2023-11-01T13:38:17-05:00 2022-12-31 135565207 KPMG LLP 191 WEST NATIONWIDE BLVD SUITE 500 COLUMBUS OH 432152568 990 2022-01-01 203238867 ALVERNO PROVENA HOSPITAL LABORATORIES INC ALVE 2199893857 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 SAMUEL C TERESE JR PRESIDENT 2199893857 2023-10-31 1 SAMUEL TERESE JR XXX-XX-XXXX 0 MOLLIE P LONGHOUSE P00294881 6142492300 2023-10-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SAMUEL C TERESE JR 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 200109419 0 X WWW.ALVERNOLABS.COM X 2005 IN BRINGING CHRIST'S MINISTRY TO THOSE WE SERVE THROUGH TIMELY HIGH-QUALITY LAB TESTING TO OUR 24 NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA. 8 8 0 8 0 0 0 0 191615247 198869421 10840 139357 0 0 191626087 199008778 0 0 0 0 0 0 0 0 0 191616893 198982904 191616893 198982904 9194 25874 27250594 22784498 27100594 22634498 150000 150000 X SEE SCHEDULE O 0 0 183194782 198869421 ALVERNO PROVENA HOSPITAL LABORATORIES, INC.'S (APHL) PRIMARY FUNCTION IS TO PROVIDE LABORATORY TESTING SERVICES TO ITS TWENTY-FOUR (24) AFFILIATED NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA. THE ORGANIZATION MAINTAINS A STRATEGIC PLAN THAT IS STRUCTURED ON THE FOLLOWING FIVE AREAS: STEWARDSHIP, PEOPLE, SERVICE, GROWTH, AND QUALITY. (CONTINUED IN SCHEDULE O) 183194782 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 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 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X STEVE WOJNICKI 2199893857 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 THOMAS GRYZBEK CHAIR 1.00 1.00 X X 0 0 0 DOUG CARTER VICE CHAIR 1.00 1.00 X X 0 0 0 MARK FRITSCH MD DIRECTOR 1.00 1.00 X 0 0 0 ROBYN PARKER DIRECTOR 1.00 1.00 X 0 0 0 BARBARA ANDERSON DIRECTOR 1.00 1.00 X 0 0 0 JENNIFER MARION DIRECTOR 1.00 1.00 X 0 0 0 DR JANIS ATKINSON DIRECTOR 1.00 1.00 X 0 0 0 DR RICHARD SCOTT DIRECTOR 1.00 1.00 X 0 0 0 SAMUEL C TERESE CEO/PRESIDENT 32.00 8.00 X 0 700443 31646 STEVEN G WOJNICKI VP FINANCE 32.00 8.00 X 0 421874 30414 BERNARD H HENRY VP HUMAN RESOURCES 32.00 8.00 X 0 346902 30738 MARTHA LAMPMAN REGIONAL LAB DIRECTOR 40.00 0.00 X 0 170211 6813 AZUCENA QUEVEDO MED TECH I 40.00 0.00 X 0 172512 7877 MARTHA ADAME-GARCIA MT COORDINATOR 40.00 0.00 X 0 173296 16905 ROBIN ADES REGIONAL LAB DIRECTOR 40.00 0.00 X 0 165360 18552 SHIRLEY KOREN ASSOCIATE REGIONAL LAB 40.00 0.00 X 0 159560 12955 0 2310158 155900 0 0 1 0 PROFESSIONAL CLINICAL LABORATORIES LLC 113 EAST 4TH ST MICHIGAN CITY IN 46360 LAB & MANAGEMENT 35736425 ALVERNO CLINICAL LABORATORIES LLC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 LAB & MANAGEMENT 30645385 AMERIPATH INDIANAPOLIS PC 13179 COLLECTION CENTER DR CHICAGO IL 60693 REFERENCE LAB 1746056 FOCUSONE SOLUTIONS LLC PO BOX 850861 MINNEAPLOIS MN 55485 STAFFING SERVICES 898311 INDIANA UNIVERSITY-PURDUE UNIVERSITY PO BOX 6020 INDIANAPOLIS IN 46206 REFERENCE LAB 735864 7 LAB SERVICES FOR PATRON HOSPITALS 621500 198869421 198869421 198869421 139357 139357 1100641 1100641 0 199008778 198869421 0 139357 X 57176395 54492557 2683838 1447695 1447695 59415 59415 839 839 60895 60895 75 75 COMPENSATION PAID BY AC 80591134 72539620 8051514 MEDICAL SUPPLIES 38608320 38608320 REFERENCE LABORATORY 10691663 10691663 ALL OTHER EXPENSES 8191427 3139496 5051931 2155046 2155046 198982904 183194782 15788122 0 0 0 9898016 1566996 0 0 7968650 9250745 0 0 0 0 0 0 0 0 434819 