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ALEXIAN BROTHERS SPECIALTY GROUP: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ALEXIAN BROTHERS SPECIALTY GROUP (EIN 80-0710751)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-09
IRS object ID
201411299349302501
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-09T15:05:51-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Wacker DriveAddressLine1
CityChicagoCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN800710751EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Alexian Brothers Specialty GroupBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlALEXNameControl
Phone8478185100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13040 West Salt Creek LaneAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code600051069ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMark FreyName
TitlePresidentTitle
Phone8478185100Phone
Date Signed2014-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLaura GillespieName
PTINP00855604PTIN
Phone3124861000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMark FreyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13040 West Salt Creek LaneAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code600051069ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12786966GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.alexianbrothershealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2011YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionSpecialty physician group in Catholic health system.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6279709ProgramServiceRevenuePriorYear
Program Service Revenue CY12325894ProgramServiceRevenueCY
Investment Income Prior Year-11831InvestmentIncomePriorYear
Investment Income Current Year461072InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year6267878TotalRevenuePriorYear
Total Revenue Current Year12786966TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6771954SalariesEtcPriorYear
Salaries Etc Current Year13048418SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2419142OtherExpensePriorYear
Other Expenses Current Year5340830OtherExpensesCurrentYear
Total Expenses Prior Year9191096TotalExpensesPriorYear
Total Expenses Current Year18389248TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2923218RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-5602282RevenuesLessExpensesCY
Total Assets BOY8702455TotalAssetsBOY
Total Assets EOY1915140TotalAssetsEOY
Total Liabilities BOY14097944TotalLiabilitiesBOY
Total Liabilities EOY12348968TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-5395489NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-10433828NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAlexian 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16403086Expense
Revenue12325894Revenue
DescriptionAlexian 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 (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.Description
Total Program Service Expense16403086TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Fred NelsonBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8478185100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13040 West Salt Creek LaneAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code600051069ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Mark Frey
Director/Chairperson/President0.0040.00XX01434790179527
Tracy Rogers
Director/Vice President0.0040.00XX066229065199
James Sances
Dir/Secretary/Treasurer (end 7/12)0.0040.00XX01697343148158
Paul Belter
Dir/Secretary/Treasurer (start 7/12)0.0040.00XX019921321767
Donna Gauthier
Assistant Secretary0.0040.00X07100715381
Daniel Isacksen
Chief Financial Officer (end 1/13)0.0040.00X028662525660
Fred Nelson
Chief Financial Officer (start 4/13)0.0040.00X000
Jim Lewandowski
Vice President0.0040.000468370805832X
Mohammed Khan
Cardiologist40.000.00088955625166X
Daniel Sauri
Cardiologist40.000.00084378620922X
Jack Chamberlin
Cardiologist40.000.00069630625166X
Andrei Pop
Cardiologist40.000.00062638825166X
Scott Tomasik
Cardiologist40.000.00060130625166X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs8476980TotalReportableCompFrmRltdOrgs
Total Other Compensation1383110TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Svcs Rev.6211101220253212202532
Intercompany Affiliate900099123362123362
FieldValueIRS element (for citing)
Total Program Service Revenue12325894TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column461072TotalRevenueColumn
Exclusion$461,072ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12786966TotalRevenueColumn
Related Or Exempt Function Income12325894RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$461,072ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total11638132Total
Program Services11638132ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total463069Total
Program Services463069ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total501466Total
Program Services501466ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total445751Total
Program Services445751ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2558Total
Program Services401ProgramServices
Management And General2157ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6843Total
Management And General6843ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2129124Total
Program Services1143916ProgramServices
Management And General985208ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total31142Total
Program Services31142ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total239993Total
Program Services178732ProgramServices
Management And General61261ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total24758Total
Program Services24758ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total624432Total
Program Services623567ProgramServices
Management And General865ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total50647Total
Program Services50647ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total24473Total
Program Services22973ProgramServices
Management And General1500ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total82847Total
Program Services82847ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total641833Total
Program Services498963ProgramServices
Management And General142870ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Management Fees1024091260233763858
Bad Debt324294324294
Dues635584195821600
Medical Supplies6221262212

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total8025Total
Program Services8025ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18389248Total
Program Services16403086ProgramServices
Management And General1986162ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY59673BOY
EOY109374EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1103108BOY
EOY1020816EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY78598BOY
EOY33866EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis809431LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec123881LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY768397BOY
