SAINT ANTHONY HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- SAINT ANTHONY HOSPITAL (EIN 51-0217097)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721359349301077
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T10:42:23-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 S WACKER DRIVE STE 800 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510217097 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAIN | BusinessNameControlTxt |
| Phone | 7734844831 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Guy A Medaglia | PersonNm |
| Person Title | President and CEO | PersonTitleTxt |
| Phone | 7734844831 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Wayne Harder | PreparerPersonNm |
| PTIN | P00294296 | PTIN |
| Phone | 3126343400 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Guy A Medaglia | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $115,799,437 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.saintanthonyhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1897 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Saint Anthony Hospital lives out the loving ministry of Jesus Christ by offering health, healing, and hope to the families of our community, regardless of a patient's ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 1198 | TotalEmployeeCnt |
| Total Volunteers | 95 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $198,558 | PYContributionsGrantsAmt |
| CY Contributions Grants | $198,193 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $115,748,491 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $112,701,629 | CYProgramServiceRevenueAmt |
| PY Investment Income | $53,029 | PYInvestmentIncomeAmt |
| CY Investment Income | $25,954 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,875,433 | PYOtherRevenueAmt |
| CY Other Revenue | $2,847,357 | CYOtherRevenueAmt |
| PY Total Revenue | $119,875,511 | PYTotalRevenueAmt |
| CY Total Revenue | $115,773,133 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $495,908 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $389,199 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $63,782,823 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $67,290,697 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $54,962,606 | PYOtherExpensesAmt |
| CY Other Expenses | $58,480,870 | CYOtherExpensesAmt |
| PY Total Expenses | $119,241,337 | PYTotalExpensesAmt |
| CY Total Expenses | $126,160,766 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $634,174 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,387,633 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $86,819,455 | TotalAssetsBOYAmt |
| Total Assets EOY | $76,778,544 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,207,181 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,734,221 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $67,612,274 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $58,044,323 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Saint Anthony Hospital (SAH) lives out the loving ministry of Jesus Christ by offering health, healing, and hope to the families of our community, regardless of a patient's ability to pay. Saint Anthony Hospital is a subsidiary corporation of Saint Anthony Health Ministries. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $113,769,382 | ExpenseAmt |
| Revenue | $114,819,616 | RevenueAmt |
| Desc | Saint Anthony Hospital (SAH) provides medical care, social services, and community outreach to Chicago's West and Southside communities. SAH accepts patients regardless of their ability to pay, whether they cannot afford healthcare or are uninsured or underinsured. Saint Anthony has continually provided millions of dollars in net community benefit expense. Founded in 1897, SAH is a 151-bed, faith based, non-profit community teaching hospital dedicated to serving the health needs of Chicago's near southwest side. For over 100 years, Saint Anthony Hospital has offered quality and affordable medical services in a caring and supportive environment. SAH's operating rooms, emergency department, and imaging center offer modern technology that helps us in providing our patients the quality services they need in our communities. Saint Anthony Hospital uses four categories to identify the resources utilized for the care of persons who are poor, and for community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured - Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor- Cost of other programs for the poor includes unreimbursed costs of programs intentionally designed to serve the poor and vulnerable of the community, including substance abusers, the homeless, victims of child abuse, and persons with Acquired Immune Deficiency Syndrome - Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings, and medical research | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $389,199 | ExpenseAmt |
| Grant | $389,199 | GrantAmt |
