2017-01-09T17:27:41-06:00 2016-06-30 351750664 DAUBY O'CONNOR & ZALESKI LLC 501 CONGRESSIONAL BLVD STE 300 CARMEL IN 46032 990 2015-07-01 840626174 FRANCIS HEIGHTS INC FRAN 6304629271 PO BOX 667 WHEATON IL 601890667 SHARI L KOEHLER CFO 6304629271 2017-01-09 1 STEVEN C LEVY P00229331 3178485700 2015 2021-01-29 14:40:06Z SHARI L KOEHLER 26W171 ROOSEVELT ROAD WHEATON IL 60187 3390584 0 0928 X N/A X 1970 CO FRANCIS HEIGHTS, INC. IS A WHOLLY OWNED SUBSIDIARY OF FRANCISCAN MINISTRIES, INC., THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION FORMED ON NOVEMBER 9, 1970, IN ACCORDANCE WITH THE NOT-FOR-PROFIT STATUTES OF COLORADO. THE CORPORATION WAS FORMED FOR THE PURPOSE OF OPERATING A 382 UNIT COMMUNITY LOCATED IN DENVER, COLORADO WHICH PROVIDES HOUSING AND RELATED SERVICES FOR ELDERLY, LOW AND MODERATE INCOME PERSONS. THE CORPORATION RECEIVES HOUSING ASSISTANCE AND A MORTGAGE INSURED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PURSUANT TO SECTION 236 OF THE NATIONAL HOUSING ACT, AS AMENDED. THE CORPORATION ALSO RECEIVED GRANTS FROM THE CITY OF DENVER AND OTHER SOURCES TO ASSIST IN ITS PURPOSE. 8 2 0 2 0 0 1501108 1397402 1755472 1791132 358 -97946 202798 201799 3459736 3292387 50522 0 0 0 0 0 0 0 0 3201215 3095232 3251737 3095232 207999 197155 8840962 9054141 2773208 2789232 6067754 6264909 X FRANCIS HEIGHTS, INC. IS A WHOLLY OWNED SUBSIDIARY OF FRANCISCAN MINISTRIES, INC., THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION FORMED ON NOVEMBER 9, 1970, IN ACCORDANCE WITH THE NOT-FOR-PROFIT STATUTES OF COLORADO. THE CORPORATION WAS FORMED FOR THE PURPOSE OF OPERATING A 382 UNIT COMMUNITY LOCATED IN DENVER, COLORADO WHICH PROVIDES HOUSING AND RELATED SERVICES FOR ELDERLY, LOW AND MODERATE INCOME PERSONS. THE CORPORATION RECEIVES HOUSING ASSISTANCE AND A MORTGAGE INSURED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PURSUANT TO SECTION 236 OF THE NATIONAL HOUSING ACT, AS AMENDED. THE CORPORATION ALSO RECEIVED GRANTS FROM THE CITY OF DENVER AND OTHER SOURCES TO ASSIST IN ITS PURPOSE. 0 0 2635398 1692935 FRANCIS HEIGHTS, INC. IS A WHOLLY OWNED SUBSIDIARY OF FRANCISCAN MINISTRIES, INC., THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION FORMED ON NOVEMBER 9, 1970, IN ACCORDANCE WITH THE NOT-FOR-PROFIT STATUTES OF COLORADO. THE CORPORATION WAS FORMED FOR THE PURPOSE OF OPERATING A 382 UNIT COMMUNITY LOCATED IN DENVER, COLORADO WHICH PROVIDES HOUSING AND RELATED SERVICES FOR ELDERLY, LOW AND MODERATE INCOME PERSONS. THE CORPORATION RECEIVES HOUSING ASSISTANCE AND A MORTGAGE INSURED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PURSUANT TO SECTION 236 OF THE NATIONAL HOUSING ACT, AS AMENDED. THE CORPORATION ALSO RECEIVED GRANTS FROM THE CITY OF DENVER AND OTHER SOURCES TO ASSIST IN ITS PURPOSE. 