2013-09-05T17:30:04-05:00 2012-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2011-07-01 651257719 Ascension Health-IS Inc ASCE 3147338000 PO Box 45998 St Louis MO 631455998 Elizabeth Foshage 3147338000 2013-09-05 1 Alicia Janisch P00741382 5137847100 2013-08-27 2011 2016-02-24 21:20:13Z Mark Barner PO Box 45998 St Louis MO 631455998 619343022 0 0928 X www.ascensionhealth.org X 2005 MO Information technology support organization for over 25 multiple location healthcare systems. 3 1 2353 1 107546 -3826 0 0 576633527 612856052 375131 298183 1742 6188787 577010400 619343022 0 100 0 0 183983037 213980385 0 0 0 407961095 399834077 591944132 613814562 -14933732 5528460 87853837 87848757 92437345 82333511 -4583508 5515246 X Ascension Health-IS, Inc. is an information technology support organization for over twenty-five multiple location, multiple corporation healthcare systems organized and operated by its parent, Ascension Health Alliance, to fulfill the mission and purpose defined by the Daughters of Charity of St. Vincent de Paul, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet (CSJ), the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province. 0 0 580081065 100 612757176 Ascension Health-IS, Inc. ("AHIS") was formed to provide information technology ("I.T.") and application support services to the member entities of Ascension Health Alliance. AHIS services are funded by the affiliated entities through the collection of service fees. In return and in addition to providing I.T. and application support services, AHIS provides an array of services including strategic leadership, development of strategies around I.T. investments, consolidation of I.T. contracts, and efficient and cost-effective installation and support for system investments. Ascension Health Alliance, a tax-exempt entity, is the parent of this organization and all member entities are related to the sponsors of Ascension Health Alliance. 580081065 1 0 0 0 0 0 0 0 0 0 1 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 0 0 1 186 0 1 2353 1 1 1 0 0 0 0 0 0 0 0 0 0 X 3 1 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Michael Oligschlaeger 3147338171 PO Box 45998 St Louis MO 63145 X Robert J Henkel Sch O 50.00 X X 0 2228469 64633 Mark Barner Sch O 50.00 X X 0 1032920 22609 Sister Bernice Coreil Sch O 50.00 X 0 0 0 Claudia Allen 50.00 X 617582 0 46733 Timothy Stettheimer 50.00 X 604529 0 38754 Mary Paul 50.00 X 676109 0 44176 Gerald R Lewis 50.00 X 612405 0 30614 Gregory Jones 50.00 X 767127 0 45129 Frank Negro end 809 0.00 X 165755 0 17304 Mark Amey end 809 0.00 X 183782 0 0 3627289 3261389 309952 413 1 1 0 Dell (Sch O) PO Box 67601 Dallas TX 752676021 IT/Support 95700582 Cerner 2800 Rockcreek Parkway Kansas City MO 64117 Software Maintence/Hosting Services 66491879 Siemens Medical Solutions 51 Valley Stream Parkway Malvern PA 19355 IT Consulting Services 19581243 McKession Information Systems PO Box 409521 Atlanta GA 303849521 Software Maintence/Hosting Services 16734752 AT&T 208 South Akard Street Dallas TX 75202 Software Maintence/Hosting Services 14051772 209 Service Fees 900099 612856052 612748506 107546 612856052 298183 298183 Pension Curtailment 900099 5458826 5458826 Restructuring Costs 900099 721291 721291 8670 8670 6188787 619343022 612757176 107546 6478300 100 100 3226454 3226454 95175 95175 175541620 168723887 6817733 7983273 7925266 58007 13846240 13396637 449603 13287623 13172174 115449 13296106 13296106 99560777 94004667 5556110 29535428 29431048 104380 186725819 186688609 37210 738177 653882 84295 2703226 2564504 138722 1328851 1054381 274470 219868 219868 1999701 14109 1985592 42401 42401 Equip. Rent/Maintenance 50559318 50479387 79931 Contracted Services 11056898 6451330 4605568 Taxes 466398 460668 5730 Professional Dues 61177 57595 3582 1539932 1461324 78608 613814562 580081065 33733497 0 21659039 16814883 15916489 19475660 29601117 27371447 5766829 3359273 1071625 2407556 15891427 17878269 3714140 3900942 87853837 87848757 79952267 63153735 12485078 19179776 92437345 82333511 X -4583508 5515246 0 0 -4583508 5515246 87853837 87848757 X 5528460 4570294 X 0 1 1 X 0 X X X 0 0 0 See Part IV 453358926 See Part IV 1 613814459 1 613814459 Schedule A, Part IV, Supplemental Information: Part I, Line 11(i): Name of Supported Organizations: Ascension Health Information Systems is organized and at all times shall be operated exclusively for the benefit of, to perform the functions of, and to carry out the purposes of the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province by and through Ascension Health Ministries. Ascension Health Ministries is the Canonical sponsor which was formed by the founding sponsors and which has been conferred public juridic personality by decree of The Congregation for Institutes of Consecrated Life and Societies of Apostolic Life of the Roman Catholic Church. 1936079 1893827 42252 129443 42954 86489 3701307 1422492 2278815 2407556 Pension and Deferred Compensation Liability 19179776 19179776 1 1 0 0 0 0 0 0 0 Robert J Henkel Sch O 0 973150 0 845151 0 410168 0 37622 0 27011 0 2293102 0 0 Mark Barner Sch O 0 460177 0 405677 0 167066 0 12250 0 10359 0 1055529 0 0 Claudia Allen 341331 0 190579 0 85672 0 30196 0 16537 0 664315 0 0 0 Timothy Stettheimer 332224 0 186777 0 85528 0 17377 0 21377 0 643283 0 0 0 Mary Paul 374333 0 207246 0 94530 0 33791 0 10385 0 720285 0 0 0 Gerald R Lewis 331217 0 185298 0 95890 0 11025 0 19589 0 643019 0 0 0 Gregory Jones 356284 0 305762 0 105081 0 23649 0 21480 0 812256 0 0 0 Frank Negro end 809 0 0 0 0 165755 0 0 0 17304 0 183059 0 0 0 Mark Amey end 809 0 0 0 0 183782 0 0 0 0 0 183782 0 0 0 Supplemental Information Part III Part I, Line 3: Ascension Health, a related organization of Ascension Health-IS, Inc., uses the following to establish the compensation of the organization's