2011-11-14T10:35:34-06:00 2010-12-31 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2010-01-01 370661234 Saint Anthony's Health Center SAIN 6184652571 One Saint Anthonys Way PO Box 3 Alton IL 620020340 EJ KUIPER 2011-11-12 true Donna J Larson 3142315544 2010 2016-02-24 21:20:13Z EJ KUIPER SAINT ANTHONYS WAY PO BOX 340 ALTON IL 62002 101476664 false 0928 X WWW.SAHC.ORG X 1925 IL SPONSORED BY THE SISTERS OF ST. FRANCIS OF THE MARTYR ST. GEORGE, SAINT ANTHONY'S HEALTH CENTER IS A TWO-CAMPUS SYSTEM WITH A MISSION OF MAKING CHRIST'S MERCIFUL LOVE VISIBLE BY PROVIDING QUALITY HEALTH CARE 25 20 993 90 768626 222863 353881 96548965 99378396 -1469146 126632 1454908 1550750 96757590 101409659 172286 23305 0 0 42817693 43058216 0 0 0 53825331 53865013 96815310 96946534 -57720 4463125 54672314 64767602 40183548 51483075 14488766 13284527 X SPONSORED BY THE SISTERS OF ST. FRANCIS OF THE MARTYR ST. GEORGE, SAINT ANTHONY'S HEALTH CENTER IS A TWO-CAMPUS SYSTEM WITH A MISSION OF MAKING CHRIST'S MERCIFUL LOVE VISIBLE BY PROVIDING QUALITY HEALTH CARE. false false 52851140 23305 768626 HEALTH CARE & OTHER SERVICES INCLUDE: ICU, OB, LEVEL II NURSERY, PEDIATRICS, PET, HOSPICE, PAIN CENTER, ULTRASOUND, NUCLEAR MEDICINE, MRI, RADIOLOGY, LABORATORY, GI DIAGNOSTIC CENTER, CANCER CENTER, I/P REHAB, SNF, & HOME HEALTH CARE. 13265317 44451818 SURGICAL SERVICES INCLUDE DENTAL, ORTHOPEDIC, GENERAL, UROLOGY, PLASTIC, OPTHAMALOGY, ENT AND PODIATRY. THERE WERE 7,126 SURGICAL SERVICES PERFORMED IN 2010. 8297649 26728781 EMERGENCY SERVICES HAD 24,712 CASES IN 2010. THIS INCLUDED 2,686 INPATIENT CASES AND 22,026 OUTPATIENT CASES. 7502481 28197797 CARDIOLOGY SERVICES HAD 6,440 CASES IN 2010. THIS INCLUDED 637 INPATIENT CASES AND 5,803 OUTPATIENT CASES. 7502481 28197797 81916587 true true false true false false false false true true false false false true false true true false false false false false false false false true false true false true true false true false false false false false false true true false false false false true true false false false false true 99 0 true 993 true true true false false false false false false false false false X 25 20 false false false false true true true true true false false false true true true true true true false true false X MICHAEL L NELSON 6184635616 815 EAST FIFTH STREET SUITE 401 ALTON IL 62002 DANIEL V BEISER 1.0 X 0 0 0 SISTER M ANSELMA BELONGEA 40.0 X 0 0 0 EDWARD BLAIR JR MD 1.0 X 2388 191388 10055 DALE CHAPMAN 1.0 X 0 0 0 MOTHER M REGINA COURY PACIS 1.0 X 0 0 0 SISTER M KATERI HAWLEY 1.0 X 0 0 0 A JESSE HOPKINS 1.0 X 0 0 0 JAMES HUDSON MD 1.0 X 0 0 0 SALVADOR LOBIANCO MD 1.0 X 15000 0 0 SISTER M MIKELA MEIDL 40.0 X X 0 0 0 THOMAS MOORE 1.0 X 0 0 0 SISTER M ANGELICA NEUMANN 40.0 X X 0 0 0 DONALD NORTON 1.0 X 0 0 0 LARRY REED MD 1.0 X 562 0 0 JANE SAALE 