255818 0 0 77592 0 0 0 8871517 10027709 0 0 0 0 0 1683230 27250594 22784498 13457689 12873593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13642905 9760905 27100594 22634498 X 150000 150000 0 0 150000 150000 27250594 22784498 25874 -25874 0 X 0 1 X 1 0 X 0 MONEY MARKET FUND 10027709 F 10027709 RIGHT OF USE ASSETS 1683230 1683230 DUE TO RELATED PARTIES 6866756 RETIREMENT BENEFIT LIABILITY 1210919 CURRENT PORTION OF OPERATING LEASE 555341 LONG-TERM OPERATING LEASE LIABILITY 1127889 9760905 X 200083545 -25874 1100641 1074767 199008778 0 199008778 200083545 1100641 1100641 198982904 0 198982904 PART X, LINE 2: APHL INC. HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE ("THE CODE") SECTION 501(E) AND THE LAWS OF THE STATES IN WHICH IT OPERATES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. THE COMPANY RECOGNIZES INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST AND INCOME TAX EXPENSE, RESPECTIVELY. THE COMPANY HAS NO AMOUNTS ACCRUED FOR INTEREST OR PENALTIES AS OF DECEMBER 31, 2022 AND 2021. DUE TO ITS TAX-EXEMPT STATUS, THE COMPANY IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE COMPANY DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. TAX RETURNS FILED BY THE COMPANY ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE COMPANY ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED DECEMBER 31, 2018 AND PRIOR. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 1,100,641. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 1,100,641. 0 0 0 0 0 0 0 0 0 SAMUEL C TERESE CEO/PRESIDENT 0 531856 0 168587 0 0 0 12200 0 19446 0 732089 0 0 STEVEN G WOJNICKI VP FINANCE 0 339568 0 82306 0 0 0 12200 0 18214 0 452288 0 0 BERNARD H HENRY VP HUMAN RESOURCES 0 280030 0 66872 0 0 0 10895 0 19843 0 377640 0 0 MARTHA ADAME-GARCIA MT COORDINATOR 0 173196 0 100 0 0 0 7041 0 9864 0 190201 0 0 ROBIN ADES REGIONAL LAB DIRECTOR 0 164860 0 500 0 0 0 6762 0 11790 0 183912 0 0 AZUCENA QUEVEDO MED TECH I 0 172412 0 100 0 0 0 6917 0 960 0 180389 0 0 MARTHA LAMPMAN REGIONAL LAB DIRECTOR 0 169711 0 500 0 0 0 6736 0 77 0 177024 0 0 SHIRLEY KOREN ASSOCIATE REGIONAL LAB 0 159060 0 500 0 0 0 6599 0 6356 0 172515 0 0 PART I, LINE 3 ALVERNO CLINICAL LABORATORIES, LLC (ACL), A RELATED ORGANIZATION IS THE PAY AGENT FOR ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (APHL). ACL USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR APHL'S TOP MANAGEMENT OFFICIALS: -INDEPENDENT COMPENSATION CONSULTANT -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -COMPENSATION COMMITTEE -COMPENSATION SURVEY OR STUDY FORM 990, PART III, LINE 1: BRINGING CHRIST'S MINISTRY TO THOSE WE SERVE THROUGH TIMELY HIGH-QUALITY LABORATORY TESTING TO OUR 24 NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA. FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS: APHL'S LONG TERM OBJECTIVE IS TO CONTINUE TO GROW SO AS TO PROVIDE QUALITY LABORATORY SERVICES TO OUR PATRON FAITH BASED HOSPITALS. IN SO DOING, APHL'S LONG TERM OBJECTIVE IS TO CONTROL COSTS, AND TO INCREASE THE NUMBER OF TESTS AVAILABLE, WITH A FOCUS ON HIGHLY RELIABLE SCIENTIFIC TEST RESULTS WHILE BUILDING A CULTURE OF SERVICE. APHL SEEKS TO ATTRACT A WORK FORCE DEDICATED TO SERVICE OF ITS PATIENTS. APHL'S SHORT TERM OBJECTIVES INCLUDE THE ENHANCEMENT OF THE COST MODEL TO IMPROVE THE RELATIVE VALUE UNIT THAT CAPTURES THE COMPLEXITY AND QUANTITATES THE PRODUCTION COST SO AS