICS FOR SEXUALLY TRANSMITTED DISEASES. SCHEDULE H, PART V, SECTION B, LINE 16B FACILITY 1 & 2 WWW.OSFHEALTHCARE.ORG/BILLING/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16C FACILITY 1 & 2 WWW.OSFHEALTHCARE.ORG/BILLING/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16I FACILITY 1 & 2 THE ACTUAL POLICY IS NOT PROVIDED TO THE PUBLIC BUT A SUMMARY IS AVAILABLE ON OUR WEBSITE. WE HAVE SIGNS IN VARIOUS LOCATIONS THROUGHOUT OUR FACILITIES INDICATING FINANCIAL ASSISTANCE IS AVAILABLE. WE HAVE ALSO INCLUDED A STATEMENT ON OUR PATIENT BILLS STATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. SCHEDULE H, PART V, SECTION B, LINE 22D FACILITY 1 & 2 WE BILL EVERYONE A STANDARD CHARGE PER CMS REQUIREMENTS. ALL UNINSURED RECEIVE AT LEAST A 25% DISCOUNT OFF CHARGES. THOSE AT OR BELOW 600% OF FPG RECEIVE A DISCOUNT OF 75% TO 100%. SAINT ANTHONY'S HEALTH CENTER AND SAINT CLARE'S HOSPITAL ARE IN COMPLIANCE WITH THE STATE OF ILLINOIS LAW THAT INDIGENT AND UNINSURED WILL NOT BE EXPECTED TO PAY MORE THAN 135% OF COST. SCHEDULE H, PART III, SECTION A, LINE 2 THE AMOUNT ON LINE 2 WAS DETERMINED USING THE COST TO CHARGE RATIO FROM WORKSHEET C OF THE MEDICARE COST REPORT AS APPLIED TO THE TOTAL BAD DEBT EXPENSE TO CALCULATE THE COST OF UNCOLLECTIBLE ACCOUNTS. WE DO NOT INCLUDE ANY BAD DEBT IN OUR COMMUNITY BENEFIT. SAINT ANTHONY'S HEALTH CENTER HAS A PRESUMPTIVE CHARITY POLICY TO DETERMINE IF PATIENTS WHO DID NOT OR COULD NOT COMPLETE CHARITY APPLICATION QUALIFIED UNDER SAINT ANTHONY'S HEALTH CENTER'S FINANCIAL ASSISTANCE PROGRAM. A TOOL THROUGH SEARCH AMERICA WAS USED TO DETERMINE ELIGIBILITY. SCHEDULE H, PART III, SECTION A, LINE 3 SAINT ANTHONY'S HEALTH CENTER HAS A PRESUMPTIVE CHARITY POLICY TO DETERMINE IF PATIENTS, WHO DID NOT COMPLETE A CHARITY APPLICATION, QUALIFIED UNDER SAHC'S FINANCIAL ASSISTANCE PROGRAM. A TOOL THROUGH SEARCH AMERICA WAS USED TO DETERMINE ELIGIBILITY. SCHEDULE H, PART III, SECTION A, LINE 4 PLEASE REFER TO PAGE 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 THE COST ON LINE 6 IS FROM THE FILED 10/31/2014 MEDICARE COST REPORT. WE DO NOT INCLUDE THE COST OF MEDICARE IN OUR COMMUNITY BENEFIT REPORT. SCHEDULE H, PART III, SECTION B, LINE 9B IF THERE IS A BALANCE LEFT AFTER CHARITY CARE HAS BEEN APPLIED OR FINANCIAL ASSISTANCE APPROVED, THEN PAYMENT ARRANGEMENTS ARE MUTUALLY AGREED UPON BY BOTH THE APPLICANT AND SAINT ANTHONY'S HEALTH CENTER. SCHEDULE H, PART VI, LINE 2 SAINT ANTHONY'S HEALTH CENTER MAINTAINS ONGOING DIALOGUE WITH KEY MEMBERS OF THE COMMUNITY SUCH AS HEADS OF VARIOUS COMMUNITY ORGANIZATIONS, CHARITY ORGANIZATIONS, AND EDUCATIONAL INSTITUTIONS. THE DIALOGUE AND RELATIONSHIPS WITH THESE COMMUNITY MEMBERS ASSIST US IN UNDERSTANDING THE HEALTH NEEDS OF OUR COMMUNITY, AND HOW WE CAN BEST POSITION OURSELVES TO SUPPORT THE NEEDS OF THE COMMUNITY. WE HAVE, PERIODICALLY, COMPLETED FOCUS GROUPS WITH MEMBERS OF THE COMMUNITY TO