2014-11-13T09:58:31-06:00 2013-12-31 381357951 PLANTE & MORAN PLLC 1111 SUPERIOR AVENUE SUITE 1250 CLEVELAND OH 44114 990 2013-01-01 742455161 ST JOSEPH SERVICES CORPORATION STJO 9797763777 2801 FRANCISCAN DRIVE BRYAN TX 778022544 JAMES SCHUESSLER CEO 9797763777 2014-11-10 1 JEREMY S HERMAN P00745789 2165231010 2013 2015-11-30 17:44:51Z ST JOSEPH HEALTH SYSTEM JAMES SCHUESSLER 2801 FRANCISCAN DRIVE BRYAN TX 778022544 12772941 0 0928 X WWW.ST-JOSEPH.ORG X 1987 TX ST. JOSEPH SERVICES CORPORATION IS ORGANIZED TO PROVIDE GOVERNANCE AND DIRECTION TO ALL ITS MEMBER ORGANIZATIONS THAT ARE SERVING THE HEALTH NEEDS OF THE COMMUNITIES IN WHICH THEY RESIDE. 16 11 0 0 0 0 0 0 12123530 12772941 0 0 0 0 12123530 12772941 0 0 0 0 5274875 4789097 0 0 0 6848655 7983846 12123530 12772943 0 -2 1713316 1018159 1963981 1266119 -250665 -247960 ST. JOSEPH SERVICES CORPORATION IS ORGANIZED TO PROVIDE GOVERNANCE AND DIRECTION TO ALL ITS MEMBER ORGANIZATIONS THAT ARE SERVING THE HEALTH NEEDS OF THE COMMUNITIES IN WHICH THEY RESIDE. 0 0 2299355 12772941 THE PRIMARY EXEMPT PURPOSE OF ST. JOSEPH SERVICES CORPORATION IS TO STEWARD THE HEALTH MINISTRY OF THE SISTERS OF ST. FRANCIS IN THE BRAZOS VALLEY BY PROVIDING GOVERNANCE AND DIRECTION TO ALL THE NETWORK ORGANIZATIONS THAT ARE ENDEAVORING TO MEET COMMUNITY HEALTH NEEDS. 2299355 1 0 0 1 0 0 0 0 0 0 1 0 1 0 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 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X DANIEL GOGGIN CFO 9797762553 2801 FRANCISCAN DRIVE BRYAN TX 778022544 GEORGE NELSON CHAIRPERSON 2.00 14.00 X X 0 0 0 JAMES E BLAIR III VICE CHAIRPERSON 1.00 6.00 X X 0 0 0 BRYAN COLE PHD SECRETARY 1.00 6.00 X X 0 0 0 PAUL BATISTA TRUSTEE 1.00 6.00 X 0 0 0 MARY BROUSSARD TRUSTEE 1.00 6.00 X 0 0 0 MICHAEL COHEN MD TRUSTEE 1.00 6.00 X 0 0 0 JOHN GRUBE TRUSTEE 1.00 7.00 X 0 0 0 CAROLINE MCDONALD TRUSTEE 1.00 6.00 X 0 0 0 ANTHONY MORELOS TRUSTEE 1.00 6.00 X 0 0 0 TIMOTHY RABROKER TRUSTEE 1.00 6.00 X 0 0 0 REBA RAGSDALE TRUSTEE 1.00 6.00 X 0 0 0 MICHAEL STEINES MD TRUSTEE 1.00 48.00 X 0 615875 50242 ROBERT UPCHURCH TRUSTEE 1.00 6.00 X 0 0 0 SR NANCY SURMA OSF EX-OFFICIO TRUSTEE 1.00 44.00 X 0 190666 8451 JAMES W POPE EX-OFFICIO TRUSTEE 1.00 58.00 X 0 780789 72652 ODETTE BOLANO PRES/CEO, EX-OFFICIO TRUSTEE 1.00 49.00 X X 0 732165 0 KATHLEEN KRUSIE COO 1.00 48.00 X 0 376797 44290 ALAN TOWNSEND INTERIM CFO THROUGH 1/15/13 1.00 48.00 X 0 37079 0 DANIEL GOGGIN SR VP/CFO STARTING 1/21/13 1.00 49.00 X 0 336705 55591 GARY MARK MONTGOMERY MD SR VP/CMO THROUGH 8/9/13 1.00 48.00 X 0 258486 17820 MICHAEL RUSSO VP/INFORMATION SERVICES 1.00 48.00 X 0 223327 49432 MICHAEL COSTA VP/HUMAN RESOURCES 1.00 48.00 X 0 208203 63923 STEVE CRICHTON VP/SUPPORT SERVICES 1.00 48.00 X 0 186432 57779 DONOVAN FRENCH VP STRATEGY & SERVICE