2012-10-28T23:38:17-05:00 2011-12-31 861065772 Deloitte Tax LLP 111 South Wacker Drive Chicago IL 60606 990 2011-01-01 364344423 Alexian Brothers Community Services ALEX 4236980802 425 Cumberland Street Chattanooga TN 37404 John Turongian 4236980802 2012-10-26 1 Laura Gillespie P00855604 3124861000 2011 2016-02-24 21:20:13Z John Turongian 425 Cumberland Street Chattanooga TN 37404 36003570 0 0928 X www.alexianbrothershealth.org X 2000 IL ABCS 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 and housing needs of those we are called to serve. 7 6 404 25 0 0 7231 460 34380499 34922085 1352398 1081025 0 0 35740128 36003570 0 0 0 0 12712402 12750004 0 0 0 20824481 22449728 33536883 35199732 2203245 803838 48886837 50502928 8158912 7537593 40727925 42965335 Alexian Brothers Community Services ("ABCS") carries out the healing mission of the Catholic as an Alexian Brothers ministry by identifying and developing effective responses to the health and housing needs of those we are called to serve. 0 0 28722801 32831406 ABCS operates a Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a community-based program whose purpose is to serve the frail elderly. The PACE program enables its participants to remain independent in their own homes and communities through a unique system of managed care. PACE combines Medicare and Medicaid funds to provide comprehensive health and social services in the home, in the community and in the hospital or nursing home. In 2011, an average of 500 participants were provided care and services through PACE. This level of participation represents approximately 94% of the program's capacity. 1560235 2090679 Alexian Brothers Live at Home/Home Care are programs designed to help older adults live independently in their own homes for as long as possible. Live at Home provides a full range of services including active independent living, a built-in guarantee of personal services and nursing home care if needed. Home Care is a home-based program of non-medical personal care, assistance and adult companionship provided on an as-needed basis to older adults in the community. In 2011, Live at Home served an average of 206 members. Home Care provided over 56,000 hours of service to individuals; 10,000 of these hours were provided to low income adults (waiver services). 30283036 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 222 0 1 404 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X Tim Booth 4236980802 425 Cumberland Street Suite 110 Chattanooga TN 37404 X Br Thomas Keusenkothen CFA 1.00 X X 0 0 0 Brother James Classon CFA 1.00 X X 0 0 0 John Turongian 1.00 X X 0 240368 43828 Brother Larry Krueger CFA 1.00 X X 0 0 0 Curtis Gielow 1.00 X 0 0 0 Sandra Johnson JD OLM 1.00 X 0 0 0 Brother Daniel McCormick CFA 1.00 X 0 0 0 Brother Warren Longo CFA 1.00 X 0 0 0 Brother Theodore Loucks CFA 1.00 X 0 0 0 Howard Roddy 1.00 X 0 0 0 Mel Causey 40.00 X 0 149310 23983 Viston Taylor 40.00 X 0 202809 44139 James Sances 1.00 X 0 642540 143948 Virginia Golembieswki 1.00 X 0 69801 16144 Jim Lewandowski 1.00 X 0 372210 66995 Lorna Birch 40.00 X 161738 0 6438 Shailaja Pulisetty 40.00 X 123780 0 1128 Alfreda Pulley 40.00 X 112284 0 761 Karen Heath 40.00 X 114568 0 0 Monica Beri 40.00 X 119225 0 690 631595 1677038 348054 5 0 1 0 Health Center of Standifer Place 2626 Walker Road Chattanooga TN 37421 Skilled Nursing Provider 1735143 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 Skilled Nursing Provider 1505011 Memorial Hospital 2525 Desales Avenue Chattanooga TN 37404 Acute Care Provider 1338458 St Mary's Health Center 6420 Clayton Road St Louis MO 63116 Skilled Nursing Provider 873427 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 Skilled Nursing Provider 682491 13 460 460 Medicare/Medicaid Pmt 621990 32828117 32828117 Home Care Services 621610 1094628 1094628 Live at Home Program 621610 999340 999340 34922085 1081025 1081025 36003570 34922085 0 1081025 10068035 8752734 1315301 148837 132911 15926 1823052 1630374 192678 710080 650424 59656 169169 169169 25938 25938 758258 330795 427463 52840 52840 804919 677949 126970 66171 21481 44690 460624 460327 297 414486 369959 44527 34180 11924 22256 19405 17329 2076 635125 567164 67961 209086 95013 114073 Purchased Serv-Medical 12600400 12600400 Medical Supplies 2681399 2681399 Management Fees 1261810 1261810 Purchased Serv-Other 1249296 475755 773541 1006622 807098 199524 35199732 30283036 4916696 0 94334 -257102 858881 946511 247143 235758 57807 56607 16451873 6591348 9678771 9860525 37894676 39589274 55225 71355 48886837 50502928 5348710 4806312 2810202 2731281 8158912 7537593 X 40727925 42965335 0 0 40727925 42965335 48886837 50502928 X 803838 1433572 X 0 1 1 X 0 X 1415 1640 2225 12633 460 18373 33245061 38105950 37281301 34380499 34922005 177934816 11982 20554 14310 46846 33258458 38128144 37297836 34393132 34922465 178000035 0 0 0 178000035 1817202 -1434727 699201 1352398 1081025 3515099 1817202 -1434727 699201 1352398 1081025 3515099 35075660 36693417 37997037 35745530 36003490 181515134 0.98060 0.98010 0.01940 0.01990 X 0 0 0 0 0 0 1 39000 0 0 39000 0 952180 952180 5515245 2441027 3074218 5426336 4128250 1298086 4558112 22071 4536041 9860525 Beneficial Interest in Alexian Brothers Health System, Inc. Investment Trust 39589274 F 39589274 Prepaid premiums 292709 Non-refundable entry fee net of amortization 2400627 Reserve for insurance losses 37945 2731281 Description of Uncertain Tax Positions Under FIN 48: Part X: Alexian Brothers Community Services 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. 