2015-05-07T14:31:18-05:00 2014-06-30 861065772 Deloitte Tax LLP 111 South Wacker Drive Chicago IL 60606 990 2013-07-01 800710751 Alexian Brothers Specialty Group ALEX 8478185100 3040 West Salt Creek Lane Arlington Heights IL 600051069 Mark Frey Chief Financial Officer 8478185100 2015-05-06 1 Laura Gillespie P00855604 3124861000 2015-04-27 2013 2016-02-25 16:41:14Z Fred 3040 West Salt Creek Lane Arlington Heights IL 600051069 12048912 0 0928 X www.alexianbrothershealth.org X 2011 IL Specialty physician group in Catholic health system. 3 0 0 0 0 0 0 0 12325894 12048912 461072 0 0 0 12786966 12048912 0 0 0 0 13048418 13928275 0 0 0 5340830 4548887 18389248 18477162 -5602282 -6428250 1915140 1834408 12348968 18696486 -10433828 -16862078 X Alexian Brothers Specialty Group ("ABSG") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health needs of those we are called to serve. 0 0 16795829 12048912 Alexian Brothers Specialty Group (ABSG) is a cardiology focused employed physician group of Alexian Brothers Health System. There are nearly 20 patient-centered, compassionate and expertly-trained providers in ABSG. The multiple, convenient locations of ABSG, in both the community and on the campus of the two Alexian Brothers Health System acute care hospitals, offer flexible access and prompt treatment for cardiology related issues. About the Alexian Brothers Health SystemAlexian Brothers Specialty Group is a member of the Alexian Brothers Health System, a comprehensive and diversified healthcare organization headquartered (See Schedule O.)in the northwest suburbs of Chicago, serving more than two million people. Alexian Brothers Health System is a Ministry Organization of Ascension Health, the largest Catholic health system in the nation. The Alexian Brothers Health System also has an enduring commitment to identifying and developing an effective response to the unique health and housing needs of older adults through a dynamic senior ministries program that operates an array of residential, retirement and community resources.These ministries exist to continue the Alexian Brothers mission of caring for the sick, the poor and the dying and promoting the physical, mental, spiritual and social health and well-being of all individuals we serve. 16795829 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X Fred Nelson 8478185100 3040 West Salt Creek Lane Arlington Heights IL 600051069 Mark Frey Director/Chairperson/President 1.00 50.00 X X 0 1498371 49865 Tracy Rogers Director/Vice President 1.00 50.00 X X 0 654056 58907 Paul Belter Director/Secretary/Treasurer 1.00 50.00 X X 0 540392 60474 Beth Tze Vice President 1.00 50.00 X 0 368859 55197 Donna Gauthier Assistant Secretary 1.00 40.00 X 0 74489 15715 Fred Nelson start 413 Chief Financial Officer 25.00 25.00 X 0 128874 7600 Jack Chamberlin Cardiologist 50.00 0.00 X 0 774076 27315 Mohammed Khan Cardiologist 50.00 0.00 X 0 927482 27247 Andrei Pop Cardiologist 50.00 0.00 X 0 697965 26644 Daniel Sauri Cardiologist 50.00 0.00 X 0 844755 22152 Scott Tomasik Cardiologist 50.00 0.00 X 0 608641 26644 Jim Lewandowski end 1112 Former Key Employee 0.00 0.00 X 0 722305 15727 0 7840265 393487 0 1 1 0 0 Net Patient Svcs Rev. 621110 11914701 11914701 Intercompany Affiliate 900099 134211 134211 12048912 12048912 12048912 0 0 X 12422601 12422601 529445 529445 518702 518702 457527 457527 2909 2909 6854 6854 2143612 1145621 997991 3003 3003 364629 294214 70415 44392 44392 658166 652435 5731 92221 92221 14230 14230 82846 82846 331188 328633 2555 Management Fees 649346 59993 589353 Dues 70476 64951 5525 Medical Supplies 58863 58863 26152 26152 18477162 16795829 1681333 0 109374 91099 1020816 999154 33866 63459 809431 206727 685550 602704 65534 77992 1915140 1834408 1567348 2351816 10781620 16344670 12348968 18696486 X -10433828 -16862078 -10433828 -16862078 1915140 1834408 -6428250 0 X X 0 1 X 1 0 X Schedule A, Part I, Line 3: The Internal Revenue Service has issued different definitions of a "hospital" for Form 990 Schedules A and H. Although Alexian Brothers Specialty Group qualifies as a hospital for purposes of Schedule A, the Organization operates physician care practices but does not operate a state licensed hospital as required for Form 990, Schedule H. Alexian Brothers Specialty Group is not recognized as a hospital by the state of Illinois and, as such, is not required to complete Form 990 Schedule H. 304888 76060 228828 504543 130667 373876 602704 Due to Affiliates 16202829 Reserve for Outstanding Insurance Losses 141841 16344670 X Part X, Line 2: From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Alexian Brothers Specialty Group: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2014. 