2013-05-13T12:00:42-05:00 2012-06-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2011-07-01 510217097 SAINT ANTHONY HOSPITAL SAIN 7734844831 2875 West 19th Street Chicago IL 60623 CHARLES R BROBST 2012-09-29 true Geralyn Hurd P00933422 3128997000 2011 2016-02-24 21:20:13Z GUY A MEDAGLIA 2875 West 19th Street Chicago IL 60623 103400514 false 0928 X WWW.SAINTANTHONYHOSPITAL.ORG X 1897 IL SAINT ANTHONY HOSPITAL LIVES OUT THE LOVING MINISTRY OF JESUS CHRIST BY OFFERING HEALTH, HEALING AND HOPE TO THE FAMILIES OF OUR COMMUNITY, REGARDLESS OF A PATIENT'S ABILITY TO PAY. 11 10 1019 125 0 0 283869 3833755 100886739 99252623 46790 29017 259090 285119 101476488 103400514 632468 300000 0 0 55072296 54785591 0 0 0 45895146 45732321 101599910 100817912 -123422 2582602 78244619 81330365 18143593 17038306 60101026 64292059 SAINT ANTHONY HOSPITAL (SAH) LIVES OUT THE LOVING MINISTRY OF JESUS CHRIST BY OFFERING HEALTH, HEALING AND HOPE TO THE FAMILIES OF OUR COMMUNITY, REGARDLESS OF A PATIENT'S ABILITY TO PAY. SAINT ANTHONY HOSPITAL IS A SUBSIDIARY CORPORATION OF SAINT ANTHONY HEALTH MINISTRIES. false false 78169017 142936 99519543 SAINT ANTHONY HOSPITAL (SAH) PROVIDES MEDICAL CARE, SOCIAL SERVICES, AND COMMUNITY OUTREACH TO CHICAGO'S WEST AND SOUTHSIDE COMMUNITIES. SAH ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, WHETHER THEY CANNOT AFFORD HEALTH CARE OR ARE UNINSURED OR UNDERINSURED. SAINT ANTHONY PROVIDES OVER $13.8 MILLION IN NET COMMUNITY BENEFIT EXPENSE. FOUNDED IN 1897, SAINT ANTHONY HOSPITAL IS A 151-BED, FAITH BASED, NON-PROFIT COMMUNITY TEACHING HOSPITAL DEDICATED TO SERVING THE HEALTH NEEDS OF CHICAGO'S NEAR SOUTHWEST SIDE. SAINT ANTHONY HOSPITAL EMPLOYS APPROXIMATELY 1,000 PEOPLE IN 700 FULL-TIME EQUIVALENT POSITIONS, IN ADDITION TO A LARGE NUMBER OF DOCTORS. EVEN THE LEAST COMPENSATED EMPLOYEES EARN THE HIGHEST SUBSIDY FOR THEIR OWN HEALTH INSURANCE. FOR OVER 100 YEARS, SAINT ANTHONY HOSPITAL HAS OFFERED QUALITY AND AFFORDABLE MEDICAL SERVICES IN A CARING AND SUPPORTIVE ENVIRONMENT. OUR OPERATING ROOMS, EMERGENCY DEPARTMENT AND IMAGING CENTER OFFER MODERN TECHNOLOGY, THAT HELPS US IN PROVIDING OUR PATIENTS THE QUALITY SERVICES THEY NEED IN OUR COMMUNITIES. SAINT ANTHONY HOSPITAL USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS WHO ARE POOR AND COMMUNITY BENEFIT PROGRAMS: -TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. -UNPAID COST OF PUBLIC PROGRAMS REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR THE POOR. -COST OF OTHER PROGRAMS FOR THE POOR INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE POOR AND VULNERABLE OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. -COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE POOR, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. 