ASCERTAIN THEIR VISION OF WHAT IS NEEDED FROM A HEALTH CARE PERSPECTIVE. WE ALSO SEEK TO UNDERSTAND THE DEMOGRAPHICS OF OUR SERVICE AREA, AS THAT OFTEN HELPS US ZERO IN ON THE PARTICULAR HEALTH NEEDS OF THE COMMUNITY. SCHEDULE H, PART VI, LINE 3 DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT THERE IS FINANCIAL ASSISTANCE AVAILABLE. THE DOCUMENTATION PROVIDES NAMES AND PHONE NUMBERS OF OUR FINANCIAL COUNSELORS. WHEN NOTIFIED BY A PATIENT, OUR FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT SCREENING THEM FOR THEIR ELIGIBILITY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 THE CITY OF ALTON, IL, LOCATED 15 MILES NORTH OF ST. LOUIS, MO, PLUS THE SURROUNDING CITIES AND TOWNSHIPS OF GODFREY, EAST ALTON, WOOD RIVER, BETHALTO, JERSEYVILLE, BRIGHTON, AND COTTAGE HILLS COMPRISE OUR PRIMARY SERVICE AREA (PSA). SCHEDULE H, PART VI, LINE 5 SAINT ANTHONY'S HEALTH CENTER MAINTAINS AN OPEN MEDICAL STAFF. WE INCLUDE NUMEROUS COMMUNITY MEMBERS ON OUR GOVERNING BOARD AND SAINT ANTHONY'S FOUNDATION BOARD. THE HOSPITAL OPERATES AT LOW PROFIT MARGINS AND AT LOW CASH LEVELS, RETURNING SURPLUSES TO ENHANCE THE MISSION OF OUR FACILITIES. SCHEDULE H, PART VI, LINE 6 SAINT ANTHONY'S HEALTH SYSTEM CONSISTS OF SAINT ANTHONY'S HEALTH CENTER AND SAINT ANTHONY'S PHYSICIAN GROUP. SAINT ANTHONY'S PHYSICIAN GROUP IS INSTRUMENTAL IN FULFILLING THE HEALTH NEEDS OF THE COMMUNITY THROUGH ITS PHYSICIAN PROVIDERS. TO MEET THE NEEDS OF OUR COMMUNITIES, SAINT ANTHONY'S PHYSICIAN GROUP HAS CONTINUED RECRUITING PHYSICIANS TO HELP SERVE THE NEEDS OF OUR PATIENTS. WHERE SAINT ANTHONY'S PHYSICIAN GROUP OFFERS THE PHYSICIAN SERVICES TO OUR POPULATION, THE HEALTH CENTER PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO FULFILL THE NEEDS IDENTIFIED BY THE PHYSICIANS. DIALOGUE WITH OUR MEDICAL STAFF IS AN IMPORTANT MEANS OF UNDERSTANDING THE NEEDS OF OUR POPULATION, AS WELL. SCHEDULE H, PART VI, LINE 7 IL SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USES THE COST TO CHARGE RATIO FROM WORKSHEET C OF THEIR MEDICARE COST REPORT AS THEIR COSTING METHODOLOGY FOR THE AMOUNTS IN THE TABLE ON PART I, LINE 7. SCHEDULE H, PART I, LINE 7, COLUMN F THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $1,670,839 REPORTED ON PART IX, LINE 24 OF THE FORM 990; HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN PART I, LINE F, COLUMN F. X true true X X X X false false false false false false false true false BLAIR DR EDWARD DIRECTOR 1500 192126 0 35 0 8267 0 0 11066 1500 211494 0 PIEPHOFF DR JAMES DIRECTOR 9900 545888 0 35 0 21989 0 0 13195 9900 581107 0 KUIPER EVERT PRESIDENT & CEO 5086 0 110681 0 94766 0 34256 0 0 244789 0 0 NELSON MICHAEL EVP/CFO 204673 0 45004 0 330 0 155035 0 11830 0 416872 0 0 FISCHER PATRICIA VP OF PHYSICIAN SERVICES 109675 0 19382 0 1245 0 70354 0 2682 0 203338 0 0 SCHUETTE DIANE AVP, MARKETING & DEVELOPMENT 99925 0 0 0 711 0 54861 0 1684 0 157181 0 0 WENDLE MARY