ALEXIAN BROTHERS AMBULATORY GROUP: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ALEXIAN BROTHERS AMBULATORY GROUP (EIN 36-4336931)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-10-04
- IRS object ID
- 201212789349300916
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-10-04T17:47:29-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 S Wacker Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606064301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364336931 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alexian Brothers Ambulatory Group | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALEX | NameControl |
| Phone | 8473857100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1 |
| City | Arlington Heights | City |
| State | IL | State |
| ZIP Code | 600051069 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Beth Tze | Name |
| Title | Chief Executive Officer | Title |
| Phone | 8473857100 | Phone |
| Date Signed | 2012-10-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Laura Gillespie | Name |
| PTIN | P00855604 | PTIN |
| Phone | 3124861000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Beth Tze | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1 |
| City | Arlington Heights | City |
| State | IL | State |
| ZIP Code | 600051069 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 50442855 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.alexianbrothershealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | ABAG carries out the healing mission of the Catholic Church (See Schedule O) as an Alexian Brothers ministry by identifying and developing effective responses to the health needs of those we are called to serve. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 1 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 17612 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 47122539 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 50244164 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 107007 | InvestmentIncomePriorYear |
| Investment Income Current Year | 107279 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 122248 | OtherRevenuePriorYear |
| Other Revenue Current Year | 91412 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 47369406 | TotalRevenuePriorYear |
| Total Revenue Current Year | 50442855 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 31629149 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 35965334 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 24294137 | OtherExpensePriorYear |
| Other Expenses Current Year | 22751253 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 55923286 | TotalExpensesPriorYear |
| Total Expenses Current Year | 58716587 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -8553880 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -8273732 | RevenuesLessExpensesCY |
| Total Assets BOY | 11030550 | TotalAssetsBOY |
| Total Assets EOY | 12152461 | TotalAssetsEOY |
| Total Liabilities BOY | 10231560 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13660156 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 798990 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1507695 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Alexian Brothers Ambulatory Group ("ABAG") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health needs of those we are called to serve. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 53502740 | Expense |
| Revenue | 50335576 | Revenue |
| Description | Alexian Brothers Health System employs more than 150 physicians and other providers through the Alexian Brothers Ambulatory Group (ABAG).ABAG offers Primary Care, Immediate Care, Specialty Care, Occupational Health Services and/or hospital-based Diagnostic Imaging Services at 25 locations across the primary and secondary service areas, including both hospital campuses. Physicians, who specialize as part of ABAG, practice in the areas of Cardiovascular Surgery, Neurosciences, General Surgery, Breast Surgery, Geriatric and Pediatric Specialties. In 2011, ABAG offices had 219,289 outpatient visits, including 138,941 primary care visits, 31,060 immediate care visits and (See Schedule O) 49,584 occupational health visits. The ABAG physician offices dedicated to serving the healthcare needs of adults over the age of 65 had 16,766 office, hospital and nursing home visits. Specialty physicians of ABAG had, in 2011, 4,965 office visits, 6,186 hospital visits and 2,393 surgeries for adult patients and 14,211 office and hospital visits for pediatric patients. | Description |
| Total Program Service Expense | 53502740 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 84 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Daniel Isacksen | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8473857100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1 |