216118 157064 COMMUNITY WELLNESS MEETS THE NEEDS OF THE COMMUNITY THROUGH A COMPREHENSIVE SET OF SERVICES IN FOUR TARGET AREAS. AT ITS CORE, THE PROGRAM PROMOTES HEALTHIER PRENATAL OUTCOMES, SOUND DEVELOPMENTAL OUTCOMES FOR YOUNG CHILDREN, POSITIVE FAMILY FUNCTIONING AND, OVERALL, HEALTHIER COMMUNITIES. THE FOUR INITIATIVES OF THE COMMUNITY WELLNESS PROGRAM INCLUDE: (1) HEALTHY BEGINNINGS, A NEWLY RENAMED AND EXPANDED INITIATIVE THAT INCLUDES PRENATAL CLASSES, POST-PARTUM AND EARLY CHILDHOOD SUPPORTS (INCLUDING A NEW MOMS CLUB), PARENTING EDUCATION, DEVELOPMENTAL SCREENINGS, REFERRALS, AND FOLLOW-UP CASE MANAGEMENT. (2) SCHOOL WELLNESS, A RESPONSE TO THE INCREASING CONCERN ABOUT CHILDHOOD OBESITY AND INTEREST IN IMPROVING SCHOOLS' HEALTH AND WELLNESS PRACTICES. IT IS AN OUTGROWTH OF THE POPULAR MISSION NUTRITION HEALTH EDUCATION CURRICULUM THAT SAINT ANTHONY HOSPITAL STAFF MEMBERS HAVE ALREADY BEEN IMPLEMENTING IN COMMUNITY SCHOOLS. IN ADDITION TO THE VARIETY OF HEALTH AND WELLNESS EDUCATIONAL SERVICES AVAILABLE TO STUDENTS AND THEIR FAMILIES, THE PROGRAM SUPPORTS SCHOOLS IN IDENTIFYING AND IMPLEMENTING SYSTEMIC CHANGES RELATED TO HEALTH AND WELLNESS. (3) PUBLIC BENEFITS AND REFERRAL SERVICE, WHICH PROVIDES INFORMATION AND ASSISTANCE IN ACCESSING CRITICAL PUBLIC HEALTH BENEFITS AND SAFETY-NET RESOURCES, PARTICULARLY TO SPANISH-SPEAKING PATIENTS. INDIVIDUALS CAN LEARN ABOUT THE BENEFITS THEY'RE ENTITLED TO, INCLUDING THE ALL-KIDS (PUBLIC HEALTH INSURANCE) PROGRAM, MEDICAID, WIC, AND THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP). (4) MENTAL HEALTH SERVICES, WHICH ADDRESSES THE GROWING NEED FOR NO-CHARGE BILINGUAL COUNSELING FOR A RANGE OF ADULT MENTAL HEALTH ISSUES, INCLUDING DEPRESSION, ANXIETY. 78385135 true true false true false false false false true true false true false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false true true true false false false true 171 0 true 1019 true false false false false false false false false false false X 11 10 false false false false true true true true true false false true true true true true true true true true X CHARLES R BROBST 7734844831 2875 WEST 19TH STREET CHICAGO IL 60623 X BERNARD FORD 1.00 X X 0 0 0 DORVAL CARTER JR 1.00 X X 0 0 0 GUY A MEDAGLIA 40.00 X X 548209 0 6957 PETER V FAZIO JR 1.00 X X 0 0 0 SISTER JOAN MCGLINCHEY 1.00 X X 0 0 0 LEONARD E WIATR 1.00 X 0 0 0 MARY CAHILLANE 1.00 X 0 0 0 MOHAMED DAHODWALA 1.00 X 0 0 0 MOHAMMAD CHAUDHARY MD 1.00 X 0 0 0 TYLA COURTNEY 1.00 X 0 0 0 WAYNE DETMER MD 1.00 X 0 0 0 CHARLES R BROBST 40.00 X 272301 0 13913 JILL M STEMMERMAN 40.00 X 174607 0 20455 ASMA QUNAYATH KHATOON 40.00 X 285880 0 5683 JOSE DEURRUTIA 40.00 X 230279 0 2471 KALEEM MALIK 40.00 X 337270 0 6349 ROMEEN LAVANI 40.00 X 253963 0 13296 STEPHEN L CO 40.00 X 219291 0 9605 2321800 0 78729 54 false true false MCKESSON TECHNOLOGIES PO BOX CHICAGO IL 60693 SOFTWARE SERVICES 3550514 METRO ANESTH CONSULTANTS 2720 S RIVER RD SUITE 218 DES PLAINES IL 60018 ANESTHESIOLOGY SERVICES 905327 ME COMPUTER 1955 W DOWNER PL AURORA IL 60506 SOFTWARE SERVICES 625000 FRESENIUS MEDICAL CARE 4013 PAYSHERE CIRCLE CHICAGO IL 60674 DIALYSIS SERVICES 340014 CATHOLIC HEALTH AUDIT NETWORK 231 S BEMISTON 300 CLAYTON MO 63105 INTERNAL AUDIT SERVICES 222627 8 333755 3500000 3833755 NET PATIENT REVENUE 96586204 96586204 MEDICAL STUDENT PROGRAM 707734 707734 CAFETERIA 524211 524211 FAMILY HEALTH NETWORK 265536 265536 