2014-05-15T09:51:50-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth street Suite 1900 Cincinnati OH 45202 990 2012-07-01 621284994 Saint Thomas Network SAIN 6152846826 4220 Harding Rd Nashville TN 37205 Craig Polkow 6152846826 2014-05-15 1 Alicia Janisch P00741382 5137847100 2012 2015-11-30 17:44:51Z Michael Schatzlein 4220 Harding Rd Nashville TN 37205 8469349 0 0928 X N/A X 1986 TN To promote and support all programs and activities for the benefit of Saint Thomas Hospital. 19 16 125 16 0 0 35744 0 6892503 6418921 174672 -73 3113481 1334028 10216400 7752876 1407345 1169403 0 0 5039731 944960 0 0 0 2814505 2003359 9261581 4117722 954819 3635154 86641186 97601492 61894927 63165647 24746259 34435845 X To promote and support all programs and other activities in the interest of and for the exempt purposes of Ascension Health and Saint Thomas Hospital including the provision of lodging for the families of critically ill patients and same-day surgery patients, operating a physician practice and investing in equity partnerships with other health care organizations. 0 1 1541737 945607 West End Medical Group is a group of board certified internal medicine physicians and nurse practitioners dedicated to provide convenient and comprehensive care for our patients. The team of doctors and nurse practitioners are highly skilled and trained and have been practicing for more than 30 years collectively. 931106 1261700 Saint Thomas Research Institute is a community-based clinical research site based in Nashville, Tennessee. Focused on high quality research practices, the Institute works effectively with sponsors, physicians, and patients to improve the health of the community by conducting research. Acting as a partner and system-wide resource, Saint Thomas Research Institute launches studies and enrolls patients quickly, which allows physicians to spend more time with their patients. 418500 633596 Saint Thomas Network operates Seton Lodge and the Inn at Saint Thomas. Seton Lodge is a 50 room motel on the grounds of Saint Thomas Hospital that provides low cost accommodations for family members residing outside Davidson County whose relatives are in critical care or special care. The Inn at Saint Thomas is a similar 50 room motel providing pre-surgical accommodations for patients traveling to Saint Thomas from long distances. 833780 1169403 4646045 Saint Thomas Network is partnered with other healthcare organizations to further the mission of providing spiritually centered, holistic care that sustains and improves the health of the communities it serves. These partnerships provide an outpatient neurosurgical center and several ambulatory surgery centers in the Central Tennessee area. 833780 1169403 4646045 3725123 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 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 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 X 19 16 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Craig Polkow 6152846826 4220 Harding Rd Nashville TN 37205 X James Bearden 1.00 8.00 X 0 0 0 Clark Baker 1.00 8.00 X 0 0 0 Mary Falls Esq 1.00 8.00 X 0 0 0 Anthony Heard 1.00 8.00 X 0 0 0 William Anderson 1.00 8.00 X 0 0 0 Robert Dray MD 1.00 8.00 X 0 0 0 Robert Hutton MD 1.00 8.00 X 0 0 0 Randy Laszewski 1.00 8.00 X 0 0 0 Mark Marsden MD 1.00 8.00 X 0 0 0 Lee Moss 1.00 9.00 X 0 0 0 Thom Rainer PhD 1.00 8.00 X 0 0 0 Sean Ryan 1.00 8.00 X 0 0 0 Patrick Sheperd 1.00 8.00 X 0 0 0 Scott Standard MD 1.00 8.00 X 0 0 0 Sister Dinah White DC 1.00 8.00 X 0 0 0 Brian Wilcox MD 1.00 8.00 X 0 0 0 John A Williams MD 1.00 8.00 X 0 0 0 Mike Schatzlein MD 1.00 47.00 X X 0 1980764 36018 Craig Polkow 1.00 46.00 X X 0 419560 26205 Wesley Littrell end 1212 1.00 46.00 X X 0 994127 27522 Karen Springer start 113 1.00 43.00 X X 0 570771 8696 David Heusinkveld MD 40.00 0.00 X 227890 0 9776 Hugh Holliday MD 40.00 0.00 X 172188 0 8217 Gertrude Stone MD 40.00 0.00 X 120067 0 14542 Bevery Turner-Winbush MD 40.00 0.00 X 114758 0 4566 Alan Strauss Sch J 