ALEXIAN BROTHERS SPECIALTY GROUP: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ALEXIAN BROTHERS SPECIALTY GROUP (EIN 80-0710751)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-11
- IRS object ID
- 201721319349304447
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-11T16:04:36-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800710751 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alexian Brothers Specialty Group | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALEX | BusinessNameControlTxt |
| Phone | 8478185100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1Txt |
| City | Arlington Heights | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60005 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Beth Tze | PersonNm |
| Person Title | Vice President | PersonTitleTxt |
| Signature | 2017-05-11 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Frey | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1Txt |
| City | Arlington Heights | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60005 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,925,568 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.alexianbrothershealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Specialty physician group in Catholic health system to improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $25,884 | PYContributionsGrantsAmt |
| CY Contributions Grants | $44,590 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,970,468 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,828,063 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $58,082 | PYOtherRevenueAmt |
| CY Other Revenue | $52,915 | CYOtherRevenueAmt |
| PY Total Revenue | $22,054,434 | PYTotalRevenueAmt |
| CY Total Revenue | $24,925,568 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,678,320 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,027,897 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,193,845 | PYOtherExpensesAmt |
| CY Other Expenses | $14,096,631 | CYOtherExpensesAmt |
| PY Total Expenses | $37,872,165 | PYTotalExpensesAmt |
| CY Total Expenses | $45,124,528 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$15,817,731 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$20,198,960 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,055,927 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,327,041 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,536,516 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,187,546 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$44,480,589 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,860,505 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Alexian Brothers Specialty Group ("ABSG") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health needs of those we are called to serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $43,918,688 | ExpenseAmt |
| Revenue | $24,880,978 | RevenueAmt |
| Desc | Alexian Brothers Specialty Group (ABSG) is comprised of specialty focused employed physicians of Alexian Brothers Health System (ABHS). The specialties include cardiology, neurosciences and pediatrics. There are nearly 60 patient-centered, compassionate and expertly-trained providers in ABSG. The multiple, convenient locations of ABSG, in both the community and on the campus of the two ABHS acute care hospitals, offer flexible access and prompt treatment for a wide range of issues. About the Alexian Brothers Health System: Alexian Brothers Specialty Group is a member of the Alexian Brothers Health System, a comprehensive and diversified healthcare organization headquartered in the northwest suburbs of Chicago, serving more than two million people. Alexian Brothers Health System is a Ministry Organization of Ascension Health, the largest Catholic health system in the nation. The Alexian Brothers Health System provides the community with a full range of comprehensive healthcare services and access to the most advanced medical technology. We are passionate about delivering exceptional health care and are proud of the powerful, cutting edge technology our skilled professionals are able to access. In addition, we offer a wide range of community health services, corporate wellness programs, preventive care and education. Our ministries exist to continue the Alexian Brothers mission of caring for the sick, the poor and the dying and promoting the physical, mental, spiritual and social health and well-being of all individuals we serve. Adventist Health System Sunbelt Healthcare Corporation and Ascension Health, the sponsors of