0 1 0 0 0 0 0 0 0 John Turongian 0 213212 0 27156 0 0 0 22190 0 21638 0 284196 0 0 Mel Causey 0 129279 0 16031 0 4000 0 8528 0 15455 0 173293 0 0 Viston Taylor 0 166604 0 21919 0 14286 0 16093 0 28046 0 246948 0 8758 James Sances 0 477155 0 136544 0 28841 0 115746 0 28202 0 786488 0 28841 Jim Lewandowski 0 280338 0 56701 0 35171 0 35309 0 31686 0 439205 0 12354 Lorna Birch 158999 0 0 0 2739 0 5077 0 1361 0 168176 0 0 0 Part I, Line 3 Alexian Brothers Community Services 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 Alexian Brothers Health System which is comprised 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 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 individual: Jim Lewandowski - $5,297. Form 990, Part VI, Section A, line 6 The Organization has two classes of members Alexian Brothers Health System (the "National Member") and Alexian Brothers Senior Ministries (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 Community Services. 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 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, sale or lease of all or substantially all of the assets of Alexian Brothers Community Services; - The annual capital and operating budget and the strategic plan of Alexian Brothers Community Services; and - Other certain reserved powers which Alexian Brothers Health System may designate. Form 990, Part VI, Section B, line 11 Alexian Brothers Community Services is an affiliate of Alexian Brothers Health System ("ABHS" or "the System"), which is a Catholic health system. Alexian Brothers Health System is the National Member and ultimate parent for each entity within the System. Alexian Brothers Community Services'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 Community Services'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 Alexian Brothers Health System reviews all compensation disclosures for each entity in Alexian Brothers Health System. These 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 Alexian Brothers Health System Board of Governors. This Committee reviews the Compensation disclosures for all entities in the System. The Alexian Brothers Community Services board reports to the Alexian Brothers Health System Board of Governors, which has ultimate oversight of the activities of all entities within the System. The Audit Committee of the Alexian Brothers Health System 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 as requested basis. It then reports back to the Alexian Brothers Health System 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 Community Services. Form 990, Part VI, Section B, line 12c Alexian Brothers Community Services collects annual attestations from board members, officers, directors and key employees. The attestations are reviewed by the Alexian Brothers Community Services compliance officer and any conflicts are shared with the Alexian Brothers Community Services Chief Executive Officer. The conflicts are also reviewed by the System's Vice President, Corporate Responsibility Officer. The Audit Committee of the Alexian Brothers Health System Board of Governors monitors and receives reports on the completion of this process. Form 990, Part VI, Section B, line 15 Alexian Brothers Community Services 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 Alexian Brothers Health System, which is comprised 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 Alexian Brothers Community Services's financial statements are available through the National Reporting Municipal Services Information Repository (NRMSIR). Conflicts of Interest and Alexian Brothers Community Services's governing documents are not made available to the public. Form 990, Part VII: Average hours devoted to related organizations when related compensation is reported: - James Sances, Jim Lewandowski and Virginia Golembiewski each worked 40 hours per week for Alexian Brothers Health System. - John Turongian worked 40 hours per week for Alexian Brothers Senior Ministries. - Viston Taylor and Mel Causey each worked 40 hours per week for the filing organization. Form 990, Part VII, Column E: Description of reasonable effort made to obtain compensation from related organization: Payroll records are kept that identify which officers/key employees are paid by a related entity. These documents also identify the organization being charged for the officer's/key employee's services. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -166,428. Equity transfer from related entity 1,600,000. Total to Form 990, Part XI, Line 5: 1,433,572. Part VIII, Line 3; Schedule D, Part VII: The amount reflected as dividends and interest reflects ABCS's share of interest, dividends and realized gains from ABCS'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. 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 Alexian Brothers of America Inc 1 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 Alexian Brothers Health System 1 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 600051069 363260495 Supports provision of healthcare services for related corporations IL Section 501(c)(3) 11, III-FI Alexian Brothers of America Inc 1 Alexian Brothers Health System Inc Investment Trust 3040 W Salt Creek Lane Arlington Heights IL 600051069 363801585 Manages pooled investments of related not-for-profit entities IL Section 501(c)(3) 11, III-FI Alexian Brothers Health System 1 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 Alexian Brothers of America Inc 1 Alexian Brothers Specialty Group 3040 W Salt Creek Lane Arlington Heights IL 600051069 800710751 Specialty physician practice group IL Section 501(c)(3) 3 Alexian Brothers Health System 1 Alexian Brothers of Chicago 3040 W Salt Creek Lane Arlington Heights IL 600051069 Inactive Corporation IL Section 501(c)(3) 9 Alexian Brothers of America Inc 1 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 Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 600051069 431295333 HUD housing MO Section 501(c)(3) 9 Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI Section 501(c)(3) 9 Alexian Brothers Health System 1 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 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN Section 501(c)(3) 9 Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 600051069 364484290 Supports the provision of healthcare for related corporations IL Section 501(c)(3) 11, III-FI Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 600051069 392039667 Community outreach WI Section 501(c)(3) 9 Alexian Brothers Health System 1 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 431470362 Skilled nursing facility MO Section 501(c)(3) 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO Section 501(c)(3) 9 Alexian Brothers Health System 1 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 Alexian Brothers Health System 1 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 Alexian Brothers Health System 1 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 Alexian Brothers Health System 1 Alexian Brothers Center for Mental Health 3436 N Kennicott Arlington Heights IL 60004 363045007 Outpatient community mental health services IL Section 501(c)(3) 7 Alexian Brothers Health System 1 Alexian Brothers Behavioral Health Hospital 1650 Moon Lake Blvd Hoffman Estates IL 60194 364251848 Behavioral health hospital IL Section 501(c)(3) 3 Alexian Brothers Health System 1 St Alexius Medical Center 1555 Barrington Road Hoffman Estates IL 60194 364251846 Acute care hospital IL Section 501(c)(3) 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 600051069 364336931 Physician services IL Section 501(c)(3) 3 Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX Section 501(c)(3) 3 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Road Elk Grove Village IL 60007 300221481 Rehabilitation hospital IL N/A Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 600051069 870783164 Provision of NeuroMeg services IL N/A Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 600051069 363853289 Medical office building IL N/A Workplace Solutions LLC 1100 E Woodfield Road Schaumburg IL 60173 364095007 Provision of EAP services IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages managed care contracts DE N/A Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 600051069 861115516 Ownership of Gamma Knife IL N/A St Alexius Center for Sleep Health LLC 665 W North Avenue Lombard IL 60148 205876371 Operation of sleep lab IL N/A 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 BD N/A C 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 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 1 0 Alexian Brothers Health System O 1194262 FMV Alexian Brothers Health System P 1020557 FMV Alexian Brothers Senior Ministries O 773541 FMV Alexian Brothers Senior Neighbors I 50742 FMV Alexian Brothers Health System Inc Investment Trust Q 1694644 FMV Alexian Village of Tennessee L 1505011 FMV Alexian Brothers Sherbrooke Village L 118190 FMV Alexian Brothers Lansdowne Village L 682491 FMV Schedule R, Part V, Line 2: ABCS 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.