| City | Arlington Heights | City |
| State | IL | State |
| ZIP Code | 600051069 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Brother T Keusenkothen | ||||||||
| Chairperson | 40.00 | X | X | 0 | 0 | 0 | ||
| Mark Frey | ||||||||
| Chairperson | 40.00 | X | X | 0 | 867276 | 184992 | ||
| James Sances | ||||||||
| Secretary/Treasurer | 40.00 | X | X | 0 | 642540 | 143948 | ||
| Tracy Rogers | ||||||||
| Vice President | 40.00 | X | X | 0 | 497648 | 78096 | ||
| Beth Tze | ||||||||
| President/CEO | 40.00 | X | 0 | 324547 | 62874 | |||
| Virginia Golembiewski | ||||||||
| Assistant Secretary | 40.00 | X | 0 | 69801 | 16144 | |||
| Daniel Isacksen | ||||||||
| Vice President/CFO | 40.00 | X | 0 | 231986 | 25573 | |||
| Jim Lewandowski | ||||||||
| VP Human Resources | 40.00 | 0 | 372210 | 66995 | X | |||
| Kim Zimmermann | ||||||||
| Chief Operating Officer | 40.00 | 0 | 193234 | 24057 | X | |||
| John Wilkerson | ||||||||
| Family Practice Physician | 40.00 | 0 | 365868 | 5421 | X | |||
| Rajammal Srinivasan | ||||||||
| Internal Medicine Physician | 40.00 | 0 | 306460 | 150 | X | |||
| Charles Kalenowski | ||||||||
| Family Practice Physician | 40.00 | 0 | 304480 | 32252 | X | |||
| Calvin Fischer | ||||||||
| Family Practice Physician | 40.00 | 2313 | 271858 | 28879 | X | |||
| Roger Weise | ||||||||
| Geriatrician | 40.00 | 0 | 255845 | 45356 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2313 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4703753 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 714737 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Schaumburg Family Phys | |||||
| 25 E Schaumburg Rd Ste 200 | Schaumburg | IL | 60192 | Medical Specialist/Physicians | 2399494 |
| Rush Univ Med Ctr | |||||
| DBA Univ Neuro 1725 W Harrison St S | Chi | IL | 60612 | Medical Specialist/Physicians | 194329 |
| Dr Amir Turayhi | |||||
| Rand Medical Clinic SC | Mt Prospect | IL | 60056 | Medical Specialist/Physicians | 141395 |
| MEA Medical Care Centers LLC | |||||
| 2000 Spring Rd STE 200 | Oak Brook | IL | 60521 | Medical Specialist/Physicians | 130443 |
| Sinai Medical Group | |||||
| 2750 W 15th Place | Chicago | IL | 60608 | Medical Specialist/Physicians | 122850 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Svcs Reven | 621111 | 50199462 | 50199462 |
| Intercompany Affiliate | 900099 | 44702 | 44702 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 50244164 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107279 | TotalRevenueColumn |
| Exclusion | $107,279 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 91412 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 91412 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 91412 | TotalRevenueColumn |
| Related Or Exempt Function Income | 91412 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50442855 | TotalRevenueColumn |
| Related Or Exempt Function Income | 50335576 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $107,279 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31344030 | Total |
| Program Services | 29331918 | ProgramServices |
| Management And General | 2012112 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 704635 | Total |
| Program Services | 669601 | ProgramServices |
| Management And General | 35034 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2214763 | Total |
| Program Services | 1989254 | ProgramServices |
| Management And General | 225509 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1701906 | Total |
| Program Services | 1607916 | ProgramServices |
| Management And General | 93990 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167578 | Total |
| Program Services | 2788 | ProgramServices |
| Management And General | 164790 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13000 | Total |
| Management And General | 13000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3541341 | Total |
| Program Services | 3360766 | ProgramServices |
| Management And General | 180575 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5160 | Total |
| Program Services | 2086 | ProgramServices |
| Management And General | 3074 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 950094 | Total |
| Program Services | 694372 | ProgramServices |
| Management And General | 255722 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16694 | Total |
| Program Services | 6694 | ProgramServices |
| Management And General | 10000 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4213148 | Total |
| Program Services | 3961299 | ProgramServices |
| Management And General | 251849 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362880 | Total |