1168938 1168938 0 0 99252623 29017 29017 0 0 266920 266920 0 266920 266920 0 0 0 0 0 0 PARKING REVENUE 18199 18199 0 0 0 0 18199 103400514 99519543 0 47216 300000 300000 0 0 0 1983249 1983249 0 42331752 35939567 6392185 1362327 1048992 313335 5864833 4985108 879725 3243430 2831466 411964 1246050 1246050 245271 245271 80908 80908 106820 106820 0 0 4286318 2569063 1717255 351912 351912 424609 424609 0 0 701736 382574 319162 0 0 0 409 409 0 1632255 889876 742379 1554543 847509 707034 BAD DEBT 7246653 7246653 PROVIDER TAX 6197388 6197388 PURCHASED SERVICE 9572868 7140635 2432233 MEDICAL AND PATIENT SUPPLIES 10432543 6848565 3583978 1652038 699007 953031 0 100817912 78385135 22432777 0 0 8657813 12155121 25140038 2557883 14484165 11964924 20034 1047378 1665794 568773 715141 56235038 35104273 17470765 21130765 0 0 10357197 29524273 498456 1616464 78244619 81330365 7280419 5923481 192550 174872 10670624 10939953 18143593 17038306 X 53392299 59093444 4767699 3257587 1941028 1941028 60101026 64292059 78244619 81330365 X 2582602 1608431 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 100000 false true 6820 106820 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 BRUCE SIMON CONSULTING REPRESENTS SAINT ANTHONY HOSPITAL AND OTHER SAFETY NET HOSPITALS BY EDUCATING ELECTED OFFICIALS ON THE IMPACT OF LEGISLATION. A PORTION OF THE ORGANIZATION'S DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION MAY BE ATTRIBUTED TO LOBBYING. THIS AMOUNT IS REPORTED ON LINE 1I. 1941028 1941028 1941028 5407 0 5407 0 1941028 2007638 0 2294 0 68904 0 1941028 2007638 0 73573 0 73573 0 2007638 1.00000 false true true 965899 965899 23935471 16269000 7666471 1879992 1879992 28747139 18835273 9911866 706537 706537 21130765 INVESTMENT IN NET ASSETS OF FOUNDATION 29480566 F INVESTMENT IN AFFILIATE 43707 F 29524273 0 SELF INSURANCE RESERVES 8078547 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS, NET 2049351 ASSET RETIREMENT OBLIGATION 180331 DIVERSIFIED 401A MATCH 352828 WORKERS COMP SELF INSURANCE 278896 10939953 Intended uses of endowment funds Schedule D, Part V, Line 4 THE INCOME FROM THE ENDOWMENT IS USED FOR GENERAL OPERATIONS TO SUPPORT SAINT ANTHONY HOSPITAL. THE ENDOWMENT IS HELD BY SAINT ANTHONY HOSPITAL FOUNDATION, A RELATED TAX-EXEMPT ORGANIZATION. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. UBIT IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. FORMS 990 FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 FILED BY THE HOSPITAL ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS 2009 AND PRIOR. true true X true X true X true true true false true true 7587000 0 7587000 0.08110 0 0 0 0.00000 0 0 0 0.00000 0 0 7587000 0 7587000 0.08110 1057303 0 1057303 0.01130 2293562 780995 1512567 0.01620 6157260 2911065 3246195 0.03470 0 0 0 0.00000 398316 0 398316 0.00430 0 0 9906441 3692060 6214381 0.06650 0 0 17493441 3692060 13801381 0.14760 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 7246654 2391396 18920664 18965443 -44779 X true true SAINT ANTHONY PHO LLC PHYSICIAN-HOSPITAL ORGANIZATION 0.5 0 0 7 1 SAINT ANTHONY HOSPITAL