0.00 0.00 X 0 1107791 50301 634903 5073013 185843 4 1 1 0 0 Ancillary Revenue 621400 4648162 4648162 Net Patient Revenue 621400 827984 827984 Lodging Revenue 624200 633596 633596 Medical Research 621500 309179 309179 6418921 -73 -73 728780 686586 42194 42194 42194 29887 29887 0 0 Management Fee 561000 952521 952521 Net Insurance Proceeds 900099 223807 223807 115506 115506 1291834 7752876 7486948 0 265928 X 1169403 1169403 1066813 853450 213363 -284966 -227973 -56993 83610 66887 16723 79503 63602 15901 8594 8594 957476 861728 95748 246 246 73158 65842 7316 55613 52832 2781 467626 420863 46763 1631 1468 163 11941 1194 10747 146806 132125 14681 19657 17691 1966 Minor Equipment 50906 45815 5091 0 Personal Property Tax 35468 28374 7094 0 Maintenance and Repair 26611 23950 2661 0 Bad debt - Non-Patient 4900 4900 0 0 142726 142726 4117722 3725123 392599 0 800 298 131472 265823 30484 4730 24018076 13908926 10344031 10109150 12580261 18209278 1214949 1214949 62339189 67797264 86641186 97601492 766362 397260 98813 124336 346137 343569 60683615 62300482 61894927 63165647 X 24746259 34435845 0 0 0 0 24746259 34435845 86641186 97601492 X 3635154 1830414 4224018 X 0 1 X 1 0 X 214875 278825 35744 529444 7556600 6332915 3597683 5937305 6418921 29843424 7771475 6611740 3597683 5973049 6418921 30372868 0 0 0 30372868 3021285 2769378 2372572 723276 728707 9615218 3021285 2769378 2372572 723276 728707 9615218 10792760 9381118 5970255 6696325 7147628 39988086 0.75950 0.76650 0.24050 0.23350 X 3091881 4228143 7320024 5806532 9004213 12254700 2556045 10014 988268 772412 225870 595334 588624 6710 293691 293190 501 10109150 Investments in Unconsolidated Entities 18209278 C 18209278 Intercompany Receivables 66873915 Prepaid Pension Asset 328592 Miscellananeous Receivables 594757 67797264 Intercompany Payables 62141993 Miscellaneous 82042 Pension Liability 61231 Self Insurance Liability 15216 62300482 1 Saint Thomas Health Foundations 4220 Harding Rd Nashville TN 37205 581663055 501(c)(3) 1169403 General Support 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Organizations requesting grants are asked to submit a request in writing which identifies the community health need the grant will be addressing, along with goals and objectives. Requests are reviewed by the Saint Thomas Health Community Health & Benefit Committee prior to approval. Awarded grantees are asked to submit a report of program /event activities. It is requested the report include demographic summary of population benefited and achieved objectives and impact on health. The reports are reviewed by the Community Health & Benefit Team in a broad manner upon receipt, but will be more thoroughly scrutinized if the grant recipient comes back to ask for a renewal or another grant. 0 1 0 0 0 0 0 0 0 Mike Schatzlein MD 0 773332 0 1008367 0 199065 0 5000 0 31018 0 2016782 0 0 Craig Polkow 0 334951 0 66820 0 17789 0 5000 0 21205 0 445765 0 0 Wesley Littrell end 1212 0 551433 0 186400 0 256294 0 5000 0 22522 0 1021649 0 0 Karen Springer start 113 0 403847 0 155925 0 10999 0 5000 0 3696 0 579467 0 0 David Heusinkveld MD 221727 0 6163 0 0 0 0 0 9776 0 237666 0 0 0 Hugh Holliday MD 152276 0 19247 0 665 0 0 0 8217 0 180405 0 0 0 Alan Strauss Sch J 0 499276 0 322744 0 285771 0 19425 0 30876 0 1158092 0 85540 Part I, Line 3 Saint Thomas Health, a related organization of Saint Thomas Network, uses the following to establish the compensation of the organization's CEO: Compensation Committee, Independent Compensation Consultant, Compensation Survey or Study, and 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 of 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 executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The filing organization contributed to the supplemental nonqualified retirement plan in the amount noted: -Craig Polkow - $18,770 -Karen Springer - $33,532 The following individuals received payments from the supplemental nonqualified retirement plan in the amount noted: -Alan Strauss - $85,540 Supplemental Information Part III Schedule J, Part II: The 2012 compensation amounts shown for Alan Strauss were paid by a related organization. $577,416 of the compensation was paid for Mr. Strauss's services as the CFO of Saint Thomas Health. His remaining compensation was paid for his services as the CFO of the related organization. Changes in Program Services Form 990, Part III, line 3 On July 1, 2012, the activity of Saint Thomas Emergency Medical Services was transferred to Saint Thomas Health. 