| Program Services | 327115 | ProgramServices |
| Management And General | 35765 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32202 | Total |
| Program Services | 11021 | ProgramServices |
| Management And General | 21181 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442817 | Total |
| Program Services | 388312 | ProgramServices |
| Management And General | 54505 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3338174 | Total |
| Program Services | 3320551 | ProgramServices |
| Management And General | 17623 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Management Fees | 3614881 | 1837686 | 1777195 |
| Medical Supplies | 1258107 | 1258107 | |
| Bad Debt | 817555 | 817555 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3977622 | Total |
| Program Services | 3915699 | ProgramServices |
| Management And General | 61923 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58716587 | Total |
| Program Services | 53502740 | ProgramServices |
| Management And General | 5213847 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 12009 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4942624 | BOY |
| EOY | 4525642 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 529275 | BOY |
| EOY | 752481 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 215150 | BOY |
| EOY | 155227 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8864198 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6575024 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2034309 | BOY |
| EOY | 2289174 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2779968 | BOY |
| EOY | 3804292 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 302032 | BOY |
| EOY | 549382 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 227192 | BOY |
| EOY | 64254 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11030550 | BOY |
| EOY | 12152461 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4113589 | BOY |
| EOY | 3332320 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6117971 | BOY |
| EOY | 10327836 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10231560 | BOY |
| EOY | 13660156 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 798990 | BOY |
| EOY | -1507695 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 798990 | BOY |
| EOY | -1507695 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11030550 | BOY |
| EOY | 12152461 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -8273732 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5967047 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3233798 | OtherCostOrOtherBasis |
| Depreciation | 2142911 | Depreciation |
| Book Value | 1090887 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5234508 | OtherCostOrOtherBasis |
| Depreciation | 4432113 | Depreciation |
| Book Value | 802395 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 395892 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 395892 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2289174 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Beneficial Int. in ABHS Invest. Trust | Description |
| Book Value | 3804292 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 3804292 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Affiliates | $9,583,282 |
| Other Liabilities | $42,920 |
| Reserve for Outstanding Insurance Losses | $701,634 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 10327836 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X: | ReturnReference |
| Explanation | Alexian Brothers Ambulatory Group 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 (ASC740) in the December 31, 2011 audit report. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark Frey | |||||||||||||
| 0 | 617468 | 0 | 172499 | 0 | 77309 | 0 | 145072 | 0 | 39920 | 0 | 1052268 | 0 | 39114 |
| James Sances | |||||||||||||
| 0 | 477155 | 0 | 136544 | 0 | 28841 | 0 | 115746 | 0 | 28202 | 0 | 786488 | 0 | 28841 |
| Tracy Rogers | |||||||||||||
| 0 | 367650 | 0 | 105531 | 0 | 24467 | 0 | 34778 | 0 | 43318 | 0 | 575744 | 0 | 24467 |
| Beth Tze | |||||||||||||
| 0 | 256610 | 0 | 67937 | 0 | 0 | 0 | 28119 | 0 | 34755 | 0 | 387421 | 0 | 0 |
| Daniel Isacksen | |||||||||||||
| 0 | 196845 | 0 | 35141 | 0 | 0 | 0 | 3060 | 0 | 22513 | 0 | 257559 | 0 | 0 |
| Jim Lewandowski | |||||||||||||
| 0 | 280338 | 0 | 56701 | 0 | 35171 | 0 | 35309 | 0 | 31686 | 0 | 439205 | 0 | 12354 |
| Kim Zimmermann | |||||||||||||
| 0 | 163955 | 0 | 29279 | 0 | 0 | 0 | 6617 | 0 | 17440 | 0 | 217291 | 0 | 0 |
| John Wilkerson | |||||||||||||
| 0 | 365868 | 0 | 0 | 0 | 0 | 0 | 4900 | 0 | 521 | 0 | 371289 | 0 | 0 |
| Rajammal Srinivasan | |||||||||||||
| 0 | 306460 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 150 | 0 | 306610 | 0 | 0 |
| Charles Kalenowski | |||||||||||||