Adventist Midwest Health (AMH) and Alexian Brothers Health System (ABHS), respectively, entered into an Affiliation Agreement that established the Joint Operating Company, Alexian Brothers-AHS Midwest Region Health Co. which became operational on February 1, 2015. The purpose of the Joint Operating Company is to provide a financially and operationally integrated organization for the common management and operation of the health care facilities and operations of AMH and ABHS while preserving the Adventist and Catholic identities and mission priorities that define AMH and ABHS, respectively. In April 2015, AMITA Health was announced as the d/b/a for Alexian Brothers-AHS Midwest Region Health Co. The word AMITA is inspired by words from several languages: friendship in Italian, honesty and truth in Hebrew, and spiritual light and boundlessness in Hindi. These words reflect our core values of friendship, truth, and mutual respect for all, as well as our faith-based call to healing. Although the name is new, the values of our two great organizations will continue to be the foundation of who we are and how we care for our communities into the future. The dedication and promise our caregivers show every day to our patients, their families and each other is deeply rooted in the new name - AMITA Health. | Desc |
| Total Program Service Expenses | $43,918,688 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Antoinette Brown | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8478185100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3040 West Salt Creek Lane | AddressLine1Txt |
| City | Arlington Heights | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60005 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PAUL BELTER | ||||||||||
| DIRECTOR & SECRETARY/TREASURER | 1.0 | 56.0 | Yes (X) | Yes (X) | $0 | $623,565 | $54,883 | |||
| MARK FREY | ||||||||||
| DIRECTOR, CHAIRPERSON & PRESIDENT | 1.0 | 58.0 | Yes (X) | Yes (X) | $0 | $2,250,984 | $38,737 | |||
| TRACY ROGERS | ||||||||||
| DIRECTOR & VICE PRESIDENT (THROUGH 8/28/15) | 1.0 | 55.0 | Yes (X) | Yes (X) | $0 | $603,873 | $59,594 | |||
| PATRICIA CASSIDY | ||||||||||
| DIRECTOR & VICE PRESIDENT (EFFECTIVE 10/1/15) | 1.0 | 56.0 | Yes (X) | Yes (X) | $0 | $501,940 | $44,723 | |||
| DONNA GAUTHIER | ||||||||||
| ASSISTANT SECRETARY | 1.0 | 50.0 | Yes (X) | $0 | $74,341 | $17,743 | ||||
| BETH TZE | ||||||||||
| VICE PRESIDENT | 16.0 | 34.0 | Yes (X) | $0 | $430,012 | $48,308 | ||||
| ERIK BAIER | ||||||||||
| CHIEF FINANCIAL OFFICER | 17.0 | 34.0 | Yes (X) | $0 | $0 | $0 | ||||
| KIMBERLY ZIMMERMANN | ||||||||||
| CHIEF OPERATING OFFICER | 17.0 | 33.0 | $0 | $260,852 | $15,022 | Yes (X) | ||||
| JACK R CHAMBERLIN MD | ||||||||||
| CARDIOLOGIST & INTERNAL MEDICINE | 50.0 | 0.0 | $0 | $771,869 | $28,829 | Yes (X) | ||||
| MOHAMMED KHAN MD | ||||||||||
| CARDIOLOGIST & ELECTROPHYSIOLOGIST | 50.0 | 0.0 | $0 | $956,363 | $28,886 | Yes (X) | ||||
| ANDREI POP MD | ||||||||||
| CARDIOLOGIST | 50.0 | 0.0 | $0 | $826,528 | $28,464 | Yes (X) | ||||
| DANIEL SAURI MD | ||||||||||
| CARDIOLOGIST | 50.0 | 0.0 | $0 | $941,021 | $28,837 | Yes (X) | ||||
| WILLIAM J GRIES MD | ||||||||||
| CARDIOLOGIST | 50.0 | 0.0 | $0 | $687,096 | $27,418 | Yes (X) | ||||
| SCOTT PETERSON | ||||||||||
| FORMER KEY EMPLOYEE | 0.0 | 0.0 | $0 | $110,504 | $0 | Yes (X) | ||||
| FREDERICK O NELSON | ||||||||||
| FORMER OFFICER | 0.0 | 0.0 | $0 | $206,578 | $11,242 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $9,245,527 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $432,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $44,590 | RelatedOrganizationsAmt |
| Total Contributions | $44,590 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Svcs Rev | 621110 | $24,759,138 | $24,759,138 |
| Physician Services to Affiliates | 900099 | $68,925 | $68,925 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,828,063 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,915 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,915 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,915 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,915 | RelatedOrExemptFuncIncomeAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|
| $0 | $0 |
| $0 | $0 |
| $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,925,568 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,880,978 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,949,020 | TotalAmt |
| Program Services | $27,949,020 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700,105 | TotalAmt |
