2012-11-15T14:35:36-06:00 2011-12-31 346565596 ERNST & YOUNG 190 CARONDELET PLAZA STE 1300 CLAYTON MO 63105 990 2011-01-01 431648435 THE FOUNDATION FOR BARNES-JEWISH HOSPITAL FOUN 3142860600 1001 HIGHLANDS PLZ DR WEST NO 140 ST LOUIS MO 631101339 JULIA RUVELSON 3142860580 2012-11-15 1 P00366526 3142901000 2011 2016-02-24 21:20:13Z JULIA RUVELSON 1001 HIGHLAND ST LOUIS MO 63110 78914715 0 X N/A X 1996 MO THE FOUNDATION FOR BARNES-JEWISH HOSPITAL HELPS DONORS ENRICH LIVES, SAVE LIVES, AND TRANSFORM PATIENT CARE THROUGH CHARITABLE GIFTS. 41 39 0 39 -46 -46 47992913 47141013 0 0 13885623 28503915 1690358 2581112 63568894 78226040 17015621 18348627 0 0 0 0 38485 21530 2706423 4063651 4093312 21117757 22463469 42451137 55762571 403076002 414723436 30767890 16930634 372308112 397792802 X THE FOUNDATION FOR BARNES-JEWISH HOSPITAL GENERATES RESOURCES TO SUPPORT BARNES-JEWISH HOSPITAL, A NATIONAL LEADER, IN ITS QUEST TO PROVIDE EXCELLENT PATIENT CARE, ADVANCE CLINICAL RESEARCH, AND SUPPORT THE EDUCATION OF HEALTHCARE PROFESSIONALS. 0 0 9589729 9589729 RESEARCH - THE FOUNDATION SUPPORTS BIOMEDICAL, AND CLINICAL-TRANSLATIONAL RESEARCH TO ENHANCE PATIENT SAFETY, ELEVATE THE STANDARDS OF CARE, IMPROVE QUALITY OF LIFE, MAKE BREAKTHROUGHS IN TREATMENT AND RECOVERY, AND WIN THE FIGHT AGAINST DEVASTATING DISEASES. THESE DISCOVERIES WILL CHANGE HEALTHCARE REGIONALLY, NATIONALLY, AND INTERNATIONALLY. WE DISBURSE RESEARCH FUNDING SOLELY TO PHYSICIANS AND RESEARCHERS AFFILIATED WITH THE HOSPITAL AND/OR WASHINGTON UNIVERSITY, OR TO FACULTY OF GOLDFARB SCHOOL OF NURSING AT BARNES-JEWISH COLLEGE. ALTHOUGH WE FUND A VARIETY OF HEALTHCARE AREAS PER DONOR WISHES, A MAJORITY OF OUR RESEARCH FUNDING IS FOR PROJECTS IN HEART AND VASCULAR CARE, CANCER, DIABETES, THE NEUROSCIENCES (STROKE, BRAIN TUMOR, AND EPILEPSY), AND ORGAN TRANSPLANT. 2922990 2922990 CHAIRHOLDER PROGRAM SUPPORT: TWENTY-SIX KEY FACULTY OF WASHINGTON UNIVERSITY AND GOLDFARB SCHOOL OF NURSING AT BARNES-JEWISH COLLEGE ARE APPOINTED TO AN ENDOWED CHAIR OR PROFESSORSHIP THROUGH THE FOUNDATION. AS CHAIRHOLDERS, EACH RECEIVES ANNUAL SUPPORT FOR THEIR ONGOING RESEARCH AND PROFESSIONAL ACTIVITIES IN ONCOLOGY,CARDIOLOGY,NEUROLOGY, GASTROENTEROLOGY, INTENSIVE CARE, NURSING AND VARIOUS SURGICAL FIELDS. 1888820 1888820 EDUCATION/SCHOLARSHIP PROGRAM SUPPORT: THE FOUNDATION SUPPORTS THE EDUCATION OF PHYSICIANS, RN'S WITHIN GOLDFARB SCHOOL OF NURSING, PHARMACISTS,TECHNICIANS,AND HEALTHCARE ADMINISTRATORS THROUGH FELLOWSHIPS, SCHOLARSHIPS, AWARDS, LECTURES AND CONFERENCES. BY PROVIDING CONTINUING EDUCATION, THE FOUNDATION ATTAINS PROFESSIONAL AND QUALITY STANDARDS. 