| 0 | 304480 | 0 | 0 | 0 | 0 | 0 | 11215 | 0 | 21037 | 0 | 336732 | 0 | 0 |
| Calvin Fischer | |||||||||||||
| 2313 | 271858 | 0 | 0 | 0 | 0 | 0 | 7926 | 0 | 20953 | 2313 | 300737 | 0 | 0 |
| Roger Weise | |||||||||||||
| 0 | 245845 | 0 | 10000 | 0 | 0 | 0 | 31057 | 0 | 14299 | 0 | 301201 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 3 | Alexian Brothers Ambulatory Group follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee. All of the items in Schedule J, Part I, Line 3 are used by the Committee to establish compensation for the CEO of the organization. | |
| Part I, Line 6 | ||
| 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 amount accrued in 2011 was included in income in Schedule J for the following individuals: Mark Frey : $77,808, James Sances : $ 52,060, Tracy Rogers : $ 5,914, Beth Tze: $ 1,896, Jim Lewandowski : $ 5,297 | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Mark Frey, James Sances, and Tracy Rogers have a business relationship due to joint employment by a common health system entity. | |
| Form 990, Part VI, Section A, line 6 | Alexian Brothers Ambulatory Group has two classes of members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Hospital Network (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 Ambulatory Group. | |
| Form 990, Part VI, Section A, line 7b | Alexian Brothers Health System has principal authority with respect to the following matters: - Amendment of the Articles of Incorporation and Bylaws of the Corporation as provided by Statute; - Appointment and removal of Directors and Executive Officers; - Adoption, amendment and repeal of fundamental statements of mission, philosophy, spirit, vision, values and charity policy, and the sponsorship of apostolic activities; - Any plan of merger, consolidation, dissolution, sales or lease of all or substantially all of the assets of the Alexian Brothers Ambulatory Group. - The annual capital and operating budget and the Strategic Plans of the Alexian Brothers Ambulatory Group; and - Other certain reserved powers which Alexian Brothers Health System may designate. | |
| Form 990, Part VI, Section B, line 11 | Alexian Brothers Ambulatory Group is an affiliate of Alexian Brothers Health System ("ABHS" or "the System"), which is a Catholic health system. ABHS is the National Member and ultimate parent for each entity within the System. Alexian Brothers Ambulatory Group's Form 990 goes through an intensive review process at the System's Corporate level prior to being filed with the IRS. The entire Form 990 is reviewed by Alexian Brothers Ambulatory Group's financial officer and the CEO. The Form 990 is also reviewed at the System Corporate level by the Chief Accounting Officer for the System. The Vice President and General Counsel for the System reviews all sections of the Form 990 with the exception of the compensation section. The Vice President of Human Resources for ABHS reviews all compensation disclosures for each entity in ABHS. The reviews were conducted before the Form 990 was signed and filed with the IRS. In addition, there is also a Compensation Committee that reports to the ABHS Board of Governors. This Committee reviews the Compensation disclosures for all entities in the System. Alexian Brothers Ambulatory Group's board reports to the ABHS Board of Governors, which has ultimate oversight of the activities of all entities within the System. The Audit Committee of the ABHS Board of Governors has responsibility for and oversight of the Tax Compliance process. The Audit Committee provides oversight for the Form 990 process for the entire System and reviews detailed Forms 990 for the System on a rotating basis. It then reports back to the ABHS Board of Governors on the results of these activities. The Forms 990 not reviewed by the Audit Committee are available to the Audit Committee members upon request. The Audit Committee did not review the 2011 Form 990 for Alexian Brothers Ambulatory Group. | |
| Form 990, Part VI, Section B, line 12c | Alexian Brothers Ambulatory Group collects annual attestations from board members, officers, directors and key employees. The attestations are reviewed by the ABAG compliance officer and any conflicts are shared with the ABAG Chief Executive Officer. The conflicts are also reviewed by the System's Vice President, Corporate Responsibility Officer. The Audit Committee of the ABHS Board of Governors monitors and receives reports on the completion of this process. | |
| Form 990, Part VI, Section B, line 15 | Alexian Brothers Ambulatory Group follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee. | |