| Desc | Community Wellness meets the needs of the community through a comprehensive set of services in four target areas. At its core, the program promotes healthier prenatal outcomes, sound developmental outcomes for young children, positive family functioning, and overall, healthier communities. The four initiatives of the Community Wellness program include: (1) Healthy Beginnings, an initiative that includes prenatal classes, post-partum and early childhood supports (including a new moms club), parenting education, developmental screenings, referrals, and follow-up case management (2) School Wellness, a response to the increasing concern about childhood obesity and interest in improving schools' health and wellness practices. It is an outgrowth of the popular Mission Nutrition health education curriculum that Saint Anthony Hospital staff members have already been implementing in community schools. In addition to the variety of health and wellness educational services available to students and their families, the program supports schools in identifying and implementing systemic changes related to health and wellness (3) Public Benefits and Referral Service, which provides information and assistance in accessing critical public health benefits and safety-net resources, particularly to Spanish-speaking patients. Individuals can learn about the benefits they're entitled to, including the All-Kids (public health insurance) program, Medicaid, WIC, and the Supplemental Nutrition Assistance Program (SNAP)(4) Mental Health Services, which addresses the growing need for no-charge bilingual counseling for a range of adult mental health issues, including depression and anxiety | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $114,158,581 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 159 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1198 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michael Kittoe | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7734844831 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Bernard Ford | |||||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Dorval R Carter Jr | |||||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 2.00 | ||
| Guy A Medaglia | |||||||||
| President & CEO | 40.00 | Yes (X) | Yes (X) | $553,982 | $0 | $21,975 | 43.00 | ||
| Peter V Fazio Jr | |||||||||
| Chairman | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 4.00 | ||
| Sister Joan McGlinchey MSC | |||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| Leonard E Wiatr | |||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| Mohamed Dahodwala MD | |||||||||
| Board Member | 1.00 | Yes (X) | $9,120 | $0 | $0 | ||||
| Frank Zappa | |||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Tyla Courtney MD | |||||||||
| Board Member | 1.00 | Yes (X) | $36,240 | $0 | $0 | ||||
| Wayne Detmer MD | |||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Candyce Mayer | |||||||||
| Interim CFO (starting 5/2/16) | 40.00 | Yes (X) | $143,758 | $0 | $15,727 | 5.00 | |||
| Justin Bynum | |||||||||
| CFO (until 5/1/16) | 40.00 | Yes (X) | $315,820 | $0 | $36,646 | 5.00 | |||
| Jill M Stemmerman | |||||||||
| VP Nursing | 40.00 | $217,693 | $0 | $32,923 | Yes (X) | ||||
| Howard Sankary | |||||||||
| Physician | 40.00 | $397,238 | $0 | $30,089 | Yes (X) | ||||
| Patricia A Heywood | |||||||||
| Physician | 40.00 | $368,423 | $0 | $24,168 | Yes (X) | ||||
| Kaman Cipi MD | |||||||||
| Physician | 40.00 | $365,504 | $0 | $38,316 | Yes (X) | ||||
| Asma Qunayath Khatoon | |||||||||
| Physician | 40.00 | $361,484 | $0 | $45,503 | Yes (X) | ||||
| Vikas Sharma | |||||||||
| Physician | 40.00 | $344,921 | $0 | $9,026 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,114,183 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $254,373 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 93 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| McKesson Technologies | |||||
| PO Box 98347 | Chicago | IL | 60693 | Software Services | $2,228,304 |
| Accretive Health Inc | |||||
| 39918 Treasury Center | Chicago | IL | 60694 | Payment Collection | $1,674,418 |
| Trimedx | |||||
| PO Box 636129 | Cincinnati | OH | 45263 | Medical Equipment Services | $1,085,606 |
| Laboratory Corporation of America | |||||
| PO Box 12140 | Burlington | NC | 27216 | Medical Laboratory Tests | $418,918 |
| Suburban Surgery Center | |||||
| 1950 N Harlem | Elmwood Park | IL | 60707 | Surgery Services | $337,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $198,193 | RelatedOrganizationsAmt |
| Total Contributions | $198,193 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Revenue | 622110 | $111,075,349 | $111,075,349 |
| Medical Student Program | 622110 | $1,626,280 | $1,626,280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $112,701,629 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,954 | TotalRevenueColumnAmt |
| Exclusion | $25,954 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $295,293 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $26,304 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $268,989 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $268,989 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $268,989 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Administrative Services | 622110 | $747,042 | $747,042 | |
| Cafeteria | 622110 | $708,240 | $708,240 | |
| Meaningful Use | 622110 | $127,362 | $127,362 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $995,724 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $974,594 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $21,130 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,578,368 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,773,133 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $114,819,616 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $755,324 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,199 | TotalAmt |