1.0 X 0 0 0 HERMAN SEEDORF 1.0 X 0 0 0 JOAN SHEPPARD 1.0 X 0 0 0 JIM SHRADER 1.0 X 0 0 0 MARK WEBER 40.0 X X 835960 0 94297 DWIGHT WERTS 1.0 X 0 0 0 STEVEN ZENKER MD 1.0 X 150 0 0 EVERT J KUIPER 40.0 X X 580434 0 69364 SISTER M ANASTASIA MAHER 40.0 X X 0 0 0 SISTER M STEPHANIE BELGERI 1.0 X 0 0 0 SISTER M ALEXANDRA MORRISON 1.0 X 0 0 0 MICHAEL L NELSON 40.0 X 234859 0 168696 MICHAEL RUSSO 40.0 X 155314 0 50503 TERRY BRENNAN 40.0 X 155149 0 25796 PATTI FISCHER 40.0 X 128284 0 61028 EUGENE GOTWAY 40.0 X 110515 0 67147 MARY WENDLE 40.0 X 112065 0 83946 ROBERT EPPING 40.0 X 108175 0 18641 2438855 191388 649473 13 false true false THOMPSON COBURN LLP PO BOX 18379M SAINT LOUIS MO 63195 ATTORNEY 642924 DELL PEROT SYSTEMS 12020 COLLECTIONS CENTER DR CHICAGO IL 60693 BILLING SERVICES 1710527 SSM HLTH CARE CLINICAL ENGINEERING 477 NORTH LINDBERGH BOULEVARD SAINT LOUIS MO 63141 MED EQUIP MAINT-RPR 1019362 SISTERS OF STFRANCIS 1 FRANSCISCAN WAY ALTON IL 62002 ADMIN&NURSING SRVCS 936905 RIGHTCHOICE 10795 WATSON ROAD SAINT LOUIS MO 63127 HLH PLN 3RD PRTY ADM 834103 20 62746 52576 238559 353881 NET PATIENT REVENUE 621110 99378396 99378396 99378396 81867 81867 0 0 35377 35377 35377 35377 111770 0 0 67005 111770 -67005 44765 44765 0 0 0 CAFETERIA SALES 722210 436038 436038 MANAGEMENT FEE 561000 305750 305750 NON-PATIENT DME SALES 453000 768626 768626 4959 4959 1515373 101409659 99378396 768626 908756 23305 23305 0 0 0 2188995 0 2188995 0 0 30305254 27715424 2589830 1367555 1250686 116869 6825378 6242094 583284 2371034 2022334 348700 99738 99738 1313693 1313693 95711 95711 0 0 0 7360361 4753035 2607326 735451 735451 17789094 16957365 831729 1070458 216718 853740 0 1810981 1774981 36000 187743 144483 43260 0 40817 3407 37410 1115613 1115613 0 3102536 2919681 182855 2045424 500 2044924 BAD DEBT EXPENSE 13804722 13804722 DUES & SUBSCRIPTIONS 371682 65140 306542 MINOR EQUIPMENT 193552 179662 13890 PROPERTY TAXES 158816 158816 DPA PROVIDER TAX 2500451 2500451 68170 68170 96946534 81916587 15029947 0 3701 3701 5539259 5033017 15305073 15439564 2080259 2960967 1668792 1662136 781257 2197093 98441066 72500671 22995095 25940395 4806522 10038419 1492356 1492310 54672314 64767602 8486354 11018054 8105966 16421734 5007474 1826312 18583754 22216975 40183548 51483075 X 13388463 11973127 1100303 1311400 14488766 13284527 54672314 64767602 X 4463125 -5667364 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true 9 false false true 59784 false 59793 false 4806522 0 442889 0 0 23640 5225771 4266928 0 539594 0 0 0 4806522 5266818 96298 -646583 425000 24605 4266928 1.00000 true false 3883217 3883217 48035320 40122230 7913090 35359315 27305985 8053330 11163214 5072456 6090758 25940395 0 THIRD PARTY SETTLEMENTS 2005000 PENSION LIABILITY 18261568 ASSET RETIREMENT OBLIGATION 1950407 22216975 101409659 