LINES 1.00 48.00 X 0 159062 11792 ANTHONY PFITZER FORMER CEO 0.00 0.00 X 0 487989 0 0 4593575 431972 0 1 1 1 0 ASSESSMENT INCOME 541610 12772941 12772941 12772941 12772941 12772941 0 0 X 4057864 4057864 266412 266412 251122 251122 213699 213699 2299355 2299355 318868 318868 87245 87245 3343068 3343068 167 167 1475560 1475560 945 945 4116 4116 143449 143449 5688 5688 10276 10276 DUES AND SUBSCRIPTIONS 292599 292599 MEDICAL SUPPLIES 2510 2510 12772943 2299355 10473588 0 895215 175224 285944 304125 46248 8497 33805 37751 498352 501059 1713316 1018159 1798029 1188242 165952 77877 1963981 1266119 X -250665 -247960 -250665 -247960 1713316 1018159 X -2 2707 X X 0 1 X 1 0 X X X 0 0 0 ST JOSEPH REGIONAL HEALTH CENTER 741282696 3 1 1 1 0 MADISON ST JOSEPH HEALTH CENTER 742761145 3 1 1 1 0 BURLESON ST JOSEPH HEALTH CENTER 742759890 3 1 1 1 0 ST JOSEPH MANOR 742847594 9 1 1 1 0 BURLESON ST JOSEPH MANOR 742913931 9 1 1 1 0 ST JOSEPH REGIONAL HEALTH PARTNERS 454088170 3 0 1 1 0 ST JOSEPH PHYSICIAN ASSOCIATES 203159302 3 1 1 1 0 BELLVILLE ST JOSEPH REGIONAL HEALTH CENTER 274005511 3 0 1 1 0 8 0 0 0 0 0 0 1 1705 0 0 0 1705 0 PART II-B, LINE 1: ST JOSEPH PAID ANNUAL DUES OF $51,515 TO CHA (CATHOLIC HEALTH ASSOCIATION) OF WHICH 3.31% ($1,705) IS USED FOR LOBBYING ACTIVITIES 10206 10206 36042 8497 27545 37751 INVEST-ALLIANCE HEALTH PROVIDERS 501059 F 501059 PAYABLE TO RELATED PARTIES 77877 77877 X PART X, LINE 2: THE COMBINED GROUP CONSISTS MOSTLY OF NONPROFIT ORGANIZATIONS AFFILIATED WITH THE SISTERS. EACH NONPROFIT MEMBER OF THE COMBINED GROUP HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OR SECTION 501(A) OF THE INTERNAL REVENUE CODE. ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY, INC. IS A FOR-PROFIT CORPORATION AND FILES A FEDERAL INCOME TAX RETURN ON A SEPARATE-ENTITY BASIS. THERE IS PRESENTLY NO PREMIUM, INCOME, OR CAPITAL GAINS TAXES IMPOSED BY THE GOVERNMENT OF THE CAYMAN ISLANDS, AND IF ANY FORM OF TAXATION WERE TO BE ENACTED IN THE FUTURE, SFH ASSURANCE, LTD HAS BEEN GRANTED AN EXEMPTION UNTIL THE YEAR 2032. THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES OR UNCERTAIN TAX POSITIONS AT DECEMBER, 31, 2013 OR 2012. 1 1 0 0 0 0 0 0 0 MICHAEL STEINES MD TRUSTEE 0 615875 0 0 0 0 0 37550 0 12692 0 666117 0 0 SR NANCY SURMA OSF EX-OFFICIO TRUSTEE 0 190666 0 0 0 0 0 0 0 8451 0 199117 0 0 JAMES W POPE EX-OFFICIO TRUSTEE 0 656090 0 124699 0 0 0 51000 0 21652 0 853441 0 0 ODETTE BOLANO PRES/CEO, EX-OFFICIO TRUSTEE 0 732165 0 0 0 0 0 0 0 0 0 732165 0 0 KATHLEEN KRUSIE COO 0 325599 0 51198 0 0 0 25550 0 18740 0 421087 0 0 DANIEL GOGGIN SR VP/CFO STARTING 1/21/13 0 291705 0 45000 0 0 0 37517 0 18074 0 392296 0 0 GARY MARK MONTGOMERY MD SR VP/CMO THROUGH 8/9/13 0 208980 0 49506 0 0 0 0 0 17820 0 276306 0 0 MICHAEL RUSSO VP/INFORMATION