2875 WEST 19TH STREET CHICAGO IL 60623

X X X X 2 SAINT ANTHONY HOSPITAL PHYSICIAN CENTER

2875 W 19TH ST CHICAGO IL 60623

OUTPATIENT CLINIC 3 BRIGHTON PARK CLINIC

4177 S ARCHER AVE CHICAGO IL 60632

OUTPATIENT CLINIC 4 ROOSEVELT RD CLINIC

3600 W ROOSEVELT RD CHICAGO IL 60624

OUTPATIENT CLINIC 5 KEDZIE AVE CLINIC

4455 S KEDZIE CHICAGO IL 60632

OUTPATIENT CLINIC 6 59TH ST CLINIC

3124 W 59TH ST CHICAGO IL 60629

OUTPATIENT CLINIC 7 BERWYN CLINIC

6917 CERMAK RD SUITE B BERWYN IL 60402

OUTPATIENT CLINIC SAINT ANTHONY HOSPITAL 1 false true true 200 true 400 true X true true X X X X true X false true X false false SAINT ANTHONY HOSPITAL PHYSICIAN CENTER 2 false false false false true X false false true X false true X false false BRIGHTON PARK CLINIC 3 false false false false true X false false true X false true X false false ROOSEVELT RD CLINIC 4 false false false false true X false false true X false true X false false KEDZIE AVE CLINIC 5 false false false false true X false false true X false true X false false 59TH ST CLINIC 6 false false false false true X false false true X false true X false false BERWYN CLINIC 7 false false false false true X false false true X false true X false false Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 7,246,653 Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 PATIENT RECEIVABLES DUE DIRECTLY FROM PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS ESTIMATED ALLOWANCES FOR DOUBTFUL ACCOUNTS AND CHARITY. MANAGEMENT ESTIMATED THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE AGING OF ITS ACCOUNTS RECEIVABLE AND ITS HISTORICAL COLLECTION EXPERIENCE FOR EACH PAYOR TYPE. MANAGEMENT ESTIMATES THE ALLOWANCE FOR CHARITY BASED ON THE HOSPITAL'S CHARITY CARE POLICY AND HISTORICAL CHARITY CARE EXPERIENCE. RECOVERIES OF ACCOUNTS RECEIVABLE PREVIOUSLY WRITTEN OFF AS UNCOLLECTED ARE RECORDED AS A REDUCTION OF THE PROVISION FOR BAD DEBTS WHEN RECEIVED. THE PAST DUE STATUS OF RECEIVABLES IS DETERMINED ON A CASE-BY-CASE BASIS DEPENDING ON THE PAYOR RESPONSIBLE. EXPLANATION OF COLLECTION EFFORTS SCHEDULE H, PART V, SECTION B, LINE 15 BEFORE ANY COLLECTIONS EFFORTS ARE INITIATED, THE HOSPITAL PERFORMS REASONABLE EFFORTS BY SENDING TWO STATEMENTS AND TWO LETTERS. THE STATEMENTS AND LETTERS INDICATE THE OPTION TO APPLY FOR FINANCIAL ASSISTANCE, IF NEEDED. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 SIGNS ARE POSTED IN WAITING AREAS OF THE HOSPITAL AS WELL AS ON THE HOSPITAL'S WEBSITE ANNOUNCING THE AVAILABILITY OF CHARITY CARE. HOSPITAL PATIENT ACCESS STAFF ASSISTS UNINSURED OR UNDER-INSURED PATIENTS IN APPLYING FOR ANY GOVERNMENT ASSISTANCE PROGRAMS THEY MAY QUALIFY FOR AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM. HOSPITAL BILLS TO PATIENTS ALSO HAVE INFORMATION ON APPLYING FOR FINANCIAL ASSISTANCE. Community information. Schedule H, Part VI, Line 4 SAINT ANTHONY HOSPITAL IS A 151 BED HEALTH CARE FACILITY LOCATED ON THE BORDER OF THE NORTH LAWNDALE AND SOUTH LAWNDALE COMMUNITIES ON CHICAGO'S WEST AND NEAR SOUTHWEST SIDE. THE AREA INCLUDES THE NORTH LAWNDALE, LITTLE VILLAGE, SOUTH LAWNDALE, PILSEN, BRIGHTON PARK, MCKINLEY PARK AND BACK OF THE YARDS NEIGHBORHOODS. SAINT ANTHONY IS IN A MEDICALLY UNDER-SERVED AREA, A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA, A MENTAL HEALTH PROFESSIONAL SHORTAGE AREA, AND A DENTAL CARE HEALTH PROFESSIONAL SHORTAGE AREA AS CLASSIFIED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE SURROUNDING AREA HAS AROUND 410,000 RESIDENTS OF WHICH MORE THAN 50% ARE LATINO AND MORE THAN 30% ARE AFRICAN AMERICAN. Promotion of community health Schedule H, Part VI, Line 5 SAINT ANTHONY HOSPITAL IS A 151 BED INDEPENDENT, FAITH BASED, NON-PROFIT, ACUTE CARE COMMUNITY HOSPITAL FOUNDED IN 1897. THE HOSPITAL PROVIDES A WIDE RANGE OF SERVICES AND COMMUNITY BENEFIT PROGRAMS TO ITS UNDER-SERVED COMMUNITY. SAINT ANTHONY BELIEVES IN TAKING A HOLISTIC APPROACH TO THE CARE OF OUR COMMUNITY. THEREFORE WE STRENGTHEN THE COMMUNITY NOT ONLY THROUGH HEALTH CARE BUT ALSO FOCUSING ON BUILDING AND SUPPORTING HEALTHY COMMUNITIES THROUGH THE POWER OF ADVOCACY AND ECONOMIC AND WORKFORCE DEVELOPMENT. WE PARTICIPATE ACTIVELY WITH A VARIETY OF COMMUNITY ORGANIZATIONS, INCLUDING THE ILLINOIS MATERNAL/CHILD HEALTH COALITION, THE RAUNER FAMILY YMCA, CENTRAL STATES SER, THE MARCH OF DIMES, THE CHICAGO ASTHMA CONSORTIUM, THE NATIONAL MUSEUM OF MEXICAN ARTS, LOCAL COMMUNITY CHURCHES, ENLACE AND THE RESURRECTION PROJECT. true CENTRO DE SALUD Y ESPERANZA 2001 S CALIFORNIA CHICAGO IL 60625 320115907 501(C)(3) 300000 N/A N/A GENERAL OPERATIONS 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THE ORGANIZATION WAS INVOLVED IN THE ORIGINAL CREATION OF ESPERANZA, A COMMUNITY HEALTH CENTER CLINIC LOCATED NEAR THE HOSPITAL, AND ANNUALLY PROVIDES FUNDS FOR GENERAL OPERATIONS. THE CEO APPROVES THE GRANT PAYMENT AND THE FINANCIAL DEPARTMENT ENSURES THE PAYMENT IS USED BY ESPERANZA FOR ITS INTENDED PURPOSES. X X X X false false false false false false false true false ROMEEN LAVANI 