96946534 4463125 234183 -5901547 -5667364 -1204239 101402964 234183 184271 418454 100984510 133557 291592 425149 101409659 96879657 66680 66680 96812977 133557 133557 96946534 INTENDED USES OF ENDOWMENT FUNDS PART V, LINE 4 THESE FUNDS ARE TO BE USED FOR FUTURE CAPITAL IMPROVEMENTS, FUTURE RETIREMENT PLAN CONTRIBUTIONS AND OTHER USES WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES. FIN 48 PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. OTHER CHANGES IN NET ASSETS PART XI, LINE 8 CHANGE IN VALUE OF TRUSTS $37,096 FAS 158 ADJUSTMENT ($3,591,097) CHANGE IN INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS ($46) TRANSFER TO ST. ANTHONY HEALTH SYSTEM ($2,347,500) TOTAL ($5,901,547) OTHER REVENUE ON BOOKS BUT NOT ON RETURN PART XII, LINE 2D LOSS FROM SALE OF ASSETS $66,680 RELEASE FROM RESTRICTIONS $117,591 TOTAL $184,271 OTHER REVENUE ON RETURN BUT NOT ON F/S PART XII, LINE 4B RESTRICTED CONTRIBUTION REVENUE $291,592 OTHER EXPENSES ON BOOKS BUT NOT ON RETURN PART XIII, LINE 2D LOSS FROM SALE OF ASSETS $66,680 true true X true X true X 600. true true true false true false 2264000 2264000 0.02720 11152449 10481474 670975 0.00810 13416449 10481474 2934975 0.03530 3252 560553 30995 529558 0.00640 984 1049143 1049143 0.01260 444 321710 229184 92526 0.00110 58755 58755 0.00070 4680 1990161 260179 1729982 0.02080 4680 15406610 10741653 4664957 0.05610 true 2590000 388500 35560218 32219283 3340935 X true true 2 1 SAINT ANTHONY'S HOSPITAL

ONE SAINT ANTHONYS WAY ALTON IL 62002

X X X 2 SAINT CLARE'S HOSPITAL

915 EAST FIFTH STREET ALTON IL 62002

X ACUTE INPATIENT PHYSICAL REHABILITATION SAINT ANTHONY'S HOSPITAL 1 SAINT CLARE'S HOSPITAL 2 2 Saint Anthony's Medical Mall

4325 Alby Street Alton IL 62002

Ambulatory Surgical Treatment Center Saint Anthony's Imaging Center

325 East Madison Avenue Wood River IL 62095

Outpatient diagnostic radiology facility COSTING METHODOLOGY PART I, LINE 7 THE ORGANIZATION USES THE COST TO CHARGE RATIO FROM WORKSHEET C OF THEIR MEDICARE COST REPORT AS THEIR COSTING METHODOLOGY FOR THE AMOUNTS IN THE TABLE ON PART I, LINE 7. PART I, LINE 7, COLUMN F: THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $13,804,722 REPORTED ON PART IX, LINE 25 OF THE FORM 990; HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS PART I, LINE 7, COLUMN F. BAD DEBT EXPENSE PART III, LINE 4A THE HEALTH CENTER'S TOTAL COST OF UNCOMPENSATED CARE RELATING TO CHARITY CARE AND UNCOLLECTIBLE ACCOUNTS ARE AS FOLLOWS FOR 2010: CHARITY CARE - $2,264,000, UNCOLLECTIBLE ACCOUNTS - $2,590,000, AND TOTAL COSTS OF UNCOMPENSATED CARE - $4,854,000. IN ADDITION TO THESE COSTS OF UNCOMPENSATED CARE, THE HEALTH CENTER ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF SUPPORTING OR FINANCIALLY VIABLE. BAD DEBT METHODOLOGY PART III, LINE 4B THE AMOUNT ON LINE 2 WAS