PHARMACY DIRECTOR 103370 0 0 0 856 0 111968 0 9135 0 225329 0 0 BOETTGER DENISE AVP, PCS OPERATIONS 100728 0 10995 0 48 0 69564 0 10313 0 191648 0 0 SCHEDULE J, PART I, LINE 1A EVERT KUIPER RECEIVED TAX GROSS-UP PAYMENTS IN THE AMOUNT OF $65.47, WHICH WERE INCLUDED IN HIS TAXABLE COMPENSATION. THERE WERE NO CLUB DUES IN 2014. SCHEDULE J, PART I, LINE 7 EVERT KUIPER EARNED BONUSES TOTALING $110,681 BASED ON QUALITY MEASURES, FINANCIAL METRICS, AND PATIENT SATISFACTION SCORES. MICHAEL NELSON EARNED BONUSES TOTALING $45,004.21 BASED ON QUALITY MEASURES, FINANCIAL METRICS, AND PATIENT SATISFACTION SCORES. PATRICIA FISCHER EARNED BONUSES TOTALING $19,381.96 BASED ON CEO DISCRETION AND FINANCIAL METRICS. A ILLINOIS FINANCE AUTHORITY 861091967 2004-11-30 4975000 CONSTRUCTION & EQUIPMENT PURCHASE false false false B ILLINOIS FINANCE AUTHORITY 861091967 2010-03-18 10000000 CONSTRUCTION & EQUIPMENT PURCHASE false false false A 0 0 4975000 0 0 0 0 0 0 4975000 0 0 2007 false false true true B 0 0 10001152 0 0 0 101424 0 0 9899728 0 0 2012 false false true true A false false false false 0 false false false true B false false false false 0 false false false true A false false false false 0 false 0 false false B false false false false 0 false 0 false false A false B false SCHEDULE K, PART II, LINE 3, COLUMN B THIS LINE INCLUDES $1,152 OF INTEREST EARNINGS IN THE ESCROW ACCOUNT. THERE WAS NO INTEREST FOR 2014. TERESA BEISER SPOUSE IS DIRECTOR 56738 EMPLOYEE COMPENSATION false MICHAEL NELSON SPOUSE IS DIRECTOR 416872 EMPLOYEE COMPENSATION false CASH AND CASH EQUIVALENTS 2014-11-01 5131130 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) SHORT-TERM INVESTMENTS 2014-11-01 4370508 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) PATIENT ACCOUNTS RECEIVABLE 2014-11-01 10058106 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) SUPPLIES 2014-11-01 2109859 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) PREPAID EXPENSE AND OTHER CURRENT ASSETS 2014-11-01 1485421 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) PROPERTY AND EQUIPMENT 2014-11-01 21861942 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) DUE FROM AFFILIATES 2014-11-01 1120064 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) INVESMENT IN SAINT CLAIRE'S VILLA 2014-11-01 1492170 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) OTHER ASSETS 2014-11-01 1872227 BOOK VALUE 370813229 OSF HEALTHCARE SYSTEM 800 N E GLEN OAK AVE PEORIA IL 61603 501(C)(3) false true false false true true true false true false SCHEDULE N, PART I, LINE 2E SR. M. MIKELA MEIDL, PRESIDENT/CEO OF SAINT ANTHONY'S HEALTH SYSTEM, AS AN AGENT OF THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE, IS WORKING FOR OSF HEALTHCARE AS AN EXECUTIVE VICE PRESIDENT. COMPENSATION IS PAID DIRECTLY TO THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE ON HER BEHALF. MICHAEL NELSON, EVP/CFO, CONTINUED HIS EMPLOYMENT