2011-05-09T21:31:30-05:00 2010-06-30 Deloitte Tax LLP 111 South Wacker Drive Chicago IL 60606 990 2009-07-01 362170873 Maryville Academy MARY 8472941999 1150 North River Road Des Plaines IL 60016 TIM MORGAN 8472941893 2011-05-09 1 Lori Lorgeree 3124861000 2009 2016-02-24 21:20:13Z Sister Catherine Ryan 1150 N River Rd Des Plaines IL 60016 52928853 0 0928 X www. maryvilleacademy.org X 1883 IL Maryville Academy is one of Illinois' oldest childcare agencies, bringing hope and healing to children and families at their time of greatest need for over 125 years. Today our full range of residential, healthcare, family support, educational, and community development programs help children and families find healing, inner strength and hope for the future. At Maryville Academy, we are dedicated to providing children and families the tools they need to reach their fullest potential. Because we believe in children, our programs focus on healthy homes and the tools they need to transition into adulthood. 17 15 618 608 0 0 1863956 1518449 31930117 33833655 320174 -610187 2265504 647316 36379751 35389233 971445 610477 0 27079681 27611333 0 520879 12505263 14385045 40556389 42606855 -4176638 -7217622 76076318 78672712 8620942 9681253 67455376 68991459 To empower at-risk children and their families to reach their fullest potential by rebuilding lives, rekindling spirits and renewing hope. 0 0 12094564 3883 12166968 Medical: A 180-licensed bed (of which 85 beds are staffed) inpatient psychiatric stabilization and who are at risk to harm themselves or others. The hospital also offers behavioral mental outpatient services to children, teens and families. 17612055 293947 15401243 Residential: Therapeutic treatment facilities for youth with severe mental health, substance abuse, or intellectual disabilities marked by emotional, behavioral and academic problems or who have been victims of acute trauma. There are approximately 130 youths in placements at any one time. 4861159 293199 3593660 Educational: The Maryville Jen School (grades 9 to 12) serves 52 children in the Maryville residential programs and students from the community with complex emotional, behavioral and learning disabilities. The school staff uses hands-on, alternative and experiential teaching methods in conjunction with traditional instruction methods to maximize the students' potential for success. The teaching staff coordinates with our therapeutic staff to ensure that our students make advancements. 4427952 19448 3274466 Shelter Care Programs: Program for parenting teens who are awaiting permanent placements. Specialized Programs: Program for families with children 0-6 years of age who are experiencing some type of crisis. Program also provides for medically-fragile children who have completed the acute phase of their care but need a hospital-to-home transition program while family members learn to care for them. 4427952 19448 3274466 38995730 1 1 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 63 0 1 618 1 0 0 0 0 0 1 1 0 0 0 17 15 1 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Tim Morgan 8472941910 1150 N River Road Des Plaines IL 60016 George Rourke 4.00 X 0 0 0 Agnes Piszczek 4.00 X 0 0 0 Robert Schank CFA CPA 4.00 X 0 0 0 Monsignor Michael Boland 1.00 X 0 35447 29200 Aurora Abella-Austriaco 1.00 X 0 0 0 Richard Devine 1.00 X 0 0 0 Kathleen DeVine 3.00 X 0 0 0 Diane Geraghty 1.00 X 0 0 0 Louis Glunz PhD 1.00 X 0 0 0 Michael Golden 1.00 X 0 0 0 Andrew Lotts CPA 2.00 X 0 0 0 Sheila Merry 1.00 X 0 0 0 Bishop George Rassas 1.00 X 0 39345 29200 Patrick Shea 1.00 X 0 0 0 Rick Velasquez 1.00 X 0 0 0 John Wilhelm MD 1.00 X 0 0 0 Melanie Pettway 1.00 X 0 0 0 Cheryl Heyden 60.00 X X 126394 0 11970 Sister Catherine Ryan 60.00 X X 0 0 0 Timothy Morgan 60.00 X 147980 0 2346 Dr Mark Friedman 46.00 X 180571 0 23120 Dr Lerwut Wongsarnpigon 41.00 X 220262 0 19190 Donald Pettway 45.00 X 123267 0 11706 Evelyn Smith 50.00 X 110844 0 7660 Richard Scalzo 42.00 X 110782 0 8796 1020100 74792 143188 9 0 1 1 Speciality Risk Services PO BOX 33579 Hartford CT 061505454 Worker's Comp Claims 422160 Mental Health and Deafness 614 Anthony Trail Northbrook IL 60062 Deaf & Hearing Consulting 240000 Chicago Loss Prevention 