DETERMINED USING THE COST TO CHARGE RATIO FROM WORKSHEET C OF THE MEDICARE COST REPORT AS APPLIED TO THE TOTAL BAD DEBT EXPENSE TO CALCULATE THE COST OF UNCOLLECTIBLE ACCOUNTS. WE DO NOT INCLUDE ANY BAD DEBT IN OUR COMMUNITY BENEFIT. MEDICARE PART III, LINE 8 THE COST ON LINE 6 IS FROM THE FILED 12/31/2010 MEDICARE COST REPORT. WE DO NOT INCLUDE THE COST OF MEDICARE IN OUR COMMUNITY BENEFIT. COLLECTION PRACTICES PART III, LINE 9B IF THERE IS A BALANCE LEFT AFTER THE CHARITY CARE HAS BEEN APPLIED OR FINANCIAL ASSISTANCE APPROVED, THEN PAYMENT ARRANGEMENTS ARE MUTUALLY AGREED UPON BY BOTH THE APPLICANT AND ST. ANTHONY'S HEALTH CENTER. NEEDS ASSESSMENT PART VI, LINE 2 SAINT ANTHONY'S HEALTH CENTER MAINTAINS ONGOING DIALOGUE WITH KEY MEMBERS OF THE COMMUNITY SUCH AS HEADS OF VARIOUS COMMUNITY ORGANIZATIONS, CHARITY ORGANIZATIONS, AND EDUCATIONAL INSTITUTIONS. THE DIALOGUE AND RELATIONSHIPS WITH THESE COMMUNITY MEMBERS ASSISTS US IN UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITY, AND HOW WE CAN BEST POSITION OURSELVES TO SUPPORT THE NEEDS OF THE COMMUNITY. WE HAVE, PERIODICALLY, COMPLETED FOCUS GROUPS WITH MEMBERS OF THE COMMUNITY TO ASCERTAIN THEIR VISION OF WHAT IS NEEDED FROM A HEALTH CARE PERSPECTIVE. WE ALSO SEEK TO UNDERSTAND THE DEMOGRAPHICS OF OUR SERVICE AREA, AS THAT OFTEN HELPS US ZERO IN ON THE PARTICULAR HEALTH NEEDS OF THE COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT THERE IS FINANCIAL ASSISTANCE AVAILABLE. THE DOCUMENTATION PROVIDES THE NAMES AND PHONE NUMBERS OF OUR FINANCIAL COUNSELORS. WHEN NOTIFIED BY A PATIENT, OUR FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT SCREENING THEM FOR THEIR ELIGIBILITY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. COMMUNITY INFORMATION PART VI, LINE 4 THE CITY OF ALTON, IL LOCATED 15 MILES NORTH OF ST. LOUIS, MO, PLUS THE SURROUNDING CITIES AND TOWNSHIPS OF GODFREY, EAST ALTON, WOOD RIVER, BETHALTO, JERSEYVILLE, BRIGHTON, AND COTTAGE HILLS COMPRISE OUR PRIMARY SERVICE AREA (PSA). THE POPULATION OF THE PSA IS APPOXIMATELY 88,000 PEOPLE. THE MEDIAN AGE OF OUR PSA IS 35 YEARS OLD. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 SAINT ANTHONY'S HEALTH CENTER MAINTAINS AN OPEN MEDICAL STAFF. WE INCLUDE NUMEROUS COMMUNITY MEMBERS ON OUR GOVERNING BOARD AND SAINT ANTHONY'S FOUNDATION BOARD. THE HOSPITAL OPERATES AT LOW PROFIT MARGINS AND AT LOW CASH LEVELS, RETURNING SURPLUSES TO ENHANCE THE MISSION OF THE FACILITY. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 SAINT ANTHONY'S HEALTH SYSTEM CONSISTS OF SAINT ANTHONY'S HEALTH CENTER AND SAINT ANTHONY'S PHYSICIAN GROUP. SAINT ANTHONY'S PHYSICIAN GROUP IS INSTRUMENTAL IN FULFILLING THE HEALTH NEEDS OF THE COMMUNITY THROUGH ITS PHYSICIAN PROVIDERS. IN 2010, SAINT ANTHONY'S HEALTH CENTER COMPLETED A PHYSICIAN NEEDS ASSESSMENT OF OUR PRIMARY AND SECONDARY SERVICE AREAS. THAT REPORT CLEARLY IDENTIFIED INTERNAL MEDICINE AND FAMILY PRACTICE PHYSICIANS AS THE GREATEST PROVIDER NEEDS OF OUR SERVICE AREA. THIS ASSESSMENT ASSISTED US IN DETERMINING OUR PHYSICIAN RECRUITMENT STRATEGY, WHICH IS HEAVILY CENTERED ON PRIMARY CARE. WHERE SAINT ANTHONY'S PHYSICIAN GROUP OFFERS THE PHYSICIAN SERVICES TO OUR POPULATION, THE HEALTH CENTER PROVIDES THE FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO FULFILL THE NEEDS IDENTIFIED BY THE PHYSICIANS. DIALOGUE WITH OUR MEDICAL STAFF IS AN IMPORTANT MEANS OF UNDERSTANDING THE NEEDS OF OUR POPULATION, AS WELL. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL, true X PROCEDURES FOR MONITORING GRANT FUNDS PART I, LINE 2 TRADITIONALLY, SAINT ANTHONY'S HEALTH CENTER DOES NOT OFFER GRANTS OR ASSISTANCE. ALL DONATIONS WERE MADE TO PRE-SELECTED, REPUTABLE, PUBLICLY SUPPORTED CHARITABLE ORGANIZATIONS. X X true true X X X true false false false false false false false false EDWARD BLAIR JR MD 2388 190388 0 0 0 1000 0 0 0 10055 2388 201443 0 0 MARK WEBER 403356 0 0 0 432604 0 93486 0 811 0 930257 0 0 0 EVERT J KUIPER 353825 0 200000 0 26609 0 22347 18532 28485 0 631266 18532 0 0 MICHAEL L NELSON 225765 0 0 0 9094 0 152928 0 15768 0 403555 0 0 0 MICHAEL RUSSO 154077 0 0 0 1237 0 29593 0 20910 0 205817 0 0 0 TERRY BRENNAN 35549 0 54171 0 65429 0 25379 0 417 0 180945 0 0 0 PATTI FISCHER 127268 0 0 0 1016 0 40683 0 20345 0 189312 0 0 0 EUGENE GOTWAY 110052 0 0 0 463 0 44681 0 22466 0 177662 0 0 0 MARY WENDLE 111182 0 0 0 883 0 61217 0 22729 0 196011 0 0 0 DESCRIPTION OF ADDITIONAL BENEFITS PROVIDED PART I, LINE 1A COUNTRY CLUB BENEFITS WERE PROVIDED TO THE FOLLOWING OFFICERS: EVERT KUIPER $7,843 MICHAEL NELSON $7,947 ALL OF THESE AMOUNTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. EVERT KUIPER ALSO RECEIVED TAX GROSS-UP PAYMENTS IN THE AMOUNT OF $4,972, WHICH WERE INCLUDED IN TAXABLE COMPENSATION. SEVERANCE PAYMENT PART I, LINE 4A MARK WEBER $400,000 TERRY BRENNAN $65,000 THE SEVERANCE PAYMENTS WERE MADE IN ACCORDANCE WITH EACH INDIVIDUAL'S EMPLOYMENT CONTRACT. ILLINOIS FINANCE AUTHORITY 861091967 2004-11-30 4975000 Construction & Equipment Purchase false false false ILLINOIS FINANCE AUTHORITY 861091967 2010-03-18 10000000 Construction & Equipment Purchase false false false 0 0 4975000 0 0 0 0 0 0 4975000 0 0 2007 false false true true 0 0 10000524 0 0 0 101424 0 0 5086452 0 4812648 false false false true false false false false true true false false false false true true false false false false false false false false false false false false PART II, LINE 3 TOTAL PROCEEDS OF ISSUE PART II, LINE 3, COLUMN B, INCLUDES $524 OF INTEREST EARNINGS IN THE ESCROW ACCOUNT. TERESA BEISER SPOUSE IS DIRECTOR 63260 EMPLOYEE COMPENSATION false INTENSIVO LLC OWNED BY DR. LOBIANCO, 236200 