253963 0 0 0 0 0 10101 0 3195 0 267259 0 0 0 GUY A MEDAGLIA 442250 0 0 0 105959 0 318 0 6639 0 555166 0 0 0 STEPHEN L CO 219291 0 0 0 0 0 9475 0 130 0 228896 0 0 0 ASMA QUNAYATH KHATOON 285880 0 0 0 0 0 0 0 5683 0 291563 0 0 0 JILL M STEMMERMAN 174607 0 0 0 0 0 8361 0 12094 0 195062 0 0 0 CHARLES R BROBST 272301 0 0 0 0 0 11025 0 2888 0 286214 0 0 0 KALEEM MALIK 337150 0 0 0 120 0 6219 0 130 0 343619 0 0 0 JOSE DEURRUTIA 230279 0 0 0 0 0 0 0 2471 0 232750 0 0 0 Non-fixed payments Schedule J, Part I, Line 7 ALTHOUGH THE BONUS PROGRAM PROVIDED TO SELECT INDIVIDUALS DOES NOT FIT WITHIN LINES 5 OR 6 ON SCHEDULE J, A DETAIL OF THE PROGRAM IS PROVIDED HERE. THE EXECUTIVE INCENTIVE PROGRAM INCLUDED GOALS RELATED TO FINANCIAL PERFORMANCE, QUALITY, PHYSICIAN RELATIONS. THESE ARE ALSO TEAM GOALS AND THESE GOALS ACCOUNTED FOR 60% OF ANY POTENTIAL INCENTIVE. THE FINANCIAL PERFORMANCE GOAL OF ACHIEVING THE HOSPITAL'S QUALITY OF EARNINGS ADJUSTED OPERATING MARGIN WAS THE TRIGGER FOR THE ENTIRE PROGRAM. NO INCENTIVES WOULD BE EARNED IF THE OPERATING MARGIN GOAL WAS NOT ACHIEVED. 30% OF THE INCENTIVE PROGRAM WAS BASED UPON ACHIEVING INDIVIDUAL GOALS AND THE REMAINING 10% WAS AT THE DISCRETION OF THE CEO. THE MAXIMUM INCENTIVE FOR THE CFO WAS 25% OF BASE SALARY AND THE MAXIMUM INCENTIVE FOR ALL OTHER VICE PRESIDENTS WAS 20% OF BASE SALARY. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, SAINT ANTHONY HEALTH MINISTRIES (FORMERLY KNOWN AS CATHOLIC HEALTH PARTNERS) IS THE SOLE MEMBER OF SAINT ANTHONY HOSPITAL WITH CERTAIN RESERVED POWERS. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a AS THE SOLE CORPORATE MEMBER OF SAINT ANTHONY HOSPITAL, SAINT ANTHONY HEALTH MINISTRIES HAS THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE GOVERNING BODY. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b AS THE SOLE CORPORATE MEMBER OF SAINT ANTHONY HOSPITAL, SAINT ANTHONY HEALTH MINISTRIES HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS MADE BY THE GOVERNING BODY. SUCH RIGHTS INCLUDE: 1) APPROVING THE MISSION AND VISION STATEMENTS OF THE ORGANIZATION; 2) APPROVING CHANGES TO THE GOVERNING DOCUMENTS; 3) APPOINTMENT OR REMOVAL OF MEMBERS OF THE GOVERNING BOARD; 4) APPROVING OR RECOMMENDING THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS, DIVESTITURES, DISSOLUTIONS, CLOSURES, MERGERS, CONSOLIDATIONS OR CHANGES IN CORPORATE MEMBERSHIP; 5) APPROVING THE OPERATING BUDGET AND CAPITAL PLAN; 6) APPROVING THE TRANSFER OR ENCUMBRANCE OF THE ASSETS; 7) APPROVING THE INCURRENCE OF DEBT OF THE ORGANIZATION. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b A THOROUGH REVIEW OF THE FORM 990 IS PERFORMED BY MANAGEMENT. A PRESENTATION IS MADE BY THE PAID TAX PREPARERS AND A COPY OF THE RETURN IS SHARED WITH THE BOARD OF DIRECTORS PRIOR TO FILING THE FORM 990 WITH THE IRS. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ANNUALLY THE CORPORATE RESPONSIBILITY OFFICER HAS THE BOARD, AS WELL AS OFFICERS AND VICE PRESIDENTS, REVIEW, FILL OUT AND SIGN THE CONFLICT OF INTEREST QUESTIONNAIRE. IF A CONFLICT OF INTEREST ARISES, THE AFFECTED BOARD MEMBER (OR OFFICER) ABSTAINS FROM VOTING ON THE RESPECTIVE ISSUE. THE CORPORATE RESPONSIBILITY OFFICER MAINTAINS ALL SIGNED CONFLICT OF INTEREST STATEMENTS ON FILE. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a ALL ANNUAL SALARY INCREASES FOR THE CEO AND VICE PRESIDENTS ARE REVIEWED AND APPROVED BY THE BOARD AND DOCUMENTED IN MINUTES PREPARED FOR EACH MEETING. ALSO AN INDEPENDENT MARKET SURVEY WAS CONDUCTED IN FY12 TO ENSURE THAT THE SALARIES OF VICE PRESIDENTS AND ABOVE WERE WITHIN MARKET. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b ALL ANNUAL SALARY INCREASES FOR VICE PRESIDENTS AND ABOVE ARE REVIEWED AND APPROVED BY THE BOARD AND DOCUMENTED IN MINUTES PREPARED FOR EACH MEETING. ALSO AN INDEPENDENT MARKET SURVEY WAS CONDUCTED IN FY12 TO ENSURE THAT THE SALARIES OF VICE PRESIDENTS AND ABOVE WERE WITHIN MARKET. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES FORM 990, PART VII, SECTION B, LINE 1, COLUMN (B) SELECT BOARD MEMBERS AND OFFICERS REPORTED ON PART VII DEVOTE APPROXIMATELY 1-5HRS A WEEK TO VARIOUS RELATED ORGANIZATIONS REPORTED ON SCHEDULE R. Other changes in net assets or fund balances Form 990, Part XI, Line 5 PRIOR PERIOD ADJUSTMENTS - -143016; CHANGE IN INTEREST IN THE FOUNDATION'S NET ASSETS - -875000; INCOME FROM SAINT ANTHONY AFFILIATES INCLUDED IN NET ASSETS OF THE HOSPITAL - 2626447; SAINT ANTHONY EMERGENCY SERVICES PHYS 2875 WEST 19TH STREET CHICAGO IL 60623 300261806 HEALTHCARE IL 13262895 256408 NA SAINT ANTHONY HEALTH AFFILIATES 2875 WEST 19TH STREET CHICAGO IL 60623 364340137 HEALTH CARE IL 501(C)(3) 9 NA true SAINT ANTHONY HOSPITAL FOUNDATION 2875 WEST 19TH STREET CHICAGO IL 60623 237448580 FUNDRAISING IL 501(C)(3) 7 NA false SAINT ANTHONY HEALTH MINISTRIES 2875 WEST 19TH STREET CHICAGO IL 60623 363903595 MANAGEMENT IL 501(C)(3) 11 - Type III - FI NA false false true true false false false false false false false false false true true false true true false