2013-05-14T14:02:00-05:00 2012-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2011-07-01 742505427 Carondelet Long-Term Care Facilities Inc CARO 8169424400 1000 Carondelet Drive Kansas City MO 641144673 Steve Cleary 8169424400 2013-05-14 1 Rebecca Lyons P01487105 5137847100 2013-05-06 2011 2016-02-24 21:20:13Z Steve Cleary 1000 Carondelet Drive Kansas City MO 641144673 28677875 0 0928 X N/A X 1988 MO Provides nursing home and assisted living facilities to in-patients. 6 3 515 3 0 0 15660 17829 28724090 28365851 9418 5550 254828 288645 29003996 28677875 0 0 0 0 20648755 20117023 0 0 0 10227593 9721817 30876348 29838840 -1872352 -1160965 6200673 5144240 9694019 9798551 -3493346 -4654311 X Carondelet Health consists of Catholic organizations dedicated to the healing ministry of Jesus Christ. Our mission is to continue the healing ministry of Jesus Christ by providing long-term health care for older persons of all faiths, races and socio-economic backgrounds. 0 0 6486854 9688286 Carondelet Manor is a 162-bed skilled nursing facility with 549 discharges and 43,816 patient days during fiscal year 2012. The sub-acute unit provides more intensive treatment for patients requiring specialty care, rehabilitation or who have nursing care needs related to medically complex diagnoses. Ancillary services include physical and occupational therapy as well as specialized speech-language vital stimulation therapy. Carondelet Manor also offers complete decongestive therapy (CDT) to individuals suffering from a common chronic condition affecting their lymphatic system, known as lymphedema. The Alzheimer/Dementia Care is a separate unit dedicated to the care of individuals with Alzheimer's disease and other forms of dementia. The cherished moments programs are designed to celebrate the life, spirit and memories of the patients. The Long-Term Care unit provides extended care services for patients 24 hours-a-day, 7 days-a-week with a goal to help the patients attain and maintain their optimal level of well-being. 7892928 9762200 St. Mary's Manor is a 132-bed skilled nursing facility with an additional 57 residential living beds. In FY12 there were 565 skilled care discharges and 33,406 skilled patient days with an additional 14,827 residential care days. St. Mary's Manor offers a full range of services including post-hospital or sub-acute, respite, short and long term care, hospice and an aggressive rehab to home program, offering both inpatient and outpatient services. St. Mary's Manor specializes in meeting individual nursing needs which include skilled care, wound care and recuperative care. Specific rehabilitation needs are met with physical, occupational and speech therapy. St. Mary's Manor has a secure care unit for those requiring Alzheimer's or other dementia care. The facility is a Parkinson Accredited Facility offering specialized training for our staff on Parkinson's disease. The residential care area offers one or two bedroom apartments for independent living with services including three meals each day, housekeeping services, laundry, and medication distribution and assistance. 7042156 8915365 Villa Saint Joseph is a 120-bed skilled nursing facility with 251 discharges and 35,283 patient days during fiscal year 2012. The medical plan of care is ordered by the physician and implemented by the nursing staff. Services include physical, speech and occupational therapy as well as a mobile x-ray unit for radiology and EKG services. Because of the importance of spiritual care to the Sisters of St. Joseph of Carondelet, there is a full-time spiritual care staff member who visits residents regularly and schedules scripture and devotional services. The social service department at Villa Saint Joseph is an integral part of the health care team. The social worker's primary responsibility is to assist with the psychosocial needs of all residents, family members and friends. The staff activities director organizes activities for individuals and groups, including social events and special activity groups. Villa Saint Joseph is a place where independent living and family participation are welcomed and encouraged. 