3947088 3947088 OTHER PROGRAM SERVICES PATIENT CARE,CAPITAL,COMMMUNITY SUPPORT/OUTREACH SERVICES,COMMUNITY GRANTS, AND OTHERS. 3947088 3947088 18348627 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 25 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 41 39 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X VALERIE GRAY 3142860572 1001 HIGHLANDS PLZ DR WEST ST LOUIS MO 631101339 WILLIAM L BASLER 0.20 X 0 0 0 S BRYAN COOK 0.10 X 0 0 0 THOMAS R CORBETT 0.10 X 0 0 0 GENE M DIEDERICH 0.20 X 0 0 0 JOHN P DUBINSKY 0.00 X 0 0 0 LEON A FELMAN 0.20 X 0 0 0 JANET B GARRETT 0.00 X 0 0 0 RICHARD S GLASSMAN 0.30 X 0 0 0 KEITH B GULLER 0.30 X 0 0 0 EARLE H HARBISON JR 0.10 X 0 0 0 THOMAS J HILLMAN 0.10 X 0 0 0 MARK E HOOD 0.20 X 0 0 0 FRANKLIN A JACOBS 0.20 X 0 0 0 DOUGLAS O KIRBERG 0.00 X 0 0 0 LEE C KLING 0.30 X 0 0 0 WILLIAM J KOMAN 5.00 X 0 0 0 EDWARD J KOPLAR 0.10 X 0 0 0 RICHARD H MILES 0.00 X 0 0 0 ROBERT D MILLSTONE 0.20 X 0 0 0 SANDRA M MOORE 0.10 X 0 0 0 FREDERICK J OERTLI 0.20 X 0 0 0 JOSEPH E RECHTER 0.40 X 0 0 0 STEVEN C ROBERTS 0.20 X 0 0 0 JUDITH RUBIN 0.00 X 0 0 0 RON RUBIN 0.00 X 0 0 0 STEVEN F SCHANKMAN 0.10 X 0 0 0 DAVID SHERMAN III 0.10 X 0 0 0 THOMAS A STERN 0.20 X 0 0 0 JOSEPH A STIEVEN 0.10 X 0 0 0 PATRICK T STOKES 0.00 X 0 0 0 LAWRENCE E THOMAS 0.00 X 0 0 0 JOHN A VIRANT 0.00 X 0 0 0 DAVID A YAWITZ 0.20 X 0 0 0 MARK H ZORENSKY 0.20 X 0 0 0 SUSAN K GOLDBERG 0.30 X X 0 0 0 RICHARD J LIEKWEG 3.70 X X 0 1098021 103377 MARK KRIEGER 0.50 X 0 457189 65267 SALLY H ROTH 0.20 X X 0 0 0 JULIA S RUVELSON 52.00 X X 0 320872 53707 PETER A SMITH 0.20 X X 0 0 0 KENNETH B STEINBACK 1.00 X X 0 0 0 KENNETH H SUELTHAUS 0.30 X X 0 0 0 HARVEY N WALLACE 0.30 X X 0 0 0 0 1876082 222351 0 0 1 0 CREATIVE PRODUCERS GROUP INC 4818 WASHINGTON BLVD ST LOUIS MO 63108 PRODUCTION SERVICES & ENTERTAINMENT 189996 1 689724 40802969 5648320 91527 47141013 4928768 -46 4928814 248727 248727 24040369 465222 23575147 23575147 23575147 805556 689724 223453 582103 582103 RECOVERY PY GRANTS 900099 1929686 1929686 ACT GAIN ON ANNUITY 900099 190080 190080 CHG IN BENEF INT-CRT 900099 -369484 -369484 1750282 78226040 0 -46 31085073 18348627 18348627 85500 85500 21530 21530 839210 839210 91633 81414 10219 339932 339932 5582 5582 257690 257690 10536 10536 24494 24494 PURCHASED SERVICES 1950594 144605 1805989 CATERING AND MEALS 89791 89791 BOOKS AND PERIODICAL 55261 55261 DONOR CULTIVATION/MISC 8650 8650 334439 334439 22463469 18348627 1408419 2706423 2065907 2557526 15070445 14858670 39300000 40350000 31671 32127 255726044 257102431 85600861 94843429 5281074 4979253 403076002 414723436 452751 