2011-10-27T12:29:55-05:00 2010-12-31 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2010-01-01 363366652 PROVENA HEALTH PROV 8158062309 9223 West ST FRANCIS ROAD FRANKFORT IL 604238334 Anthony J Filer 8158062309 2011-10-26 true KPMG LLP 6142492300 2010 2016-03-07 17:11:31Z Guy Weibking 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 151156278 false X www.provena.org X 1997 IL Shares clinical procedures and administrative tasks between a group of six faith based hospitals and fifteen residential centers to control costs and implement technologies designed to improve efficiency. 15 14 709 14 0 0 0 95994950 97756808 23613561 53283195 218516 116275 119827027 151156278 0 0 0 0 55439055 63106053 0 0 0 98452944 72216755 153891999 135322808 -34064972 15833470 495642366 518199982 804021367 798878848 -308379001 -280678866 PROVENA HEALTH CONSISTS OF A NUMBER OF FAITH-BASED ORGANIZATIONS THAT WERE BROUGHT TOGETHER TO STRENGTHEN THE CATHOLIC HEALING MINISTRY IN THE REGION. AS A GROUP OF SIX HOSPITALS, AND FIFTEEN LONG TERM CARE AND RESIDENTIAL CENTERS, CLINICAL PROCEDURES AND ADMINISTRATIVE TASKS WILL BE SHARED IN ORDER TO CONTROL COSTS AND IMPLEMENT TECHNOLOGIES DESIGNED TO IMPROVE EFFICIENCY to support the mission of healthcare in our communities. false false 133824441 97756808 PROVIDE MANAGEMENT AND CONSULTING SERVICES TO RELATED HEALTH ORGANIZATIONS WHICH PROVIDE VARIOUS HEALTH CARE SERVICES LOCATED IN KANKAKEE, CHAMPAIGN-URBANA, ELGIN, JOLIET, ROCKFORD, AND ILLINOIS MARKETPLACES. 133824441 true false false true false false false false false true true true false true true false true false false false false false false false false false false false true true false false false false false true false false false false false false false false true true false false true false true 86 0 true 709 true false false false false false false false false false false false false false X 15 14 false false false false false true true true true false true true true true true true true true true true true true IL X X PATRICK QUINN 8158062328 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 WILLIAM BERRY PHD 1.0 X 0 0 0 ROBERT BIEDRON 1.0 X X 0 0 0 AIDA GIACHELLO PHD 1.0 X 0 0 0 MARK HANSON 1.0 X X 0 0 0 SISTER LINDA HATTON SSCM 1.0 X X 0 0 THOMAS HUBERTY MD 1.0 X 0 0 SISTER MARY ELIZABETH IMLER 1.0 X 0 0 BETTINA JOHNSON 1.0 X X 0 0 LUCIA JONES 1.0 X 0 0 SISTER TERRY MALTBY 1.0 X 0 0 BECKY MEGGESIN 1.0 X 0 0 DANIEL RUSSEL 1.0 X 0 0 KENT RUSSELL 1.0 X 0 0 GUY WIEBKING 40.0 X X 836955 12250 Marsha Ladenburger 1.0 X 0 0 JEFFREY BRICKMAN 40.0 X 755911 96789 WILLIAM BROWN 40.0 X 671382 30108 ANTHONY FILER 40.0 X 647860 109267 DAVID BERTAUSKI 40.0 X 577156 90247 MARGARET GAVIGAN 40.0 X 544420 84543 STEPHEN SCOGNA 40.0 X 530403 116869 ROBERT PERMUT 40.0 X 563624 75607 EDWARD MOLARE 40.0 X 431152 65543 CONNIE MARCH-CURTIS 40.0 X 419349 71112 MARGERY KIEFFER 40.0 X 413592 69492 GARY GASBARRA 40.0 X 403151 83499 TERRY SOLEM 40.0 X 377149 64086 MICHAEL ARNO 40.0 X 345270 90985 JOHN LYNCH 40.0 X 326022 68413 PAUL BELTER 40.0 X 316969 62724 MICHAEL BROWN 40.0 X 318105 57638 JAMES WITT 40.0 X 309572 63798 THOMAS NEHRING 40.0 X 296512 59306 EDWIN ROSE 40.0 X 274906 67825 LINDA CHARLEY 