2013-05-14T17:19:41-05:00 2012-06-30 861065772 Deloitte Tax LLP 250 East Fifth street Suite 1900 Cincinnati OH 45202 990 2011-07-01 621284994 Saint Thomas Network SAIN 6152846826 4220 Harding Road Nashville TN 37205 Craig Polkow 6152846826 2013-05-14 1 Matthew Montgomery P00492843 5137847100 2011 2016-02-24 21:20:13Z Michael Schatzlein 4220 Harding Road Nashville TN 37205 11268521 0 0928 X N/A X 1986 TN To promote and support all programs and activities for the benefit of Saint Thomas Hospital. 16 14 199 15 1055904 -1115494 0 35744 7103846 6892503 4268444 174672 1285580 3113481 12657870 10216400 1123038 1407345 0 0 6063864 5039731 0 0 0 3484135 2814505 10671037 9261581 1986833 954819 83738916 86641186 56591222 61894927 27147694 24746259 X To promote and support all programs and other activities in the interest of and for the exempt purposes of Ascension Health and Saint Thomas Hospital including the provision of lodging for the families of critically ill patients and same-day surgery patients, operating a physician practice, performing research and investing in equity partnerships with other health care organizations. 0 0 2582651 2099838 West End Medical Group is a group of Board Certified Internal Medicine Physicians and Nurse Practitioners dedicated to provide convenient and comprehensive care for our patients. The team of doctors and Nurse Practitioners are highly skilled and trained and have been practicing for more than 30 years collectively. 1552625 1688350 Saint Thomas Research Institute is a community-based clinical research site based in Nashville, Tennessee. Focused on high quality research practices, the Institute works effectively with sponsors, physicians, and patients to improve the health of the community by conducting research. Acting as a partner and system-wide resource, Saint Thomas Research Institute launches studies and enrolls patients quickly, which allows physicians to spend more time with their patients. 1824461 1055904 Saint Thomas Emergency Medical Services (STEMS) is an A-Rated Ambulance and event medicine company providing exceptional patient care, unmatched customer service, and a full spectrum of medical transport services for central Tennessee. 2005350 1407345 2152853 Saint Thomas Network operates Seton Lodge and the Inn at Saint Thomas. Seton Lodge is a 50 room motel on the grounds of Saint Thomas Hospital that provides low cost accommodations for family members residing outside Davidson County whose relatives are in critical care or special care. The Inn at Saint Thomas is a similar 50 room motel providing pre-surgical accommodations for patients traveling to Saint Thomas from long distances.Saint Thomas Network is partnered with other healthcare organizations to further the mission of providing spiritually centered, holistic care that sustains and improves the health of the communities it serves. These partnerships provide an outpatient cardiac catheterization center, an outpatient neurosurgical center and several ambulatory surgery centers in the central Tennessee area. 2005350 1407345 2152853 7965087 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 49 0 1 199 1 1 1 0 0 0 0 0 0 0 0 0 0 X 16 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Craig Polkow 6152846826 4220 Harding Rd Nashville TN 37205 X James Bearden 1.00 X 0 0 0 Clark Baker 1.00 X 0 0 0 Mary Falls Esq 1.00 X 0 0 0 Anthony Heard 1.00 X 0 0 0 William Anderson 1.00 X 0 0 0 William Coltharp MD 1.00 X 0 0 0 Robert Dray MD 1.00 X 0 0 0 Webb Earthman 1.00 X 0 0 0 Robert Hutton MD 1.00 X 0 0 0 Randy Laszewski 1.00 X 0 0 0 Lee Moss 1.00 X 0 0 0 Matt Murfree Esq 1.00 X 0 0 0 Sean Ryan MD 1.00 X 0 0 0 Patrick Shepherd 1.00 X 0 0 0 Sister Dinah White DC 1.00 X 0 0 0 Brian Wilcox MD 1.00 X 0 0 0 Shirley Zeitlin 1.00 X 0 0 0 Alan Strauss 40.00 X X 0 891630 29684 Michael Schatzlein MD 40.00 X X 0 1208662 37438 Wesley Littrell 40.00 X X 0 841124 23349 David Heusinkveld MD 40.00 X 626742 0 17805 Hugh Holliday MD 40.00 X 220888 0 7330 Beverly Turner-Winbush MD 40.00 X 174763 0 7959 Gertrude Stone MD 40.00 X 127659 0 16504 