611014 10432698 9839415 19882441 6480205 30767890 16930634 X 83414109 76571514 138808429 170404900 150085574 150816388 372308112 397792802 403076002 414723436 X 55762571 -30277881 X 0 1 1 X 0 X 18038844 12483377 13420798 47992913 47141013 139076945 18038844 12483377 13420798 47992913 47141013 139076945 2383002 136693943 10478778 8069356 4184226 4378617 5177495 32288472 171365417 2345776 0.79770 0.70300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 256144032 2114161 -3651117 -8695853 -1909894 244001329 231841082 2369196 31241126 -7486185 -1821206 256144032 183913060 6386429 49067704 -5770532 -1755579 231841082 259028869 11648832 -75193815 -9725489 -1845337 183913060 0.20140 0.55720 0.24140 0 0 0 PRIVATE EQUITY 15570156 F ALTERNATIVE INVESTMENT 62160402 F REAL ASSETS 17112871 F 94843429 FUNDS HELD FOR WASHINGTON UNIVERSITY 3170724 DUE TO BARNES-JEWISH HOSPITAL 46283 ANNUITY OBLIGATIONS 871826 LIABILITY UNDER TRUST AGREEMENTS 2338048 BJC HEALTH CARE AFFILITATES 53324 6480205 78226040 22463469 55762571 -31277881 1000000 -30277881 25484690 47108949 -31277881 1000000 -30277881 77386830 839210 839210 78226040 21624259 0 21624259 839210 839210 22463469 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE FOUNDATION ALLOCATES AND ADMINISTERS ENDOWMENT EARNINGS TO ADVANCE PROJECTS AND PROGRAMS IN HEALTHCARE BEYOND STANDARD OPERATING NEEDS, AND WHICH FURTHER THE MISSIONS OF BARNES-JEWISH HOSPITAL, WASHINGTON UNIVERSITY SCHOOL OF MEDICINE, AND PARTNERING HEALTHCARE ORGANIZATIONS IN THE COMMUNITY. THIS INCLUDES HOSPITAL CENTERS, NURSING SCHOOL PROFESSORSHIPS AND DEANSHIPS, RESEARCH, FELLOWSHIPS, SCHOLARSHIPS, AWARDS, PATIENT CARE, HEALTH-RELATED SOCIAL SERVICES AND PATIENT SERVICES, COMMUNITY OUTREACH AND EDUCATION PROGRAMS. PART XI, LINE 8 - OTHER ADJUSTMENTS: EQUITY TRANSFER FROM BARNES-JEWISH HOSPITAL AUXILIARY NET ASSETS 1,000,000. X X X X 1 WORDDATA&IMAGING LLC 3190 RIDER TRAIL EARTH CITY MO 63045 DIRECT MAIL 0 196559 9534 187025 THUMBS UP 13545 BARRETT PKY BALLWIN MO 63021 TELEMARKING 0 11850 11996 -146 208409 21530 186879 MO FL ILLUMINATIONS GALA 1495280 689724 805556 142564 77000 3889 3 1495280 689724 805556 142564 77000 3889 223453 582103 1 BARNES - JEWISH HOSPITAL 216 SOUTH KINGSHIGHWAY ST LOUIS MO 63110 237309937 501(C)(3) 3648136 RESEARCH, PATIENT SUPPORT, EDUCATION, CAPITAL, COMMUNITY SERVICES WASHINGTON UNIVERSITY SCHOOL OF MEDICINE CAMPUS BOX 8018 660 SOUTH EUCLID AVE ST LOUIS MO 63110 430653611 501(C)(3) 14163450 RESEARCH, PATIENT SUPPORT, EDUCATION, MD RECRUITMENT ST LOUIS CHILDRENS'S HOSPITAL ONE CHILDRENS PLACE ST LOUIS MO 63110 430654870 501(C)(3) 29416 PURCHASE