WITH OSF HEALTHCARE AS CFO. SR. M. ANSELMA, CHIEF OPERATING OFFICER, AS AN AGENT OF THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE, IS WORKING FOR OSF HEALTHCARE AS THE CHIEF OPERATING OFFICER. COMPENSATION IS PAID DIRECTLY TO THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE ON HER BEHALF. SR. M. ANASTASIA MAHER, SECRETARY/DIRECTOR OF SAINT CLARE'S VILLA, AS AN AGENT OF THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE, IS WORKING FOR OSF HEALTHCARE AS THE DIRECTOR OF SAINT CLARE'S VILLA. COMPENSATION IS PAID DIRECTLY TO THE SISTERS OF ST. FRANCIS OF THE MARYTR ST. GEORGE ON HER BEHALF. SCHEDULE N, PART I, LINE 3 THE NECESSARY APPROVALS WERE RECEIVED BY EVERYONE BEFORE THE MERGER WAS COMPLETE. SCHEDULE N, PART I, LINE 6C OSF HEALTHCARE PAID THE BALANCE OF THE BOND ISSUE ON NOVEMBER 1, 2014. FORM 990, PART I, LINE 1 SPONSORED BY THE SISTERS OF ST. FRANCIS OF THE MARTYR ST. GEORGE, SAINT ANTHONYS HEALTH CENTER IS A TWO-CAMPUS SYSTEM WITH A MISSION OF MAKING CHRISTS MERCIFUL LOVE VISIBLE BY PROVIDING QUALITY HEALTH CARE FORM 990, PART VI, SECTION A, LINE 2 MICHAEL NELSON IS THE SPOUSE OF ELIZABETH NELSON. FORM 990, PART VI, SECTION A, LINE 6 SAINT ANTHONY'S HEALTH CENTER HAS ONE MEMBER, DESIGNATED AS THE CORPORATE MEMBER, WHICH SHALL BE SAINT ANTHONY'S HEALTH SYSTEM, AN ILLINOIS NOT-FOR-PROFIT CORPORATION. SAINT ANTHONY'S HEALTH SYSTEM SHALL ACT IN STEWARDSHIP CAPACITY AND ENSURE THAT ALL ACTIONS OF SAINT ANTHONY'S HEALTH CENTER ARE CONSISTENT WITH THE PURPOSES, AND ETHICAL AND RELIGIOUS PRINCIPLES IN FURTHERANCE OF THEIR CHARITABLE APOSTOLATE OF QUALITY HEALTH CARE. FORM 990, PART VI, SECTION A, LINES 7A & 7B SAINT ANTHONY'S HEALTH SYSTEM HAS THE EXCLUSIVE POWER TO APPOINT AND REMOVE THE DIRECTORS AND THE PRESIDENT/CEO, ADOPT, AMEND, RESTATE AND REPEAL THE ARTICLES OF INCORPORATION AND THE BYLAWS, ADOPT ANY PLAN OF MERGER, CONSOLIDATION, OR DISSOLUTION, ADOPT STATEMENT OF PHILOSOPHY, MISSION, AND APOSTOLATE, ESTABLISH A CORPORATE LIMIT FOR EXPENDITURES, AND APPROVE THE MISSION STATEMENT, STRATEGIC PLAN, AND ANNUAL OPERATING BUDGET. SAINT ANTHONY'S HEALTH SYSTEM MUST APPROVE PURCHASES, SALES, TRANSFERS, LEASES OR ENCUMBRANCES OF REAL PROPERTY OR OF SUBSTANTIALLY ALL OF THE PERSONAL PROPERTY, BORROWING WHICH IS IN EXCESS OF THE CORPORATE LIMIT AS DETERMINED FROM TIME TO TIME BY SAINT ANTHONY'S HEALTH SYSTEM, THE EXECUTION OF ANY DEEDS, MORTGAGES, OR BONDS, ANY TRANSACTION WHICH INVOLVES AN ALIENATION OF PROPERTY OR OTHER ACT OF EXTRAORDINARY ADMINISTRATION, AND EXTRAORDINARY MEDICAL/MORAL ISSUES AND ANY MATTER CHALLENGING THE CATHOLICITY OF SAINT ANTHONY'S HEALTH CENTER. FORM 990, PART VI, SECTION B, LINE 11B SAINT ANTHONY'S HEALTH CENTER USES AN OUTSIDE PREPARER TO PREPARE ITS FORM 990. ONCE COMPLETED, THE RETURNS ARE REVIEWED INTERNALLY BY THE PRESIDENT, CFO AND THE CONTROLLER BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT MUST BE COMPLETED ANNUALLY BY: ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, DIRECTORS, MANAGERS, EMPLOYED PHYSICIANS, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICAL AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST; AND NON-EMPLOYED MEMBERS OF THE MEDICAL STAFF WHO ALSO EITHER: HOLDS PAID OR UNPAID MEDICAL ADMINISTRATIVE POSITIONS OR HAVE PROCUREMENT RESPONSIBILITY OR THE AUTHORITY EFFECTIVELY TO RECOMMEND SUCH PROCUREMENT. THE STATEMENTS ARE REVIEWED ANNUALLY BY THE PRESIDENT/CEO AND THE BOARD SECRETARY. ANY MEMBER OF A BOARD INCLUDING PHYSICIANS SHALL REFRAIN FROM VOTING ON ANY POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15A IN 2010, HEWITT ASSOCIATES WAS ENGAGED TO PERFORM A REVIEW OF EXECUTIVE COMPENSATION, INCLUDING ALL DISQUALIFIED PERSONS. HEWITT ASSOCIATES ISSUED AN OPINION LETTER SHOWING REBUTTABLE PRESUMPTION OF REASONABLENESS OF EXECUTIVE COMPENSATION FOR SAINT ANTHONY'S. THIS ANALYSIS INVOLVED COMPARABLE DATA. SAINT ANTHONY'S CONTINUES TO USE HEWITT'S DATA BY ADJUSTING FOR AN AGING FACTOR AND LOOKING AT ANY MARKET DYNAMICS SINCE 2010 WHEN MAKING CHANGES TO EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD OVERSEES MATTERS OF EXECUTIVE COMPENSATION AND UTILIZES OUTSIDE CONSULTING SERVICES WHEN APPROPRIATE. THE PROCESS IS DOCUMENTED IN COMPENSATION COMMITTEE MEETING MINUTES. THERE HAVE BEEN NO CHANGES TO THIS PROCESS IN THE PAST YEAR. DURING 2014, COMPENSATION THAT WOULD HAVE BEEN PAID DIRECTLY TO THE CEO WAS PAID TO THE SISTERS OF ST. FRANCIS OF THE MARTYR ST. GEORGE ON HER BEHALF. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION COMMITTEE OF SAINT ANTHONY'S HEALTH SYSTEM, PARENT CORPORATION, RELIED ON MARKET SURVEYS AND COMPENSATION ANALYSIS COMPLETED BY HEWITT ASSOCIATES DURING 2010 TO ASSIST IN CALCULATING COMPENSATION IN 2014. THE 2010 DATA WAS ADJUSTED BY AN AGING FACTOR AND CHANGES IN THE MARKET TO CREATE THE 2014 COMPENSATION FOR SENIOR TEAM MEMBERS IN 2014. ALL OF THIS ACTIVITY IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION IS PROVIDED IN ACCORDANCE WITH THE FREEDOM OF INFORMATION ACT. FORM 990, PART IX, LINE 11G CONTRACT SERVICES 3,638,885 PURCHASED SERVICES 2,079,236 PHYSICIAN FEES 1,002,080 PHYSICIAN SUPPORT SERVICES 522,932 REFERENCE LAB SERVICES 249,046 PURCHASED LAUNDRY SERVICES 246,431 OTHER FEES FOR SERVICES 662,759 ---------- 8,401,369 FORM 990, PART XI, LINE 9 CHANGE IN TEMPORARILY RESTRICTED ASSETS 8,657 FAS 158 ADJUSTMENT (11,334,247) CHANGE IN INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS (27) TRANSFER TO ST. ANTHONY HEALTH SYSTEM (5,058,218) NET ASSET TRANSFER TO OSF 7,997,116 ------------ (8,386,719) FORM 990, PART VI, SECTION A, LINE 4 ARTICLES OF AMENDMENT WERE ADOPTED BY THE ORGANIZATION ON OCTOBER 31, 2014. COPY ATTACHED. SAINT ANTHONY'S LLC 915 EAST FIFTH STREET ALTON IL 62002 371407745 ASSISTED LIV. 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