2635398 1 1 0 0 0 0 0 0 0 0 1 0 1 0 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 13 0 1 0 0 0 0 0 0 0 0 0 X 8 2 0 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 X SHARI L KOEHLER 6309096900 PO BOX 667 WHEATON IL 601890667 X SUSAN DILLBERG CHAIR - DIRECTOR 1.00 40.00 X X 0 305377 93565 SHARI L KOEHLER VICE CHAIR/SECRETARY/TREASURER-DIRECTOR 1.00 40.00 X X 0 215040 42577 JOHN HOLTZ PRESIDENT - DIRECTOR 1.00 40.00 X X 0 113432 6816 SEBASTIAN GALAN ASST TREASURER - DIRECTOR 1.00 40.00 X X 0 79270 13374 JENNIFER S TRUPPA DIRECTOR 1.00 40.00 X 0 99545 34743 DIANE GONZALEZ DIRECTOR 1.00 40.00 X 0 56188 3194 RUTH BOYLE DIRECTOR 1.00 1.00 X 0 0 0 MARY ELLEN FREAS DIRECTOR 1.00 1.00 X 0 0 0 SARAH HERZOG KEY EMPLOYEE 1.00 40.00 X 0 543221 71802 JOHN OLIVERIO KEY EMPLOYEE 1.00 40.00 X 0 3733710 180697 0 5145783 446768 0 0 1 0 SECURITAS SECURITY SERVICES USA INC FILE 57220 LOS ANGELES CA 900747220 SECURITY SERVICE 208751 AMI MECHANICAL INC 12141 PENNSYLVANIA STREET THORNTON CO 802413115 CONSTRUCTION 202140 SEGURA'S RESTORATION LLC 17920 JARVIS PLACE AURORA CO 80013 CONSTRUCTION 163310 HIGHLANDS RANCH CARPET AND REPAIR 16338 ORCHARD GRASS LANE PARKER CO 80134 CONSTRUCTION 150048 EXCELLENCE ROOFING & CONSTRUCTION LLC 2921 COTTONWOOD DR DENVER CO 80221 CONSTRUCTION 144330 5 12808 1384594 9153 1397402 RENTAL INCOME 531110 1791132 1791132 1791132 251 251 98197 -98197 -98197 -98197 COMMERCIAL RENT 531110 120992 120992 RESIDENT SERVICES 531110 48851 48851 LAUNDRY AND VENDING 531110 17210 17210 14746 14746 201799 3292387 1692935 0 202050 263994 263994 5844 5844 18625 18625 726 726 4983 4983 90615 90615 960030 960030 7616 7616 11744 11744 3517 3517 591683 591683 55687 55687 MANAGEMENT COMPANY EMPL 1077099 1077099 BAD DEBTS 3069 3069 3095232 2635398 459834 0 259875 118594 38289 29493 14051619 6384972 7319939 7666647 986046 1020264 93183 70420 143630 148723 8840962 9054141 237048 252102 41195 26258 2297840 2315061 197125 195811 2773208 2789232 X 6067754 6264909 6067754 6264909 8840962 9054141 197155 0 X X 0 1 X 1 1 1 X 1675741 1664364 1640924 1501108 1397402 7879539 1612589 1573489 1704407 1755472 1791132 8437089 3288330 3237853 3345331 3256580 3188534 16316628 0 0 0 16316628 1216 745 591 358 251 3161 1216 745 591 358 251 3161 191966 205768 200018 202798 201799 1002349 3481512 3444366 3545940 3459736 3390584 17322138 0.94200 0.94290 0.00020 0.00040 X SCHEDULE A, PART III, LINE 12: MISCELLANEOUS INCOME CONSISTS OF TENANT CHARGES, LAUNDRY AND VENDING CHARGES AND OTHER INCOME ITEMS FOR SERVICES PROVIDED FOR THE CONVENIENCE OF THE TENANTS. INCLUDED ON PAGE 9, PART VIII IN CURRENT YEAR OTHER REVENUE LINE 7C IS A LOSS ON DISPOSAL OF DEPRECIABLE ASSETS OF $98,197. THE LOSS IS NOT BEING INCLUDED ON SCHEDULE A, PART III, LINE 12 BECAUSE IT DOES NOT MEET THE DEFINITION OF SUPPORT