SERVICES 0 196556 0 26771 0 0 0 22907 0 26525 0 272759 0 0 MICHAEL COSTA VP/HUMAN RESOURCES 0 188945 0 19258 0 0 0 42329 0 21594 0 272126 0 0 STEVE CRICHTON VP/SUPPORT SERVICES 0 167531 0 18901 0 0 0 41983 0 15796 0 244211 0 0 DONOVAN FRENCH VP STRATEGY & SERVICE LINES 0 159062 0 0 0 0 0 4273 0 7519 0 170854 0 0 ANTHONY PFITZER FORMER CEO 0 487989 0 0 0 0 0 0 0 0 0 487989 0 487989 PART I, LINE 3 ODETTE BOLANO, PRESIDENT/CEO OF ST. JOSEPH HEALTH SYSTEM, RECEIVES COMPENSATION FROM ASCENSION, AN UNRELATED ORGANIZATION. PART I, LINES 4A-B ANTHONY PFITZER'S SEVERANCE COMPENSATION WAS ACCRUED IN 2012 AND REPORTED AS DEFERRED COMPENSATION ON 2012 990. HOWEVER, RECEIVED PAYMENTS THROUGHOUT 2013 IN THE AMOUNT OF $487,989, THE ORGANIZATION BACKS OUT ACTUAL PAID FROM THE ACCRUED PAYROLL EXPENSE EACH MONTH FOR A ZERO NET EFFECT. THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER. CURRENT YEAR PAYMENTS, REPORTED IN PART II, COLUMN (B)(III), ARE SUMMARIZED BELOW: JAMES W POPE $108,634 PART II SR. NANCY SURMA, OSF, PHD AND SR. PENNY DUNN WORK 40 HOURS A WEEK FOR SYLVANIA FRANCISCAN HEALTH BUT DO NOT RECEIVE A W-2. ALL COMPENSATION EARNED WAS PAID TO THE SISTERS OF ST. FRANCIS OF SYLVANIA OHIO'S CONGREGATION IN ACCORDANCE WITH IRS REVENUE RULING 77-290. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE CORPORATION SHALL CONSIST OF ONE (1) CLASS AND THE ONLY MEMBER OF THE CORPORATION SHALL BE ST. JOSEPH SERVICES CORPORATION, D/B/A ST. JOSEPH HEALTH SYSTEM, A TEXAS NONPROFIT CORPORATION (HEREINAFTER REFERRED TO AS "ST. JOSEPH HEALTH SYSTEM" OR "SJHS" OR THE "MEMBER"). FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERSHIP OF ST. JOSEPH HEALTH SYSTEM SHALL CONSIST OF (1) CLASS AND THE MEMBER OF ST. JOSEPH HEALTH SYSTEM IS SYLVINIA FRANCISCAN HEALTH. FORM 990, PART VI, SECTION A, LINE 7B ACTION BY THE MEMBER SHALL BE REQUIRED, AND SHALL BE SUFFICIENT: A) TO ADOPT OR CHANGE THE PHILOSOPHY, OBJECTIVES, PURPOSES OR ETHICAL OR RELIGIOUS STANDARDS OF ST. JOSEPH HEALTH SYSTEM AND OF ORGANIZATION CONTROLLED BY ST. JOSEPH HEALTH SYSTEM; B) TO ELECT THE TRUSTEES OF ST. JOSEPH HEALTH SYSTEM AND TO REMOVE THEM AT WILL, WITH OR WITHOUT CAUSE AS PROVIDED IN ARTICLE III OF THE BYLAWS; C) TO ELECT AND REMOVE THE CHAIRPERSON AND THE PRESIDENT OF ST. JOSEPH HEALTH SYSTEM AS PROVIDED IN ARTICLE VII OF THE BYLAWS; D) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE BYLAWS OF ST. JOSEPH HEALTH SYSTEM AS PROVIDED IN ARTICLE XI OF THE BYLAWS; E) TO DISSOLVE OR TERMINATE THE EXISTENCE OF ST. JOSEPH HEALTH SYSTEM AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH DISSOLUTION OR TERMINATION IN ACCORDANCE WITH THE ARTICLES OF INCORPORATION; F) THE APPROVAL OF ANY MERGER OR CONSOLIDATION OF ST. JOSEPH HEALTH SYSTEM AND ANY SALE OF SUBSTANTIALLY