James Houser 0.00 X 0 684615 3101 1150052 3626031 143170 4 1 1 0 Nashville Healthcare Solutions 104 Woodmont Blvd Nashville TN 37024 Billing/Transcription 609508 The Heart Group PLLC 4230 Harding Road Suite 523 Nashville TN 37205 Medical Services 339148 Williams Mailing Service PO Box 292998 Nashville TN 37229 Printing/Mailing Services 200553 Medical Transcription of Middle Tennesse PO Box 1004 Brentwood TN 37024 Transcription 111743 4 35744 35744 Ancillary Revenue 621000 2750010 2750010 Net Patient Revenue 621400 1996334 1996334 Community Medicine 621500 955198 0 955198 Medical Research 621500 669486 669486 Lodging Revenue 624200 521475 521475 6892503 241 241 723035 695362 27673 27673 27673 531190 356759 174431 174431 174431 Net Insurance Proceeds 900099 1415111 1415111 Management Fee 561000 1021678 1021678 Pension Curtailment 900099 510351 510351 138668 37962 100706 3085808 10216400 6996945 1055904 2127807 1407345 1407345 4279427 3423542 855885 77107 61686 15421 346178 276942 69236 337019 269615 67404 4000 4000 1279609 1151648 127961 4837 4837 210369 189332 21037 36492 34667 1825 816114 734503 81611 5140 4626 514 876 788 88 12881 1288 11593 215659 194093 21566 24750 22275 2475 Maintenance and Repair 140046 126041 14005 0 Bad debt 5000 5000 0 0 58732 52859 5873 9261581 7965087 1296494 0 7912025 800 109429 131472 21281 30484 23970457 13626426 10748054 10344031 11416977 12580261 1214949 1214949 52316201 62339189 83738916 86641186 1341427 766362 100727 98813 348645 346137 54800423 60683615 56591222 61894927 X 27147694 24746259 0 0 27147694 24746259 83738916 86641186 X 954819 -3356254 X 0 1 1 X 0 X 19493 214875 278825 35744 548937 10735427 7556600 6332915 3597683 5937305 34159930 10754920 7771475 6611740 3597683 5973049 34708867 0 0 0 34708867 1687843 3021285 2769378 2372572 723276 10574354 1687843 3021285 2769378 2372572 723276 10574354 12442763 10792760 9381118 5970255 6696325 45283221 0.76650 0.76430 0.23350 0.23570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 7320024 7320024 14714135 12047965 2666170 986282 674159 312123 627938 584728 43210 322078 319574 2504 10344031 Investments in Unconsolidated Entities 14879661 C Long-term Investment Sleep Center -2299400 C 12580261 Intercompany Receivables 61678146 Prepaid Pension Asset 136649 Miscellaneous Receivables 524394 62339189 Intercompany Payables 60405904 Pension Liability 116196 Self Insurance Liability 67762 Miscellaneous 93753 60683615 1 Saint Thomas Health Foundations 4220 Harding Rd Nashville TN 37205 581663055 501(c)(3) 1407345 General Support 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: We request that the receiving organization send a report of the efficacy of the project the grant has funded - at a minimum, the number of persons served and some of their demographics, but also any qualitative measures the receiving agency uses to measure success (reading levels improved, jobs successfully obtained after training, etc.). The reports are reviewed by the Mission Integration Team in a broad manner upon receipt, but will be more thoroughly scrutinized if the grant recipient comes back to ask for a renewal or another grant. We are in the process of creating a Community Benefit Council for STHe and the plan is to bring all efficacy reports reviewed and analyzed there. 1 1 0 0 0 0 0 0 0 Alan Strauss 0 516869 0 133999 0 240762 0 4900 0 24784 0 921314 0 0 Michael Schatzlein MD 0 745734 0 339375 0 123553 0 4900 0 32538 0 1246100 0 0 Wesley Littrell 0 520062 0 134488 0 186574 0 0 0 23349 0 864473 0 0 David Heusinkveld MD 613894 0 12684 0 164 0 0 0 17805 0 644547 0 0 0 Hugh Holliday MD 202087 0 1580 0 17221 0 0 0 7330 0 228218 0 0 0 Beverly Turner-Winbush MD 171049 0 3605 0 109 0 0 0 7959 0 182722 0 0 0 James Houser 0 0 0 0 0 684615 0 0 0 3101 0 687716 0 0 Supplemental Information Part III Part I, Line 3: Saint Thomas Health, a related organization of Saint Thomas Network, uses the following to establish the compensation of the organization's CEO: Compensation Committee, Independent Compensation Consultant, Written Employment Contract, Compensation Survey or Study, and Approval by the Board or Compensation Committee Supplemental Information Part III Part I, Line 4a: The following officer received Severance Payments during the year: James Houser - $198,979. 