100 Higgins Rd Park Ridge IL 60068 Security 158694 Northwest Benefit Consultant 2720 S River Rd Des Plaines IL 60018 403B Consultant 157394 Aftab S Noorani MD 2516 Anne Lane Northbrook IL 60062 Medical Services 140280 11 101567 235000 1181882 299130 1518449 Government Fees 900099 32665469 32665469 3rd Party Insur Claims 900099 1168186 1168186 33833655 1487857 1487857 602682 602682 602682 602682 15203301 16979 17308597 9727 -2105296 7252 -2098044 -2098044 265930 101567 221296 44634 44634 35389233 34436337 0 -565553 610477 610477 350675 350675 21427831 18657122 2539903 230806 1251667 1073093 165271 13303 2915104 2675258 213868 25978 1666056 1427270 221129 17657 1399933 720573 630193 49167 1040904 1040904 262696 262696 63730 63730 31410 31410 539471 349728 108894 80849 2886884 2028113 837576 21195 436942 328278 108664 62539 11890 50454 195 268595 268595 1788800 1356697 432007 96 754211 687184 62523 4504 Medicine/Drugs 1507810 1507810 HFS Hospital Assessment 1209170 1209170 Post Retirement Benefit 734452 734452 Dietary Supplies 710541 710541 Miscellaneous Expenses 686957 515752 158557 12648 4858179 -4891250 33071 42606855 38995730 3090246 520879 78567 123935 3325698 2051551 205731 4329 5067373 7334493 46951765 35127565 12914836 11824200 29817359 30276121 16052968 18941342 8613786 8116741 76076318 78672712 7996367 8962631 624575 718622 8620942 9681253 X 66830372 68405514 625004 585945 67455376 68991459 76076318 78672712 X 0 1 1 X 1 1 X 29288786 26300795 27732559 1863956 1518449 86704545 3366200 2002365 2110367 34195621 34480971 76155524 32654986 28303160 29842926 36059577 35999420 162860069 0 0 0 162860069 3323058 3331859 3041077 1784165 1487857 12968016 3323058 3331859 3041077 1784165 1487857 12968016 35978044 31635019 32884003 37843742 37487277 175828085 0.92620 0.91480 0.07380 0.08520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 4856432 132408 222009 4766831 0 625004 341034 380093 585945 390014 858835 623845 625004 1.00000 0 0 1521226 1521226 38058767 29034360 9024407 63098 63098 0 7112389 5941784 1170605 196285 88323 107962 11824200 US Gov. Agencies, Bonds & Corp. Securities 18941342 F 18941342 Cash Surrender Value of Insurance Policies 5850163 Split-Interest and Remainder Trust Agreement 437418 Prepaid Postretirement Benefits 607072 Other Long Term Receivables 1222088 8116741 Security Deposit 37684 Deferred Revenue 373778 Other Liability 300470 Unclaimed Properties 6690 718622 35389233 42606855 -7217622 8753705 8753705 1536083 44364234 8753705 221296 8975001 35389233 0 35389233 42828151 221296 221296 42606855 0 42606855 Part IV, Line 1b: Maryville provides certain medical & dental benefits for retired employees. The employees do not contribute to the cost of this benefit. The obligation is funded on an annual basis, and the assets for this plan are segregated and held in a separate legal trust. The trust was audited by Deloitte & Touche LLP as of June 30, 2010. Part V, Line 4: Description of Intended Use of Endowment Funds: The endowment funds are temporarily restricted as expenses paid in the current fiscal year did not fully offset amounts donated for particular programs. The remaining funds will be used in the next fiscal year. Part X, Line 2: FIN No. 48 is Effective July 1, 2009. Maryville evaluates its uncertain tax positions using the provisions of ASC Topic 740. It previously followed ASC Topic 405, Liabilities. Maryville's adoption of the updated ASC Topic 740 guidance had no impact on Maryville's financial statements. Part XII, Line 2d: Special events expense - $221,296 Part XIII, Line 2d: Special events expense - $221,296 Guardian Medallion 134949 26300 108649 49821 5505 40313 Shell Oil Golf Outing 95440 15272 80168 9 137108 59995 77113 8205 93231 24221 367497 101567 265930 8205 143052 5505 64534 221296 44634 1 1 1 X 170.000000000000 1 X 210.000000000000 1 1 1 0 0 1 2 1238429 1142376 96053 0.00800 10796018 10995541 -199523 0.00000 1 2 12034447 12137917 -103470 0.00800 133692 133692 133692 54771 78921 0.00660 133692 133692 133692 54771 78921 0.00660 133693 133694 12168139 12192688 -24549 0.01460 1 43499 0 1 1 Maryville Scott Nolan Center

555 Wilson Lane Des Plaines IL 60016