NEW CABINETS IN DAY CARE BARNES-JEWISH WEST COUNTY HOSPITAL 12634 OLIVE STREET ROAD ST LOUIS MO 63141 431527130 501(C)(3) 24800 OWEN KANTER LECTURE AND HEALING GARDEN MAINTENANCE BJC HOME CARE SERVICES 8300 EAGER ROAD ST LOUIS MO 63144 431450457 501(C)(3) 100220 HOME CARE - CARING FOR PATIENTS $35,000, HOSPICE $35,500, LUMINA TRAINING $29,720. CASA DE LA SALUD 3200 CHOUTEAU AVE ST LOUIS MO 63103 270732049 501(C)(3) 50000 COMMUNITY OUTREACH PROGRAM - CLINIC SUPPORT STLOUIS HEALTH EQUIPMEMT LENDING PROGRAM DBA ST LOUIS HELP 9709 DIELMAN ROCK ISLAND INDUSTRIAL DRIVE ST LOUIS MO 631322152 801044355 501(C)(3) 20000 COMMUNITY GRANT EXTERNAL MATERNAL CHILD AND FAMILY HEALTH COALITION 539 NORTH GRAND BLVDSTE 403 ST LOUIS MO 63103 412139772 501(C)(3) 78750 DEDICATED TO IMPROVEMENT BIRTH OUTCOMES. PEDAL THE CAUSE 7733 FORSYTH BLVD1375 ST LOUIS MO 63105 272233336 501(C)(3) 150000 ANNUAL FUNDRAISING BIKE CHALLENGE FOR CANCER RESEARCH HAVEN HOUSE 12685 OLIVE BLVD ST LOUIS MO 63141 201876315 501(C)(3) 26000 GRANT TO SUPPORT HAVEN HOUSE TO ACCOMPLISH THEIR MISSION. SUPPORT DOGS INC 11645 LILBURN PARK ROAD ST LOUIS MO 63146 431379801 501(C)(3) 5000 TO TRAIN DOGS TO ASSIST DISABLED PEOPLE, OBEDIENCE TRAINING, STPATRICKS CENTER ST LOUIS 800 NORTH TUCKER BLVD ST LOUIS MO 63101 431263499 501(C)(3) 29250 THE HEALTH CARE WING,LOCATED WITHIN ST. PATRICK CENTER PARTNERSHIP CENTER. HEALTH PROTECTION AND EDUCATION SERVICES 6901 WASHINGTON AVE ST LOUIS MO 63130 272096715 501(C)(3) 23605 PROVIDES HEALTH SCREENING AND CARE REFERRALS TO MEDICALLY UNDERSERVED. 13 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FOUNDATION FOR BARNES-JEWISH HOSPITAL (FOUNDATION) PROVIDES GRANT SUPPORT TO BARNES-JEWISH HOSPITAL (HOSPITAL), WASHINGTON UNIVERSITY SCHOOL OF MEDICINE, AND A LIMITED NUMBER OF COMMUNITY ORGANIZATIONS WHOSE MISSIONS ARE CONSISTENT WITH THE WORK OF THE HOSPITAL. FOR THE HOSPITAL AND UNIVERSITY: GRANT APPLICATIONS ARE SUBMITTED WHICH INCLUDE A BUDGET AND A NARRATIVE. THE APPLICATIONS FOR SPECIFIC PROJECT GRANTS MUST BE REVIEWED AND APPROVED BY AN INSTITUTIONAL OFFICIAL PRIOR TO SUBMISSION. IN SOME CASES, APPLICATIONS ARE RECEIVED IN RESPONSE TO A SPECIFIC CALL FOR PROPOSALS, WHICH ARE REVIEWED FOR MERIT BY A SPECIAL ADVISORY COMMITTEE. GRANTS ARE AWARDED TYPICALLY FOR A 12-MONTH PERIOD, WITH A NOTICE OF GRANT AWARD ISSUED WHICH INCLUDES THE TERMS AND CONDITIONS. ALL GRANT EXPENSES INCURRED BY THE HOSPITAL ARE REVIEWED FOR COMPLIANCE BY HOSPITAL ACCOUNTING STAFF. HOSPITAL ACCOUNTING STAFF RECEIVE ONGOING TRAINING ON THE TERMS AND CONDITIONS OF FOUNDATION GRANTS. A REVIEW OF WU SCHOOL OF MEDICINE