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. Amounts Paid: James Houser - $179,475 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 Saint Thomas Health entity boards. Form 990, Part VI, Section A, line 6 Saint Thomas Network has a single corporate member, Saint Thomas Health. Form 990, Part VI, Section A, line 7a Saint Thomas Network has a single corporate member, Saint Thomas Health, who has the ability to elect members to the governing body of the Saint Thomas Network. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Saint Thomas Network financial information or corporation as a whole are subject to approval by its sole corporate member, Saint Thomas Health. Ascension Health, the sole corporation member of Saint Thomas Health, has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. 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 the compensation of the organization's CEO, the process performed by Saint Thomas Health, a related organization of Saint Thomas Network, 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 CEO was compared to individuals at other health systems 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. The individual was not present when his compensation was decided. In determining the compensation of other officers or key employees of the organization, the process performed by Saint Thomas Health, a related organization of Saint Thomas Network, 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 other officers or key employees of the organization were compared to individuals at other hospitals 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. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Explanation of the Board of Directors Listing: Form 990, Part VII: Saint Thomas Health is the sole corporate member of Saint Thomas Network. As the sole corporate member, Saint Thomas Health retains reserved authority over the certain activity of Saint Thomas Network. Therefore, the Saint Thomas Health Board of Directors is listed on Form 990, Part VII. Explanation of Hours for Officers: Form 990, Part VII, Section A: Officers of Saint Thomas Network provide services to Saint Thomas Health and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore where noted with a "Schedule O" reference, officers hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all entities. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net Asset Transfers to Affiliated Entities -1,960,334. Noncontrolling Interest Activity -45,600. Transfer to Ascension for Pension -1,350,320. Total to Form 990, Part XI, Line 5: -3,356,254. Dispensary of Hope LLC 102 Woodmont Boulevard Suite 700 Nashville TN 37205 208973035 Operates Pharmaceutical Wholesaler/Distributor and Mail Order Pharmacy TN 0 0 Saint Thomas Network Richland Internal Medicine LLC 4220 Harding Road Nashville TN 37205 621868762 Physician Practice TN 0 4879 Saint Thomas Network Saint Thomas Research Institute LLC 4220 Harding Road Nashville TN 37205 208018726 Research TN 1688350 3295386 Saint Thomas Network Saint Thomas NP LLC 4220 Harding Road Nashville TN 37205 261614782 Healthcare TN 0 0 Saint Thomas Network USLIFELINK LLC 618 Church Street Suite 520 Nashville TN 379122457 319441128 Healthcare TN 0 0 Saint Thomas Network Bellvue Medical Group LLC 4220 Harding Road Nashville TN 37205 621868848 Physician Practice TN 6099838 3794562 Saint Thomas Network Saint Thomas Emergency Medical Services LLC 4220 Harding Road Nashville TN 37205 208957092 Ambulance Services TN 1055904 1041930 Saint Thomas Network Premier IPA LLC 4220 Harding Road Nashville TN 37205 Healthcare TN 0 0 Saint Thomas Network Children and Adults Medical Group LLC 4220 Harding Road Nashville TN 37205 621868855 Physician Practice TN 0 0 Saint Thomas Network Saint Thomas Outpatient Cardiac Catheterization Center LLC 4220 Harding Road Nashville TN 37205 321775306 