2015-05-07T14:31:17-05:00 2014-06-30 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 606064301 990 2013-07-01 363276552 Alexian Brothers Hospital Network ALEX 8473857100 3040 W Salt Creek Lane Arlington Heights IL 600051069 Mark Frey President & CEO 8473857100 2015-05-06 1 Laura Gillespie P00855604 3124861000 2015-04-27 2013 2016-02-25 16:41:14Z Mark Frey 3040 W Salt Creek Lane Arlington Heights IL 600051069 79401042 0 0928 X www.alexianbrothershealth.org X 1983 IL Area member for Catholic health system ministries. 6 0 0 1 0 0 0 0 101358155 79303509 0 97533 0 0 101358155 79401042 0 0 0 0 26532873 23154326 0 0 0 71178569 57545470 97711442 80699796 3646713 -1298754 129212972 128422194 142533597 143041573 -13320625 -14619379 X Alexian Brothers Hospital Network ("ABHN") carries out the healing mission of the Catholic Church through the Alexian Brothers ministries by identifying and developing effective responses to the health and housing needs of those we are called to serve. 0 0 78045000 78275935 Alexian Brothers Hospital Network (ABHN) strives to provide a prophetic, holistic approach to health care, rooted in Gospel values and the legacy of the Alexian Brothers, an 800-year-old Congregation that carries out the healing ministry of Jesus Christ in the tradition of the Roman Catholic Church. Through partnerships with our associates, physicians and the community, we identify and develop effective responses to the health and housing needs of those we are called to serve. Alexian Brothers Hospital Network and its entities are a Ministry Organization of Ascension Health, the largest Catholic health system in the nation.(See Schedule O)Alexian Brothers Hospital Network provides the community with a full range of comprehensive healthcare services and access to the most advanced medical technology. We are passionate about delivering exceptional health care and are proud of the powerful, cutting edge technology our skilled professionals are able to access. In addition, we offer a wide range of community health services, corporate wellness programs, preventive care and education. Our ministries exist to continue the Alexian Brothers mission of caring for the sick, the poor and the dying and promoting the physical, mental, spiritual and social health and well-being of all individuals we serve. 78045000 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X Jeannie Justie 8478185100 3040 West Salt Creek Lane Arlington Heights IL 600051069 X Mark Frey Ex-Officio Member & Chairperson 1.00 50.00 X X 0 1498371 49865 John Werrbach Director & Vice President 1.00 50.00 X X 0 563423 66440 Len Wilk Director & Vice President 1.00 50.00 X X 0 386998 47238 Clayton Ciha Director & Vice President 1.00 50.00 X X 0 332166 65458 Paul Belter Director & Secretary/Treasurer 1.00 50.00 X X 0 540392 60474 Tracy Rogers Director 1.00 50.00 X 0 654056 58907 Brother James Classon CFA Director (end 3/14) 1.00 1.00 X 0 0 0 Donna Gauthier Assistant Secretary 1.00 40.00 X 0 74489 15715 Scott Peterson Vice President-Human Resources 1.00 50.00 X 0 342755 38484 Rob Wright Vice President-Managed Care 50.00 0.00 X 0 370695 53070 Patti Baker Vice President-Oncology 50.00 0.00 X 0 260181 270456 Don Franke Vice President-Clinical Integration 50.00 0.00 X 0 347049 48682 Andrew Snyder Vice President-Marketing 50.00 0.00 X 0 328627 26110 Kelley Clancy Vice President-External Affairs 50.00 0.00 X 0 273420 78065 Edward Goldberg Former Officer 0.00 0.00 X 0 482509 76856 Jim Lewandowski Former Key Employee 0.00 0.00 X 0 722305 15727 0 7177436 971547 0 1 1 0 0 Management Fees 561000 74977521 74977521 Rehab. Revenue 900099 3158330 3158330 Research Revenues 541700 997565 997565 Managed Care Cost Allo 900099 135071 135071 35022 5013 30009 79303509 97533 97533 79401042 78275935 0 1125107 X 15805719 15572084 233635 6216770 6190643 26127 1131837 1110937 20900 1111000 1111000 410257 410257 22754614 20872509 1882105 4267797 4256363 11434 144288 133342 10946 129572 129572 501838 501838 209460 209087 373 14779 14760 19 15132424 15132424 62452 5406 57046 Public Relations 2000480 2000480 Medical Supplies 706303 706303 Dues 491934 491934 Dietary 11640 11534 106 9596632 9594784 1848 80699796 78045000 2654796 0 228466 241846 4505867 3409126 225412 1053101 53520240 27363623 34109349 26156617 53941828 53941828 7774141 9354346 28414529 34278710 129212972 128422194 15280267 8399934 127253330 134641639 142533597 143041573 X -13320625 -14619379 -13320625 -14619379 129212972 128422194 -1298754 0 X 0 1 X 1 0 X X X 0 0 0 Alexian Brothers Medical Center 362596381 3 1 1 1 0 St Alexius Medical Center 364251846 3 1 1 1 0 Alexian Brothers Behavioral Health Hospital 364251848 3 1 1 1 0 Alexian Brothers Center for Mental Health 363045007 7 1 1 1 0 4 0 Schedule A, Part I, Line 11h: ABHN supports the provision of healthcare services at the corporations to which it is a member by the provision of centralized administrative support, including Billing and Collections; Managed Care Contracting; Property Management; Clinical Research (including Oncology, Neurosciences, and General Research); Marketing; Logistics; External Affairs; Public Relations; and Construction. Costs of certain of these departments are charged to the corporations through a management fee. Transactions with each corporation is delineated on Schedule R. 0 1 0 0 0 0 1 789485 0 0 789485 0 Part II-B, Line 1: The Department of External Affairs at Alexian Brothers Health System is responsible for advocacy at the local, county, state and federal government. The Vice President of External Affairs works with the Illinois Hospital Association and the American Hospital Association on issues that affect the hospital industry in Illinois and in the entire country. These issues include regulation, reimbursement, workforce and overall health policy. The Vice President of External Affairs is responsible for retaining certain consultants to provide advice and support for issues of specific concern to Alexian Brothers Health System. One such example is our support of a full interchange from a nearby toll way that would save lives by providing easier, quicker ambulance access to the St. Alexius Medical Center campus emergency department, an acute care hospital, of which ABHN is the area member. 