EXPENSES RELATED TO SPECIFIC PROJECT GRANTS ARE PERFORMED BY UNIVERSITY STAFF AS THE EXPENSES ARE INCURRED. THE UNIVERSITY SUBMITS QUARTERLY EXPENSE REPORTS TO THE FOUNDATION FOR REVIEW. HOSPITAL ACCOUNTING STAFF RECEIVES INVOICES SUBMITTED BY THE UNIVERSITY AND APPROVES THEM ON THE FOUNDATION'S BEHALF. FOR ALL HOSPITAL AND UNIVERSITY GRANTS, A PROGRESS REPORT, INCLUDING NARRATIVE AND EXPENSE RECAP, IS REQUIRED UPON EXPIRATION OF A BUDGET PERIOD. FOUNDATION STAFF VERIFY THE COMPLETENESS OF THE REPORT. FOR COMMUNITY GRANTS: SELECTED SUPPORT IS PROVIDED TO LOCAL NONPROFITS FOR HEALTH-RELATED PROGRAMS TO BENEFIT COMMUNITY RESIDENTS, WITH EMPHASIS ON PROGRAM INNOVATION AND SERVICE DELIVERY TO TRADITIONALLY UNDERSERVED POPULATIONS. COMMUNITY GRANT MATERIALS WERE ADAPTED CLOSELY FROM THE HOSPITAL AND WU SCHOOL OF MEDICINE GRANTEE DOCUMENTS. SUPPORT PARAMETERS WERE DEVELOPED BY FOUNDATION STAFF AND THE STEWARDSHIP COMMITTEE OF THE FOUNDATION BOARD, WHICH IS CHARGED TO REVIEW AND RECOMMEND APPLICATIONS FOR FUNDING TO THE BOARD. TYPICALLY, SUPPORT IS GRANTED FOR 12 MONTHS, WITH SOME GRANTEES AWARDED MULTI-YEAR FUNDING CONDITIONED ON SUCCESSFUL FULFILLMENT OF OBJECTIVES. ANNUAL AWARDS ARE PAID AT THE START OF THE GRANT PERIOD. COMMUNITY GRANTEES SUBMIT INTERIM (SIX MONTHS) AND FINAL PROGRESS REPORTS, INCLUDING NARRATIVE AND EXPENSE RECAP. FOUNDATION STAFF REVIEW THESE FOR COMPLIANCE AND SUCCESS IN MEETING OBJECTIVES AND REPORT FINDINGS TO THE STEWARDSHIP COMMITTEE. TOTAL GRANTS FOR 2011 $18,348,627. X 1 1 0 1 0 0 0 0 0 1 0 RICHARD J LIEKWEG 0 606875 0 484997 0 6149 0 77133 0 26244 0 1201398 0 34340 MARK KRIEGER 0 348248 0 105823 0 3118 0 45362 0 19905 0 522456 0 0 JULIA S RUVELSON 0 224883 0 94558 0 1431 0 29391 0 24316 0 374579 0 14435 PART I, LINE 1A DURING 2011, THE ORGANIZATION REIMBURSED EXPENSES FOR SOCIAL CLUB DUES FOR TWO EXECUTIVES IN THE AMOUNT OF $8,330. THE PAYMENTS WERE MADE PURSUANT TO A WRITTEN POLICY THAT ALLOWS FOR DIRECT PAYMENTS OR REIMBURSEMENTS BASED ON ADEQUATE SUBSTANTIATION OF THE ALLOWABLE EXPENSE. DOCUMENTATION OF THESE EXPENSES IS RETAINED IN THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION AND, IF REQUIRED, INCLUDED IN THE REPORTABLE COMPENSATION OF THE INDIVIDUALS LISTED HERE IN. PART I, LINE 3 FORM 990, PART VI, SECTION B, LINE 15A-B: THE COMPENSATION AND BENEFIT AMOUNTS OF THE ORGANIZATION'S OFFICERS AND TOP MANAGEMENT OFFICIALS ARE DETERMINED BY AN INDEPENDENT COMMITTEE OF BJC HEALTH SYSTEM, AN AFFILIATE OF THE FOUNDATION FOR BARNES-JEWISH HOSPITAL. THE COMMITTEE IS COMPRISED OF INDEPENDENT PERSONS AND USES INDEPENDENT COMPENSATION STUDIES AND