EOY685550EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY6673351BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY19328BOY
EOY65534EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8702455BOY
EOY1915140EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2187341BOY
EOY1567348EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11910603BOY
EOY10781620EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14097944BOY
EOY12348968EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-5395489BOY
EOY-10433828EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-5395489BOY
EOY-10433828EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8702455BOY
EOY1915140EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-5602282ReconcilationRevenueExpenses
Reconciliation Unrealized Invest563943ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
General ExplanationSchedule A, Part IV, Supplemental Information: 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.GeneralExplanation

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis304888OtherCostOrOtherBasis
Depreciation45550Depreciation
Book Value259338BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis504543OtherCostOrOtherBasis
Depreciation78331Depreciation
Book Value426212BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings685550TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$10,639,779
Reserve for Outstanding Insurance Losses$141,841
FieldValueIRS element (for citing)
Total Of Amounts10781620TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
ExplanationPart X, Line 2: Alexian Brothers Specialty Group does not file a separate audit report, but is part of the Alexian Brothers Health System consolidated audit report. There is no ASC 740 (fka FIN 48) footnote for the current year.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mark Frey
Director/Chairperson/President011101380263024061628013795604157101614317044628
Tracy Rogers
Director/Vice President047801301652170190600350750301240727489019060
James Sances
Dir/Secretary/Treasurer (end 7/12)0358665021376001124918012694302121501845501033210
Paul Belter
Dir/Secretary/Treasurer (start 7/12)0199213000009552012215022098000
Daniel Isacksen
Chief Financial Officer (end 1/13)02313510552740004362021298031228500
Jim Lewandowski
Vice President0328372088552051446077927902655301274202033988
Mohammed Khan
Cardiologist0889556000005000020166091472200
Daniel Sauri
Cardiologist0843786000005000015922086470800
Jack Chamberlin
Cardiologist0696306000005000020166072147200
Andrei Pop
Cardiologist0626388000005000020166065155400
Scott Tomasik
Cardiologist0601306000005000020166062647200

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart IIIReturnReference
ExplanationPart I, Line 3: Alexian Brothers Health System, a related organization of Alexian Brothers Specialty Group, uses all of the items in Schedule J, Part I, Line 3 to establish the compensation of the organization's CEO. Part I, Line 4a: The following individual listed in Schedule J received the referenced amount of change in control payments in calendar 2012. 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. James Sances - $1,091,708 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. The amount paid in calendar 2012 was included in income in Schedule J for the following individual: Jim Lewandowski - $19,123Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Mark Frey, Tracy Rogers, James Sances, Paul Belter, Donna Gauthier, Jim Lewandowski, Dan Isacksen and Fred Nelson have a business relationship due to joint employment by a common health system entity.
Form 990, Part VI, Section A, line 6Alexian Brothers Specialty Group has two classes of members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Hospital Network ( the "Area Member" ).
Form 990, Part VI, Section A, line 7aAlexian 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 7bAll 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 11Management, 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 Member's questions.
Form 990, Part VI, Section B, line 12cThe 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 meeting 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 15In determining compensation of the organization's CEO, Executive Director, or top management official, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee of the Board of Governors of Alexian Brothers Health System reviewed and approved the compensation. In the review of the compensation, the CEO, Executive Director, or top management were compared to individuals at other similarly situated organizations that hold the same or a similar title. During the review and approval of the compensation, the documentation of the decision was recorded in the Compensation Committee minutes. The individual was not present when his/her compensation was decided. In determining compensation of other officers or key employees of the organization, the process 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 19The 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 VII, Section A:Officers and certain key employees for Alexian Brothers Specialty Group provide services to Alexian Brothers Health System (the National Member) and its subsidiaries. Hours worked are not tracked on an entity by entity basis, and a 40 hour work week is used as a proxy for all individuals listed on Part VII if employed by the filing organization or a related organization (even though more hours may be worked on average). Therefore, all officers, directors, trustees, and key employee hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees represent aggregate hours worked per week for all entities. Compensation amounts for Mark Frey, Tracy Rogers, James Sances and Paul Belter represents payment for services rendered to Alexian Brothers Health System, a related entity. The amounts are not for services as a board member of Alexian Brothers Specialty Group.
Form 990, Part IX, line 11gPurchased Services - Billing: Program service expenses 5,645. Management and general expenses 969,858. Fundraising expenses 0. Total expenses 975,503. Purchased Services: Program service expenses 979,223. Management and general expenses 0. Fundraising expenses 0. Total expenses 979,223. Other fees-for-service: Program service expenses 159,048. Management and general expenses 15,350. Fundraising expenses 0. Total expenses 174,398.Other Fees
Form 990, Part V, Line 1a and Part VII, Section B: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 Alexian Brothers Health System Form 990.
Form 990 Part VIII, Line 3 and Schedule D, Part VII:The amount reflected as dividends and interest reflects Alexian Brothers Specialty Group's share of interest, dividends and realized gains/losses from Alexian Brothers Specialty Group's beneficial share in the Alexian Brothers Health System, Inc. Investment Trust (ABHSIT). ABHSIT is a related entity whose purpose is to pool the investments of the not-for-profit entities in Alexian Brothers Health System and acts as an internal mutual fund. Details of gains and losses are shown on the Form 990 of ABHSIT.