Outpatient Services TN 0 22240 Saint Thomas Network Ascension Health PO Box 45998 St Louis MO 63134 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Saint Thomas Health 4220 Harding Road Nashville TN 37205 581716804 System Parent TN Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Saint Thomas Hospital 4220 Harding Road Nashville TN 37205 620347580 Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Saint Thomas Health Foundations PO Box 380 Nashville TN 37202 581663055 Operates Foundation TN Section 501(c)(3) Schedule A, Line 7 Saint Thomas Network 1 Covenant Care Inc 102 Woodmont Blvd Suite 800 Nashville TN 37205 621695737 Inactive TN Section 501(c)(3) Schedule A, Line 11a Saint Thomas Network 1 Middle Tennessee Medical Center Inc 1700 Medical Center Parkway Murfreesboro TN 37219 620475842 Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Middle Tennessee Medical Center Foundation 1700 Medical Center Parkway Murfreesboro TN 37219 621167917 Foundation TN Section 501(c)(3) Schedule A, Line 11a Middle Tennessee Medical Center Inc 1 Seton Corporation 4220 Harding Road Nashville TN 37205 621869474 Acute Care Hospital TN Section 501(c)(3) Schedule A, Line 3 Saint Thomas Health 1 Baptist Hospital Foundation of Nashville Inc 2000 Church Street Nashville TN 37236 581861378 Inactive TN Section 501(c)(3) Schedule A, Line 11a Seton Corporation 1 Baptist Health Care Affiliates Inc 2000 Church Street Nashville TN 37236 581509251 Community Health Promotion TN Section 501(c)(3) Schedule A, Line 11a Seton Corporation 1 Baptist Health Care Group 2000 Church Street Nashville TN 37236 621529858 Healthcare Provider TN Section 501(c)(3) Schedule A, Line 3 Seton Corporation 1 Baptist Saint Thomas Home Care 2000 Church Street Nashville TN 37236 510172298 Inactive TN Section 501(c)(3) Schedule A, Line 9 Seton Corporation 1 Hickman Community Health Care Services Inc 135 East Swan Street Centerville TN 37033 581737573 Hospital TN Section 501(c)(3) Schedule A, Line 3 Baptist Healthcare Affiliates Inc 1 Hickman Community Home Care Inc 135 East Swan Street Centerville TN 37033 621836937 Home Health Care TN Section 501(c)(3) Schedule A, Line 9 Hickman Community Health Care Services Inc 1 Baptist Womens Health Center LLC 1900 Church Street Suite 300 Nashville TN 37203 621772195 Owns and Operates Specialty Hospital TN N/A Middle Tennessee Ambulatory Surgery Center LP 500 N Highland Ave Murfreesboro TN 37130 Operates Outpatient Surgery Center TN N/A St Thomas Research Institute LLC Cardiology Series 102 Woodmont Blvd Nashville TN 37205 264591782 Cardiology Research TN Saint Thomas Network Related 119945 600176 0 0 0.81000 STHS Sleep Center LLC 102 Woodmont Suite 800 Nashville TN 37219 203664894 Operates a Sleep Center TN Saint Thomas Network Related 887843 653656 0 0 0.72500 Baptist Surgery Center LP 1900 Church Street Suite 300 Nashville TN 37203 Operates Outpatient Surgery Center TN N/A Sova Inc 102 Woodmont Boulevard Suite 700 Nashville TN 37205 261319638 Health Services TN N/A C Vincentian Ventures Inc PO Box 380 Nashville TN 37202 621331896 Health Services TN Saint Thomas Network C -100 1.00000 St Thomas Medical Clinic 4220 Harding Road Nashville TN 37205 621583605 Health Services TN Saint Thomas Network C -33433 1.00000 Baptist Health Care Ventures Inc 2000 Church Street Nashville TN 37236 620469214 Holding Company TN N/A C Middle Tennessee Network Inc 2000 Church Street Nashville TN 37236 621570989 Health Services TN N/A C MissionPoint Health Partners 102 Woodmont Boulevard Suite 700 Nashville TN 37205 452958482 Accountable Care Organization TN N/A C 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 Saint Thomas Health Foundations B 1407345 Actual Amount Paid Baptist Healthcare Affiliates R 5048055 Actual Amount Paid Baptist Healthcare Group Q 1226155 Actual Amount Paid Saint Thomas Hospital Q 11705356 Actual Amount Paid Seton Corporation R 3363563 Actual Amount Paid Saint Thomas Health R 3402744 Actual Amount Paid Middle Tennessee Medical Center Q 253497 Actual Amount Paid Ascension Health Q 167148 Actual Amount Paid