AS DEFINED IN SECTION 509(D) OF THE INTERNAL REVENUE CODE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 125802 125802 10830789 4754495 6076294 265935 116854 149081 2829093 1513623 1315470 7666647 RESTRICTED CASH 968850 C MORTGAGE ESCROW DEPOSITS 51414 C 1020264 TENANT SECURITY DEPOSITS 144984 CAPITAL RECOVERY NOTE 50827 195811 X 3395084 4500 4500 3390584 -98197 -98197 3292387 3193429 98197 98197 3095232 0 3095232 PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND STATE INCOME TAX AND HAS BEEN CLASSIFIED AS AN OTHER THAN PRIVATE FOUNDATION. ACCORDINGLY, NO PROVISION FOR FEDERAL AND STATE TAXES ON REVENUE AND INCOME HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. GENERALLY, THE FEDERAL AND STATE TAX RETURNS WERE SUBJECT TO EXAMINATIONS FROM THE THREE YEARS AFTER THE LATER OF THE ORIGINAL OR EXTENDED DUE DATE OR THE DATE FILED BY THE APPLICABLE TAX AUTHORITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: DEFERRED REVENUE 4,500. PART XI, LINE 4B - OTHER ADJUSTMENTS: TAX GAIN/LOSS ON DISPOSAL OF ASSETS -98,197. PART XII, LINE 2D - OTHER ADJUSTMENTS: BOOK GAIN/LOSS ON DISPOSAL OF ASSETS 98,197. 0 1 0 0 0 0 0 0 0 SUSAN DILLBERG CHAIR - DIRECTOR 0 226404 0 53000 0 25973 0 72712 0 20853 0 398942 0 0 SHARI L KOEHLER VICE CHAIR/SECRETARY/TREASURER-DIREC 0 182017 0 32330 0 693 0 28898 0 13679 0 257617 0 0 SARAH HERZOG KEY EMPLOYEE 0 341539 0 189300 0 12382 0 43560 0 28242 0 615023 0 0 JOHN OLIVERIO KEY EMPLOYEE 0 1016542 0 1204600 0 1512568 0 113538 0 67159 0 3914407 0 0 SCHEDULE J, LINE 4B: WHEATON FRANCISCAN SERVICES, INC., ESTABLISHED THE WHEATON FRANCISCAN SERVICES, INC. NON-QUALIFIED BENEFIT RESTORATION PLAN TO PROVIDE SELECTED EMPLOYEES WITH CERTAIN BENEFITS WHICH THEY ARE UNABLE TO RECEIVE UNDER THE QUALIFIED PLAN BECAUSE OF LIMITATIONS ON SUCH QUALIFIED PLANS UNDER SECTIONS 401(A)(17) AND 415(B) OF THE INTERNAL REVENUE CODE. THIS PLAN IS INTENDED TO SATISFY THE SHORT-TERM DEFERRAL EXCEPTION UNDER CODE SECTION 409(A). ACCORDINGLY, THE PARTICIPANT'S PLAN ACCRUALS ARE CALCULATED AS OF THE LAST DAY OF EACH PLAN YEAR AND PAID AS A TAXABLE DISTRIBUTION TO THE PARTICIPANT IN THAT PLAN YEAR. AT THIS TIME, THERE ARE TWO LONG-TERM SENIOR OFFICIALS WHO ARE ELIGIBLE FOR BENEFITS UNDER THE PLAN, JOHN OLIVERIO, CHIEF EXECUTIVE OFFICER, AND GREG SMITH, CHIEF INFORMATION OFFICER. UNDER THIS PLAN, JOHN OLIVERIO RECEIVED A 2015 TAXABLE PAYOUT OF $1,487,537. FORM 990, PART VI, SECTION A, LINE 3 FRANCIS HEIGHTS, INC. IS MANAGED BY FRANCISCAN MINISTRIES, INC., A PROFESSIONAL PROPERTY MANAGEMENT COMPANY. FRANCISCAN MINISTRIES, INC. IS RELATED TO THE ORGANIZATION DUE TO THE FACT THAT IT IS THE SOLE MEMBER OF FRANCIS HEIGHTS, INC. FRANCISCAN MINISTRIES, INC. HAS A PROJECT OWNER AND MANAGEMENT AGENT CERTIFICATION FOR MULTIFAMILY HOUSING PROJECTS