CRITICAL CARE PROVIDER false INTENSIVO LLC DIRECTOR DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS PART VI, LINE 6 SAINT ANTHONY'S HEALTH CENTER HAS ONE MEMBER, DESIGNATED AS THE CORPORATE MEMBER, WHICH SHALL BE SAINT ANTHONY'S HEALTH SYSTEM, AN ILLINOIS NOT-FOR-PROFIT CORPORATION. SAINT ANTHONY'S HEALTH SYSTEM SHALL ACT IN STEWARDSHIP CAPACITY AND ENSURE THAT ALL ACTIONS OF SAINT ANTHONY'S HEALTH CENTER ARE CONSISTENT WITH THE PURPOSES, AND ETHICAL AND RELIGIOUS PRINCIPLES IN FURTHERANCE OF THEIR CHARITABLE APOSTOLATE OF QUALITY HEALTH CARE. DESCRIPTION APPROVAL AND VOTING RIGHTS OF MEMBERS OR STOCKHOLDERS PART VI, LINE 7A AND 7B SAINT ANTHONY'S HEALTH SYSTEM HAS THE EXCLUSIVE POWER TO APPOINT AND REMOVE THE DIRECTORS AND THE PRESIDENT/CEO, ADOPT, AMEND, RESTATE AND REPEAL THE ARTICLES OF INCORPORATION AND THE BYLAWS, ADOPT ANY PLAN OF MERGER, CONSOLIDATION, OR DISSOLUTION, ADOPT STATEMENT OF PHILOSOPHY, MISSION, AND APOSTALATE, ESTABLISH A CORPORATE LIMIT FOR EXPENDITURES, AND APPROVE THE MISSION STATEMENT, STRATEGIC PLAN, AND ANNUAL OPERATING BUDGET. SAINT ANTHONY'S HEALTH SYSTEM MUST APPROVE PURCHASES, SALES, TRANSFERS, LEASES OR ENCUMBRANCES OF REAL PROPERTY OR OF SUBSTANTIALLY ALL OF THE PERSONAL PROPERTY, BORROWING WHICH IS IN EXCESS OF THE CORPORATE LIMIT AS DETERMINED FROM TIME TO TIME BY SAINT ANTHONY'S HEALTH SYSTEM, THE EXECUTION OF ANY DEEDS, MORTGAGES, OR BONDS, ANY TRANSACTION WHICH INVOLVES AN ALIENATION OF PROPERTY OR OTHER ACT OF EXTRAORDINARY ADMINISTRATION, AND EXTRAORDINARY MEDICAL/MORAL ISSUES AND ANY MATTER CHALLENGING THE CATHOLICITY OF SAINT ANTHONY'S HEALTH CENTER. PROCESS TO REVIEW 990 PART VI, LINE 11 SAINT ANTHONY'S HEALTH CENTER USES AN OUTSIDE PREPARER TO PREPARE ITS FORM 990 AND 990-T. ONCE COMPLETED, THE RETURNS ARE REVIEWED INTERNALLY BY THE VP/CONTROLLER, EVP/CFO AND ITS PRESIDENT/CEO BEFORE FILING. ANNUALLY, THE RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, FORM 990, AND THE EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN, FORM 990-T, WILL BE PROVIDED TO THE SAINT ANTHONY'S HEALTH SYSTEM GOVERNING BOARD AND SAINT ANTHONY'S HEALTH CENTER FINANCE COMMITTEE FOR REVIEW PRIOR TO FILING SUCH RETURNS WITH THE INTERNAL REVENUE SERVICE FOR SAINT ANTHONY'S HEALTH CENTER, SAINT ANTHONY'S PHYSICIAN GROUP, AND SAINT ANTHONY'S FOUNDATION. WRITTEN NOTIFICATION WILL BE SENT TO EACH OF THE GOVERNING BOARDS' MEMBERS OF SAINT ANTHONY'S HEALTH CENTER, SAINT ANTHONY'S PHYSICIAN GROUP, AND SAINT ANTHONY'S FOUNDATION ADVISING THEM THAT THE RETURNS HAVE BEEN FILED AND TO CONTACT MICHAEL NELSON AT (618) 463-5616 IF THEY WOULD LIKE TO REVIEW THEIR RESPECTIVE RETURN. COMPLIANCE WITH CONFLICT OF INTEREST POLICY PART VI, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT MUST BE COMPLETED ANNUALLY BY: ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, DIRECTORS, MANAGERS, EMPLOYED PHYSICIANS, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICAL AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST; AND NON-EMPLOYED MEMBERS OF THE MEDICAL STAFF WHO ALSO EITHER: HOLD PAID OR UNPAID MEDICAL ADMINISTRATIVE POSITIONS OR HAVE PROCUREMENT RESPONSIBILITY OR THE AUTHORITY EFFECTIVELY TO RECOMMEND SUCH PROCUREMENT. THE STATEMENTS ARE REVIEWED ANNUALLY BY THE PRESIDENT/CEO AND THE BOARD SECRETARY. ANY MEMBER OF A BOARD INCLUDING PHYSICIANS SHALL REFRAIN FROM VOTING ON ANY POTENTIAL CONFLICTS. PROCESS FOR DETERMINING COMPENSATION PART VI, LINE 15A IN MARCH 2011, THE COMPENSATION COMMITTEE OF THE SAINT ANTHONY'S HEALTH SYSTEM BOARD, PARENT CORPORATION, USED MARKET SURVEY AND COMPENSATION ANALYSIS COMPLETED BY HEWITT & ASSOCIATES IN SPRING 2010 TO DETERMINE THE CEO'S COMPENSATION. THE COMPENSATION COMMITTEE INTENDS TO HAVE HEWITT OR ANOTHER ORGANIZATION UPDATE THIS ANALYSIS EVERY TWO YEARS. IN THE INTERIM, THE COMPENSATION COMMITTEE WILL RELY UPON OTHER SOURCES OF MARKET DATA TO DETERMINE THE CEO'S COMPENSATION. AVAILABILITY TO THE PUBLIC PART VI, LINE 19 FINANCIAL INFORMATION IS PROVIDED IN ACCORDANCE WITH THE FREEDOM OF INFORMATION ACT. AVERAGE RELATED HOURS DISCLOSURE PART VII, SECTION A, COLUMN B ESTIMATED HOURS WORKED BY OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AT RELATED ENTITIES: EDWARD BLAIR, JR., MD - 40 HOURS MOTHER M. REGINA COURY PACIS - 40 HOURS OTHER CHANGES TO NET ASSETS PART XI, LINE 5 NET UNREALIZED GAINS $234,183 CHANGE IN TEMPORARILY $37,096 RESTRICTED ASSETS FAS 158 ADJUSTMENT ($3,591,097) CHANGE IN INVESTMENT IN ($46) UNCONS. ORGANIZATIONS TRANSFER TO ST. ANTHONY'S ($2,347,500) HEALTH SYSTEM ____________ TOTAL CHANGE IN NET ASSETS ($5,667,364) SAINT ANTHONY'S LLC 915 EAST FIFTH STREET ALTON IL 62002 371407745 ASSISTED LIV. DE 110502 13703 NA ST ANTHONY'S HEALTH CENTER AUXILIARY SAINT ANTHONYS WAYPO BOX 340 ALTON IL 62002 376048318 SUPPORT IL 501(C)(3) 11 II N/A SAINT ANTHONY'S HEALTH SYSTEM SAINT ANTHONYS WAYPO BOX 340 ALTON IL 62002 371252623 SUPPORT IL 501(C)(3) 11 I N/A SAINT ANTHONY'S FOUNDATION SAINT ANTHONYS WAYPO BOX 340 ALTON IL 62002 371325398 SUPPORT IL 501(C)(3) 11 II SA HLTH SYST ST ANTHONY'S PHYSICIAN GROUP 915 EAST FIFTH STREET ALTON IL 62002 371365059 HEALTH CARE IL 501(C)(3) 9 SA HLTH SYST SISTERS OF ST FRANCIS MARTYR ST GEORGE 2120 CENTRAL AVENUE ALTON IL 62002 376034163 RELIGIOUS IL 501(C)(3) 1 NA SAINT CLARE'S VILLA LTD PARTNERSHIP 915 EAST 5TH STREET ALTON IL 62002 371397289 LOW INCOME HO IL ST ANTHONY LLC UNRELATED -47 2331485 false 0 true 0.00010 SAINT ANTHONY'S PHO INC SAINT ANTHONYS WAY PO BOX 340 ALTON IL 62002 371337385 MANAGEMENT IL NA C CORP false true true false false false false false true false true true true true false true false false