2014-05-09T15:06:59-05:00 2013-06-30 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 606064301 990 2012-07-01 431470362 Alexian Brothers Lansdowne Village ALEX 3143516888 4624 Lansdowne St Louis MO 63116 Pierre Smith 3143516888 2014-05-09 1 Laura Gillespie P00855604 3124861000 2012 2015-11-30 17:44:51Z Pierre Smith 4624 Lansdowne St Louis MO 63116 11967070 0 0928 X www.alexianbrothershealth.org X 1987 MO Skilled nursing facility 7 4 212 26 0 0 4759 5966 5765765 11358322 381263 580738 10247 22044 6162034 11967070 0 0 0 0 2735429 4811195 0 0 0 2838329 6712369 5573758 11523564 588276 443506 18104257 19013571 781759 875200 17322498 18138371 Alexian Brothers Lansdowne Village ("ABLV") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health and housing needs of those we are called to serve. 0 0 9520602 11358322 Skilled Nursing Facility - Inspired by the healing mission of the Alexian Brothers to the elderly, ABLV provides a continuum of care to residents that maximizes dignity and independence. Rooted in the Catholic tradition of caring, the staff is committed to promoting the well-being of those we serve through the delivery of quality care. The facility has 145 beds with an average capacity of 133.7 in 2013, 20,780 days of care were provided to Medicaid recipients, 7,489 days of care were provided to Medicare recipients. The cost of charity care provided was $132,213, and community benefits of $3,171 were provided in 2013. The excess of Medicaid cost over reimbursement was $107,052. 9520602 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 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 32 0 1 212 1 0 0 0 0 0 0 0 0 0 0 0 X 7 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Cindy Winters 3147293500 12250 Weber Hill Road Suite 200 St Louis MO 63127 X Alec Blanc 1.00 0.00 X X 0 0 0 Patricia Yaeger 1.00 0.00 X X 0 0 0 Charles Gulas 1.00 0.00 X X 0 0 0 Pierre Smith 40.00 0.00 X X 0 18268 0 John Turongian 0.00 40.00 X X 0 339442 50851 Barbara Prosser 1.00 0.00 X X 0 0 0 Daniel Stricker 40.00 0.00 X X 0 185641 27219 Mark Frey 0.00 40.00 X 0 1434790 179527 Brother Jeffrey Callander CFA 1.00 0.00 X 0 0 0 Donna Gauthier 0.00 40.00 X 0 71007 15381 Jim Lewandoski 0.00 40.00 X 0 468370 805832 Peggy Randell 40.00 0.00 X 0 107530 10449 0 2625048 1089259 0 0 1 0 TouchPoint Support Services PO Box 102289 Atlanta GA 303682289 Dietary/Environmental Services 1436200 SSM Rehab 2455C McMullen Booth Rd Clearwater FL 33759 Therapy Services 1093302 Interlock Pharmacy 345 Dunn Rd St Louis MO 63031 Pharmaceuticals 642649 United Healthcare Insurance Company 22561 Network Place Chicago IL 60673 Employee Insurance 247940 Midwest Medical Supply PO Box 955588 St Louis MO 631955588 Medical Supplies 179246 7 5966 5966 Medicare & Medicaid 623000 7852235 7852235 Skilled Nursing Svcs 623000 3506087 3506087 11358322 580738 580738 Barber/Beauty 900099 13880 13880 Guest & Employee Meals 722210 6800 6800 Vending Revenue 900099 693 693 671 671 22044 11967070 11358322 0 602782 X 4051487 3747103 304384 58589 54080 4509 408031 373398 34633 293088 270199 22889 528429 528429 133 133 10200 10200 702 702 1520061 1467130 52931 205444 166407 39037 236047 236047 317798 317798 18693 1153 17540 13115 5949 7166 472056 400858 71198 108181 108181 Purchased Serv-Medical 1197364 1174364 23000 0 Medical Supplies 825919 825919 0 0 Taxes-NFRA/Medicaid 604258 604258 0 0 Bad Debt 270000 0 270000 0 383969 111284 272685 11523564 9520602 2002962 0 23096 121384 1176446 1880906 16604 19937 85857 60961 4590978 704710 3948866 3886268 12846081 13034182 7307 9933 18104257 19013571 725565 835543 56194 39657 781759 875200 X 17315462 18131334 7036 7037 0 17322498 18138371 18104257 19013571 443506 372367 0 X 0 1 X 1 0 X 1741 1885 15821 4759 5966 30172 11481545 11526986 10651288 5765765 11358322 50783906 11483286 11528871 10667109 5770524 11364288 50814078 0 0 0 50814078 -450067 195797 373213 381263 580738 1080944 -450067 195797 373213 381263 580738 1080944 10247 10247 11033219 11724668 11040322 6162034 11945026 51905269 0.97900 0.97460 0.02080 0.02490 X Schedule A, Part IV, Supplemental Information: Schedule A, Part IV: For the year ended 6/30/12, the organization filed a short period return due to a change of accounting period. Thus, the amounts in column 2011 of Schedule A reflect the tax year 1/1/2012 6/03/2012 activity. Prior balances have been rolled backward. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 702 702 0 Explanation of Lobbying Activities: Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to Leading Age that is specifically allocable to lobbying. 120000 120000 3810477 607088 3203389 463804 82887 380917 196697 14735 181962 3886268 Beneficial Interest in Alexian Brothers Health System, Inc. Investment Trust 13034182 F 13034182 Outstanding Reserve for Insurance Losses 36286 Due to Affiliates - Alexian Brothers Senior Ministries 3371 39657 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Alexian Brothers Lansdowne Village does not file a separate audit report, but is part of the Alexian Brothers Health System consolidated audit report. There were no uncertain tax positions, and as a result there was no disclosure related to FIN 48 (ASC 740) in the June 30, 2013 audit report. 