| Program Services | $700,105 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,157 | TotalAmt |
| Program Services | $1,223,157 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,155,615 | TotalAmt |
| Program Services | $1,155,615 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141 | TotalAmt |
| Management And General | $141 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,491 | TotalAmt |
| Management And General | $11,491 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,570,101 | TotalAmt |
| Program Services | $4,526,836 | ProgramServicesAmt |
| Management And General | $1,043,265 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,159 | TotalAmt |
| Program Services | $12,159 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $542,227 | TotalAmt |
| Program Services | $396,724 | ProgramServicesAmt |
| Management And General | $145,503 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,680 | TotalAmt |
| Program Services | $15,680 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,826,828 | TotalAmt |
| Program Services | $1,821,388 | ProgramServicesAmt |
| Management And General | $5,440 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,035 | TotalAmt |
| Program Services | $303,035 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,395 | TotalAmt |
| Program Services | $16,395 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,873 | TotalAmt |
| Program Services | $162,873 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,303,972 | TotalAmt |
| Program Services | $1,303,972 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| ABHN ABHS Management Fees | $3,823,543 | $3,823,543 |
| Dues | $164,420 | $164,420 |
| Medical Supplies | $331,864 | $331,864 |
| Licenses & Permits | $11,902 | $11,902 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,124,528 | TotalAmt |
| Program Services | $43,918,688 | ProgramServicesAmt |
| Management And General | $1,205,840 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,182 | BOYAmt |
| EOY | $42,163 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,192,550 | BOYAmt |
| EOY | $3,088,700 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,002 | BOYAmt |
| EOY | $78,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,485,473 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $421,051 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,947 | BOYAmt |
| EOY | $1,064,422 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,246 | BOYAmt |
| EOY | $53,640 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,055,927 | BOYAmt |
| EOY | $4,327,041 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,090,560 | BOYAmt |
| EOY | $2,593,038 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,445,956 | BOYAmt |
| EOY | $3,594,508 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,536,516 | BOYAmt |
| EOY | $6,187,546 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$44,480,589 | BOYAmt |
| EOY | -$1,860,505 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$44,480,589 | BOYAmt |
| EOY | -$1,860,505 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,055,927 | BOYAmt |
| EOY | $4,327,041 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$20,198,960 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $62,819,044 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $364,335 | OtherCostOrOtherBasisAmt |
| Depreciation | $141,207 | DepreciationAmt |
| Book Value | $223,128 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $841,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $279,844 | DepreciationAmt |
| Book Value | $561,718 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $279,576 | OtherCostOrOtherBasisAmt |
| Book Value | $279,576 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,064,422 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to affiliates | $3,594,508 |
| Reserve for outstanding insurance losses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,594,508 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | 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, 2016. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAUL BELTER | ||||||||||||||
| DIRECTOR & SECRETARY/TREASURER | $0 | $469,949 | $0 | $132,868 | $0 | $20,748 | $0 | $28,456 | $0 | $26,427 | $0 | $678,448 | $0 | $20,748 |
| MARK FREY | ||||||||||||||
| DIRECTOR, CHAIRPERSON & PRESIDENT | $0 | $804,452 | $0 | $1,428,532 | $0 | $18,000 | $0 | $17,434 | $0 | $21,303 | $0 | $2,289,721 | $0 | $0 |
| TRACY ROGERS | ||||||||||||||
| DIRECTOR & VICE PRESIDENT (THROUGH 8/28/15) | $0 | $376,254 | $0 | $154,996 | $0 | $72,623 | $0 | $40,969 | $0 | $18,625 | $0 | $663,467 | $0 | $72,623 |