TO PROVIDE THE COOPERATIVE WITH AN INTEGRATED DELIVERY SYSTEM TO PROVIDE FOR PATIENT NEEDS ON THE PRODUCTION SIDE. THE USE OF LEAN CONCEPTS PROMOTES THE ELIMINATION OF WASTE AND THE EFFICIENT FLOW OF PRODUCTION. SCORE CARDS ARE IN PLACE AND MONITORED FOR QUALITY INTERVENTION NEED. APPROXIMATELY 19,470 TESTS A DAY ARE PERFORMED AT THE CENTRAL LABORATORY WHILE MAINTAINING RAPID RESPONSE LABORATORIES AT EACH HOSPITAL SITE. EACH LABORATORY SITE IS INSPECTED BY CAP AND PROVIDED A CERTIFICATION IN ADDITION TO THE INTERNAL APHL QUALITY DEPARTMENT INSPECTIONS AND PROGRAMS PROMOTING EXCELLENCE IN LABORATORY SCIENCE. FORM 990, PART V, LINE 1A: FOR TAX YEAR 2021, THERE WAS AN ERROR IN THE FORM 1099/FORM 1096 REPORTING AS A RESULT OF SWITCHING ERP SYSTEMS. ALL OF THE FORMS 1099 THAT SHOULD HAVE BEEN ISSUED BY ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (APHL) WERE INADVERTENTLY ISSUED BY A RELATED ENTITY, ALVERNO CLINICAL LABORATORIES, LLC (ACL). THEREFORE, THERE WERE ZERO FORMS 1099 ISSUED BY APHL. ACL AND APHL ARE CURRENTLY LOOKING INTO RESOLVING AND CORRECTING THIS ISSUE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO CLASSES OF MEMBERS, VOTING AND NON-VOTING. THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS, REFERRED TO AS PARTICIPANT HOSPITALS. EACH PARTICIPANT HAS THE RIGHT TO APPOINT BOARD MEMBERS WHO HAVE THE RIGHT TO VOTE ON ALL MATTERS PRESENTED TO THE MEMBERS OF THE CORPORATION, INCLUDING THE ELECTION OF DIRECTORS. THE PATRONS DO NOT HAVE VOTING RIGHTS. CURRENTLY, APHL, INC. HAS THREE PARTICIPANTS AND NO PATRONS. FORM 990, PART VI, SECTION A, LINE 7A PARTICIPANT HOSPITAL SYSTEM REPRESENTATIVES ARE APPOINTED BY THE PARTICIPANT HOSPITAL SYSTEM OF APHL'S PARENT ORGANIZATIONS. THE PARTICIPANT HOSPITAL SYSTEM REPRESENTATIVES CAN ACT ON BEHALF OF THE PARTICIPANT HOSPITAL SYSTEM CEO ON ALL MATTERS. FORM 990, PART VI, SECTION A, LINE 7B THE PARTICIPANT HOSPITAL SYSTEMS SHALL HAVE THE EXCLUSIVE POWER TO: A) APPROVE THE ADMISSION OF ADDITIONAL PARTICIPANTS OF THE CORPORATION. B) APPOINT AND REMOVE DIRECTORS AND FILL VACANCIES ON THE BOARD OF DIRECTORS. C) APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION. D) APPROVE AMENDMENTS AND/OR RESTATEMENTS FROM TIME TO TIME TO THE ARTICLES PROPOSED BY THE BOARD OF DIRECTORS. E) APPROVE AMENDMENT OR REPEAL OF THE BYLAWS AND THE ADOPTION OF NEW BYLAWS. F) APPROVE THE SALE, LEASE, PURCHASE, EXCHANGE, OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION OR THE DISPOSITION OF ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS. G) APPROVE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER CORPORATION. H) APPROVE THE PLAN FOR ALLOCATION AND DISTRIBUTION OF THE CORPORATION'S PROPERTY UPON DISSOLUTION IF NOT OTHERWISE PROVIDED FOR UNDER THE BYLAWS. I) APPROVE PARTICIPANTS' REQUIRED CAPITAL CONTRIBUTIONS TO THE CORPORATION OR DUES PAYABLE TO THE CORPORATION. J) APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION IN EXCESS OF AMOUNTS DETERMINED FROM TIME TO TIME BY THE PARTICIPANTS. K) ADOPT THE ANNUAL CAPITAL AND OPERATING BUDGETS OF THE COMPANY, AND ANY MATERIAL DEVIATIONS THEREFROM, SUCH ANNUAL BUDGETS TO INCLUDE ANY PREVIOUSLY APPROVED CAPITAL CONTRIBUTIONS. L) ADOPT THE STRATEGIC PLANS FOR THE CORPORATION AND APPROVE ANY MATERIAL CHANGES TO THE SERVICES OFFERED BY THE CORPORATION WHICH ARE NOT EXPRESSLY IDENTIFIED IN THE PREVIOUSLY APPROVED STRATEGIC