X X Part I, Line 6a: Maryville Academy prepares an annual survey which identifies community benefits and files it with the Illinois Department of Public Health and prepares a separate document regarding community benefits and files it with the American Hospital Association. Part I, Line 7: Maryville Scott Nolan Center uses the cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost to Charge, of the Schedule H instructions. Part I, Line 7f: Total bad debt expenses reported by Maryville Academy is $108,818 of which the Maryville Scott Nolan Center portion is $46,824. Total expense for the Maryville Scott Nolan Center of $12,094,564 less bad debt of $46,824 were used to calculate the percentages in this column. Part III, Line 9b: Maryville Scott Nolan Center follows the language of the Fair Patient Billing Act. Patients who are known to qualify for charity care are not subject to collection efforts. Part V: Maryville Scott Nolan Center also has one hospital-to-home transitional facility for medically-fragile children. Part VI, Line 2: The Community Relations Coordinator for the hospital meets on a frequent basis with all SASS agencies within the referral area to identify the needs of the patients in the various communties and report the information to hospital management. The coordinator attends LANS meetings in different regions during which representatives from community agencies and other relevant social service agencies work together to assure that necessary services are available for patients in need. The hospital also maintains contact with schools, hospital emergency rooms, and other professionals in the field in an effort to provide the care that is needed. Part VI, Line 3: The notice regarding eligibility for assistance is posted prominently in the lobby and intake office at the hospital. The notice and application are posted on the website for Maryville Academy. In addition, at times of intake families who may be in need of assistance are advised of the existence of sliding scale and charity care alternatives and are assisted in completing eligibility paperwork by intake office staff. Intake office staff are also advised to expedite review and eligibility decisions by immediately contacting hospital administration. Part VI, Line 4: The hospital serves the greater Chicago Metropolitan area, including but not limited to, Cook County, Lake County, Will County, McHenry County and DuPage County. Ninety-two percent (92%) of the hospital's patients use Medicaid insurance to pay for their services. Part VI, Line 5: The hospital operates a behavioral and family clinic serving the geographic area surrounding Des Plaines, Illinois. The clinic offers this type of counseling to the general public and specifically employs a bilingual clinician so that it could provide culturally-competent services to the burgeoning Hispanic community in northwest Cook County. Part VI, Line 6: As stated above, 92% of the hospital's patients use Medicaid as their payor. Our Medicaid rates are established annually by the Illinois Department of Healthcare and Family Services (HFS) and the relatively small surplus generated by the hospital is used to fund other social services programs operated by Maryville Academy. Some of these other programs are residential programs for: children with intellectual disabilities/mental illness; mental illness/substance abuse; social and behavioral disorders; and pregnant/parenting teens with mental illness (all of these programs operate at a deficit). Other programs include a Crisis Nursery (free to the public) for families needing temporary shelter for children under seven years of age during emergencies; a hospital- to-home transitional program for medically-fragile children (all of whom use Medicaid as their payor); and a shelter for teenage girls, many of whom are pregnant or parenting teens. Another community program includes the Catholic Youth Organization (CYO). This program, subsidized by Maryville Academy, allows teens not on their schools' sports teams to participate in organized games. The program operates in several economically disadvantaged communities within the City of Chicago as well as in suburban Cook County. 