BENCHMARKING DATA TO ESTABLISH COMPENSATION AMOUNTS AND GUIDELINES. ALL AMOUNTS ARE APPROVED BY THE COMPENSATION COMMITTEE. THE ORGANIZATION RECONCILES THE AGGREGATE AMOUNTS PAID TO THE APPROVAL AMOUNTS SHORTLY AFTER THE CLOSE OF EACH CALENDAR YEAR. PART I, LINE 4B DURING 2011, THE FOLLOWING INDIVIDUALS RECEIVED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ACCRUALS FROM THE ORGANIZATION AS REPORTED IN THE DETAILS OF COMPENSATION AND BENEFITS (SEE FROM 990, PART VII AND SCHEDULE J, PART II): MARK H. KRIEGER $20,357 JULIA S. RUVELSON $26,238 RICHARD J. LIEKWEG $101,440 BOARD OF DIRECTORS WORKED HOURS FOR RELATED PARTY PER WEEK MARK KRIEGER 39.50 RICHARD J. LEIKWEG 36.50 PART I, LINE 7 DURING 2011 COMPENSATION PROVIDED BY RELATED ORGANIZATIONS INCLUDED INCENTIVE PAYMENTS TO CERTAIN EXECUTIVES THAT ARE CALCULATED USING A PERCENT OF BASE PAY AFTER CERTAIN PERFORMANCE AND OPERATING GOALS ARE MET. THE AMOUNT OF INCENTIVE PAYMENTS DID NOT ACCRUE TO THE BENEFIT OF THE INDIVIDUALS UNTIL AFTER THE FINANCIAL RESULTS OF THE RELATED ORGANIZATION WERE DETERMINED FOR THE CALENDAR YEAR. X 24 91527 AVERAGE HIGH/LOW 0 1 1 THIRD PARTY USE: PART I, LINE 32B: GIFTS OF SECURITIES ARE DELIVERED INTO ACCOUNTS ESTABLISHED UNDER THE FOUNDATION FOR BARNES-JEWISH HOSPITAL'S NAME AT VARIOUS FINANCIAL INSTITUTIONS. WHEN SECURITIES ARE RECEIVED, REPRESENTATIVES OF THESE INSTITUTIONS NOTIFY THE FOUNDATION FOR BARNES-JEWISH HOSPITAL OF THE DATE OF DELIVERY. NORMALLY THE FOUNDATION FOR BARNES-JEWISH HOSPITAL PERSONNEL INSTRUCT THESE INSTITUTIONS TO SELL THE SECURITIES IMMEDIATELY UPON RECEIPT, UNLESS OTHER DONOR STIPULATIONS EXIST OR IT IS NOT PRUDENT AND/OR POSSIBLE TO DO SO. FORM 5471 - STATEMENT OF CONTROLLED FOREIGN CORPORATION THIS STATEMENT IS BEING FILED PURSUANT TO TREAS. REG. 1.6038-2(J)(3). FOUNDATION FOR BARNES-JEWISH HOSPITAL'S FILING REQUIREMENT FOR FORM 5471 FOR THE CONTROLLED FOREIGN CORPORATION LISTED BELOW HAS BEEN SATISFIED BY BJC HEALTH SYSTEM (FEIN: 43-1617558). BJC HEALTH SYSTEM HAS INCLUDED FORM 5471 WITH ITS FORM 990 WHICH WAS FILED ELECTRONICALLY. ATG ASSURANCE COMPANY LTD FEIN: 98-0599167 P.O.BOX 1109 GRAND CAYMAN, CAYMAN ISLANDS FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OFFICERS, DIRECTORS OR KEY EMPLOYEES OF THE FOUNDATION AND BJC HEALTH SYSTEM (BJC) MAY ALSO SERVE ON THE BOARDS OF OTHER RELATED OR UNRELATED ORGANIZATIONS. ADDITIONALLY, CERTAIN FAMILY MEMBERS OF OFFICERS, DIRECTORS OR KEY EMPLOYEES MAY, DURING THE NORMAL COURSE OF BUSINESS YET CONSISTENT WITH THE STATED EXEMPT PURPOSE OF THE FOUNDATION, ENGAGE IN TRANSACTIONS IN WHICH POTENTIAL CONFLICTS OF INTEREST COULD