1 1 0 0 0 0 0 0 0 Mark Frey Director/Chairperson/President 0 712178 0 693941 0 92252 0 14702 0 35163 0 1548236 0 74752 Tracy Rogers Director/Vice President 0 490446 0 142500 0 21110 0 30990 0 27917 0 712963 0 21110 Paul Belter Director/Secretary/Treasurer 0 420392 0 120000 0 0 0 25845 0 34629 0 600866 0 0 Beth Tze Vice President 0 274214 0 76836 0 17809 0 27864 0 27333 0 424056 0 17809 Jack Chamberlin Cardiologist 0 774076 0 0 0 0 0 5100 0 22215 0 801391 0 0 Mohammed Khan Cardiologist 0 927482 0 0 0 0 0 5100 0 22147 0 954729 0 0 Andrei Pop Cardiologist 0 697965 0 0 0 0 0 5100 0 21544 0 724609 0 0 Daniel Sauri Cardiologist 0 844755 0 0 0 0 0 5100 0 17052 0 866907 0 0 Scott Tomasik Cardiologist 0 608641 0 0 0 0 0 5100 0 21544 0 635285 0 0 Jim Lewandowski end 1112 Former Key Employee 0 0 0 0 0 722305 0 0 0 15727 0 738032 0 722305 Part I, Line 3 Alexian Brothers Health System, a related organization of Alexian Brothers Specialty Group, uses the following methods to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Form 990 of Other Organizations - Compensation Survey or Study - Approval by the Board or Compensation Committee Part I, Line 4a: The following individual listed in Schedule J received the referenced amount of change in control payments in calendar 2013. The payments under a change-of-control arrangement are made in connection with retirement that changed the terms of employment resulting from a change in control of the organization: Jim Lewandowski - $689,832 Part I, Line 4b: Alexian Brothers Health System offers a Supplemental Employee Retirement Plan to all employees who participate in the executive benefits program and whose compensation exceeds the IRS allowable limit for a qualified pension plan. The purpose of the plan is to restore retirement benefits that are restricted because of compensation limits for the executives. Neither contributions to nor distributions from the supplemental nonqualified retirement plan were made in the current year. Form 990, Part V, Line 1a: Alexian Brothers Health System, a related organization of Alexian Brothers Specialty Group, uses a common bank account to compensate all independent contractors within the Health System. The number attributable to each organization is not easily distinguished. The total number of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of the Alexian Brothers Health System Form 990. Form 990, Part VI, Section A, line 2 Mark Frey, Tracy Rogers, Beth Tze, Paul Belter, Donna Gauthier and Fred Nelson have a business relationship due to joint employment by a common health system entity. Form 990, Part VI, Section A, line 6 Alexian Brothers Specialty Group has two classes of corporate members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Hospital Network (the "Area Member"). Form 990, Part VI, Section A, line 7a Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of Alexian Brothers Specialty Group. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Alexian Brothers Specialty Group's financial information or corporation as a whole are subject to approval by the National Member, Alexian Brothers Health System. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board Members' questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of Alexian Brothers Specialty Group, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other similarly situated organization's employees that hold the same or similar title. During the review and approval of the compensation by the Compensation Committee, documentation of the decision was recorded in the minutes. Form 990, Part VI, Section C, line 19 The financial statements of Alexian Brothers Specialty Group are available through the Office of the Illinois Attorney General. Conflict of Interest statements and the governing documents of Alexian Brothers Specialty Group are not made available to the public. Form 990, Part IX, line 11g Purchased Services - Billing: Program service expenses 2,862. Management and general expenses 993,966. Fundraising