1 Scholarships for students attending Catholic High Schools in the Chicago area 34 137325 Scholarships for Maryville Alumni to attend college or trade schools. Scholarships pay for tuition, books, and housing. 12 138330 New clothing purchased for residents 345 99724 Fair Market Value Clothing Youth Allowances 345 72121 Provision of gifts and incentives for residents 345 49278 Fair Market Value Gifts and incentives Provision of youth entertainment to residents 345 48316 Fair Market Value Tickets to sporting events Provision of miscellaneous items to residents 171 65381 Fair Market Value Beauty and hygiene supplies Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: High school and college students are required to submit offical statements from their respective school for payment. Students are also required to produce grades for each school year as proof that they are in attendance. High school students must have a 2.0 G.P.A. at the end of each year, college students at the end of each semester. X X X X 0 0 0 0 0 0 0 0 0 Timothy Morgan 147980 0 0 0 0 0 2346 0 0 0 150326 0 0 0 Dr Mark Friedman 180571 0 0 0 0 0 5657 0 17463 0 203691 0 0 0 Dr Lerwut Wongsarnpigon 220262 0 0 0 0 0 2470 0 16720 0 239452 0 0 0 Supplemental Information Part III Dr. Lerwut Wongsarnpigon received compensation of $16,709 from Mental Health and Deafness, Inc. ("MHDI") for services he provided to MHDI clients while they were in the psychiatric unit at Maryville Scott Nolan Center. X 29072 Cost/ Selling price X 3 7699 Cost/ Selling price X 17 12880 Cost/ Selling price X Golf equip. 3 211514 Cost/ Selling price X Toys 18 20327 Cost/ Selling price X Tickets/cards 45 17638 Cost/ Selling price 0 0 0 Form 990, Part VI, Section A, line 2 Chairman George Rourke is the father-in-law of director Michael Golden. Form 990, Part VI, Section A, line 7b Certain by-laws and appointment of board members and the executive director must be approved by the Catholic Bishop of Chicago. Form 990, Part VI, Section B, line 11 The Form 990 will be presented to the audit committee for internal review before the Form 990 is presented to the entire board for approval prior to filing. Form 990, Part VI, Section B, line 12c Annually each member of the board signs a conflict of interest statement and these documents are held at the office of our corporate attorney. Also, if the organization intends to enter into any business relationship with a board member, the proposed business relationship is presented to the Board of Directors and the potential conflict of interest is fully disclosed. If there is a conflict of interest for any employee, it is brought to the attention of the Associate Executive Director and/or Human Resources Director as required in Maryville Academy Personnel Policy and Procedure Manual. Form 990, Part VI, Section B, line 15 During the fiscal year 2010, a salary survey for a number of executive positions, that accounted for comparability data was undertaken by an independent consultant engaged by Maryville Academy. The results of the survey were forwarded to the Human Resources Committee, for review in determining the compensation for each position. The salary recommendations of the Committee were utilized in connection with the establishment of the annual budget of Maryville Academy for the next fiscal year. The annual budget, inclusive of the salary results, was presented to the Maryville Board of Directors for review and ratification, subject to any revisions it deems appropriate. Maryville Academy expects to follow a similar process in subsequent fiscal years. Form 990, Part VI, Section C, line 19 The public can request the documents and Maryville will make copies and mail them to the requestor. PART VII No Salary is reported for Sr. Catherine Ryan, Maryville Academy Executive Director, as her salary of $65,817 is paid to the Order of School Sisters of St. Francis and not to Sr. Catherine Ryan, pursuant to a vow of poverty taken by Sr. Catherine Ryan. Monsignor Michael Boland, who is a Maryville Academy director, works 35 hours per week as the Executive Director of Catholic Charities of the Archdiocese of Chicago. Bishop George Rassas, who is a Maryville Academy director, works 45 hours per week as an Auxiliary Bishop for the Catholic Archdiocese of Chicago. 1 1 1