0 1 0 0 0 0 0 0 0 John Turongian 0 273039 0 55523 0 10880 0 22993 0 27858 0 390293 0 10880 Daniel Stricker 0 144904 0 32081 0 8656 0 6617 0 20602 0 212860 0 0 Mark Frey 0 1110138 0 263024 0 61628 0 137956 0 41571 0 1614317 0 44628 Jim Lewandoski 0 328372 0 88552 0 51446 0 779279 0 26553 0 1274202 0 33988 Part I, Line 3 Alexian Brothers Health System, a related organization of Alexian Brothers Lansdowne Village, uses all of the items in Schedule J, Part I, Line 3 to establish the compensation of the organization's CEO. Supplemental Information Part III 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 2012 was included in income in Schedule J for the following individual: Jim Lewandowski - $19,123 Form 990, Part VI, Section A, line 2 John Turongian, Daniel Stricker, Pierre Smith, Mark Frey, Donna Gauthier and Jim Lewandowski have a business relationship due to joint employment by a common health system entity. Form 990, Part VI, Section A, line 6 Alexian Brothers Lansdowne Village has two classes of members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Senior Ministries ( the "Area 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 Lansdowne Village. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Alexian Brothers Lansdowne Village 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 Member's 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. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee of the Board of Governors of Alexian Brothers Health System reviewed and approved the compensation. In the review of the compensation, the CEO, was compared to individuals at other similarly situated organizations that hold the same or a similar title. During the review and approval of the compensation, the documentation of the decision was recorded in the Compensation 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 who 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 Lansdowne Village are available through the National Reporting Municipal Services Information Repository (NRMSIR). Conflict of Interest statements and the governing documents of Alexian Brothers Lansdowne Village are not made available to the public. Form 990, Part VII, Section A: Officers and certain key employees for Alexian Brothers Lansdowne Village provide services to Alexian Brothers Health System (the National Member) and its subsidiaries. Hours worked are not tracked on an entity by entity basis, and a 40 hour work week is used as a proxy for all individuals listed on Part VII if employed by the filing organization or a related organization (even though more hours may be worked on average). Therefore, all officers, directors, trustees, and key employee hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees represent aggregate hours for worked per week for all entities. Compensation amount for John Turongian represents payments for services rendered to Alexian Brothers Senior Ministries, a related entity and compensation amount for Mark Frey represents payment for services rendered to Alexian Brothers Health System, a related entity. The amounts are not for services as a board member of Alexian Brothers Lansdowne village. Other Fees Form 990, Part IX, line 11g Dietary and Environmental Purchased Services: Program service expenses 1,314,575. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,314,575. Beautician Services: Program service expenses 12,404. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,404. Other fees-for-service: Program service expenses 140,151. Management and general expenses 52,931. Fundraising expenses 0. Total expenses 193,082. Form 990 Part VIII, Line 3 and Schedule D, Part VII: The amount reflected as dividends and interest reflects Alexian Brothers Lansdowne Village's share of interest, dividends and realized gains/losses from Alexian Brothers Lansdowne Village's beneficial share in the Alexian Brothers Health System, Inc. Investment Trust (ABHSIT). ABHSIT is a related entity whose purpose is to pool the investments of the not-for-profit entities in Alexian Brothers Health System and acts as an internal mutual fund. Details of gains and losses are shown on the Form 990 of ABHSIT. Form 990, Part XII, Line 2b - Audit Disclosure: The financial statements of Alexian Brothers Lansdowne Village 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 audits the financial statements. 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 11 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 11 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 11 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 11 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 11 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 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 Alexian Brothers of St Louis Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 430653236 Acute care hospital (sponsorship transferred in 1997) MO Section 501(c)(3) Schedule A,Line11 C Alexian Brothers Health System 1 Alexian Brothers Hospital Network 3040 W Salt Creek Lane Arlington Heights IL 60005 363276552 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11 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 7 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 N/A 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 Workplace Solutions LLC 1100 E Woodfield Road Schaumburg IL 60173 364095007 Provision of EAP services IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages managed care contracts DE N/A 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 N/A C 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 0 0 0 0 0 0 1 0 1 0 Alexian Brothers Health System P 527727 FMV Alexian Brothers Health System R 521604 FMV Alexian Brothers Senior Ministries P 227765 FMV