top management official: -Compensation Committee -Independent Compensation Consultant -Compensation Survey or Study Supplemental Information Part III Part I, Line 4a: Severance Payments: Frank Negro (end 08/09) - $167,710 Mark Amey (end 08/09) - $183,782 Supplemental Information Part III Part I, lIne 4b: 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. Amounts Paid: Frank Negro - $6,579 Form 990, Part VI, Section A, line 2 Many of the persons listed in Part VII, Section A have a "business relationship" with each other by virtue of employment with Ascension Health-IS, Inc. and its related entities. Form 990, Part VI, Section A, line 4 The organization's governing documents have been changed. The governing documents have been updated for the change in sole corporate member from Ascension Health to Ascension Health Alliance, to establish the sponsorship role of Ascension Health Ministries, and to update registered agent and office address. Form 990, Part VI, Section A, line 6 Ascension Health-IS, Inc. has a single corporate member, Ascension Health Alliance. Form 990, Part VI, Section A, line 7a Ascension Health-IS, Inc. has a single corporate member, Ascension Health Alliance, that has the ability to elect members to the governing body of Ascension Health-IS, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Ascension Health-IS, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, Ascension Health Alliance. The following powers are reserved to Ascension Health Alliance: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. 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. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's top management official, the process performed by Ascension Health, a related entity that paid the top management official, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health Compensation Committee of the Board engaged an independent compensation consultant to advise the Committee with respect to the compensation of the top management official. Then the Ascension Health Compensation Committee reviewed and approved the compensation. In the review of the compensation, the top management official was compared to individuals at other organizations who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. The individual was not present when his compensation was decided. In determining compensation of other officer or key employees of the organization, the process performed by Ascension Health, a related organization of Ascension Health-IS, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health Compensation Committee of the Board engaged an independent compensation consultant to advise the Committee with respect to the executive team members. Then the Ascension Health Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officer or key employees were compared to individuals at other organizations who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. Ascension Health performed all of the above procedures to obtain the rebuttable presumption respecting compensation arrangements (per IRC Section 4958). 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: Officers for Ascension Health-IS, Inc. provide services to Ascension Health Alliance and its related entities. Hours worked are not tracked on an entity by entity basis. Therefore all officers, directors, trustees, and key employees hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees represent aggregate hours worked per week for all entities. Amounts paid for the services of Sister Bernice Coreil are paid directly to her religious province; therefore, her compensation on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees is zero. Form 990, Part VII, Section B, Line 1: Amounts paid to Dell represent amounts paid for services and materials. These amounts cannot be separated. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -29,887. Transfer from Ascension Health 9,000,000. Deferred Pension Cost -4,390,099. Transfer to Ascension Health Alliance -9,720. Total to Form 990, Part XI, Line 5: 4,570,294. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 631455998 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 1 Catholic Healthcare Investment Management Company PO Box 45998 St Louis MO 631455998 273174701 Supporting Organization MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 1 Ascension Health Global Mission 101 South Hanley Suite 450 St Louis MO 63105 651205990 Supporting Organization MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 1 AHA Professional & General Liability Self-Insurance Trust 4600 Edmundson Road St Louis MO 631343806 367046706 Supporting Organization MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 1 CHV II LLC 101 South Hanley Rd Ste 200 Clayton MO 63105 360534243 Investing MO N/A CHV III LLC 101 South Hanley Rd Ste 200 Clayton MO 63105 454486925 Investing MO N/A CHIMCO Alpha Fund 12443 Olive Boulevard Suite 102 Creve Coeur MO 63141 900786464 Investing DE N/A Clinical Holdings Corp 101 South Hanley Rd Ste 200 Clayton MO 63105 453802297 Holding Company MO N/A C Ascension Health Insurance Limited PO Box 1159 Grand Cayman BWI CJ Insurance CJ N/A C Travel Services Corporation PO Box 45998 St Louis MO 631455998 263764978 Travel Services MO N/A C AH Incubations Accelerator Inc 101 South Hanley Rd Ste 450 St Louis MO 63105 455078523 Medical Service MO N/A C TriMedx Inc 5451 Lakeview Parkway South Dr Indianapolis IN 46268 460563336 Medical Equipment IN N/A C TriMedx India Pvt Ltd 5451 Lakeview Parkway South Dr Indianapolis IN 46268 Trust IN N/A T Smart Health Inc 101 South Hanley Rd Ste 200 Clayton MO 63105 454413419 Medical Service MO N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Ascension Health R 57190934 Actual Amount Transferred Ascension Health Alliance R 22589969 Actual Amount Transferred