2018-05-15T15:16:44-05:00 2017-06-30 990 2016-07-01 391486775 Wheaton Franciscan Healthcare - Terrace at St Francis Inc WHEA 3147338000 12550 WEBER HILL RD STE 200 ST LOUIS MO 63127 Tonya Mershon Tax Officer 2018-05-15 2016 2022-09-23 18:48:47Z X MICHAEL GORDON CFO 12250 WEBER HILL RD STE 200 ST LOUIS MO 63127 13412600 false X WWW.ASCENSIONLIVING.ORG X 1984 WI TO PROVIDE SPIRITUALLY CENTERED, HOLISTIC, COMPASSIONATE TRANSITIONAL CARE THAT BRIDGES THE GAP BETWEEN HOSPITAL AND HOME. IN ADDITION, WE ALSO PROVIDE EXTENDED CARE. 8 5 148 26 0 0 912120 17171 6964882 13355742 -23770 31 17604 39656 7870836 13412600 0 0 0 5280736 7494295 0 0 0 2319473 6910801 7600209 14405096 270627 -992496 3190179 11661287 1496885 5908287 1693294 5753000 AS A MEMBER OF ASCENSION HEALTH SENIOR CARE (AHSC), OUR AFFILIATES STRIVE TO LIVE OUT THE HEALING MINISTRY OF JESUS WHILE PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTE THE DIGNITY AND WELL-BEING OF THE PATIENTS AND COMMUNITIES WE SERVE. OUR VISION IS TO BE RECOGNIZED FOR SUPERIOR HEALTHCARE SERVICE, CLINICAL EXCELLENCE, AS THE HEALTHCARE EMPLOYER OF CHOICE, AND THE PREFERRED PARTNER OF PHYSICIANS. false false 12070517 0 13355742 WHEATON FRANCISCAN HEALTHCARE'S SERVICE TO SOUTHEAST WISCONSIN DATES BACK TO 1879 WHEN THE FRANCISCAN SISTERS BEGAN OPERATING A HEALTH CARE MINISTRY OUT OF A SMALL HOUSE. FIVE YEARS LATER THEY OPENED THEIR FIRST HOSPITAL IN MILWAUKEE - ST. JOSEPH. OVER THE NEXT 100 YEARS, THE SISTERS - KNOWN AS THE WHEATON FRANCISCANS AFTER 1947 - EXPANDED THEIR MILWAUKEE HEALTH CARE MINISTRY AND, IN 1993, PARTNERED WITH THE FELICIAN SISTERS. THROUGH THE UNION OF NUMEROUS SEPARATE BUT COMMON FUNCTIONS INCLUDING BOARDS OF DIRECTORS, MEDICAL GROUPS, AND CORPORATE SERVICES, WHEATON FRANCISCAN HEALTHCARE HAS CREATED A FULLY INTEGRATED REGION THAT ALLOWS IT TO SHARE BEST PRACTICES AND CREATE COST EFFICIENCIES. IN FY2017, THE REGION WAS FURTHER EXPANDED AS A NEW CORPORATE MEMBER OF ASCENSION HEALTH SENIOR CARE. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO THOSE WHO CANNOT AFFORD TO PAY AND WHO MEET ALL CRITERIA FOR FINANCIAL ASSISTANCE. CHARITY CARE IS BASED ON ACTUAL COSTS, NOT CHARGES, AND DOES NOT INCLUDE BAD DEBT. UNREIMBURSED COST OF PUBLIC PROGRAMS: $2,702,420 IS DEFINED AS THE SHORTFALL EXPERIENCED WHEN PAYMENTS RECEIVED ARE BELOW THE COST OF TREATING PUBLIC BENEFICIARIES THROUGH MEDICAID AND OTHER LOCAL PUBLIC PROGRAMS. A TOTAL OF $11,276 IN THE FOLLOWING TYPES OF COMMUNITY SERVICES BENEFITS WERE PROVIDED DURING FY 2017: COMMUNITY HEALTH IMPROVEMENT SERVICES ARE DEFINED AS CLINICAL AND NON-CLINICAL SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH, WHICH ARE PROVIDED TO THE COMMUNITY FOR FREE OR FOR FEES THAT DID NOT COVER COSTS. FINANCIAL CONTRIBUTIONS ARE DEFINED AS CONTRIBUTIONS, INCLUDING CASH, NON-CASH ITEMS SUCH AS FOOD, FURNITURE, EQUIPMENT, SUPPLIES, AND LOANED STAFF FOR VOLUNTEER AND CHARITABLE PURPOSES, MADE TO INDIVIDUALS, COMMUNITY GROUPS, OR NONPROFIT ORGANIZATIONS FOR CHARITABLE PURPOSES. HEALTH PROFESSIONS EDUCATION IS DEFINED AS DIRECT COSTS INCURRED FOR ACCREDITED TRAINING AND EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, ALLIED HEALTH PROFESSIONALS AND TECHNICIANS (DOES NOT INCLUDE ONGOING EDUCATION FOR STAFF). COMMUNITY BUILDING ACTIVITIES ARE DEFINED AS PROGRAMS THAT, WHILE NOT DIRECTLY RELATED TO HEALTH CARE, PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL ISSUES. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS. COMMUNITY BENEFIT OPERATIONS ARE DEFINED AS COSTS ASSOCIATED WITH DEDICATED STAFF AND COMMUNITY HEALTH NEEDS AND/OR ASSETS ASSESSMENT, AS WELL AS OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGY AND OPERATIONS. WHEATON FRANCISCAN TRANSITIONAL CARE FACILITIES (SOUTHEAST WISCONSIN) FRANCISCAN WOODS, A 120-BED SKILLED CARE NURSING HOME AND THE TERRACE AT ST. FRANCIS, AN 81-BED SKILLED CARE NURSING HOME, BOTH MEET COMMUNITY NEEDS FOR SERVICES BETWEEN HOSPITAL AND HOME, AND IS DESIGNED FOR PEOPLE WHO NEED CARE FOR A FEW DAYS OR WEEKS AFTER DISCHARGE FROM THE HOSPITAL BUT ARE NOT YET FULLY ABLE TO RESUME THEIR NORMAL ROUTINE. IT CAN INVOLVE THE PROVISION OF COMPLEX PATIENT CARE SERVICES INCLUDING INTRAVENOUS (IV) MEDICATIONS, FEEDING TUBES, INTRAVENOUS NUTRITION, BLOOD TRANSFUSIONS, DIALYSIS, AND POST-OPERATIVE RECOVERY. THE SKILLED NURSES ARE ALSO TRAINED IN CANCER CARE, PALLIATIVE CARE, RESPIRATORY, REHABILITATIVE CARE, AND WOUND CARE. TRANSITIONAL CARE THROUGH WHEATON FRANCISCAN HEALTHCARE OFFERS ADVANTAGES THAT NO OTHER PROVIDER CAN MATCH. HOSPITAL-BASED MEDICAL DIRECTORS AND CONSULTING SPECIALISTS PROVIDE EXTENSIVE PHYSICIAN INVOLVEMENT. OUTSTANDING CLINICAL CARE IS PROVIDED BY TEAMS OF SPECIALLY EDUCATED NURSES, THERAPISTS, AND OTHER HEALTH CARE PROFESSIONALS. THE INTEGRATED HEALTH CARE NETWORK ENSURES READY ACCESS TO HOSPITAL, HOME HEALTH, OUTPATIENT, PHYSICIAN, AND CARE MANAGEMENT SERVICES. SPIRITUAL SUPPORT IS OFFERED TO ALL PATIENTS AND THEIR LOVED ONES, AND COMPREHENSIVE EDUCATION HELPS PREPARE PATIENTS AND THEIR FAMILIES FOR CONTINUED PROGRESS AFTER DISCHARGE. THE TRANSITIONAL CARE PROGRAM IS FORTUNATE TO RECEIVE SUPPORT FOR VARIOUS ENRICHMENT PROGRAMS FROM THE WHEATON FRANCISCAN HEALTHCARE-CIRCLE OF LIFE FOUNDATION. 12070517 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 0 0 148 false false false false false false false false false false X 8 5 false false false false true true true true true false false false true true true true true false false false WI X ELIZABETH A RITTER 4144653542 400 WEST RIVER WOODS PARKWAY MILWAUKEE WI 53212 ANDREA OHMAN EX-OFFCIO 40.0 0.0 X X 0 71257 1687 DAVID WARD VICE CHAIR 1.0 3.0 X X 0 0 0 KARI KLASEN SECRETARY (END 2/2017) 1.0 40.0 X X 0 125825 44257 JONATHAN SOHN TREASURER 1.0 45.0 X X 0 707247 95164 Tracy A Rogers DIRECTOR 1.0 40.0 X 0 1380803 41883 MARK CHARBOGIAN DIRECTOR (END 12/2016) 1.0 39.0 X 0 158246 46106 LINDA CZERNICKI DIRECTOR 1.0 3.0 X 0 0 0 JASON KAYZAR DIRECTOR 1.0 3.0 X 0 0 0 SURESH MISRA MD DIRECTOR 1.0 3.0 X 0 0 0 RICK ROMANSHEK DIRECTOR 1.0 3.0 X 0 0 0 PATRICIO VIERNES MD DIRECTOR (END 2/2017) 1.0 3.0 X 0 0 0 Robin Owens Registered Nurse 45.0 0 X 142827 0 31082 JAMES GRESHAM FORMER OFFICER (END 6/2016) 0.0 0.0 X 0 364264 1588 SHARON POVLICH FORMER OFFICER (END 6/2016) 0.0 40.0 X 0 109592 15541 142827 2917234 277308 1 true true false SODEXO INC & AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE MGMT 248580 CONCEPT REHABILITATION INC 7150 GRANITE CIRCLE STE 200 TOLEDO OH 43617 THERAPY SERVICES 196028 PROFESSIONAL HEALTH CARE SERVICES INC 10827 W LINCOLN AVE WEST ALLIS WI 53227 TEMPORARY STAFFING 122482 3 X 17171 17171 Skilled Nursing Facility 621990 13355742 13355742 0 0 0 0 13355742 31 31 0 0 0 0 Other Revenue 900099 21786 21786 Cafeteria Revenue 722514 2705 2705 GIFT SHOP 453220 15165 15165 0 0 0 0 39656 13412600 13355742 0 39687 5740627 4945641 794986 344417 296721 47696 1006684 867274 139410 402567 346818 55749 117808 50489 67319 0 29765 10838 18927 1472 1472 229215 227532 1683 7004 752 6252 1298 728 570 34307 34307 149990 149990 292 292 PURCHASED SERVICES 2116068 2074379 41689 