PLANS. M) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF, ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; AND N) APPROVE ANY AMENDMENTS TO THE COOPERATIVE SERVICES AGREEMENT AMONG THE CORPORATION AND THE PARTICIPANTS, EFFECTIVE AS OF JULY 1, 2005, OR SUCH OTHER DATE AGREED UPON BY THE PARTICIPANTS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S MANAGEMENT. THEN A FINAL DRAFT OF THE FULL FORM 990, INCLUDING APPLICABLE SCHEDULES, IS MADE AVAILABLE TO THE FINANCE COMMITTEE AT A REGULARLY SCHEDULED MEETING WITH OUR TAX ADVISORS PRESENT. EACH REMAINING MEMBER OF THE BOARD OF GOVERNANCE IS ALSO PROVIDED A FINAL DRAFT OF THE FULL FORM 990 FOR REVIEW. THESE REVIEWS OCCUR PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C COVERED PERSONS: ALL MANAGEMENT PERSONNEL AND MEMBERS OF THE BOARD OF DIRECTORS ARE COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. MANAGEMENT PERSONNEL INCLUDE SUPERVISORS THROUGH THE PRESIDENT/CEO OF THE ORGANIZATION. POLICY SUMMARY: THE CONFLICT-OF-INTEREST POLICY IS SENT OUT TO COVERED PERSONS FOR REVIEW. EACH PERSON IS REQUIRED TO COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE AND RETURN IT. IT IS THE RESPONSIBILITY OF HUMAN RESOURCES AND THE EXECUTIVE ASSISTANT TO ENSURE THE QUESTIONNAIRES ARE RETURNED AND COMPLETED. THE COMPLETED QUESTIONNAIRES ARE FORWARDED TO THE VICE PRESIDENT OF HUMAN RESOURCES FOR REVIEW TO DETERMINE IF CONFLICTS EXIST. AN INTERESTED PERSON HAS A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT, TRANSACTION OR ARRANGEMENT IN WHICH ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (APHL) IS (OR WOULD BE, IF APPROVED) A PARTY IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH A BUSINESS, INVESTMENT, FAMILY OR OTHER RELATIONSHIP: A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY INVOLVED IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; B) A COMPENSATION ARRANGEMENT WITH AN INDIVIDUAL OR ENTITY INVOLVED IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, AN INDIVIDUAL OR ENTITY WITH WHICH APHL IS NEGOTIATING SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; OR D) A FIDUCIARY POSITION (E.G., MEMBER, OFFICER, DIRECTOR, COMMITTEE MEMBER) WITH RESPECT TO AN ENTITY IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; OR E) A NON-ECONOMIC AFFILIATION OR RELATIONSHIP, DIRECTLY (OR INDIRECTLY, THROUGH A THIRD PARTY) WITH AN INDIVIDUAL OR ENTITY WITH WHICH APHL IS NEGOTIATING OR MAINTAINS A CONTRACT, TRANSACTION OR ARRANGEMENT SUCH THAT THE AFFILIATION OR RELATIONSHIP COULD RENDER THE INTERESTED PERSON INCAPABLE OF MAKING A DECISION WITH ONLY THE BEST INTERESTS OF APHL IN MIND. IN ADDITION, AN INTERESTED PERSON HAS A CONFLICT OF INTEREST IN ANY EXISTING OR POTENTIAL COMPENSATION ARRANGEMENT BETWEEN APHL AND THAT INTERESTED PERSON OR ANY BUSINESS, INVESTMENT OR FAMILY MEMBER RELATED TO THAT PERSON. FOR PURPOSES OF THIS SECTION, COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION, AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. SERVICE OF INDIVIDUALS ON THE BOARD OF DIRECTORS FOR ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (AND COMMITTEES THEREOF), BOARDS OR COMMITTEES OF THE MEMBER ORGANIZATIONS OR EMPLOYMENT BY A MEMBER ORGANIZATION OR ALVERNO CLINICAL LABORATORIES, A RELATED ORGANIZATION, IS NOT CONSIDERED A CONFLICT OF INTEREST, AS DEFINED IN THE POLICY. THE VP OF HUMAN RESOURCES COMPILES THE RESULTS AND