| Form 990, Part VI, Section C, line 19 | The financial statements of Alexian Brothers Ambulatory Group are available through the Office of the Illinois Attorney General. Conflict of Interest statements and the governing documents of Alexian Brothers Ambulatory Group are not made available to the public. | |
| Form 990, Part VII: | Disclosure for estimated hours per week devoted to related organizations for which compensation was reported: Mark Frey, James Sances, Tracy Rogers, Virginia Golembiewski, and Jim Lewandowski all worked 40 hours per week for Alexian Brothers Health System. | Column E and F Disclosure: |
| Form 990, Part VII: Column E (Reasonable Efforts) | Payroll records are kept that identify which officers/key employees are paid by a related entity. These documents also show the organization being charged for the officer's or key employee's services. | |
| Form 990, Part XI, line 5: | Net unrealized losses on investments: -32,953. Equity transfers from affiliates: 6,000,000. Total to Form 990, Part XI, Line 5: 5,967,047. | Changes in Net Assets or Fund Balances: |
| Form 990, Part VIII, Line 3, Schedule D, Part VII: | The amount reflected as dividends and interest reflects Alexian Brothers Ambulatory Group's share of interest, dividends and realized gains/losses from Alexian Brothers Ambulatory Group'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 ABHS and acts as an internal mutual fund. Details of gains and losses are shown on the Form 990 of ABHSIT. | |
| Form 990, Schedule A, Part I, Line 3: | The Internal Revenue Service has issued different definitions of a "hospital" for Form 990 Schedules A and H. Although Alexian Brothers Ambulatory Group qualifies as a hospital for purposes of Schedule A, the Organization operates physician care practices but does not operate a state licensed hospital as required for Form 990, Schedule H. Alexian Brothers Ambulatory Group is not recognized as a hospital by the State of Illinois and, as such, is not required to complete Form 990 Schedule H. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (25 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexian Brothers of America Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 362606768 | Religious order of Roman Catholic men | TX | Section 501(c)(3) | 1 | N/A | 0 | |
| Brothers of St Alexius Health and Welfare Fund Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 362976617 | Provides for health & welfare payments for religious sponsor | TX | Section 501(c)(3) | 1 | 1 | Alexian Brothers of America Inc | |
| 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) | 9 | 1 | Alexian Brothers Health System | |
| 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) | 11, III-FI | 1 | Alexian Brothers of America Inc | |
| Alexian Brothers Health System Inc Investment Trust | |||||||||||
| 3040 W Salt Creek Ln | Arlington Heights | IL | 60005 | 363801585 | Manages pooled investments of related not-for-profit entities | IL | Section 501(c)(3) | 11, III-FI | 1 | Alexian Brothers Health System | |
| Alexian Brothers of America Investment Trust | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 364390471 | Manages pooled investments of related not-for-profit entities | IL | Section 501(c)(3) | 11, III-FI | 1 | Alexian Brothers of America Inc | |
| Alexian Brothers Specialty Group | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 800710751 | Specialty physician practice group | IL | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
| Alexian Brothers of Chicago | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | Inactive Corporation | IL | Section 501(c)(3) | 9 | 1 | Alexian Brothers of America Inc | ||
| Alexian Brothers of San Jose Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 941530037 | Acute care hospital (sold in 1998) | TX | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Services Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 431295333 | HUD housing | MO | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Village of Milwaukee Inc | |||||||||||
| 9301 N 76th Street | Milwaukee | WI | 53223 | 391351584 | Continuing care retirement community | WI | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Community Services | |||||||||||
| 425 Cumberland Street Suite 110 | Chattanooga | TN | 37404 | 364344423 | Provides comprehensive & coordinated community based services | IL | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| 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) | 7 | 1 | Alexian Brothers Health System | |
| Alexian Village of Tennessee | |||||||||||
| 437 Alexian Way | Signal Mountain | TN | 37377 | 621136742 | Continuing care retirement community | TN | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Senior Ministries | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 364484290 | Supports the provision of healthcare services for related corporations | IL | Section 501(c)(3) | 11, III-FI | 1 | Alexian Brothers Health System | |