CONTRACT LABOR 1534878 1489829 45049 MEDICAL SUPPLIES 1189232 1189197 35 management fees to affiliates 727842 727842 771630 418857 352773 0 14405096 12070517 2334579 0 700 3000 0 17171 878899 2650735 0 0 0 11434 66337 2710605 231599 2287349 2479006 0 0 11797 6445038 3190179 11661287 568035 2769900 0 918253 0 10597 3138387 1496885 5908287 X 1693294 5735829 0 17171 1693294 5753000 3190179 11661287 X -992496 5052202 X false true X true false X 775288 711298 376416 912120 17171 2792293 6823880 7056013 6919249 6964882 13355742 41119766 0 0 0 7599168 7767311 7295665 7877002 13372913 43912059 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43912059 160 258 154 65 31 668 0 160 258 154 65 31 668 0 21307 20388 26223 17604 39656 125178 7620635 7787957 7322042 7894671 13412600 44037905 0.9971 0.9976 0.0000 0.0 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - OTHER INCOME, COLUMN A - 21307.0, COLUMN B - 20388.0, COLUMN C - 26223.0, COLUMN D - 17604.0, COLUMN E - 21786.0, COLUMN F - 107308.0; DESCRIPTION - CAFETERIA, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 2705.0, COLUMN F - 2705.0; DESCRIPTION - GIFT SHOP, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 15165.0, COLUMN F - 15165.0; 1758435 118481 1639954 373010 94985 278025 579160 18133 561027 2479006 OTHER ASSETS DUE FROM AFFILIATES 6438186 OTHER RECEIVABLES 6852 6445038 RESIDENT TRUST PAYABLE DUE TO AFFILIATES 2466715 Net Long-Term Debt 575381 Savings Plan Payable 70515 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 25776 3138387 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2017. true true false false false false false false false KARI KLASEN SECRETARY (END 2/2017) 0 110982 0 14288 0 555 0 9265 0 34992 0 170082 0 0 JONATHAN SOHN TREASURER 0 487399 0 206003 0 13845 0 67575 0 27589 0 802411 0 0 Tracy A Rogers DIRECTOR 0 717307 0 547153 0 116343 0 15900 0 25983 0 1422686 0 0 MARK CHARBOGIAN DIRECTOR (END 12/2016) 0 153400 0 0 0 4846 0 21060 0 25046 0 204352 0 0 JAMES GRESHAM FORMER OFFICER (END 6/2016) 0 155378 0 0 0 208886 0 0 0 1588 0 365852 0 0 SHARON POVLICH FORMER OFFICER (END 6/2016) 0 108152 0 0 0 1440 0 9889 0 5652 0 125133 0 0 Robin Owens Registered Nurse 142769 0 0 0 58 0 13807 0 17275 0 173909 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH SENIOR CARE, A RELATED ORGANIZATION OF WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization during calendar year 2016: JAMES GRESHAM - $192,459 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted during calendar year 2016: Jonathan Sohn - $9,620. Form 990, Part V, Line 1a PART V LINE 1A AND PART VII SEC B LINES 1-2 WHEATON FRANCISCAN HEALTHCARE STREAMLINED THEIR REPORTING OF IRS FORMS 1099-MISC SO THAT MOST 1099-MISC ARE NOW REPORTED USING THE FEIN NUMBER OF THE PARENT ORGANIZATION OR OF A RELATED ORGANIZATION. THE ACTUAL EXPENSE CONTINUES TO BE PAID BY, OR TRANSFERRED TO, THE INDIVIDUAL ENTITY WHICH IS NORMALLY A SUBSIDIARY OR RELATED ORGANIZATION TO THE ORGANIZATION(S) ISSUING THE 1099. FOR THIS REASON, THE READER MAY NOTICE ON SOME 990'S THAT THERE ARE TOP 5 INDEPENDENT CONTRACTORS REPORTED, BUT NO 1099S ARE REPORTED. LIKEWISE ON THE 990'S OF THE ORGANIZATION(S) REPORTING NUMBER OF 1099'S, THERE MAY BE A DISPROPORTIONATE SHARE OF 1099'S REPORTED AS COMPARED WITH THE ACTUAL EXPENSES AND TOP 5 INDEPENDENT CONTRACTORS REPORTED. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the Organization's top management official, the process performed by Ascension Health Senior Care, a related organization of Wheaton Franciscan Healthcare - Terrace at St. Francis, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the top management official was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the Committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY Ascension Health Senior Care, A RELATED ORGANIZATION OF Wheaton Franciscan Healthcare - Terrace at St. Francis, Inc., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST FRANCIS, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH SENIOR CARE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST FRANCIS, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH SENIOR CARE, WHO HAS THE ABILITY TO APPOINT AND REMOVE DIRECTORS AND EXECUTIVE OFFICERS OF WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ASCENSION HEALTH SENIOR CARE, D.B.A. ASCENSION SENIOR LIVING, HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY IN THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE: NEW ORGANIZATIONS & MAJOR TRANSACTIONS; APPOINTMENT/REMOVALS/EVALUATION DEBT LIMITS; STRATEGIC & FINANCIAL PLANS; ASSETS; SYSTEM POLICIES & PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION PER THE SYSTEM AUTHORITY MATRIX. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part VII, Section A, Line 1a, Column (B) PART V, COLUMN B MINISTRIES THAT WERE AFFILIATES OF WHEATON FRANCISCAN HEALTHCARE DURING THE FISCAL YEAR ENDING JUNE 30, 2017 OPERATED AS A CONTROLLED GROUP OF RELATED HEALTHCARE ORGANIZATIONS. AS SUCH, MANY EMPLOYEES WHO ARE AT THE DIRECTOR LEVEL OR ABOVE, OR WHO ARE OFFICERS AND/OR DIRECTORS OF ORGANIZATIONS WHERE WHEATON HAS COMMON BOARDS AND OTHER OVERLAPS IN COMMITTEE REPRESENTATIONS, SPEND SIGNIFICANT TIME DEVOTED TO TASKS NOT ONLY FOR THE FILING ORGANIZATION, BUT ALSO FOR RELATED ORGANIZATIONS. WHILE THERE IS NO OFFICIAL TIME STUDY TRACKING THAT IS DONE, IT IS ESTIMATED THAT FOR EACH EMPLOYEE, TASKS DEVOTED TO RELATED ORGANIZATIONS COULD APPROXIMATE UP TO 80% OR MORE OF TOTAL HOURS. Form 990, Part VIII, Line 2f Other Program Service Revenue Net Patient Revenue - Total Revenue: 0, Related or Exempt Function Revenue: , Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSET TRANSFERS WITH AFFILIATES - 5052202; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS The activity of WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST. FRANCIS, INC. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. DISCLOSURE STATEMENT RELATED TO FORMS 5471 INFORMATION RETURN OF US PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF INTERNAL REVENUE CODE SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF US PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER US TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: WHEATON FRANCISCAN SERVICES, INC. ADDRESS: 26 W171 ROOSEVELT ROAD, WHEATON IL 60187 FEIN NUMBER OF US TAX RETURN WITH WHICH FORM 5471 WAS FILED: 36-3262111 IRS SERVICE CENTER WHERE US TAX RETURN WAS OR WILL BE FILED: E-FILED CORE FORM - ADDRESS GENERAL INFORMATION-C-ADDRESS THE PHYSICAL ADDRESS OF 39-1486775 WHEATON FRANCISCAN HEALTHCARE-TERRACE AT ST. FRANCIS INC. IS: 3200 SOUTH 20TH STREET, MILWAUKEE, WI, 53215. THE ADDRESS LISTED ON PAGE 1 ON THIS RETURN IS FOR MAILING PURPOSES ONLY. ASCENSION HEALTH ALLIANCE PO BOX 45998 St Louis MO 63145 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) NA false ASCENSION HEALTH PO BOX 45998 St Louis MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) ASCENSION HEALTH ALLIANCE false ASCENSION HEALTH SENIOR CARE 12250 Weber Hill Road St Louis MO 63127 431227406 PARENT COMPANY MO 501(c)(3) ASCENSION HEALTH false ALEXIAN