40.0 X 270664 25986 PATRICK QUINN 40.0 X 301747 62670 BRYANT HAMMIG 40.0 X 288299 49197 LORETTA CLIFFORD 40.0 X 228955 50313 OKSANA SHULZHENKO 40.0 X 222668 4453 SUSAN MORELLI-PURICELLI 40.0 X 217715 36142 STEVEN HUNTER 40.0 X 701526 10163 11591034 0 1679025 99 true true false HURON CONSULTING GROUP LLC 4795 PAYSPHERE CIRCLE CHICAGO IL 60674 CONSULTING 7174120 CATHOLIC HEALTHCARE AUDIT NETWORK 231 S BEMISTON AVE SUITE 300 CLAYTON MO 63105 CONSULTING 2059607 MIRAMED REVENUE GROUP 991 OAK CREEK DRIVE LOMBARD IL 60148 COLLECTIONS 2029052 BOLINGBROOK INVESTORS PARK SEVENTEEN 1717 MCKINNEY AVE DALLAS TX 75202 OFFICE RENT 1996798 RAYMOND E CLUTTS 1111 N PLAZA DR SUITE 405 SCHAUMBURG IL 601734981 Collections 3042508 22 0 ADMIN REVENUE 561000 97756808 97756808 97756808 53280428 2767 0 0 0 0 0 0 OTHER REVENUE 561000 116275 116275 116275 151156278 97873083 0 0 0 0 0 11096211 10154248 941963 0 33286106 33286106 1190731 1190731 14375778 14375778 3157227 3157227 0 656068 656068 253164 253164 0 0 0 2634904 2572977 61927 100648 100648 801747 722400 79347 0 0 3447628 3447628 235577 207790 27787 0 82588 75780 6808 36149595 36149595 0 12456566 12456566 2019458 2019458 CONSULTING 265353 265353 REPAIRS & MAINTENANCE 9075565 9046986 28579 0 UTILITIES 2202491 2151126 51365 EQUIPMENT RENTAL EXPENSE 1164326 1062744 101582 RECRUITMENT 234077 233624 453 437000 238444 198556 0 135322808 133824441 1498367 0 2100 2100 42428898 62669497 9890947 16071906 8609188 10454545 156849645 117140183 44152189 39709462 291327304 299123255 47801034 38309008 36935305 36935305 14495401 14924904 495642366 518199982 30937740 41390741 6548 836000 0 629883359 621672506 0 0 142364268 135809053 804021367 798878848 X -308379001 -280678866 0 -308379001 -280678866 495642366 518199982 X 15833470 11866665 X false true true X false X X false false false PROVENA HOSPITALS 364195126 03 true true true -4157121 PROVENA SERVICE CORP 364314354 03 true true true 10843228 PROVENA SENIOR SERVICES 371127787 05 true true true -2072160 PROVENA CARE HOME 460483587 09 true true true 0 PROVENA HOME HEALTH 460483581 09 true true true 135831 PROVENA HEALTH SELF INSURANCE TRUST 362987310 09 true true true -24224184 6 -19474406 POSITIVE SUPPORT WAS PROVIDED TO PROVENA HOSPITALS, PROVENA SENIOR SERVICES AND PROVENA HEALTH SELF INSURANCE TRUST IN 2010. HOWEVER, AMOUNTS WERE OWED FROM THESE ENTITIES TO PROVENA HEALTH THAT WERE GREATER THAN THE SUPPORT PROVIDED WHICH REDUCED THE ACTUAL AMOUNT OF SUPPORT TRANSFERRED. false true false false false false true 180000 false false 180000 false SUPPLEMENTAL INFORMATION TO FORM 990 SCHEDULE C PART II-B, QUESTION 1I THE ORGANIZATION MAINTAINS AN ADVOCACY SECTION ON ITS WEBSITE THAT INCLUDES POSITION PAPERS ON KEY ISSUES, AS WELL AS ALERTS FOR PEOPLE TO CONTACT LEGISLATORS ON PARTICULAR PIECES OF LEGISLATION. 