WITH THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. UNDER THIS CERTIFICATION, HUD HAS APPROVED FRANCISCAN MINISTRIES, INC. TO MANAGE THE FRANCIS HEIGHTS, INC. COMMUNITY. THE MANAGEMENT CONTRACT ENCOMPASSES THE DAY TO DAY OPERATIONS OF THE PROJECT INCLUDING, BUT NOT LIMITED TO, COLLECTION OF RENTS, MAINTENANCE OF FACILITIES, SUPERVISION OF STAFF, AND ONGOING SUPPORT FOR BOTH THE OWNERS AND TENANTS AS NEEDED IN ORDER TO ESTABLISH A SAFE, SANITARY AND AFFORDABLE ENVIRONMENT. FORM 990, PART VI, SECTION A, LINE 6 FRANCIS HEIGHTS, INC. HAS ONE MEMBER WHICH HOLDS SEVERAL RESERVED POWERS OVER FRANCIS HEIGHTS, INC. THESE RESERVED POWERS INCLUDE, BUT ARE NOT LIMITED TO, THE ELECTION OF MEMBERS OF THE GOVERNING BODY AND ELECTION OF OFFICERS, APPROVAL OF CERTAIN FINANCIAL EXPENDITURES IN ACCORDANCE WITH POLICY, AND APPROVAL OF BUDGETS AND STRATEGIC PLANS; THESE APPROVALS ARE BASED ON RECOMMENDATIONS FROM THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A PLEASE SEE EXPLANATION FOR PART VI, LINE 6. FORM 990, PART VI, SECTION A, LINE 7B PLEASE SEE EXPLANATION FOR PART VI, LINE 6. FORM 990, PART VI, SECTION B, LINE 11 AFFILIATES OF FRANCISCAN MINISTRIES, INC. USE A MULTIPLE-LEVEL REVIEW PROCESS ON ALL FEDERAL AND STATE INFORMATION AND TAX RETURNS TO ENSURE ACCURATE AND TIMELY FILING FOR ALL ORGANIZATIONS. UNDER THE DIRECTION OF THE FMI ACCOUNTING TEAM, THE AUDIT FIRM PREPARES ALL 990'S THROUGHOUT THE SYSTEM, AND WORKS WITH THE TAX MANAGER OF ASCENSION WISCONSIN (FORMERLY WHEATON FRANCISCAN HEALTHCARE / FRANCISCAN MINISTRIES) TO GATHER AND REPORT THE INFORMATION NEEDED. WHEN COMPLETE, THE RETURN IS FIRST REVIEWED BY THE ACCOUNTING DIRECTOR, WHO FOCUSES ON INCOME STATEMENT AND BALANCE SHEET ITEMS, AND SCHEDULES WHERE TRANSACTIONS OF THIS TYPE MIGHT BE REPORTED. IF DISCREPANCIES ARE FOUND, THE ITEM WILL BE CORRECTED PRIOR TO THE NEXT STEP IN THE REVIEW PROCESS. ONCE CLEARED THROUGH ACCOUNTING, A SAMPLING OF RETURNS IS PROVIDED TO THE TAX DEPARTMENT IN CERTAIN YEARS, AND THE TAX MANAGER FOCUS THEIR REVIEW ON CONSISTENCY OF REPORTING BETWEEN ALL INFORMATION RETURNS, ACCURACY OF TAX RELATED INFORMATION, AND NARRATIVE EXPLANATION OF ANY OUTLIERS. AGAIN, ANY PROBLEMS OR QUESTIONS ARE INVESTIGATED AND CORRECTED BY THE ACCOUNTING DEPARTMENT UTILIZING THE AUDIT FIRM WHO PREPARES THE RETURNS. THE AUDIT FIRM, UPON COMPLETION OF ALL LEVELS OF REVIEW, WILL SCHEDULE AN APPOINTMENT WITH THE CFO, WHO WILL PERFORM A REVIEW PRIOR TO SIGNING THE RETURN. ONCE SIGNED, THE RETURN IS CLEARED TO PROVIDE TO MEMBERS OF THE BOARD OF DIRECTORS. THE PARENT ORGANIZATION, WHEATON FRANCISCAN SERVICES, INC. HAS DESIGNATED THAT THE FINANCE AND OPERATIONS COMMITTEE REVIEW THE REGIONAL HOLDING COMPANY RETURN OF FRANCISCAN MINISTRIES, INC. IN CERTAIN YEARS. THE 990 IS EXPLAINED