| Program Services | $389,199 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,169,492 | TotalAmt |
| Management And General | $1,169,492 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,911,283 | TotalAmt |
| Program Services | $54,190,542 | ProgramServicesAmt |
| Management And General | $720,741 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,156,320 | TotalAmt |
| Program Services | $1,040,688 | ProgramServicesAmt |
| Management And General | $115,632 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,267,693 | TotalAmt |
| Program Services | $4,769,714 | ProgramServicesAmt |
| Management And General | $1,497,979 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,785,909 | TotalAmt |
| Program Services | $3,706,944 | ProgramServicesAmt |
| Management And General | $78,965 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $547,389 | TotalAmt |
| Management And General | $547,389 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,992 | TotalAmt |
| Management And General | $105,992 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,000 | TotalAmt |
| Management And General | $195,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,600,647 | TotalAmt |
| Program Services | $8,700,485 | ProgramServicesAmt |
| Management And General | $2,900,162 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,724 | TotalAmt |
| Program Services | $273,724 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,597 | TotalAmt |
| Management And General | $200,597 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,067,102 | TotalAmt |
| Program Services | $2,300,326 | ProgramServicesAmt |
| Management And General | $766,776 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $865,612 | TotalAmt |
| Program Services | $455,844 | ProgramServicesAmt |
| Management And General | $409,768 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,651,561 | TotalAmt |
| Program Services | $2,008,359 | ProgramServicesAmt |
| Management And General | $1,643,202 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,033 | TotalAmt |
| Management And General | $861,033 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Bad Debt | $13,595,152 | $13,595,152 |
| Medical/Patient Supplie | $11,512,770 | $11,512,770 |
| Provider Tax | $7,024,968 | $7,024,968 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,979,323 | TotalAmt |
| Program Services | $4,189,866 | ProgramServicesAmt |
| Management And General | $789,457 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,160,766 | TotalAmt |
| Program Services | $114,158,581 | ProgramServicesAmt |
| Management And General | $12,002,185 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,002,563 | BOYAmt |
| EOY | $2,949,706 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,854,422 | BOYAmt |
| EOY | $1,860,220 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,470 | BOYAmt |
| EOY | $112,138 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,681,586 | BOYAmt |
| EOY | $19,963,517 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,662 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,429,836 | BOYAmt |
| EOY | $1,452,121 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,346,660 | BOYAmt |
| EOY | $2,907,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $70,293,351 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $48,673,201 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,098,093 | BOYAmt |
| EOY | $21,620,150 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,086,011 | BOYAmt |
| EOY | $25,370,649 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,102 | BOYAmt |
| EOY | $46,236 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $952,050 | BOYAmt |
| EOY | $495,866 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,819,455 | BOYAmt |
| EOY | $76,778,544 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,321,980 | BOYAmt |
| EOY | $10,576,335 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $267,911 | BOYAmt |
| EOY | $306,035 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,617,290 | BOYAmt |
| EOY | $7,851,851 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,207,181 | BOYAmt |
| EOY | $18,734,221 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,150,491 | BOYAmt |
| EOY | $54,594,581 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520,755 | BOYAmt |
| EOY | $1,508,714 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,941,028 | BOYAmt |
| EOY | $1,941,028 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,612,274 | BOYAmt |
| EOY | $58,044,323 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,819,455 | BOYAmt |
| EOY | $76,778,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$10,387,633 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $68,270 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $751,412 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $195,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,122 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $200,122 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Bruce Simon Consulting and The Roosevelt Group represent Saint Anthony Hospital and other safety net hospitals by educating elected officials on the impact of legislation. A portion of the organization's dues paid to the American Hospital Association and Catholic Health Association may be attributed to lobbying. This amount is reported on Line 1i. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,941,028 | BeginningYearBalanceAmt |