expenses 0. Total expenses 996,828. Purchased Services: Program service expenses 982,635. Management and general expenses 0. Fundraising expenses 0. Total expenses 982,635. Other fees-for-service: Program service expenses 160,124. Management and general expenses 4,025. Fundraising expenses 0. Total expenses 164,149. Form 990, Part XII, Line 2b - Audit Disclosure: The financial statements of Alexian Brothers Specialty Group were audited on a consolidated basis. The Audit Committee of the Board of Governors of Alexian Brothers Health System has been delegated the responsibility to oversee the audited financial statements and the selection of the independent accountants that audit the financial statements. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 60005 363260495 Supports provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Alexian Brothers Bonaventure House 825 Wellington Avenue Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Health System Inc Investment Trust 3040 W Salt Creek Lane Arlington Heights IL 60005 363801585 Manages pooled investments of related not-for-profit entities IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers of San Jose Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 941530037 Acute care hospital (sold in 1998) TX Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 60005 364484290 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 431295333 HUD housing MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Hospital Network 3040 W Salt Creek Lane Arlington Heights IL 60005 363276552 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Community Services 425 Cumberland Street Suite 110 Chattanooga TN 37404 364344423 Provides comprehensive & coordinated community based services IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Neighbors 250 East 10th Street Chattanooga TN 37402 620646376 Supports the provision of community services for senior citizens TN Section 501(c)(3) Schedule A, Line 7 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 392039667 Community outreach WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 431470362 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Savelli Properties Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363308965 Owns or leases properties where healthcare services are delivered IL Section 501(c)(2) N/A Alexian Brothers Health System 1 Alexian Brothers Center for Mental Health 3436 N Kennicott Avenue Arlington Heights IL 60004 363045007 Outpatient community mental health services IL Section 501(c)(3) Schedule A, Line 7 Alexian Brothers Health System 1 Alexian Brothers Behavioral Health Hospital 1650 Moon Lake Blvd Hoffman Estates IL 60194 364251848 Behavioral health hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 St Alexius Medical Center 1555 Barrington Road Hoffman Estates IL 60194 364251846 Acute care hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 60005 364336931 Physician services IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Road Elk Grove Village IL 60007 300221481 Rehabilitation hospital IL N/A Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 870783164 Provision of NeuroMeg services IL N/A Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 60005 363853289 Medical office building IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages managed care contracts DE N/A Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 861115516 Ownership of Gamma Knife IL N/A St Alexius Center for Sleep Health LLC 1300 S Main Street Lombard IL 60148 205876371 Operation of sleep lab IL N/A Thelen Corporation 3040 W Salt Creek Lane Arlington Heights IL 60005 363266316 Owns/leases property; joint venture partner IL N/A C 0 Alexian Brothers Health Providers Association Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363853286 Messenger model IPA IL N/A C 0 Alexian Brothers Corpus Christi Housing Project LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 943465394 Tax credit financed housing IL N/A C 0 Alexian Village of Elk Grove 3040 W Salt Creek Lane Arlington Heights IL 60005 352211303 Tax credit financed housing IL N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 Alexian Brothers Health System P 473282 FMV Alexian Brothers Hospital Network P 176064 FMV Alexian Brothers Health System S 6539469 FMV Alexian Brothers Health System R 327074 FMV