VILLAGE OF MILWAUKEE INC 9301 N 76th Street Milwaukee WI 53223 391351584 CONTINUING CARE RETIREMENT COMMUNITY WI 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ALEXIAN VILLAGE OF TENNESSEE 437 Alexian Way Signal Mountain TN 37377 621136742 CONTINUING CARE RETIREMENT COMMUNITY TN 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ALEXIAN BROTHERS COMMUNITY SERVICES 425 Cumberland St Suite 110 Chattanooga TN 37404 364344423 PACE- COMPREHENSIVE & COORDINATED COMMUNITY BASED SERVICES TN 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ALEXIAN BROTHERS LANSDOWNE VILLAGE 12250 Weber Hill Road SUITE 200 ST LOUIS MO 63127 431470362 SKILLED NURSING FACILITY MO 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ALEXIAN BROTHERS SHERBROOKE VILLAGE 4005 Ripa Avenue St Louis MO 63125 431592502 SKILLED NURSING FACILITY MO 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true SETON MANOR INC 1000 Seton Drive Orwigsburg PA 17961 232960726 SKILLED NURSING FACILITY PA 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true OUR LADY OF PEACE INC 5285 Lewiston Road Lewiston NY 14092 161608735 SKILLED NURSING FACILITY NY 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true BORGESS NURSING HOME INC 3057 Gull Road Kalamazoo MI 49048 382555589 SKILLED NURSING FACILITY MI 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ST JOSEPH'S MINISTRIES INC 331 S Seton Avenue Emmitsburg MD 21727 521835288 SKILLED NURSING FACILITY MD 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true CARONDELET LONG-TERM CARE FACILITIES INC 621 Carondelet Drive Kansas City MO 64114 742505427 SKILLED NURSING FACILITY MO 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ST CATHERINE'S LABOURE MANOR 1750 Stockton Street Jacksonville FL 32204 591878316 SKILLED NURSING FACILITY FL 501(c)(3) 3 ASCENSION HEALTH SENIOR CARE true PROVIDENCE PARK INC 300 W Highway 6 Waco TX 76712 611759304 SKILLED NURSING FACILITY TX 501(c)(3) 3 ASCENSION HEALTH SENIOR CARE true VIA CHRISTI VILLAGES INC 2622 W Centra Suite 100 Wichita KS 67203 480559086 MANAGEMENT COMPANY KS 501(c)(3) ASCENSION HEALTH SENIOR CARE true VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS INC 2622 W Centra Suite 100 Wichita KS 67203 481236589 PACE (SNF) KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE PONCA CITY INC 1601 Academy Road Ponca City OK 74604 731153337 RETIREMENT COMMUNITY OK 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE HAYS INC 2225 Canterbury Drive Hays KS 67601 202828680 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE MCLEAN INC 777 N McLean Blvd McLean KS 67203 481247723 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true CORNERSTONE ASSISTED LIVING INC 2622 W Centra Suite 100 Wichita KS 67203 481241079 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE MANHATTAN INC 2800 Willow Grove Road Manhattan KS 66502 481078862 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE GEORGETOWN INC 1655 S Georgetown Georgetown KS 67218 481129325 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true VIA CHRISTI VILLAGE PITTSBURG INC 1502 E Centennial Drive Pittsburg KS 66762 743070971 RETIREMENT COMMUNITY KS 501(c)(3) 10 VIA CHRISTI VILLAGES INC true NAZARETH HALL 1475 EL PASO TX 79903 742387843 RETIREMENT COMMUNITY TX 501(c)(3) 10 ASCENSION HEALTH SENIOR CARE true ALEXIAN BROTHERS CORPUS CHRISTI HOUSING PROJECT LLC 3900 SOUTH GRAND ST LOUIS MO 63118 943465394 HOUSING MO NA C Corporation true false false false false false false false false false false false false false false false false false false false