| Alexian Elderly Services Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 392039667 | Community outreach | WI | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Lansdowne Village | |||||||||||
| 4624 Lansdowne | St Louis | MO | 63116 | 431470362 | Skilled nursing facility | MO | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Sherbrooke Village | |||||||||||
| 4005 Ripa Avenue | St Louis | MO | 63125 | 431592502 | Skilled nursing facility | MO | Section 501(c)(3) | 9 | 1 | Alexian Brothers Health System | |
| Alexian Brothers of St Louis Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 430653236 | Acute care hospital (sponsorship transferred in 1997) | MO | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Hospital Network | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 363276552 | Supports the provision of healthcare services for related corporations | IL | Section 501(c)(3) | 11, III-FI | 1 | Alexian Brothers Health System | |
| Savelli Properties Inc | |||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 363308965 | Owns or leases properties where healthcare services are delivered | IL | Section 501(c)(2) | N/A | 1 | Alexian Brothers Health System | |
| 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) | 7 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Behavioral Health Hospital | |||||||||||
| 1650 Moon Lake Blvd | Hoffman Estates | IL | 60194 | 364251848 | Behavioral health hospital | IL | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
| St Alexius Medical Center | |||||||||||
| 1555 Barrington Road | Hoffman Estates | IL | 60194 | 364251846 | Acute care hospital | IL | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
| Alexian Brothers Medical Center | |||||||||||
| 800 Biesterfield Road | Elk Grove Village | IL | 60007 | 362596381 | Acute care hospital | TX | Section 501(c)(3) | 3 | 1 | Alexian Brothers Health System | |
Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| Alexian Rehabilitation Services LLC | ||||||||||
| 935 Beisner Road | Elk Grove Village | IL | 60007 | 300221481 | Rehabilitation hospital | IL | N/A | N/A | 0 | 0 |
| Illinois NeuroMeg Center LLC | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 870783164 | Provision of NeuroMeg services | IL | N/A | N/A | 0 | 0 |
| Elk Grove MOB Limited Partnership | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363853289 | Medical office building | IL | N/A | N/A | 0 | 0 |
| Workplace Solutions LLC | ||||||||||
| 1100 East Woodfield Road | Schaumburg | IL | 60173 | 364095007 | Provision of EAP services | IL | N/A | N/A | 0 | 1 |
| Bonaventure Medical Foundation LLC | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363978153 | Manages managed care contracts | DE | N/A | N/A | 0 | 0 |
| Neurosciences Equipment LLC | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 861115516 | Ownership of Gamma Knife | IL | N/A | N/A | 0 | 0 |
| St Alexius Center for Sleep Health LLC | ||||||||||
| 665 W North Avenue | Lombard | IL | 60148 | 205876371 | Operation of sleep lab | IL | N/A | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|
| Thelen Corporation | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 363266316 | Owns/leases property; joint venture partner | IL | N/A | C | |
| Edessa Insurance Company Ltd | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | Captive insurer located in Bermuda | N/A | C | BD | ||
| Alexian Brothers Health Providers Association Inc | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 363853286 | Messenger model IPA | IL | N/A | C | |
| Alexian Brothers Corpus Christi Housing Project LLC | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 943465394 | Tax credit financed housing | IL | N/A | C | |
| Alexian Village of Elk Grove | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 600051069 | 352211303 | Tax credit financed housing | IL | N/A | C | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Alexian Brothers Medical Center | ||
| P | 4620420 | FMV |
| Alexian Brothers Medical Center | ||
| J | 268005 | FMV |
| St Alexius Medical Center | ||
| P | 6281790 | FMV |
| Savelli Properties Inc | ||
| J | 1780817 | FMV |
| Thelen Corporation | ||
| J | 59631 | FMV |
| Alexian Brothers Health System | ||
| O | 4543811 | FMV |
| Alexian Brothers Health System | ||
| R | 8760790 | FMV |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Schedule R, Part V, Line 2: | ReturnReference |
| Explanation | Alexian Brothers Ambulatory Group tracks all transactions with related organizations in the general ledger or subsidiary schedules to the general ledger. Amounts are valued based on the fair market value of the transaction. | Explanation |