197831 197831 7901828 3952147 3949681 144702090 112986268 31715822 4047896 3937 4043959 39709462 LIMITED USE ASSETS 38172007 F LT INVESTMENTS CAPTIVE 137001 F 38309008 INV IN PROVENA SENIOR SERVICES 124013 F INV IN PROVENA VENTURES 32162647 F INVESTMENT IN PPIC 4648645 F 36935305 0 OTHER LONG-TERM LIABILITIES 29994063 DUE TO AFFILIATES 1695186 WORKERS COMP LIABILITIES 12300486 PENSION LIABILITY 91819318 135809053 Supplemntal Information On January 1, 2008, Provena adopted ASC Subtopic 740-10 Income Taxes- Overall, which addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, Provena may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. At the date of adoption, and as of December 31, 2010, Provena does not have any liabilities for any unrecognized tax benefits. X X true true X X X X X true true false false false true true false false GUY WIEBKING 787764 0 49191 12250 914 850119 PATRICK QUINN 225247 18684 57816 35148 28405 365300 BRYANT HAMMIG 212924 20241 55134 32264 17797 338360 LORETTA CLIFFORD 188204 17375 23376 25226 25087 279268 OKSANA SHULZHENKO 222668 0 0 4453 0 227121 SUSAN MORELLI-PURICELLI 170362 14675 32678 19852 16996 254563 JEFFREY BRICKMAN 540902 82794 132215 77700 19089 852700 WILLIAM BROWN 72698 26877 571807 8986 22036 702404 ANTHONY FILER 505495 59049 83316 73043 37138 758041 DAVID BERTAUSKI 462173 81940 33043 64486 26657 668299 MARGARET GAVIGAN 428837 52351 63232 64253 21204 629877 STEPHEN SCOGNA 376404 90745 63254 82374 35409 648186 ROBERT PERMUT 489444 0 74180 52949 23572 640145 EDWARD MOLARE 268666 32068 130418 50540 15917 497609 CONNIE MARCH-CURTIS 271471 54549 93329 48639 22387 490375 MARGERY KIEFFER 310555 38457 64580 53552 16854 483998 GARY GASBARRA 297897 38213 67041 50837 33576 487564 TERRY SOLEM 287046 33615 56488 48969 16031 442149 MICHAEL ARNO 256167 48230 40873 43334 48565 437169 JOHN LYNCH 255629 29320 41073 47679 21648 395349 PAUL BELTER 276926 13352 26691 34408 29230 380607 MICHAEL BROWN 251128 13953 53024 39001 19551 376657 JAMES WITT 254248 20791 34533 44138 20574 374284 THOMAS NEHRING 228177 29030 39305 43469 16751 356732 EDWIN ROSE 203260 23370 48276 42236 26503 343645 LINDA CHARLEY 207359 20499 42806 12635 14265 297564 STEVEN HUNTER 0 0 701526 0 11077 712603 part i, question 4a PART I, QUESTION 4A THE FOLLOWING RECEIVED SEVERANCE PAYMENTS: STEVEN HUNTER 701,526 PART I, QUESTIONS 6A & 6B THE ORGANIZATION HAS AN INCENTIVE COMPENSATION PLAN BASED ON KEY TARGETS BASED ON QUALITY, SERVICE, AND STEWARDSHIP. IF TARGETS ARE ACHIEVED, PAYOUTS ARE MADE TO COVERED EMPLOYEES. THE COVERED EMPLOYEES INCLUDE MANAGERS, DIRECTORS, VICE PRESIDENTS, AND CHIEF EXECUTIVE OFFICERS. ILLINOIS FINANCE AUTHORITY 861091967 45200FYA1 2009-06-25 194912720 09A-capital expenditure reimbu false false false ILLINOIS FINANCE AUTHORITY 861091967 45200FYF0 2009-07-09 50000000 09b-capital expenditure reimbu false false false ILLINOIS FINANCE AUTHORITY 861091967 45200FYG8 2009-07-09 41000000 09c-capital expenditure reimbu false false false ILLINOIS FINANCE AUTHORITY 861091967 45200FYH6 2009-07-09 25000000 09d-capital expenditure reimbu false false false 200000000 19458800 3140000 175129200 2009 true false true true 50000000 581897 50000000 2009 true false true true 41000000 477155 41000000 2009 true false true true 25000000 290948 25000000 2009 true false true true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false false false false false false false false false false false false true false false false false false true false false false false ELIZABETH HUGHES RELOCATION X 350000 100867 false true 100867 FORM 990 PART VI SECTION A, QUESTIONS 