| End Year Balance | $1,941,028 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,941,028 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,778 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,778 | OtherExpendituresAmt |
| End Year Balance | $1,941,028 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,941,028 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,881 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,881 | OtherExpendituresAmt |
| End Year Balance | $1,941,028 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,941,028 | BeginningYearBalanceAmt |
| End Year Balance | $1,941,028 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,941,028 | BeginningYearBalanceAmt |
| End Year Balance | $1,941,028 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $973,787 | OtherCostOrOtherBasisAmt |
| Book Value | $973,787 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,474,607 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,734,471 | DepreciationAmt |
| Book Value | $7,740,136 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,770,904 | OtherCostOrOtherBasisAmt |
| Book Value | $5,770,904 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,617,549 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,938,730 | DepreciationAmt |
| Book Value | $6,678,819 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $456,504 | OtherCostOrOtherBasisAmt |
| Book Value | $456,504 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,620,150 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment Held by Foundation | Desc |
| Book Value | $25,370,649 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $25,370,649 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Self Insurance Reserves | $6,217,486 |
| Estimated Third Party Payor Settlements, Net | $1,318,743 |
| Asset Retirement Obligation | $221,188 |
| 403(b) Match | $94,434 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,851,851 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The income from the endowment is used for general operations to support Saint Anthony Hospital. The endowment is held by Saint Anthony Hospital Foundation, a related tax-exempt organization. |
| Part X, Line 2: | The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. UBIT is reported on Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Forms 990 filed by the Hospital are subject to examination by the Internal Revenue Service (IRS) up to three years from the extended due date of each return. Forms 990 filed by the Hospital are no longer subject to examination for the years 2012 and prior. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,742,949 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,742,949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03760 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,434,852 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,056,626 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$12,621,774 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,282,814 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,282,814 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01810 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,460,615 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,056,626 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$5,596,011 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05570 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,365,306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,365,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,696,283 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,476,995 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,219,288 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04930 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $490,928 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $490,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,552,517 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,476,995 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,075,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,013,132 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $34,533,621 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,479,511 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11970 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $13,595,152 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,277,615 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,364,758 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $912,857 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 Saint Anthony PHO LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Physician-Hospital Organization | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.50000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.saintanthonyhospital.org | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.saintanthonyhospital.org | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | sah.healthforecast.net/index-3.html | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.saintanthonyhospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.saintanthonyhospital.org/index.php/component/content/article/85- | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Saint Anthony Hospital | Part V, Section B, Line 5: Saint Anthony Hospital used Professional Research Consultants, Inc. (PRC) to collect the relevant data for the CHNA. PRC collected data that was largely based on the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System. PRC conducted a telephone survey of 396 individuals, age 18 and older, in Saint Anthony's service area to obtain preliminary information regarding the community's health needs.In addition, three focus groups were held as part of this CHNA. The focus groups included:- key informants from the Southside of Chicago (including health professionals, social service providers, and other community leaders),- key informants from throughout Cook county (including representatives from public health, physicians, other health professionals, social service providers, and other community leaders), and- key informants from the Loop and the Westside of Chicago (a physician, social service providers, and another community leader). |
