2017-05-15T10:42:23-05:00 2016-06-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2015-07-01 510217097 Saint Anthony Hospital SAIN 7734844831 2875 West 19th Street Chicago IL 60623 Guy A Medaglia President and CEO 7734844831 2017-05-11 1 Wayne Harder P00294296 3126343400 2015 2021-01-29 14:40:06Z Guy A Medaglia 2875 West 19th Street Chicago IL 60623 115799437 0 0928 X www.saintanthonyhospital.org X 1897 IL 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. 10 8 1198 95 0 0 198558 198193 115748491 112701629 53029 25954 3875433 2847357 119875511 115773133 495908 389199 0 0 63782823 67290697 0 0 0 54962606 58480870 119241337 126160766 634174 -10387633 86819455 76778544 19207181 18734221 67612274 58044323 X 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. 0 0 113769382 114819616 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 389199 389199 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 114158581 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 159 0 1 1198 1 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Michael Kittoe 7734844831 2875 West 19th Street Chicago IL 60623 Bernard Ford Treasurer 1.00 X X 0 0 0 Dorval R Carter Jr Vice Chair 1.00 2.00 X X 0 0 0 Guy A Medaglia President & CEO 40.00 43.00 X X 553982 0 21975 Peter V Fazio Jr Chairman 1.00 4.00 X X 0 0 0 Sister Joan McGlinchey MSC Secretary 1.00 1.00 X X 0 0 0 Leonard E Wiatr Board Member 1.00 2.00 X 0 0 0 Mohamed Dahodwala MD Board Member 1.00 X 9120 0 0 Frank Zappa Board Member 1.00 X 0 0 0 Tyla Courtney MD Board Member 1.00 X 36240 0 0 Wayne Detmer MD Board Member 1.00 X 0 0 0 Candyce Mayer Interim CFO (starting 5/2/16) 40.00 5.00 X 143758 0 15727 Justin Bynum CFO (until 5/1/16) 40.00 5.00 X 315820 0 36646 Jill M Stemmerman VP Nursing 40.00 X 217693 0 32923 Howard Sankary Physician 40.00 X 397238 0 30089 Patricia A Heywood Physician 40.00 X 368423 0 24168 Kaman Cipi MD Physician 40.00 X 365504 0 38316 Asma Qunayath Khatoon Physician 40.00 X 361484 0 45503 Vikas Sharma Physician 40.00 X 344921 0 9026 3114183 0 254373 93 0 1 0 McKesson Technologies PO Box 98347 Chicago IL 60693 Software Services 2228304 Accretive Health Inc 39918 Treasury Center Chicago IL 60694 Payment Collection 1674418 Trimedx PO Box 636129 Cincinnati OH 45263 Medical Equipment Services 1085606 Laboratory Corporation of America PO Box 12140 Burlington NC 27216 Medical Laboratory Tests 418918 Suburban Surgery Center 1950 N Harlem Elmwood Park IL 60707 Surgery Services 337500 13 198193 198193 Patient Revenue 622110 111075349 111075349 Medical Student Program 622110 1626280 1626280 112701629 25954 25954 295293 26304 268989 268989 268989 Administrative Services 622110 747042 747042 Cafeteria 622110 708240 708240 Meaningful Use 622110 127362 127362 995724 974594 21130 2578368 115773133 114819616 0 755324 389199 389199 1169492 1169492 54911283 54190542 720741 1156320 1040688 115632 6267693 4769714 1497979 3785909 3706944 78965 547389 547389 105992 105992 195000 195000 11600647 8700485 2900162 273724 273724 200597 200597 3067102 2300326 766776 865612 455844 409768 3651561 2008359 1643202 861033 861033 Bad Debt 13595152 13595152 Medical/Patient Supplie 11512770 11512770 Provider Tax 7024968 7024968 4979323 4189866 789457 126160766 114158581 12002185 0 14002563 2949706 1854422 1860220 34470 112138 15681586 19963517 276662 1429836 1452121 3346660 2907941 70293351 48673201 24098093 21620150 25086011 25370649 57102 46236 952050 495866 86819455 76778544 8321980 10576335 267911 306035 10617290 7851851 19207181 18734221 X 64150491 54594581 1520755 1508714 1941028 1941028 67612274 58044323 86819455 76778544 X -10387633 68270 751412 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 195000 0 1 5122 200122 0 Part II-B, Line 1: 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. 