6342811 1519192 4823619 45834937 25826681 20008256 1342492 17750 1324742 26156617 Equity Investment in Taxable Affiliates 53941828 F 53941828 Due from Affiliates (ARS) 25163035 Due from Affiliates (ABHN) 6472803 Receivables (CIN) 2447990 Due from Ascension (VCO) (ABHN) 194882 34278710 Due to Affiliates 134639661 Released from Restricted 1978 134641639 X Part X, Line 2: From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Alexian Brothers Hospital Network: 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 1 0 0 0 0 0 0 0 Mark Frey Ex-Officio Member & Chairperson 0 712178 0 693941 0 92252 0 14702 0 35163 0 1548236 0 74752 John Werrbach Director & Vice President 0 439800 0 91375 0 32248 0 38835 0 27605 0 629863 0 32248 Len Wilk Director & Vice President 0 351373 0 35625 0 0 0 20832 0 26406 0 434236 0 0 Clayton Ciha Director & Vice President 0 251527 0 69206 0 11433 0 32152 0 33306 0 397624 0 11433 Paul Belter Director & Secretary/Treasurer 0 420392 0 120000 0 0 0 25845 0 34629 0 600866 0 0 Tracy Rogers Director 0 490446 0 142500 0 21110 0 30990 0 27917 0 712963 0 21110 Scott Peterson Vice President-Human Resources 0 302795 0 39960 0 0 0 14311 0 24173 0 381239 0 0 Rob Wright Vice President-Managed Care 0 300454 0 58544 0 11697 0 26469 0 26601 0 423765 0 11697 Patti Baker Vice President-Oncology 0 66693 0 0 0 193488 0 247700 0 22756 0 530637 0 16530 Don Franke Vice President-Clinical Integration 0 289304 0 57745 0 0 0 18579 0 30103 0 395731 0 0 Andrew Snyder Vice President-Marketing 0 259821 0 49374 0 19432 0 17433 0 8677 0 354737 0 13102 Kelley Clancy Vice President-External Affairs 0 218960 0 42594 0 11866 0 41482 0 36583 0 351485 0 11866 Edward Goldberg Former Officer 0 0 0 0 0 482509 0 26610 0 50246 0 559365 0 487386 Jim Lewandowski Former Key Employee 0 0 0 0 0 722305 0 0 0 15727 0 738032 0 722305 Part I, Line 3 Alexian Brothers Health System, a related organization of Alexian Brothers Hospital Network, uses all of the items in Schedule J, Part I, Line 3 to establish the compensation of the organization's CEO. - Compensation Committee - Independent compensation consultant - Form 990 of other organizations - Compensation survey or study - Approval by the Board or Compensation Committee Part I, Line 4a: The following individual listed in Schedule J received the referenced amount of change in control payments in calendar year 2013. 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 - $689,832 Edward Goldberg - $487,386 The following individual listed in Schedule J received the referenced amount of severance in calendar year 2013: Patti Baker - $176,958 Part I, Line 4b: Alexian Brothers Health System 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. The amount paid in calendar 2013 was included in income in Schedule J for the following individual: Patti Baker - $3,272 Form 990, Part V, Line 1a: Alexian Brothers Health System, a related organization and sole corporate member of Alexian Brothers Hospital Network, uses a common bank account to compensate all independent contractors within the Health System. The number attributable to each organization is not easily distinguished. The total number of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of the Alexian Brothers Health System Form 990. Form 990, Part VI, Section A, line 2 Tracy Rogers, Len Wilk, Clay Ciha, John Werrbach, Paul Belter, Mark Frey, Scott Peterson, and Donna Gauthier have a business relationship due to joint employment by a common health system entity. Form 990, Part VI, Section A, line 6 Alexian Brothers Hospital Network has one member, Alexian Brothers Health System (the "National Member"). Form 990, Part VI, Section A, line 7a Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of Alexian Brothers Hospital Network. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Alexian Brothers Hospital Network's financial information or corporation as a whole are subject to approval by the National Member, Alexian Brothers Health System. 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 Members' 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, 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 15 In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of Alexian Brothers Hospital Network, 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 his compensation was decided. 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. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other similarly situated organizations' employees that hold the same or similar title. During the review and approval of the compensation by the Compensation Committee, documentation of the decision was recorded in the minutes. Form 990, Part VI, Section C, line 19 The financial statements of Alexian Brothers Hospital Network are available through the Office of the Illinois Attorney General. Conflict of Interest statements and the governing documents of Alexian Brothers Hospital Network are not made available to the public. Form 990, Part VII, Section A: Compensation amount for Len Wilk represent payment for services rendered to St. Alexius Medical Center, a related entity, Compensation amount for Clayton Ciha represents payment for services rendered to Alexian Brothers Behavioral Health Hospital, a related entity and compensation amounts for Tracy Rogers, Paul Belter, and Mark Frey represent payment for services rendered to Alexian Brothers Health System, a related entity. Compensation amount for John Werrbach represents payment for services rendered to Alexian Brothers Medical Center, a related entity. The amounts are not for services as a board member of Alexian Brothers Hospital Network. Form 990, Part IX, line 11g Other Fees: Program service expenses 20,872,509. Management and general expenses 1,882,105. Fundraising expenses 0. Total expenses 22,754,614. Part XI, Line 2b Audit Disclosure: The financial statements of Alexian Brothers Hospital Network were audited on a consolidated basis. The Audit Committee of the Board of Governors of Alexian Brothers Health System has been delegated the responsibility to oversee the audited financial statements and the selection of the independent accountants that audit the financial statements. Alexian Brothers Accountable Care Organization LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 900855278 Accountable Care Organization IL -1533262 495148 Alexian Brothers Hospital Network Alexian Brothers Clinically Integrated Network LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 800967178 Clinically Integrated Network IL -676988 2726457 Alexian Brothers Hospital Network 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 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 60005 363260495 Supports provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Alexian Brothers Bonaventure House 825 Wellington Avenue Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Health System Inc Investment Trust 3040 W Salt Creek Lane Arlington Heights IL 60005 363801585 Manages pooled investments of related not-for-profit entities IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Specialty Group 3040 W Salt Creek Lane Arlington Heights IL 60005 800710751 Specialty physician practice group IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers of San Jose Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 941530037 Acute care hospital (sold in 1998) TX Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 431295333 HUD housing MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Community Services 425 Cumberland Street Suite 110 Chattanooga TN 37404 364344423 Provides comprehensive & coordinated community based services IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Neighbors 250 East 10th Street Chattanooga TN 37402 620646376 Supports the provision of community services for senior citizens TN Section 501(c)(3) Schedule A, Line 7 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 60005 364484290 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 392039667 Community outreach WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 431470362 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Savelli Properties Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363308965 Owns or leases properties where healthcare services are delivered IL Section 501(c)(2) N/A Alexian Brothers Health System 1 Alexian Brothers Center for Mental Health 3436 N Kennicott Avenue Arlington Heights IL 60004 363045007 Outpatient community mental health services IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Behavioral Health Hospital 1650 Moon Lake Blvd Hoffman Estates IL 60194 364251848 Behavioral health hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 St Alexius Medical Center 1555 Barrington Road Hoffman Estates IL 60194 364251846 Acute care hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 60005 364336931 Physician services IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Road Elk Grove Village IL 60007 300221481 Rehabilitation hospital IL Alexian Brothers Hospital Network Related 3158637 1976744 0 0 0.51000 Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 870783164 Provision of NeuroMeg services IL N/A Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 60005 363853289 Medical office building IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages managed care contracts DE N/A Related 6821929 0 0 0.50000 Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 861115516 Ownership of Gamma Knife IL N/A St Alexius Center for Sleep Health LLC 1300 S Main Street Lombard IL 60148 205876371 Operation of sleep lab IL N/A Thelen Corporation 3040 W Salt Creek Lane Arlington Heights IL 60005 363266316 Owns/leases property; joint venture partner IL Alexian Brothers Hospital Network C 6478864 1.00000 0 Alexian Brothers Health Providers Association Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363853286 Messenger model IPA IL N/A C 0 Alexian Brothers Corpus Christi Housing Project LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 943465394 Tax credit financed housing IL N/A C 0 Alexian Village of Elk Grove 3040 W Salt Creek Lane Arlington Heights IL 60005 352211303 Tax credit financed housing IL N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 Alexian Brothers Health System J 98571 FMV Alexian Brothers Medical Center P 32240470 FMV St Alexius Medical Center P 24714970 FMV Alexian Brothers Behavioral Health Hospital P 3772612 FMV Thelen Corporation P 261804 FMV Savelli Properties Inc P 354348 FMV Alexian Brothers Ambulatory Group P 1909999 FMV Alexian Brothers Senior Ministries P 1632889 FMV Alexian Brothers Health Providers Association Inc P 101292 FMV Alexian Brothers Specialty Group P 176064 FMV Alexian Brothers Health System R 57679546 FMV