| Saint Anthony Hospital | Part V, Section B, Line 11: Saint Anthony Hospital takes pride in addressing the health care needs of our community, and we recognize the importance of each of the areas of opportunity that emerged from the CHNA process. However, we are only a piece of the puzzle and must stay focused in our efforts in order to be effective and efficient with our limited resources and stay within our scope of practice and expertise. For this reason we have chosen to focus on 9 out of the 18 areas of opportunity identified through the CHNA. The other nine areas oral health, sexually transmitted diseases, sickle-cell anemia, tobacco use, vision, and, for the most part, chronic kidney disease, respiratory disease, substance abuse, and HIV were excluded from our implementation strategy because we have limited or no expertise or services in each of these areas. When we come into contact with patients and community members with these specific issues, we refer them to other community organizations or healthcare providers with more experience and resources that meet their needs. Furthermore, although chronic kidney disease, respiratory disease, and substance abuse are all within Saint Anthony's scope of practice, they were not selected for action at this time because of limited resources and higher priorities. |
| Part V, Section B, line 15 | Before any collections efforts are initiated, the Hospital performs reasonable efforts by sending two statements and two letters. The statements and letters indicate the option to apply for financial assistance, if needed. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Saint Anthony Hospital Physician Center | ||||
| 2875 West 19th Street | Chicago | IL | 60623 | Outpatient Clinic |
| 2 - Brighton Park Clinic | ||||
| 4177 South Archer | Chicago | IL | 60632 | Outpatient Clinic |
| 3 - Kedzie Ave Clinic | ||||
| 4455 South Kedzie | Chicago | IL | 60632 | Outpatient Clinic |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The cost to charge ratio derived from Worksheet 2 was used to calculate the amounts reported in Lines 7a and 7g. Lines 7e, 7f, and 7i were derived from a cost accounting system that addresses all patient segments. |
| Part I, Line 7g: | Physician clinic costs of $3,461,339 were included as subsidized health services. |
| Part I, line 7, column (f) | $13,595,152 is the amount of bad debt expense included on Form 990, Part IX, Line 25 but subtracted for purposes of calculating the percentage in this column. |
| Part III, Line 2: | The Hospital uses the following methods to determine the amount of bad debt reported:1) Potential public aid third party liability accounts are identified by a monthly report generated by the collection system. 2) The Medicare bad debt specialist will review the accounts to ensure that the proper balance is on the account. 3) Accounts returned from collection agency as uncollectible will be reviewed to ensure that they have aged greater than 120 days from first notice to patient prior to the account placement with agency. 4) The Medicare bad debt specialist will obtain copies of the Medicare voucher showing the deductible and co-insurance amount, and accounts will be logged with the balance of the co-insurance and deductible amount from the Medicare voucher. 5) Public aid third party liability accounts will be logged with copies of the Medicare and public aid vouchers. The amount logged will reflect the Medicare deductible and co-insurance, minus any payment amount from public aid. 6) A copy of the completed log will be provided to reimbursement and a copy will be maintained in the patient financial services department. |
| Part III, Line 3: | Detailed data is unavailable to estimate the amount of bad debt attributable to patients who would likely be eligible for financial assistance. |
| Part III, Line 4: | The collection of receivables from third-party payors and patients is the Hospital's primary source of cash for operations and is critical to its operating performance. The primary collection risks relate to uninsured patient accounts and patient accounts for which the primary insurance payor has paid, but patient responsibility amounts (deductibles and copayments) remain outstanding. Accounts receivable, where a third-party payor is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual allowances or discounts provided to third-party payors.Receivables due directly from patients are carried at the original charge for the service provided less amounts covered by third-party payors and less estimated allowances for doubtful accounts and charity care. Management estimates the allowance for doubtful