AT A HIGH LEVEL BY MANAGEMENT REPRESENTATIVES, AND ANY QUESTIONS OR CONCERNS THAT THE COMMITTEE HAS CAN BE ADDRESSED. AT A LATER DATE AND PRIOR TO EFILING, THE FULL BOARD, AS WELL AS ANY REPORTABLE INDIVIDUALS, ARE PROVIDED ACCESS TO ALL 990'S THROUGHOUT THE FRANCISCAN MINISTRIES SYSTEM VIA AN ONLINE PORTAL. FORM 990, PART VI, SECTION B, LINE 12C FRANCISCAN MINISTRIES, INC. AND SUBSIDIARIES HAVE ADOPTED A CONFLICT OF INTEREST POLICY. UNDER THAT POLICY, IF AT ANY TIME, AN OFFICER OR DIRECTOR BECOMES AWARE THAT THE BOARD MAY DISCUSS OR ACT UPON ANY TRANSACTION OR ARRANGEMENT WHICH MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, A FINANCIAL INTEREST OF THE INDIVIDUAL, THE FINANCIAL INTEREST MUST BE DISCLOSED. ALL ASSOCIATES OF THE ORGANIZATION MUST DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES (OR BEFOREHAND IF NOT IN EXISTENCE AT THE TIME OF HIRE). THE DISCLOSURES ARE REVIEWED AND A DETERMINATION IS MADE AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND HOW IT MIGHT BE MANAGED. ADDITIONALLY, AS PART OF AN ONGOING PROCESS, CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT OUT TO ALL OFFICERS, DIRECTORS, AND OTHER INDIVIDUALS IN KEY POSITIONS USING SOFTWARE DESIGNED TO CAPTURE THIS INFORMATION. THE RESPONSES ARE ANALYZED IN ORDER TO DETERMINE INFORMATION ON POTENTIAL CONFLICTS, AS WELL AS INFORMATION ON BUSINESS AND FAMILY RELATIONSHIPS FOR PURPOSES OF ANSWERING CERTAIN QUESTIONS ON IRS FORM 990. RESPONSES TO THESE QUESTIONS ARE REVIEWED BY THE VICE PRESIDENT OF COMPLIANCE AND THE MANAGER OF TAX COMPLIANCE, AND FOLLOW UP ACTION, IF ANY, ARE DOCUMENTED WITHIN THE SOFTWARE. NON-RESPONDERS ARE REMINDED OF THEIR OUTSTANDING DISCLOSURE REQUIREMENT AUTOMATICALLY THROUGH THE SOFTWARE SYSTEM. RESPONSES TO QUESTIONS ARE REVIEWED AND DOCUMENTED THROUGHOUT THIS TIME PERIOD, WHICH WAS MOST RECENTLY COMPLETED IN MARCH 2016 FOR ALL BOARD MEMBERS AND OTHER 990 REPORTABLES ON RECORD. ANY RESPONSES REQUIRING DISCLOSURE ON FORM 990 ARE MADE, AND MONITORED FOR ALL FUTURE YEARS. AT A LATER DATE, ANY NON RESPONDER NAMES ARE DETERMINED, AND A LETTER, ALONG WITH THE ACTUAL CONFLICT OF INTEREST POLICY, IS SENT TO THE CHAIRPERSON OF EACH BOARD. THE LETTER OUTLINES THE CURRENT NON RESPONDERS, AS WELL AS ANY OFFICER OR BOARD MEMBER THAT HAS DISCLOSED A FINANCIAL INTEREST THAT MIGHT POSE A POTENTIAL CONFLICT OF INTEREST. DEPENDING UPON THE NATURE OF THE FINANCIAL INTEREST AND WORK DONE BY THE BOARD, SEVERAL ACTIONS MAY BE CONSIDERED - THE BOARD MEMBER WITH A FINANCIAL INTEREST WOULD NEED TO VOLUNTARILY EXCUSE HIM OR HERSELF FROM THE DELIBERATIONS AND/OR VOTING ON SUCH A MATTER; OR, IF NECESSARY, THE BOARD WOULD DETERMINE THAT THE SUBJECT'S FINANCIAL INTEREST WAS AN ACTUAL CONFLICT OF INTEREST, IN WHICH CASE THE BOARD MEMBER WOULD BE INFORMED