ALL OF ITS ASSETS; G) THE AUTHORIZATION FOR THE CREATION OF ANY SUBSIDIARY ORGANIZATION OR THE AFFILIATION OF ST. JOSEPH HEALTH SYSTEM WITH ANY OTHER ENTITY FOR THE PURPOSE OF THE JOINT CONDUCT OF BUSINESS OR OTHER PROGRAMS, WHETHER IN THE FORM OF PARTICIPATION IN A CORPORATION, PARTNERSHIP, JOINT VENTURE, CO-TENANCY OR ANY OTHER FORM OF OWNERSHIP OR CONTROL; H) THE APPROVAL OF THE CONVEYANCE OF REAL PROPERTY OR THE GRANTING OF MORTGAGES OR TRUST DEEDS OR THE CREATION OF OTHER LIENS UPON ANY REAL PROPERTY OWNED BY ST. JOSEPH HEALTH SYSTEM; AND I) TO TAKE ANY ACTION NECESSARY TO CONFORM THE PURPOSES AND ACTIVITIES OF ST. JOSEPH HEALTH SYSTEM AND OF ORGANIZATIONS CONTROLLED BY ST. JOSEPH HEALTH SYSTEM WITH THE TRADTIONS, TEACHINGS AND CANON LAW OF THE ROMANY CATHOLIC CHURCH AS THEY MAY BE IN EFFECT FROM TIME TO TIME, AND WITH APPLICABLE LAW AND POLICY OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND ACCOMPANYING SCHEDULES WERE MADE AVAILABLE TO ALL TRUSTEES EITHER ELECTRONICALLY OR BY HARD COPY, DEPENDING UPON THE TRUSTEES PREFERENCE, BEFORE THE COMPANY FINALIZED AND SENT THE DOCUMENTS TO THE IRS. THIS DRAFT WAS ALSO AVAILABLE AT THE ADMINISTRATIVE OFFICES OF THE REPORTING ENTITY FOR TRUSTEES'S REVIEW BEFORE THE FINAL FORM 990 AND ACCOMPANYING SCHEDULES WERE FINALIZED AND SENT TO THE IRS. THE REVIEW WAS UNDER THE DIRECTION OF THE CFO AND/OR TAX RETURN PREPARERS, PLANTE & MORAN, PLLC, IF REQUESTED BY THE TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C DESCRIPTION OF PERSONS COVERED UNDER THE CONFLICT OF INTEREST POLICY IN ACCORDANCE WITH THE ST JOSEPH HEALTH SYSTEM POLICY NO 38, "CONFLICT OF INTEREST": ANY BOARD MEMBER, TRUSTEE, GOVERANCE COUNCIL MEMBER, BOARD COMMITTEE MEMBER, CORPORATE OFFICER, EXECUTIVE, MEDICAL STAFF MEMBER,LICENSED INDEPENDENT PRACTICTIONER (LIP), DEPARTMENT DIRECTOR, SUPERVISOR, OR OTHER INDIVIDUAL THAT HAS A FINANCIAL INTEREST. DESCRIPTION OF PROCESS TO MONITOR TRANSACTION FOR CONFLICTS OF INTEREST IN ACCORDANCE WITH THE ST JOSEPH HEALTH SYSTEM POLICY NO 38, "CONFLICT OF INTEREST", SECTION 6, DISCLOSURE STATEMENT: "A CONFLICT OF INTEREST SHALL BE RETAINED BY THE CORPORATION IN ITS ADMINISTRATIVE OFFICE. THIS STATEMENT SHALL BE RENEWED AT LEAST ANNUALLY AT THE REQUEST OF THE CORPORATION AND AT ANY TIME THAT A CONFLICT OF INTEREST MAY ARISE." TO HELP ENSURE THAT DISCLOSURE STATEMENTS ARE COMPLETED ANNUALLY BY ALL BOARD OF TRUSTEE MEMBERS, THE CEO'S OFFICE SUMMARIZES ALL CONFLICTS OF INTEREST DISCLOSED BY EACH ENTITY'S TRUSTEES. IN 2012, THE SUMMARY WAS PRESENTED AS AN AGENDA ITEM AT EACH ENTITY'S BOARD OF TRUSTEES MEETINGS HELD. IN APRIL 2012, THE AGENDA ITEM WAS TITLED, "CONFLICT OF INTEREST DISCLOSURE REVIEW" OR SIMILAR DESCRIPTION. THE REVIEW IS PERFORMED BY THE OFFICE OF THE CEO WHERE DISCLOSURE STATEMENTS ARE ALSO FILED FOR TRUSTEES. OTHER DESIGNATED PERSONS DISCLOSURE STATEMENTS ARE FILED IN INDIVIDUAL PERSONNEL FILES IF EMPLOYED BY ST JOSEPH REGIONAL HEALTH CENTER. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON SHALL LEAVE THE MEETING AT WHICH THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, LINES 13 AND 14: WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY: THE WHISTLEBLOWER POLICY AND THE DOCUMENT RETENTION POLICY ARE DOCUMENTED AND APPROVED BY THE PRESIDENT AND CEO OF THE SYSTEM. THE BYLAWS OF ST JOSEPH STATE "THE PRESIDENT/CEO SHALL HAVE ALL AUTHORITY AND RESPONSIBILITY NECESSARY TO OPERATE THE CORPORATION IN ALL ITS ACTIVITIES AND DEPARTMENTS, SUBJECT ONLY TO SUCH POLICIES AS MAY BE ISSUED BY THE BOARD. THE PRESIDENT/CEO SHALL ACT AS A DULY AUTHORIZED REPRESENTATIVE OF THE BOARD AND OF THE CORPORATION IN ALL MATTERS IN WHICH IT HAS NOT DESIGNATED SOME OTHER PERSON TO ACT." THEREFORE, THE PRESIDENT/CEO, BY THE AUTHORITY GRANTED TO HIM IN THE ABOVE PARAGRAPH, APPROVES THE POLICIES. THE TWO POLICIES WERE APPROVED BY THE ST JOSEPH HEALTH SYSTEM BOARD AT THE LAST 2012 BOARD MEETING. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 862,726. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 862,726. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,068,659. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,068,659. ADMINISTRATION PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,289,121. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,289,121. PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 122,562. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 122,562. FORM 990, PART XI, LINE 9: CHANGES IN UNRESTRICTED NET ASSETS 2,707. FORM 990, PART XII, LINE 2C: THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. FORM 990, SCH R, PART II THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION #0928. ST LEONARD LIMITED PARTNERSHIP (MERGED WITH JBR LLC IN 2013) 88 EAST BROAD STREET SUITE 1800 CENTERVILLE OH 45458 311481761 LOW INCOME RENTAL RESIDENTIAL OH N/A ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY 2801 FRANCISCAN DRIVE BRYAN TX 77802 742466914 PHYSICIAN HOSPITAL ORGANIZATION TX N/A C 0 ST LEONARD CENTER 1 INC (DISSOLVED IN 2013) 8100 CLYO ROAD CENTERVILLE OH 45458 311481764 LOW INCOME RENTAL RESIDENTIAL OH N/A C 0 SFH ASSURANCE LTD SUITE 6 GRAND PAVILION COMMERICAL GRAND CAYMAN KY1- CJ 981056892 INSURANCE CJ N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 ST JOSEPH REGIONAL HEALTH CENTER Q 10763417 CASH BURLESON ST JOSEPH HEALTH CENTER Q 358994 CASH ST JOSEPH MANOR Q 226144 CASH MADISON ST JOSEPH HEALTH CENTER Q 530963 CASH BURLESON ST JOSEPH MANOR Q 120128 CASH ST JOSEPH PHYSICIAN ASSOCIATES Q 740823 CASH SYLVANIA FRANCISCAN HEALTH K 2750909 CASH