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 Saint Thomas Health entity boards. Form 990, Part VI, Section A, line 6 Saint Thomas Network has a single corporate member, Saint Thomas Health. Form 990, Part VI, Section A, line 7a Saint Thomas Network has a single corporate member, Saint Thomas Health, who has the ability to elect members to the governing body of the Saint Thomas Network. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Saint Thomas Network financial information or corporation as a whole are subject to approval by its sole corporate member, Saint Thomas Health. Ascension Health, the sole corporation member of Saint Thomas Health, 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, 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 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. In determining the compensation of the organization's CEO, the process, performed by Saint Thomas Health, a related organization of Saint Thomas Network, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other health systems 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. The individual was not present when his compensation was decided. In determining the compensation of other officers or key employees of the organization, the process, performed by Saint Thomas Health, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to individuals at other hospitals 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. 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 B Independent Contractor Reporting Compensation of independent contractors is paid by and reported on the Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Ascension Health EIN 31-1662309. Expenses are allocated to and reimbursed by the filing organization to Ascension Health. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B. Other Fees Form 990, Part IX, line 11g Physician Fees: Program service expenses 346,202. Management and general expenses 38,467. Fundraising expenses 0. Total expenses 384,669. Purchased Services: Program service expenses 502,433. Management and general expenses 55,826. Fundraising expenses 0. Total expenses 558,259. Other: Program service expenses 13,093. Management and general expenses 1,455. Fundraising expenses 0. Total expenses 14,548. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Net Asset Transfers to Affiliated Entities 2,412,212. Transfer to Ascension for Pension -35,122. Noncontrolling Interest Activity 1,846,928. Richland Internal Medicine LLC 4220 Harding Road Nashville TN 37205 621868762 Physician Practice TN 0 0 Saint Thomas Network Saint Thomas Research Institute LLC 4220 Harding Road Nashville TN 37205 208018726 Research TN 1261700 4503100 Saint Thomas Network Saint Thomas NP LLC 4220 Harding Road Nashville TN 37205 261614782 Inactive TN 0 0 Saint Thomas Network USLIFELINK LLC 618 Church Street Suite 520 Nashville TN 379122457 319441128 Healthcare TN 0 0 Saint Thomas Network Bellvue Medical Group LLC 4220 Harding Road Nashville TN 37205 621868848 Physician Practice TN 945607 5185513 Saint Thomas Network Saint Thomas Emergency LLC 4220 Harding Road Nashville TN 37205 208957092 Ambulance Services TN 0 0 Saint Thomas Network Premier IPA LLC 4220 Harding Road Nashville TN 37205 Inactive TN 0 0 Saint Thomas Network Children and Adults Medical Group LLC 4220 Harding Road Nashville TN 37205 621868855 Physician Practice TN 0 0 Saint Thomas Network Saint Thomas Outpatient Cardiac Catheterization Center LLC 4220 Harding Road