accounts based on the aging of its accounts receivable and its historical collection experience for each payor type. Management estimates the allowance for charity based on the Hospital's charity care policy and historical charity care experience. Recoveries of accounts receivable previously written off as uncollectible are recorded as a reduction of the provision for bad debts when received.The past due status of receivables is determined on a case-by-case basis depending on the payor responsible. Interest is not charged on past due accounts.The Hospital's allowance for uncollectible accounts for self-pay patients was approximately 88 percent and 94 percent of self-pay accounts receivable at June 30, 2016 and 2015, respectively. The Hospital's self-pay write-offs were $13,438,000 and $10,474,000 in 2016 and 2015, respectively. The Hospital has not changed its charity care or uninsured discount policies during 2016 or 2015. The Hospital does not maintain a material allowance for uncollectible accounts from third-party payors, nor did it have significant write-offs from third-party payors.Receivables or payables related to estimated settlements on various payor contracts, primarily Medicare and Blue Cross, are reported as estimated third-party payor settlements. Significant changes in payor mix, business office operations, economic conditions or trends in federal and state governmental health care coverage could affect the Hospital's collection of accounts receivable, cash flows and results of operations. |
| Part III, Line 8: | The surplus is arrived at by using the Medicare Cost and Reimbursement Summary. The Summary takes into account the Medicare cost less the Medicare reimbursement. |
| Part III, Line 9b: | Saint Anthony Hospital has posted signage throughout the Hospital informing all patients about the financial assistance program. In addition to the signage, the financial assistance program is listed on the Hospital's website. Patients who qualify for assistance often have their entire balance written off. Patients who do not qualify for any assistance can enter into payment arrangements with the Hospital. If that patient fails to keep those arrangements, their account will be referred to an outside collection agency. |
| Part VI, Line 2: | Saint Anthony Hospital completed its latest Community Health Needs Assessment (CHNA) in 2012, in cooperation with the Metropolitan Chicago Healthcare Council (MCHC). This CHNA, a follow-up to a similar assessment conducted in 2009, is a systematic, data-driven approach to determining the health status, behaviors, and needs of residents in Saint Anthony Hospital's community. It is a tool to assist us in reaching three basic goals:- improving residents' health status, increasing their life spans, and elevating their overall quality of life,- reducing the health disparities among residents, and- increasing accessibility to preventive services for all community residents.Our CHNA was conducted by Professional Research Consultants, Inc. (PRC), a nationally-recognized healthcare consulting firm with extensive experience conducting assessments in hundreds of communities across the United States since 1994. It incorporates data from both quantitative and qualitative sources. Quantitative data input includes results from the PRC community health survey and secondary research. Qualitative data input includes primary research gathered through a series of key informant focus groups. The survey instrument used for this CHNA was based largely on the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. To ensure the best representation of the population surveyed, a telephone interview methodology, incorporating both landline and cell phone interviews, was employed. The sample design used for this effort consisted of a random sample of 396 individuals, age 18 and older, in Saint Anthony's service area. All administration of the surveys, data collection, and data analysis was conducted by PRC. MCHC and Saint Anthony provided PRC with a list of recommended participants for the focus groups. Potential participants were chosen because of their ability to identify primary concerns of the community overall. Audio from the focus group sessions was recorded, participants were asked to speak candidly and assured of confidentiality. These findings represent qualitative rather than quantitative data. The group was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Thus, these findings are based on perceptions, not facts. A variety of secondary data sources was consulted to complement the research quality of this CHNA. Saint Anthony's CHNA Steering Committee includes the Hospital's Vice President of Mission and Community Development and his Coordinator for Special Projects, along with the Manager of Development Communications from the Saint Anthony Hospital Foundation. The Steering Committee digested the results of the Assessment and then met to determine the process and criteria for prioritizing the areas of opportunity identified through the Assessment. |
| Part VI, Line 3: | Signs are posted in waiting areas of the Hospital, as well as on the Hospital's website, announcing the availability of financial assistance. Hospital Patient Access staff assists uninsured or under-insured patients in applying for any government assistance programs that they may qualify for, as well as the Hospital's financial assistance program. Hospital bills to patients also have information on applying for financial assistance. |