BY THE BOARD CHAIRPERSON THAT HE OR SHE WOULD NOT BE ALLOWED TO VOTE IN ANY SUCH MATTERS DUE TO THIS REAL OR PERCEIVED CONFLICT OF INTEREST. MINUTES OF THE BOARD MEETING WOULD DOCUMENT THIS DECISION PROCESS, AND REFLECT WHATEVER ACTION(S) ARE ULTIMATELY TAKEN. THE BOARD CHAIRPERSON IS ALSO REQUIRED TO DISCUSS WITH NON RESPONDERS THE REPERCUSSIONS OF NOT RESPONDING, AND REQUIRE THE BOARD MEMBER TO COMPLETE THE ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONS BEFORE BEING ALLOWED TO CONTINUE IN ANY BOARD MATTERS. IF THE BOARD MEMBER REFUSES, THE CHAIRPERSON HAS THE AUTHORITY TO DETERMINE THE APPROPRIATE ACTION, INCLUDING, BUT NOT LIMITED TO PROHIBITING THEM FROM PARTICIPATING IN DELIBERATIONS, PREVENTING THEM FROM VOTING, AND/OR REMOVING THEM AS A BOARD MEMBER. FORM 990, PART VI, SECTION C, LINE 19 FRANCISCAN MINISTRIES, INC. AND AFFILIATES PROVIDE UPON REQUEST CERTAIN DOCUMENTS INCLUDING OUR FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS THAT SUPPORT OUR TAX EXEMPT STATUS, INCLUDING, BUT NOT LIMITED TO, ARTICLES OF INCORPORATION AND BYLAWS. REQUESTS FOR INFORMATION ARE CONSIDERED ON A CASE-BY-CASE BASIS, AND THIS PROCESS IS OUTLINED IN OUR PUBLIC DISCLOSURE POLICY. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B: FRANCISCAN MINISTRIES ARE A CONTROLLED GROUP OF RELATED HOUSING MINISTRIES. AS SUCH, MANY EMPLOYEES WHO ARE AT THE DIRECTOR LEVEL OR ABOVE, OR WHO ARE OFFICERS AND/OR DIRECTORS OF ORGANIZATIONS WHERE FMI 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 XII, LINE 2C: THE MANAGEMENT COMPANY RECEIVES A COPY OF THE AUDIT. THE CFO OF FRANCISCAN MINISTRIES REVIEWS THE AUDIT. IF THERE ARE ANY MATERIAL PROBLEMS OR CONCERNS, THE CFO CONTACTS THE REGIONAL DIRECTOR. IT IS THE RESPONSIBILITY OF THE CFO TO GIVE FINAL APPROVAL OF THE AUDIT. WHEN THE AUDIT IS UP FOR BID, THE BOARD DISCUSSES THE RELATIONSHIP WITH THE CURRENT AUDITORS AND MAKES A DETERMINATION AS TO WHETHER TO MAINTAIN THIS RELATIONSHIP OR CHANGE TO A NEW AUDITING FIRM. DISCLOSURE STATEMENT RELATED TO FORMS 5471: INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPS 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 4 AND/OR 5 FILER WITH RESPECT TO WHEATON FRANCISCAN INSURANCE COMPANY, FEIN #98-0691609. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 WITH RESPECT TO THE FOREIGN CORPORATION ON THE TAXPAYER BEHALF BY THE 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 FORM 990, PART VI, SECTION B, LINES 10A-10B: FRANCISCAN MINISTRIES ORGANIZATIONS ARE PART OF A CONTROLLED GROUP OF HOUSING MINISTRIES, CONTROLLED UNDER A COMMON PARENT ORGANIZATION WHEATON FRANCISCAN SERVICES, INC. SOME OF THESE ORGANIZATIONS ARE EXEMPT THROUGH THE CATHOLIC GROUP RULING AND OTHER ORGANIZATIONS HAVE A STAND-ALONE EXEMPTION (IRS DETERMINATION) LETTER. AS SUCH, THESE RELATED AFFILIATES HAVE CERTAIN POLICIES AND PROCEDURES THAT WERE ADOPTED AT THE PARENT LEVEL, BUT ARE APPLICABLE TO THE ENTIRE CONTROLLED GROUP OF ORGANIZATIONS. ALL POLICY AND PROCEDURE MATTERS ARE HANDLED IN A MANNER TO ENSURE THAT ALL ACTIVITIES ARE CONSISTENT WITH THE ORGANIZATION'S OVERALL EXEMPT PURPOSES. PLEASE SEE SCHEDULE R FOR A FULL LISTING OF ALL RELATED AFFILIATE ORGANIZATIONS. 