| PATRICIA CASSIDY | ||||||||||||||
| DIRECTOR & VICE PRESIDENT (EFFECTIVE 10/1/15) | $0 | $380,202 | $0 | $112,938 | $0 | $8,800 | $0 | $15,751 | $0 | $28,972 | $0 | $546,663 | $0 | $0 |
| FREDERICK O NELSON | ||||||||||||||
| FORMER OFFICER | $0 | $92,187 | $0 | $32,778 | $0 | $81,613 | $0 | $2,527 | $0 | $8,715 | $0 | $217,820 | $0 | $0 |
| BETH TZE | ||||||||||||||
| VICE PRESIDENT | $0 | $326,241 | $0 | $83,887 | $0 | $19,884 | $0 | $26,126 | $0 | $22,182 | $0 | $478,320 | $0 | $19,884 |
| SCOTT PETERSON | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $0 | $0 | $0 | $0 | $110,504 | $0 | $0 | $0 | $0 | $0 | $110,504 | $0 | $0 |
| KIMBERLY ZIMMERMANN | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $225,632 | $0 | $35,220 | $0 | $0 | $0 | $6,872 | $0 | $8,150 | $0 | $275,875 | $0 | $0 |
| JACK R CHAMBERLIN MD | ||||||||||||||
| CARDIOLOGIST & INTERNAL MEDICINE | $0 | $588,843 | $0 | $183,026 | $0 | $0 | $0 | $5,300 | $0 | $23,529 | $0 | $800,698 | $0 | $0 |
| MOHAMMED KHAN MD | ||||||||||||||
| CARDIOLOGIST & ELECTROPHYSIOLOGIST | $0 | $650,623 | $0 | $305,740 | $0 | $0 | $0 | $5,300 | $0 | $23,586 | $0 | $985,250 | $0 | $0 |
| ANDREI POP MD | ||||||||||||||
| CARDIOLOGIST | $0 | $436,265 | $0 | $390,263 | $0 | $0 | $0 | $5,300 | $0 | $23,164 | $0 | $854,992 | $0 | $0 |
| DANIEL SAURI MD | ||||||||||||||
| CARDIOLOGIST | $0 | $600,295 | $0 | $340,726 | $0 | $0 | $0 | $5,300 | $0 | $23,537 | $0 | $969,859 | $0 | $0 |
| WILLIAM J GRIES MD | ||||||||||||||
| CARDIOLOGIST | $0 | $358,507 | $0 | $328,589 | $0 | $0 | $0 | $4,718 | $0 | $22,700 | $0 | $714,514 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part II FORM 990, PART VII, SECTION A, LINE 5 | The following individual(s) was compensated by Adventist Health System Sunbelt Healthcare Corporation "AHSSHC" in 2015 for services provided to the filing organization. Please see our response to Form 990, Part III, Line 4A for a discussion concerning the filing organization's affiliation with AHSSHC. Individuals that are considered Officers have been reported in Part VII. Individuals that are considered Key Employees have not been reported in Part VII since they did not receive reportable compensation in excess of $150,000 from this organization and/or related organizations. Name of Employer: Adventist Health System Sunbelt Healthcare Corporation Name of Employee: Donald J. Russell, Key Employee Type and Amount of Compensation Paid/Accrued from AHSSHC for services rendered to the filing organization: Base Compensation: $312,868 Bonus & Incentive Compensation: $40,291 Other Reportable Compensation: $31,149 Retirement & Other Deferred Compensation: $20,149 Nontaxable benefits: $40,754 Name of Employer: Adventist Health System Sunbelt Healthcare Corporation Name of Employee: Erik Baier, Officer Type and Amount of Compensation Paid/Accrued from AHSSHC for services rendered to the filing organization: Base Compensation: $291,573 Bonus & Incentive Compensation: $39,090 Other Reportable Compensation: $41,522 Retirement & Other Deferred Compensation: $46,289 Nontaxable benefits: $28,385 |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Alexian Brothers - AHS Midwest Region Health Co., a related organization of the filing organization, uses the following methods to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Compensation survey or study - Approval by the Compensation Committee |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individuals listed in Schedule J were paid the referenced amount of severance in calendar 2015: Frederick O. Nelson - $81,613 Scott Peterson - $110,504 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Alexian Brothers Health System offers a Supplemental Employee Retirement Plan to CERTAIN employees who participate in the executive benefits program and whose compensation exceeds the IRS allowable limit for a qualified pension plan. The purpose of the plan is to restore retirement benefits that are restricted because of compensation limits for the executives. No distributions from the supplemental nonqualified retirement plan were made in the current year. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a IRS FILINGS AND TAX COMPLIANCE | ALEXIAN BROTHERS HEALTH SYSTEM, A RELATED ORGANIZATION OF ALEXIAN BROTHERS SPECIALTY GROUP, USES A COMMON BANK ACCOUNT TO COMPENSATE ALL INDEPENDENT CONTRACTORS WITHIN THE HEALTH SYSTEM. THE NUMBER ATTRIBUTABLE TO EACH ORGANIZATION IS NOT EASILY DISTINGUISHED. THE TOTAL NUMBER OF FORMS 1099 FILED FOR THE ENTIRE HEALTH SYSTEM APPEARS ON PART V, LINE 1A OF THE ALEXIAN BROTHERS HEALTH SYSTEM FORM 990. |