2399560 Traditional Charity Care - $58,262Unpaid Medicaid Loss - $1,101,581Community Benefits - $3,825Cash & In-Kind Contributions for Community Benefits - $11,695Community Building Activities - $2,892Other Program Service Expenses - $1,221,305 2399560 23821498 1 1 0 0 0 0 0 0 0 0 0 0 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 1 0 1 35 0 1 515 1 0 0 0 0 0 0 0 0 0 0 0 X 6 3 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Steve Cleary 8169432819 1000 Carondelet Drive Kansas City MO 64114 X Steve Chies 1.00 X X 0 0 0 Fleury Yelvington Sch O 1.00 X X 0 954787 53367 Scott Kashman end 711 1.00 X X 0 326081 36004 Steve Cleary Sch O 1.00 X X 0 311916 59188 Larry Rubin Sch O 1.00 X X 0 234153 56352 Dale Thompson 1.00 X 0 0 0 Kevin Rymanowski 1.00 X 0 0 0 Carla Brogdon Sch O 1.00 X 0 52908 14886 0 1879845 219797 0 0 1 0 Benedictine Health System 1995 E Rum River Drive Cambridge MN 55008 Management Services 945691 LJHRET Ascension SJ LLC 5575 Payspher Circle Chicago IL 60674 Management Services 936244 2 17829 17829 Patient Revenue 623990 28365851 28365851 28365851 5550 5550 Beauty Shop 812900 126967 126967 Medicoach 900000 124626 124626 Dietary Guest Meals 722210 25876 25876 11176 11176 288645 28677875 28365851 0 294195 16797228 13806662 2990566 67174 55179 11995 2066006 1698176 367830 1186615 815428 371187 1449 1449 1206755 142316 1064439 43961 15260 28701 717029 471309 245720 60220 60220 2507183 1943067 564116 65887 14517 51370 15664 6217 9447 3415 2647 768 178290 178290 Medical Supplies 2877195 2877195 NFRA Fee 1058833 1058833 Bad Debt 309577 309577 Purchased Services 287615 184931 102684 388744 241894 146850 29838840 23821498 6017342 0 1368493 1157419 4612440 3779804 64771 62113 154969 144904 6200673 5144240 1665021 1412741 913000 833902 7115998 7551908 9694019 9798551 X -3493346 -4654311 0 0 -3493346 -4654311 6200673 5144240 -1160965 0 X X 0 1 1 X 0 X 4423 16613 7176 15660 17829 61701 27854264 27833350 29597889 28988208 28365851 142639562 27858687 27849963 29605065 29003868 28383680 142701263 0 0 0 142701263 479892 529141 23531 9289 5550 1047403 479892 529141 23531 9289 5550 1047403 260992 242306 264658 259318 288645 1315919 28599571 28621410 29893254 29272475 28677875 145064585 0.98370 0.98020 0.00720 0.01100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 Other Current Liabilities 1212 Self Insurance Liability 91855 Related Affiliates - LTD 7458841 7551908 0 1 0 0 0 0 0 0 0 Fleury Yelvington Sch O 0 482482 0 328758 0 143547 0 40633 0 12734 0 1008154 0 0 Scott Kashman end 711 0 278049 0 0 0 48032 0 22564 0 13440 0 362085 0 0 Steve Cleary Sch O 0 286774 0 0 0 25142 0 45381 0 13807 0 371104 0 0 Larry Rubin Sch O 0 202716 0 0 0 31437 0 39443 0 16909 0 290505 0 0 Supplemental Information Part III Part I, Line 3: Carondelet Long-Term Care Facilities, Inc. relied on a related organization (Carondelet Health) that used one or more of the methods described below to establish the top management official's compensation: - Compensation Committee - Independent Compensation Consultant - Written Employment Contract - Compensation Survey or Study - Approval by the Board/Compensation Committee. Supplemental Information Part III 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. A related organization that paid the salaries of the individuals listed in Schedule J, Part II, contributed to the supplemental nonqualified retirement plan in the amount as noted: - Fleury Yelvington - $114,060 - Steve Cleary - $20,265 - Scott Kashman - $21,584 - Larry Rubin - $24,750. 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 Carondelet Health entity boards. Form 990, Part VI, Section A, line 3 Carondelet Long-Term Care Facilities, Inc. delegated control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to Benedictine Health System. The Benedictine Health System is a 501(c)(3) nonprofit organization. The Benedictine Health System is committed to providing compassionate, quality care with special concern for the underserved and those in need. Form 990, Part VI, Section A, line 6 Carondelet Long-Term Care Facilities, Inc. has a single corporate member, Carondelet Health. Form 990, Part VI, Section A, line 7a Carondelet Long-Term Care Facilities, Inc., has a single corporate member, Carondelet Health, who has the ability to elect members to the governing body of Carondelet Long-Term Care Facilities Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Carondelet Long-Term Care Facilities, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Carondelet Health. 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 meeting 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 top management official the process performed by Carondelet 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 top management official 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 board minutes. Individual was not present when her compensation was decided. In determining compensation of other officers of the organization, the process performed by Carondelet 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 compensations, the other officers of the organization were 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 audit committee minutes. Individuals were not present when their compensation was decided. 