EXIST. THESE OFFICERS, DIRECTORS, KEY EMPLOYEES AND RELATED PERSONS DISCLOSE THESE POTENTIAL CONFLICTS TO THE FOUNDATION AND BJC ANNUALLY AND DO NOT PARTICIPATE IN DECISIONS IN WHICH THEY HAVE SUCH CONFLICTS. SUCH CONFLICTS AND RELATIONSHIPS ARE REVIEWED TO ENSURE THAT ANY PAYMENTS RECEIVED OR AMOUNTS PAID DO NOT EXCEED THE FAIR MARKET VALUE OF THE GOODS AND SERVICES RECEIVED BY THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 6 BARNES-JEWISH HOSPITAL IS THE SOLE CORPORATE MEMBER OF THE REPORTING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A BARNES-JEWISH HOSPITAL HAS THE POWER TO ELECT OR APPOINT MEMBERS OF THE FOUNDATION BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO FOUNDATION BYLAWS OR GOVERNING DOCUMENTS ARE SUBJECT TO THE APPROVAL OF BARNES-JEWISH HOSPITAL, THE SOLE CORPORATE MEMBER, AND BJC HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PREPARES DRAFT COPIES OF FORM 990 AND ATTACHMENTS FOR REVIEW BY MEMBERS OF FINANCE, LEGAL AND TAX DEPARTMENTS. THE FINAL DRAFT RETURNS ARE REVIEWED BY AN INDEPENDANT ACCOUNTING FIRM AND A COMPLETE COPY IS PROVIDED FOR THE FOUNDATION BOARD OF DIRECTORS TO REVIEW. QUESTIONS AND COMMENTS THAT ARISE DURING THE INDIVIDUAL BOARD MEMBER REVIEWS OF THE FORMS ARE ADDRESSED IN ADVANCE OF SUBMISSION TO THE APPROPRIATE TAXING AUTHORITIES. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH THE POLICY BY ISSUING ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE REMINDING COVERED INDIVIDUALS OF THEIR OBLIGATIONS TO DISCLOSE POTENTIAL CONFLICTS AND REQUESTING THAT THEY COMPLETE A CONFLICTS QUESTIONNAIRE. THE QUESTIONNAIRE REQUIRES THE DISCLOSURE OF CONFLICTS AND AN ATTESTATION TO THEIR CONTINUING OBLIGATION TO DISCLOSE SHOULD THE NEED ARISE. THE RESULTS OF THE CONFLICTS QUESTIONNAIRE ARE REVIEWED AND APPROPRIATE ACTION TAKEN AS NECESSARY. ADDITIONALLY, SHOULD THE ORGANIZATION BECOME AWARE OF CONFLICTS NOT PREVIOUSLY REPORTED, THE GENERAL COUNSEL WOULD INVESTIGATE AND RESPOND IN ACCORDANCE WITH THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE FOR INSPECTION BY THE GENERAL PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES. NET ASSETS WERE ADJUSTED FOR UNREALIZED GAIN/LOSS AND EQUITY TRANSFER PART XI RECONCILIATION OF NET ASSETS LINE 5 OTHER CHANGES AMOUNTS FOR UNREALIZED GAINS/LOSS (31,277,881) EQUITY TRANSFERS 1,000,000 NET (30,277,881) ALTON MEMORIAL HOSPITAL ONE MEMORIAL HOSPITAL DRIVE ALTON IL 62002 370661172 HEALTHCARE ORGANIZATION IL 501(C)(3) 3 CH ALLIED SERVICE INC 1 ALTON MEMORIAL HEALTH SVCS FNDN 1109 N OXFORDSHIRE LANE EDWARDSVILLE IL 62025 371177053 FINANCIAL SUPPORT TO HOSPITAL AND COMMUNITY