| Form 990, Part VI, Line 15 COMPENSATION OF CEO, OTHER OFFICERS OR KEY EMPLOYEES | IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY Alexian Brothers - AHS Midwest Region Health Co., A RELATED ORGANIZATION OF the filing organization, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE Alexian Brothers - AHS Midwest Region Health Co. COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO 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/HER COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS PERFORMED BY Alexian Brothers - AHS Midwest Region Health Co., A RELATED ORGANIZATION OF the filing organization INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO OTHER SIMILARLY SITUATED ORGANIZATIONS' EMPLOYEES THAT HOLD THE SAME OR SIMILAR TITLE. |
| Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS | MARK FREY, TRACY ROGERS, BETH TZE, PAUL BELTER, PATRICIA CASSIDY AND DONNA GAUTHIER HAVE A BUSINESS RELATIONSHIP DUE TO A JOINT EMPLOYMENT BY A COMMON HEALTH SYSTEM ENTITY. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Alexian Brothers Specialty Group has two classes of corporate members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Hospital Network (the "Area Member"). |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Subject to the ratification of the Board of Alexian Brothers - AHS Midwest Region Health Co., the Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of Alexian Brothers Specialty Group. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to Alexian Brothers Specialty Group's financial information or corporation as a whole are subject to approval by the National Member, Alexian Brothers Health System, subject to the approval of Alexian Brothers - AHS Midwest Region Health Co. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board Members' questions. |
| 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 conflict 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 financial statements of Alexian Brothers Specialty Group are available through the Office of the Illinois Attorney General. Conflict of Interest statements and the governing documents of Alexian Brothers Specialty Group are not made available to the public. |
| Form 990, Part IX, Line 11g Other Fees | Purchases Services - Billing fees - Total Expense: 1465429, Program Service Expense: 1465429, Management and General Expenses: , Fundraising Expenses: ; Purchased Services - Total Expense: 1236752, Program Service Expense: 193487, Management and General Expenses: 1043265, Fundraising Expenses: ; Other Fee for Service - Total Expense: 280301, Program Service Expense: 280301, Management and General Expenses: , Fundraising Expenses: ; Medical Fees - Total Expense: 2587619, Program Service Expense: 2587619, Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Transfers to/from affiliate - 62819044; |
| Form 990, Part XII, Line 2b AUDIT DISCLOSURE | The activity of Alexian Brothers Specialty Group is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Alexian Brothers Specialty Group is completed. Ascension Health Alliance's audit committee assumes responsibility for oversight of the audit of the financial statements. The audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Alexian Brothers Specialty Group. |
| Schedule A, Part I, Line 3 Hospital organization | The Internal Revenue Service has issued different definitions of a "hospital" for Form 990 Schedules A and H. Although Alexian Brothers Specialty Group qualifies as a hospital for purposes of Schedule A, the organization operates physician care practices but does not operate a state licensed hospital as required for Form 990, Schedule H. Alexian Brothers Specialty Group is not recognized as a hospital by the State of Illinois and, as such, is not required to complete Form 990, Schedule H. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Alexian Brothers - AHS Midwest Region Health Co | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 472360513 | Joint Operating Company | IL | 501(c)(3 | Type II | NA | false |
| Ascension Health Alliance | ||||||||||
| PO Box 45998 | St Louis | MO | 631455998 | 453358926 | National Health System | MO | 501(c)(3 | Type I | NA | false |
| Ascension Health | ||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | 501(c)(3 | Type I | Ascension Health Alliance | false |
| Alexian Brothers Bonaventure House | ||||||||||