| Part VI, Line 4: | Saint Anthony Hospital is a 151-bed healthcare facility located on the border of the North Lawndale and South Lawndale communities on Chicago's West and Near Southwest side. The area includes the North Lawndale, Little Village, South Lawndale, Pilsen, Brighton Park, McKinley Park, and Back of the Yards neighborhoods. Saint Anthony is in a medically under-served area, a Primary Care Health Professional Shortage Area, a Mental Health Professional Shortage Area, and a Dental Care Health Professional Shortage Area, as classified by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. The surrounding area has around 410,000 residents, of which more than 50% are Latino and more than 30% are African American. |
| Part VI, Line 5: | Saint Anthony Hospital is a 151-bed, independent, faith-based, non-profit, acute care community hospital founded in 1897. The Hospital provides a wide range of services and community benefit programs to its under-served community. Saint Anthony believes in taking a holistic approach to the care of our community. Therefore, we strengthen the community not only through healthcare, but also focusing on building and supporting healthy communities through the power of advocacy and economic and workforce development. We participate actively with a variety of community organizations and local community churches. Saint Anthony, its neighborhood clinics, and the offices of its community-based human services programs further the organization's exempt purpose by providing the following services at no cost to community residents: pregnancy testing, prenatal education, gestational diabetes education, early childhood development consultation and support, parent-child play groups, parenting skills training, blood pressure and blood glucose screenings, health and nutrition education presentations, mental health counseling, transportation to and from hospital appointments, patient navigation, and state and federal government benefits counseling and application assistance. Saint Anthony has and will always try to hire qualified professional and non-professional staff from within the communities in its service area. A majority of the Hospital's governing body is comprised of persons who reside in the Chicago community who are not employees or independent contractors of the Hospital, nor family members thereof. The Hospital extends medical privileges to all qualified physicians in the community. |
| Part VI, Line 6: | For over 100 years, Saint Anthony Hospital has been improving the health and wellness of families across Chicagoland by providing medical care, social services, and community outreach to the residents of eight city neighborhoods: Little Village, North Lawndale, Pilsen, Brighton Park, Back of the Yards, McKinley Park, Archer Heights, and Chicago Lawn, as well as suburban Cicero and Berwyn. The outpatient clinics are strategically located within the surrounding communities to provide healthcare services just as the Hospital does, but on a smaller scale. Those individuals requiring more care are referred to the Hospital for further evaluation. Saint Anthony Health Affiliates provides non-emergency physician services to the community that the Hospital serves. The Foundation was organized for the purpose of soliciting, earning, and receiving funds from public and private sources, accumulating such funds, and making distributions to the Hospital. Saint Anthony Health Ministries (SAHM) is the sole corporate member of the Hospital, and SAHM supports the Hospital. |
| Part VI, Line 7, Reports Filed With States | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Centro de Salud Esperanza | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 South California | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60625 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 320115907 | RecipientEIN |
| IRC Section | 501(c)3 | IRCSectionDesc |
| Cash Grant | $389,199 | CashGrantAmt |
| Purpose Of Grant | General Operating Support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The organization was involved in the original creation of Esperanza, a Federally Qualified Health Center located near the hospital, and annually provides funds for general operations. The CEO approves the grant payment and the financial department ensures the payment is used by Esperanza for its intended purposes. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Guy A Medaglia | ||||||||||||||
| President & CEO | $484,170 | $0 | $0 | $0 | $69,812 | $0 | $4,225 | $0 | $17,750 | $0 | $575,957 | $0 | $0 | $0 |
| Candyce Mayer | ||||||||||||||
| Interim CFO (starting 5/2/16) | $138,218 | $0 | $5,434 | $0 | $106 | $0 | $6,661 | $0 | $9,066 | $0 | $159,485 | $0 | $0 | $0 |
| Justin Bynum | ||||||||||||||
| CFO (until 5/1/16) | $306,568 | $0 | $9,000 | $0 | $252 | $0 | $12,963 | $0 | $23,683 | $0 | $352,466 | $0 | $0 | $0 |
| Jill M Stemmerman | ||||||||||||||
| VP Nursing | $211,327 | $0 | $5,959 | $0 | $407 | $0 | $5,580 | $0 | $27,343 | $0 | $250,616 | $0 | $0 | $0 |
| Howard Sankary | ||||||||||||||
| Physician | $382,508 | $0 | $14,730 | $0 | $0 | $0 | $11,589 | $0 | $18,500 | $0 | $427,327 | $0 | $0 | $0 |
| Patricia A Heywood | ||||||||||||||
| Physician | $362,423 | $0 | $6,000 | $0 | $0 | $0 | $0 | $0 | $24,168 | $0 | $392,591 | $0 | $0 | $0 |
| Kaman Cipi MD | ||||||||||||||