FORWARDS THE RESULTS TO THE CEO. THE ASSESSMENTS OF ANY POTENTIAL CONFLICT ARE MADE IN COLLABORATION WITH LEGAL COUNSEL AS APPROPRIATE. THE CEO REVIEWS ANY CONFLICTS WITH THE BOARD DURING A SCHEDULED BOARD MEETING. POLICY VIOLATIONS: IF THE BOARD OR MANAGERS HAS REASON TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO COMPLY WITH THE DISCLOSURE OBLIGATIONS OF THIS POLICY, THE BOARD OF MANAGERS SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND PROVIDE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF SUCH A PERSON AND CONDUCTING FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OF MANAGERS SHALL DETERMINE WHETHER SUCH PERSON HAS IN FACT, VIOLATED THE DISCLOSURE REQUIREMENTS OF THE CONFLICT-OF-INTEREST POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE REMOVAL (IF THE INTERESTED PERSON IS A BOARD OR COMMITTEE MEMBER, DIRECTOR, OR MANAGEMENT EMPLOYEE) OR TERMINATION (IF THE INTERESTED PERSON IS AN EMPLOYEE OF ALVERNO PROVENA HOSPITAL LABORATORIES, INC., ALVERNO CLINICAL LABORATORIES, LLC OR A MEMBER ORGANIZATION). RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT ARE DETERMINED ON A CASE-BY-CASE BASIS BY THE CEO IN COLLABORATION WITH LEGAL COUNSEL. AS OF THIS DATE, NO MATERIAL CONFLICTS OF INTEREST HAVE BEEN IDENTIFIED. IF A MATERIAL CONFLICT IS IDENTIFIED IN THE FUTURE, THAT PERSON WOULD BE REQUIRED TO RECUSE THEMSELVES FROM PARTICIPATING IN DECISIONS AND/OR VOTING PRIVILEGES DIRECTLY RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 FORM 990 PART VI LINE 15A THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS PAID BY ALVERNO CLINICAL LABORATORIES, LLC, A RELATED ORGANIZATION; THEREFORE, THIS QUESTION HAS BEEN ANSWERED NO IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. THE BOARD OF DIRECTORS APPOINTED A COMPENSATION COMMITTEE, WHICH IS A SUB-COMMITTEE OF THE BOARD. THE COMPENSATION FOR THE PRESIDENT/CEO IS REVIEWED BY SYSTEM REPRESENTATIVES APPOINTED TO THE BOARD. SALARY INCREASES ARE APPROVED ANNUALLY. THE BUDGET IS RECOMMENDED FOR APPROVAL OR APPROVED ANNUALLY BY THE FINANCE COMMITTEE, BOARD MEMBERS FROM EACH PARTICIPATING SYSTEM AND SYSTEM REPRESENTATIVES APPOINTED TO THE BOARD BY THE SYSTEM CEO'S. FORM 990 PART VI LINE 15B THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES ARE PAID BY ALVERNO CLINICAL LABORATORIES, LLC, A RELATED ORGANIZATION; THEREFORE, THIS QUESTION HAS BEEN ANSWERED NO IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SVC-OTHER: PROGRAM SERVICE EXPENSES 3,898,029. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,898,029. PCL LAB SERVICES: PROGRAM SERVICE EXPENSES 43,804,777. MANAGEMENT AND GENERAL EXPENSES -1,371,620. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,433,157. ACL MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 6,789,751. MANAGEMENT AND GENERAL EXPENSES 4,055,458. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,845,209. ALVERNO LAB LLC 2434 INTERSTATE PLAZA DR HAMMOND IN 46324 203240648 MANAGEMENT SVCS IN N/A 0 0 PROF LAB LLC 2434 INTERSTATE PLAZA DR HAMMOND IN 46324 300711211 MEDICAL SERVICES IN N/A 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 SCHEDULE R, PART III LISTED BELOW ARE THE COMPLETE NAMES AND STREET ADDRESSES FOR PART III: 1) ALVERNO CLINICAL LABORATORIES, LLC; 2434 INTERSTATE PLAZA DRIVE; HAMMOND, IN 46324 2) PROFESSIONAL CLINIC LABORATORIES, LLC; 2434 INTERSTATE PLAZA DRIVE; HAMMOND, IN 46324