| 825 Wellington Avenue | Chicago | IL | 60657 | 363527899 | Housing and supportive care services for persons with HIV/AIDS | IL | 501(c)(3 | 9 | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Health System | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363260495 | Supports the provision of healthcare services for related corporations for which it is a member | IL | 501(c)(3 | Type III-FI | Ascension Health | false |
| Alexian Brothers of San Jose Inc | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 941530037 | Acute care hospital (sold in 1998) | TX | 501(c)(3 | Type I | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Services Inc | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 431295333 | HUD housing | MO | 501(c)(3 | 9 | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Senior Ministries | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 364484290 | Supports the provision of healthcare for related corporations | IL | 501(c)(3 | Type III-FI | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Hospital Network | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363276552 | Supports the provision of healthcare services for related corporations | IL | 501(c)(3 | Type III-FI | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Medical Center | ||||||||||
| 800 Biesterfield Road | Elk Grove Village | IL | 60007 | 362596381 | Acute care hospital | TX | 501(c)(3 | 3 | Alexian Brothers Health System | Yes (true) |
| Savelli Properties Inc | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363308965 | Owns or leases properties where healthcare services are delivered | IL | 501(c)(2 | Alexian Brothers Health System | Yes (true) | |
| Alexian Brothers Behavioral Health Hospital | ||||||||||
| 1650 Moon Lake Blvd | Hoffman Estates | IL | 60169 | 364251848 | Behavioral health hospital | IL | 501(c)(3 | 3 | Alexian Brothers Health System | Yes (true) |
| St Alexius Medical Center | ||||||||||
| 1555 Barrington Road | Hoffman Estates | IL | 60194 | 364251846 | Acute care hospital | IL | 501(c)(3 | 3 | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Ambulatory Group | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 364336931 | Physician services | IL | 501(c)(3 | 3 | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Center for Mental Health | ||||||||||
| 3436 N Kennicott Avenue | Arlington Heights | IL | 60004 | 363045007 | Outpatient community mental health services | IL | 501(c)(3 | 9 | Alexian Brothers Health System | Yes (true) |
| Alexian Brothers Medical Care Group NFP | ||||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 471930457 | Physician services | IL | 501(c)(3 | 3 | Alexian Brothers Health System | Yes (true) |
| ALEXIAN BROTHERS MEDICAL GROUP SPECIALITY CARE | ||||||||||
| 3040 W SALT CREEK LANE | ARLINGTON HEIGHTS | IL | 60005 | 811110738 | SPECIALITY PHYSICIAN PRACTICE GROUP | IL | 501(c)(3 | 3 | ALEXIAN BROTHERS HEALTH SYSTEM | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|
| Alexian Rehabilitation Services LLC | |||||||||
| 935 Beisner | Elk Grove Village | IL | 60007 | 300221481 | Rehabilitation hospital | IL | NA | N/A | 0 |
| Illinois NeuroMeg Center LLC | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 870783164 | Provision of NeuroMeg services | IL | NA | N/A | 0 |
| Elk Grove MOB Limited Partnership | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363853289 | Medical office building | IL | NA | N/A | 0 |
| Bonaventure Medical Foundation LLC | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 363978153 | Manages managed care contracts | DE | NA | N/A | 0 |
| Neurosciences Equipment LLC | |||||||||
| 3040 W Salt Creek Lane | Arlington Heights | IL | 60005 | 861115516 | Ownership of Gamma Knife | IL | NA | N/A | 0 |
| St Alexius Center for Sleep Health LLC | |||||||||
| 1300 S Main Street | Lombard | IL | 60148 | 205876371 | Operation of sleep lab | IL | NA | N/A | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Thelen Corporation | |||||||||
| 3040 W Salt Creek | Arlington Heights | IL | 60005 | 363266316 | Owns/ leases property; joint venture partner | IL | NA | C Corporation | Yes (true) |
| Alexian Brothers Health Providers Association Inc | |||||||||
| 3040 W Salt Creek | Arlington Heights | IL | 60005 | 363853286 | Messenger model IPA | IL | NA | C Corporation | Yes (true) |
| Alexian Village of Elk Grove | |||||||||
| 3040 W Salt Creek | Arlington Heights | IL | 60005 | 352211303 | Tax credit financed housing | IL | NA | C Corporation | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ALEXIAN BROTHERS MEDICAL CENTER | ||
| K | $108,580 | FMV |
| ST ALEXIUS MEDICAL CENTER | ||
| K | $427,550 | FMV |
| THELEN CORPORATION | ||
| K | $352,783 | FMV |