Nashville TN 37205 321775306 Outpatient Services TN 0 24649 Saint Thomas Network Ascension Health PO Box 45998 St Louis MO 63134 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Saint Thomas Health 4220 Harding Road Nashville TN 37205 581716804 System Parent TN Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Saint Thomas West Hospital fka Saint Thomas Hospital 4220 Harding Road Nashville TN 37205 620347580 Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Saint Thomas Health Foundations PO Box 380 Nashville TN 37202 581663055 Operates Foundation TN Section 501(c)(3) Schedule A, Line 7 Saint Thomas Network 1 Covenant Care Inc 102 Woodmont Blvd Suite 800 Nashville TN 37205 621695737 Inactive TN Section 501(c)(3) Schedule A, Line 11a Saint Thomas Network 1 Saint Thomas Rutherford Hospital fka Middle Tennessee Medical Center Inc 1700 Medical Center Parkway Murfreesboro TN 37219 620475842 Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Middle Tennessee Medical Center Foundation 1700 Medical Center Parkway Murfreesboro TN 37219 621167917 Foundation TN Section 501(c)(3) Schedule A, Line 11a Saint Thomas Rutherford Hospital 1 Saint Thomas Midtown Hospital fka Seton Corporation 4220 Harding Road Nashville TN 37205 621869474 Acute Care Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Baptist Hospital Foundation of Nashville Inc 2000 Church Street Nashville TN 37236 581861378 Inactive TN Section 501(c)(3) Schedule A, Line 11a Saint Thomas Midtown Hospital 1 Baptist Health Care Affiliates Inc 2000 Church Street Nashville TN 37236 581509251 Community Health Promotion TN Section 501(c)(3) Schedule A, Line 11a Saint Thomas Network 1 Baptist Health Care Group 2000 Church Street Nashville TN 37236 621529858 Healthcare Provider TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Network 1 Saint Thomas Hickman Hospital fka Hickman Community Health Care Services 135 East Swan Street Centerville TN 37033 581737573 Hospital TN Section 501(c)(3) Schedule A, Line 3 Baptist Healthcare Affiliates Inc 1 Saint Thomas Home Care 135 East Swan Street Centerville TN 37033 621836937 Home Health Care TN Section 501(c)(3) Schedule A, Line 9 Saint Thomas Hickman Hospital 1 Baptist Womens Health Center LLC 1900 Church Street Suite 300 Nashville TN 37203 621772195 Owns and Operates Specialty Hospital TN N/A Middle Tennessee Ambulatory Surgery Center LP 500 N Highland Ave Murfreesboro TN 37130 Operates Outpatient Surgery Center TN N/A St Thomas Research Institute LLC Cardiology Series 102 Woodmont Boulevard Nashville TN 37205 264591782 Cardiology Research TN Saint Thomas Network Related 14363 0 0 STHS Sleep Center LLC 102 Woodmont Suite 800 Nashville TN 37205 203664894 Operates a Sleep Center TN Saint Thomas Network Related 911877 685231 0 0 0.75000 Baptist Surgery Center LP 1900 Church Street Suite 300 Nashville TN 37203 Operates Outpatient Surgery Center TN N/A Middle Tennessee Imaging LLC 400 N Highland Avenue Murfreesboro TN 37219 010570490 Diagnostic Imaging Center TN N/A RADS OF AMERICA LLC PO Box 249 Goodlettsville TN 370700249 Ambulatory Surgery Center TN N/A Murfreesboro Diagnostic Imaging LLC 400 N Highland Avenue Murfreesboro TN 37219 200291952 Diagnostic Imaging Center TN N/A Sova Inc 102 Woodmont Boulevard Suite 700 Nashville TN 37205 261319638 Health Services TN N/A C 0 Baptist Health Care Ventures Inc 2000 Church Street Nashville TN 37236 620469214 Holding Company TN N/A C 0 MissionPoint Health Partners 102 Woodmont Boulevard Suite 700 Nashville TN 37205 452958482 Accountable Care Organization TN N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 Saint Thomas Health Foundations B 1169403 Actual Amount Paid Baptist Health Care Group R 152478 Actual Amount Paid Saint Thomas Midtown Hospital R 300918 Actual Amount Paid Saint Thomas Health S 3721310 Actual Amount Paid Saint Thomas West Hospital R 4783404 Actual Amount Paid Ascension Health S 120907 Actual Amount Paid Saint Thomas Research Institute LLC Cardiology Series R 94818 Actual Amount Paid