7A & 7B The member body consisting of 2 members appointed by the leadership teams of each sponsoring congregation that are Franciscan Sisters of the Sacred Heart, Servants of the Holy Heart of Mary, USA Province and Sisters of Mercy, West, Mid-West Region has the authority to appoint Board members and approve the recommendations of the Board. FORM 990 PART VI SECTION B, QUESTION 11A THE BOARD REVIEWS THE FORM 990 AND SUPPORTING SCHEDULES AT A MEETING BEFORE SUBMISSION TO THE IRS. THE RETURN IS SUBMITTED WITH THE BOARD PACKAGE AND IS ALSO PLACED ON A BOARD MEMBER WEBSITE. ANNUAL EDUCATION SESSIONS ON THE 990 ARE ALSO GIVEN TO THE BOARD. FORM 990 PART VI SECTION B, QUESTIONS 12A, 12B, & 12C THE ORGANIZATION HAS ADOPTED A POLICY THAT REQUIRES BOARD MEMBERS TO COMPLETE A STATEMENT THAT DISCLOSES ALL ACTIVITIES AND PROHIBITS VOTING ON ANY MATTERS INVOLVING ANY CONFLICTS. EVERY AGENDA HAS A STATEMENT THAT PROHIBITS VOTING ON AGENDA ITEMS WHERE BOARD MEMBERS HAVE CONFLICTS. VENDOR FILES ARE MATCHED WITH COMPANIES BOARD MEMBERS THAT HAVE AFFILIATIONS WITH TO DETERMINE IF CONFLICTS EXIST. FORM 990 PART VI SECTION B, QUESTIONS 15A & 15B AN INDEPENDENT HUMAN RESOURCES COMPANY REVIEWS SALARY SURVEYS FOR CEO'S AND KEY EMPLOYEES DURING THE YEAR AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. FORM 990 PART VI SECTION C, QUESTION 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND ARE ON THE ORGANIZATION'S WEBSITE. FORM 990 PART XI Line 5, Other Change in Net Asset or Fund Balance Unrealized gain on securities 14,261,185 Change in FMV of interest rate swap 95,114 Change in FMV of derivative instruments (6,791,743) Net Asset Transfers 19,474,405 Cumulative effect of change in accounting principal (15,172,296) Other Changes in Net Assets or Fund Balances (Line 5) 11,866,665 Alverno Provena Hospitals Laboratory 2434 Interstate Plaza Drive Hammond IN 46324 203238867 Healthcare IN 102287227 150000 NA PROVENA HOSPITALS 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 364195126 HEALTHCARE IL 501(c)(3) 3 N/A PROVENA SENIOR SERVICES 19065 HICKORY CREEK DRIVE MOKENA IL 60448 371127787 HEALTHCARE IL 501(C)(3) 7 N/A PROVENA CARE HOME 19065 HICKORY CREEK DRIVE Mokena IL 60448 460483587 HEALTHCARE IL 501(c)(3) 9 N/A PROVENA HOME HEALTH INC 19065 HICKORY CREEK DRIVE Mokena IL 60448 460483581 HEALTHCARE IL 501(c)(3) 9 N/A PROVENA SELF-INSURANCE TRUST 9223 WEST ST ST FRANCIS ROAD FRANKFORT IL 60423 362987310 INSURANCE IL 501(c)(3) 9 NA PROVENA LAVERNA TERRACE 19065 HICKORY CREEK DRIVE STE 310 Mokena IL 60448 363438977 HEALTHCARE IL 501(c)(3) 9 NA PROVENA VENTURES 9223 West ST FRANCIS ROAD FRANKFORT IL 60423 371168085 MEDICAL IL N/A C Corp -277397 10983414 1.00000 PROVENA SERVICE CORPORATION 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 364314354 MEDICAL IL provena hospita C Corp PROVENA PROPERTIES 9223 west st francis road frankfort IL 60423 363520630 medical IL N/A C Corp PROVENA ASSURANCE CORPORATION 9223 west st francis road frankfort IL 60423 980420054 MEDICAL IL NA C Corp false false false false false false false false false false false false false false true true true true TRANSFERRED CASH TO PROVENA SERVICE CORP FOR q 10846117 ACCOUNTS PAYABLE AND PAYROLL