FOR SELECTED PROJECTS IL 501(C)(3) 11 TYPE I ALTON MEMORIAL HOSPITAL 1 BARNES-JEWISH HOSP AUXIL PARKVIEW CHAPTER 216 SO KINGSHIGHWAY CAB 140 ST LOUIS MO 63110 237000410 FUNDRAISING MO 501(C)(3) 11TYPE III FI BARNES-JEWISH HOSPITAL 1 BARNES-JEWISH HOSPITAL ONE BARNES-JEWISH HOSP PLZ ST LOUIS MO 63110 237309937 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 BJC HEALTH SYSTEM 1 BARNES-JEWISH ST PETERS HOSP INC 10 HOSPITAL DRIVE ST PETERS MO 63376 431452426 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 BARNES-JEWISH HOSPITAL 1 BARNES-JEWISH WEST COUNTY HOSP 12634 OLIVE STREET ROAD CREVE COEUR MO 63141 431527130 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 BARNES-JEWISH HOSPITAL 1 BJC BEHAVIORAL HEALTH 1430 OLIVE STREET SUITE 400 ST LOUIS MO 63103 431610561 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 BJC HEALTH SYSTEM 1 BJC CORPORATE HEALTH SERVICES 5000 MANCHESTER AVENUE ST LOUIS MO 63110 431324103 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 BARNES-JEWISH HOSPITAL 1 BJC HEALTH SYSTEM 4901 FOREST PARK AVE ST LOUIS MO 63108 431617558 SUPPORTING ORGANIZATION MO 501(C)(3) 11 TYPE I N/A 0 BJC HOME CARE SERVICES 8300 EAGER ROAD ST LOUIS MO 63144 431450457 HEALTHCARE ORGANIZATION MO 501(C)(3) 9 BARNES-JEWISH HOSPITAL 1 BOONE HOSPITAL CENTER'S VISIT NURSES INC 601 BUSINESS LOOP 70 W COLUMBIA MO 65203 430998347 HEALTHCARE ORGANIZATION MO 501(C)(3) 9 CH ALLIED SERVICE INC 1 CH ALLIED SERVICES INC 1600 E BROADWAY COLUMBIA MO 65201 431279063 HEALTHCARE SERVICES MO 501(C)(3) 3 CH HEALTH SERVICES DEV CORP 1 CH HEALTH SERVICES DEVELOPMENT CORPORATION 11133 DUNN ROAD ST LOUIS MO 63136 431230583 HEALTHCARE SERVICES MO 501(C)(3) 11 TYPE I BJC HEALTH SYSTEM 1 CHILDREN'S HEALTH NETWORK ONE CHILDRENS PLACE ST LOUIS MO 63110 431640467 HEALTHCARE SERVICES MO 501(C)(3) 9 ST LOUIS CHILDREN'S HOSPITAL 1 CHRISTIAN HOSPITAL FOUNDATION 11155 DUNN ROAD SUITE 300 N ST LOUIS MO 63136 431947644 SUPPORT TO CHNE MO 501(C)(3) LINE 7 CHRISTIAN HOSPITAL NE-NW 1 CHRISTIAN HOSPITAL ILLINOIS SERVICES 8 SUNSET HILLS EDWARDSVILLE IL 62025 260131339 HEALTHCARE SERVICES MO 501(C)(3) 3 CH ALLIED SERVICE INC 1 CHRISTIAN HOSPITAL NE-NW 11133 DUNN ROAD ST LOUIS MO 63136 436057893 HEALTHCARE ORGANIZATION MO 501(C)(3) 3 CH HEALTH SERVICES DEV CORP 1 COMMUNITY HEALTH CONNECTION 4353 CLAYTON AVE RM 164 ST LOUIS MO 63110 460819384 HEALTHCARE ORGANIZATION MO 501(C)(3) 9 BJC HEALTH SYSTEM 1 FAIRVIEW HEIGHTS MED GROUP SC 670 MASON RIDGE CENTER DR SUITE 300 ST LOUIS MO 63141 364147189 HEALTHCARE SERVICES IL 501(C)(3) 3 N/A 1 MISSOURI BAPTIST 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