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HOME HLTH WI 501(C)(3) LINE 3 WFH-SE WI 0 WHEATON FRANCISCAN -ELMBROOK FNDN 19333 WEST NORTH AVENUE BROOKFIELD WI 53045 392028808 FOUNDATION WI 501(C)(3) LINE 11A, I WF INC 0 WHEATON FRANCISCAN INC 5000 WEST CHAMBERS STREET MILWAUKEE WI 53210 390816857 HOSPITAL WI 501(C)(3) LINE 3 WFH-SE WI 0 WHEATON FRANCISCAN LABORATORIES INC 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 391701402 LABORATORY WI 501(C)(3) LINE 9 WFH-SE WI 0 WHEATON FRANCISCAN MEDICAL GROUP INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391791586 MED GROUP WI 501(C)(3) LINE 3 WFH-SE WI 0 WHEATON FRANCISCAN SERVICES INC 26 W 171 ROOSEVELT RD WHEATON IL 60187 363262111 PARENT CORP IL 501(C)(3) LINE 11A, I N/A 0 WHEATON FRANCISCAN SISTERS FOUNDATION PO BOX 667 WHEATON IL 601870667 391471463 HOLDING CO WI 501(C)(3) LINE 11A, I WFSI 0 SAXONY MANOR LLC 1860 27TH AVENUE KENOSHA WI 53140 352521928 HOUSING WI GLCF FOR HOUSING LP 29 RELATED 0 0 0.00010 WHEATON FRANCISCAN ENTERPRISES INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391985204 HOLDING CO WI N/A C 0 WHEATON FRANCISCAN HOLDINGS INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391836357 HOLDING CO WI N/A C 0 WHEATON FRANCISCAN INSURANCE COMPANY PO BOX 69 GT GEORGETOWN CJ 980691609 OTHER INVESTMENT UK N/A 0 WHEATON FRANCISCAN MED GRP-SUSSEX INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391361100 MED GROUP WI N/A C 0 WHEATON FRANCISCAN PROVIDER NETWORK INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391952140 ADMN SUPPORT WI N/A C 0 FMOB CONDOMINIUM ASSCN 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 341983857 CONDO MGMT WI N/A C 0 WHEATON WAY CONDO OWNERS ASSCN INC 10101 SOUTH 27TH STREET FRANKLIN WI 53132 300659830 CONDO ASSCN WI N/A C 0 0 0 1 0 1 0 0 0 0 1 0 0 1 1 0 1 0 0 0 FORM 990, SCHEDULE R: (1) EFFECTIVE MARCH 1, 2016, ORGANIZATIONS IN THE SOUTHEAST WISCONSIN REGION WERE TRANSFERRED FROM WHEATON FRANCISCAN SERVICES, INC. TO ASCENSION HEALTH, AND AS A RESULT, CEASED TO BE RELATED AS OF THIS DATE. (2) EFFECTIVE MARCH 1, 2016, ORGANIZATIONS IN THE MARIANJOY REGION WERE TRANSFERRED FROM WHEATON FRANCISCAN SERVICES, INC. TO NORTHWESTERN MEMORIAL HEALTHCARE, INC., AND AS A RESULT, CEASED TO BE RELATED AS OF THIS DATE. (3) EFFECTIVE MAY 4, 2016, O.S.F. SERVICES, INC. CHANGED ITS LEGAL NAME TO WHEATON FRANCISCAN SISTERS