1941028 1941028 1941028 2778 2778 1941028 1941028 3881 3881 1941028 1941028 1941028 1941028 1941028 1.00000 0 1 1 973787 973787 24474607 16734471 7740136 5770904 5770904 38617549 31938730 6678819 456504 456504 21620150 Investment Held by Foundation 25370649 F 25370649 Self Insurance Reserves 6217486 Estimated Third Party Payor Settlements, Net 1318743 Asset Retirement Obligation 221188 403(b) Match 94434 7851851 X 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. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 4742949 4742949 0.03760 19434852 32056626 -12621774 0.00000 2282814 2282814 0.01810 26460615 32056626 -5596011 0.05570 1365306 1365306 0.01080 8696283 2476995 6219288 0.04930 490928 490928 0.00390 10552517 2476995 8075522 0.06400 37013132 34533621 2479511 0.11970 1 13595152 0 16277615 15364758 912857 X 1 1 1 Saint Anthony PHO LLC Physician-Hospital Organization 0.50000 0.50000 1 1 Saint Anthony Hospital 2875 West 19th Street Chicago IL 60623 www.saintanthonyhospital.org X X X X Saint Anthony Hospital 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X www.saintanthonyhospital.org X sah.healthforecast.net/index-3.html X 1 15 1 www.saintanthonyhospital.org 0 0 1 X 200.000000000000 600.000000000000 X 1 1 X X X X 1 X http://www.saintanthonyhospital.org/index.php/component/content/article/85- X X X X X 1 0 X X X X 1 X 0 0 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. 3 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 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 1 Centro de Salud Esperanza 2001 South California Chicago IL 60625 320115907 501(c)3 389199 General Operating Support 1 0 Part I, Line 2: 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. X X X X 0 0 0 0 0 0 0 1 0 Guy A Medaglia President & CEO 484170 0 0 0 69812 0 4225 0 17750 0 575957 0 0 0 Candyce Mayer Interim CFO (starting 5/2/16) 138218 0 5434 0 106 0 6661 0 9066 0 159485 0 0 0 Justin Bynum CFO (until 5/1/16) 306568 0 9000 0 252 0 12963 0 23683 0 352466 0 0 0 Jill M Stemmerman VP Nursing 211327 0 5959 0 407 0 5580 0 27343 0 250616 0 0 0 Howard Sankary Physician 382508 0 14730 0 0 0 11589 0 18500 0 427327 0 0 0 Patricia A Heywood Physician 362423 0 6000 0 0 0 0 0 24168 0 392591 0 0 0 Kaman Cipi MD Physician 357579 0 7551 0 374 0 11649 0 26667 0 403820 0 0 0 Asma Qunayath Khatoon Physician 361220 0 0 0 264 0 18000 0 27503 0 406987 0 0 0 Vikas Sharma Physician 344592 0 0 0 329 0 0 0 9026 0 353947 0 0 0 Part I, Line 7 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. 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. Saint Anthony Emergency Services Physician 2875 West 19th Street Chicago IL 60623 300261806 Healthcare IL 0 0 Saint Anthony Hospital Saint Anthony Health Affiliates 2875 West 19th Street Chicago IL 60623 364340137 Healthcare IL 501(c)(3) Line 9 Saint Anthony Hospital 1 Saint Anthony Hospital Foundation 2875 West 19th Street Chicago IL 60623 237448580 Fundraising IL 501(c)(3) Line 7 Saint Anthony Hospital 1 Saint Anthony Health Ministries 2875 West 19th Street Chicago IL 60623 363903595 Management IL 501(c)(3) Line 11b, II N/A 0 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 1 Chicago Southwest Community Organization 2875 West 19th Street Chicago IL 60623 461578466 Community Development IL 501(c)(3) Line 7 N/A 1 SAH Anesthesia Group LLC 2875 West 19th Street Chicago IL 60623 474991463 Healthcare IL Saint Anthony Hospital S 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 Saint Anthony Hospital Foundation C 118493 FMV Chicago Southwest Development Corporation L 747042 FMV Saint Anthony Health Affiliates S 284638 FMV