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 A: Fleury Yelvington, Larry Rubin, Carla Brogdon and Steve Cleary receive compensation from Carondelet Health, a related organization of Carondelet Long-Term Care Facilities, Inc. The compensation they receive is for their role at Caondelet Health, and not for their role as a Director/Officer of Carondelet Long-Term Care Facilities, Inc. Description of Organization's Audited Financial Statements: Form 990, Part XII, Line 2: The financial statements of Carondelet Long-Term Care Facilities, Inc. fall under the limited scope audit of Carondelet Health. The activity of Carondelet Long-Term Care Facilities, Inc. and other members of the Carondelet Health System are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Carondelet Long-Term Care Facilities, Inc. is completed. Community Benefit Information: Form 990, Part III, Line 4: Carondelet Long-Term Care Fiscal Year 2011 (July 1, 2011 - June 30, 2012) 1) Care of the poor - at cost - $58,262 2) Government sponsored health care - net expense - $1,101,581 Unpaid cost of public indigent care programs (includes Medicaid, SCHIP, other safety net programs: does not include Medicare shortfall) 3) Community Benefit Programs - net expense - $18,412 These community programs include: - Community Benefits - $3,825 - Cash and in-kind Contributions for Community Benefit - $11,695 - Community Building Activities - $2,892 Total quantifiable community benefit as determined in accordance with CHA reporting guidelines - $1,178,255 Total quantifiable community benefit - $1,178,255 Ascension Health PO Box 45998 St Louis MO 63145 311662306 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Carondelet Health 1000 Carondelet Drive Kansas City MO 641144673 431276738 System Parent MO Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Carondelet Health Corp & Affil Emp Health & Dental Care 1000 Carondelet Drive Kansas City MO 641144673 431116849 VEBA MO Section 501(c)(9) N/A Carondelet Health 1 Carondelet Home Care Services Inc 11050 Roe Suite 120 Overland Park MO 66211 431379352 Home Health Care Services MO Section 501(c)(3) Schedule A, Line 3 Carondelet Health 1 St Joseph Medical Center 1000 Carondelet Drive Kansas City MO 641144673 440546292 Health Care MO Section 501(c)(3) Schedule A, Line 3 Carondelet Health 1 St Mary's Medical Center 201 West RD Mize Rd Blue Springs MO 64014 431284526 Health Care MO Section 501(c)(3) Schedule A, Line 3 Carondelet Health 1 St Mary's Medical Center Foundation 1000 Carondelet Drive Kansas City MO 641144673 431918107 Fundraising MO Section 501(c)(3) Schedule A, Line 11c Carondelet Health 1 St Joseph Medical Center Foundation 1000 Carondelet Drive Kansas City MO 641144673 431388461 Fundraising MO Section 501(c)(3) Schedule A, Line 11c Carondelet Health 1 South Kansas City Surgical Center LLC 10730 Nall Suite 100 Overland Park KS 66211 Health Care KS N/A Indian Creek Center Inc 1000 Carondelet Drive Kansas City MO 641144673 480956627 Management MO N/A C Carondelet Management Company Inc 11050 Roe Suite 110 Overland Park MO 66211 431352545 Health Management MO N/A C Carondelet Pharmacy 1000 Carondelet Drive Kansas City MO 641144673 431699329 Pharmacy MO N/A C Carondelet Primary Care Network Inc 1000 Carondelet Drive Kansas City MO 641144673 431596702 Health Care MO N/A C Saint Joseph Ambulatory Surgical Center LLC 1000 Carondelet Drive Kansas City MO 641144673 251905706 Health Care MO N/A C Carondelet Occupational Health Wellness & Edu Serv Inc 1000 Carondelet Drive Kansas City MO 641144673 861144194 Health Care MO N/A C Carondelet Physician Services 1000 Carondelet Drive Kansas City MO 641144673 562661163 Health Care MO N/A C Carondelet Medical Enterprises 1000 Carondelet Drive Kansas City MO 641144673 562661165 Office Admin. Services MO N/A C Carondelet Cardiology Services 1000 Carondelet Drive Kansas City MO 641144673 271322670 Health Care MO N/A C 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 Carondelet Health Corp & Affiliates Emp Health & Dental Care Q 2222103 Cash Carondelet Health J 828868 Cash St Mary's Medical Center J 650868 Cash Carondelet Health P 6500000 Cash Carondelet Health R 4022025 Cash