FOUNDATION, INC. (4) EFFECTIVE JUNE 9, 2016, CANTICLE MINISTRIES, INC. WAS DISSOLVED, AND AS SUCH, THIS WILL BE IT'S FINAL 990 AND THE FINAL YEAR IT WILL BE REPORTED AS A RELATED ORGANIZATION. (5) UHS, INC. IS LISTED WITHOUT A DIRECT CONTROLLING ENTITY BECAUSE OF THE TWO ORGANIZATIONS WITH AN INTEREST, KHMC COMMUNITY BOARD AND WHEATON FRANCISCAN SISTERS FOUNDATION, INC., NEITHER CAN APPOINT A MAJORITY OF THE BOARD, AND SINCE KHMC IS NOT AN ENTITY (IT IS A COMMUNITY BOARD), NEITHER BODY "CONTROLS". (6) EFFECTIVE APRIL 1, 2016, ORGANIZATIONS IN THE IOWA REGION WERE TRANSFERRED FROM WHEATON FRANCISCAN SERVICES, INC. TO MERCY HEALTH NETWORK, INC., AND AS A RESULT, CEASED TO BE RELATED AS OF THIS DATE. (7) INDIANAPOLIS MANOR 1, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE NOVEMBER 5, 2015. (8) KOKOMO MANOR, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE APRIL 4, 2016. (9) INDIANAPOLIS MANOR 2, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE NOVEMBER 5, 2015. (10) PADUCAH MINISTRIES 1, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE APRIL 15, 2016. (11) PRINCETON MINISTRIES 4, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE MARCH 21, 2016. (12) RICHARDSON MINISTRIES, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE JANUARY 15, 2016. (13) EFFINGHAM MINISTRIES, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE DECEMBER 21, 2015. (14) MOLINE MINISTRIES 1, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE APRIL 6, 2016. (15) MOLINE MINISTRIES 2, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE MARCH 30, 2016. (16) LAKE WALES MINISTRIES, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE JANUARY 7, 2016. (17) PENDLETON MINISTRIES 2, INC. WAS INCORPORATED ON SEPTEMBER 29, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE MAY 12, 2016. (18) TUCSON MINISTRIES, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE FEBRUARY 3, 2016. (19) PHOENIX MINISTRIES 3, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE MARCH 16, 2016. (20) DAVENPORT MINISTRIES, INC. WAS INCORPORATED ON SEPTEMBER 29, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE JANUARY 15, 2016. (21) ALEXANDRIA MANOR, INC. WAS INCORPORATED ON SEPTEMBER 25, 2015 AND WAS GRANTED EXEMPT STATUS EFFECTIVE FEBRUARY 2, 2016. (22) EFFECTIVE JANUARY 31, 2016, VILLA ST. CLARE, INC. WAS SOLD TO AN UNRELATED PARTY. FORM 990, SCHEDULE R, PART V, LINE 1: FOR THE PURPOSES OF SCHEDULE R, PART V, THE FOLLOWING APPLIES: -LINE ITEM 1C INCLUDES GIFTS/GRANTS FROM RELATED ORGANIZATIONS -LINE ITEM 1E INCLUDES PAYABLES TO RELATED ORGANIZATIONS -LINE ITEM 1J INCLUDES RENTAL INCOME FROM SHARED FACILITIES FROM RELATED ORGANIZATIONS -LINE ITEM 1M INCLUDES MANAGEMENT FEES PAID TO RELATED ORGANIZATIONS -LINE ITEM 1P INCLUDES ALL SALARIES, EMPLOYEE BENEFITS, AND PAYROLL TAXES