| Physician | $357,579 | $0 | $7,551 | $0 | $374 | $0 | $11,649 | $0 | $26,667 | $0 | $403,820 | $0 | $0 | $0 |
| Asma Qunayath Khatoon | ||||||||||||||
| Physician | $361,220 | $0 | $0 | $0 | $264 | $0 | $18,000 | $0 | $27,503 | $0 | $406,987 | $0 | $0 | $0 |
| Vikas Sharma | ||||||||||||||
| Physician | $344,592 | $0 | $0 | $0 | $329 | $0 | $0 | $0 | $9,026 | $0 | $353,947 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | Saint Anthony Hospital paid discretionary bonuses during the year that were subject to the approval of the President & CEO. The bonuses are reported on Part II, column B(ii) as taxable income. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Saint Anthony Health Ministries is the sole corporate member of Saint Anthony Hospital. |
| Form 990, Part VI, Section A, line 7a | As the sole corporate member of Saint Anthony Hospital, Saint Anthony Health Ministries has the right to appoint or remove members of the governing body. |
| Form 990, Part VI, Section A, line 7b | As the sole corporate member of Saint Anthony Hospital, the Canonical Directors of Saint Anthony Health Ministries have the right to approve or ratify significant decisions made by the governing body. Such rights include: 1) Approving the mission and vision statements of the organization, 2) Approving changes to the governing documents, 3) Appointment or removal of members of the governing board, 4) Approving or recommending the formation of legal entities, the sale, transfer, or substantial change in use of all or substantially all of the assets, divestitures, dissolutions, closures, mergers, consolidations, or changes in corporate membership, 5) Approving the operating budget and capital plan, 6) Approving the transfer or encumbrance of the assets, and 7) Approving the incurrence of debt of the organization. |
| Form 990, Part VI, Section B, line 11 | A thorough review of Form 990 is performed by mangagement. A copy of the return is shared with the Board of Directors prior to filing Form 990 with the IRS. |
| Form 990, Part VI, Section B, line 12c | Annually, the Corporate Responsibility Officer has the Board, as well as officers, vice presidents, and operational department heads, review, fill out, and sign the conflict of interest questionnaire. The Corporate Responsibility Officer reviews the completed conflict of interest questionnaires. If a conflict of interest arises, the affected board member (or officer) abstains from voting on the respective issue. The Corporate Responsibility Officer maintains all signed conflict of interest statements on file. |
| Form 990, Part VI, Section B, line 15 | All annual salary increases for the top management official are reviewed and approved by the President Compensation Sub-Committee and documented in minutes prepared for each meeting. Also, an independent market survey was conducted in November 2015 to ensure that the salaries of the CEO and vice presidents were within standard market range. All annual salary increases for vice presidents and other officers are reviewed and approved by the Compensation Committee and documented in minutes prepared for each meeting. Also, an independent market survey was conducted in November 2015 to ensure that the salaries of vice presidents are above were within standard market range. |
| Form 990, Part VI, Section C, line 19 | Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code Section 6104. These documents are not available to the public at this time. |
| Form 990, Part XI, line 9: | Transfer of net assets from Saint Anthony Health Affiliates 466,774. Change in interest of Saint Anthony Hospital Foundation 284,638. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Emergency Services Physician | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300261806 | EIN |
| Primary Activities | Healthcare | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Hospital | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Saint Anthony Health Affiliates | |||||||||||
| 2875 West 19th Street | Chicago | IL | 60623 | 364340137 | Healthcare | IL | 501(c)(3) | Line 9 | Saint Anthony Hospital | Yes (1) | |
| Saint Anthony Hospital Foundation | |||||||||||
| 2875 West 19th Street | Chicago | IL | 60623 | 237448580 | Fundraising | IL | 501(c)(3) | Line 7 | Saint Anthony Hospital | Yes (1) | |
| Saint Anthony Health Ministries | |||||||||||
| 2875 West 19th Street | Chicago | IL | 60623 | 363903595 | Management | IL | 501(c)(3) | Line 11b, II | 0 | N/A | |
| Chicago Southwest Development Corporation | |||||||||||
| 2875 West 19th Street | Chicago | IL | 60623 | 461575093 | Community Development | IL | 501(c)(3) | Line 11a, I | Chicago Southwest Community Organization | Yes (1) | |
| Chicago Southwest Community Organization | |||||||||||
| 2875 West 19th Street | Chicago | IL | 60623 | 461578466 | Community Development | IL | 501(c)(3) | Line 7 | Yes (1) | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAH Anesthesia Group LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2875 West 19th Street | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 474991463 | EIN |
| Primary Activities | Healthcare | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Saint Anthony Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | S | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Saint Anthony Hospital Foundation | ||
| C | $118,493 | FMV |
| Chicago Southwest Development Corporation | ||
| L | $747,042 | FMV |
| Saint Anthony Health Affiliates | ||
| S | $284,638 | FMV |