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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (22 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Ascension Health
PO Box 45998St LouisMO63145311662309National Health SystemMOSection 501(c)(3)Schedule A, Line 11aAscension Health Alliance0
Alexian Brothers Health System
3040 W Salt Creek LaneArlington HeightsIL60005363260495Supports provision of healthcare services for related corporationsILSection 501(c)(3)Schedule A, Line 11cAscension Health0
Alexian Brothers Bonaventure House
825 Wellington AvenueChicagoIL60657363527899Housing and supportive care services for persons with HIV/AIDSILSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Health System Inc Investment Trust
3040 W Salt Creek LaneArlington HeightsIL60005363801585Manages pooled investments of related not-for-profit entitiesILSection 501(c)(3)Schedule A, Line 11cAlexian Brothers Health System1
Alexian Brothers of San Jose Inc
3040 W Salt Creek LaneArlington HeightsIL60005941530037Acute care hospital (sold in 1998)TXSection 501(c)(3)Schedule A, Line 11cAlexian Brothers Health System1
Alexian Brothers Services Inc
3040 W Salt Creek LaneArlington HeightsIL60005431295333HUD housingMOSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Village of Milwaukee Inc
9301 N 76th StreetMilwaukeeWI53223391351584Continuing care retirement communityWISection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Community Services
425 Cumberland Street Suite 110ChattanoogaTN37404364344423Provides comprehensive & coordinated community based servicesILSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Senior Neighbors
250 East 10th StreetChattanoogaTN37402620646376Supports the provision of community services for senior citizensTNSection 501(c)(3)Schedule A, Line 7Alexian Brothers Health System1
Alexian Brothers Senior Ministries
3040 W Salt Creek LaneArlington HeightsIL60005364484290Supports the provision of healthcare services for related corporationsILSection 501(c)(3)Schedule A, Line 11cAlexian Brothers Health System1
Alexian Elderly Services Inc
3040 W Salt Creek LaneArlington HeightsIL60005392039667Community outreachWISection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Lansdowne Village
4624 LansdowneSt LouisMO63116431470362Skilled nursing facilityMOSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Sherbrooke Village
4005 Ripa AvenueSt LouisMO63125431592502Skilled nursing facilityMOSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers of St Louis Inc
3040 W Salt Creek LaneArlington HeightsIL60005430653236Acute care hospital (sponsorship transferred in 1997)MOSection 501(c)(3)Schedule A, Line 11cAlexian Brothers Health System1
Alexian Brothers Hospital Network
3040 W Salt Creek LaneArlington HeightsIL60005363276552Supports the provision of healthcare services for related corporationsILSection 501(c)(3)Schedule A, Line 11cAlexian Brothers Health System1
Savelli Properties Inc
3040 W Salt Creek LaneArlington HeightsIL60005363308965Owns or leases properties where healthcare services are deliveredILSection 501(c)(2)N/AAlexian Brothers Health System1
Alexian Brothers Center for Mental Health
3436 N Kennicott AvenueArlington HeightsIL60004363045007Outpatient community mental health servicesILSection 501(c)(3)Schedule A, Line 7Alexian Brothers Health System1
St Alexius Medical Center
1555 Barrington RoadHoffman EstatesIL60194364251846Acute care hospitalILSection 501(c)(3)Schedule A, Line 3Alexian Brothers Health System1
Alexian Brothers Ambulatory Group
3040 W Salt Creek LaneArlington HeightsIL60005364336931Physician servicesILSection 501(c)(3)Schedule A, Line 3Alexian Brothers Health System1
Alexian Brothers Medical Center
800 Biesterfield RoadElk Grove VillageIL60007362596381Acute care hospitalTXSection 501(c)(3)Schedule A, Line 3Alexian Brothers Health System1
Alexian Village of Tennessee
437 Alexian WaySignal MountainTN37377621136742Continuing care retirement communityTNSection 501(c)(3)Schedule A, Line 9Alexian Brothers Health System1
Alexian Brothers Behavioral Health Hospital
1650 Moon Lake BlvdHoffman EstatesIL60194364251848Behavioral health hospitalILSection 501(c)(3)Schedule A, Line 3Alexian Brothers Health System1

Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Alexian Rehabilitation Services LLC
935 Beisner RoadElk Grove VillageIL60007300221481Rehabilitation hospitalILN/A
Illinois NeuroMeg Center LLC
3040 W Salt Creek LaneArlington HeightsIL60005870783164Provision of NeuroMeg servicesILN/A
Elk Grove MOB Limited Partnership
3040 W Salt Creek LaneArlington HeightsIL60005363853289Medical office buildingILN/A
Workplace Solutions LLC
1100 E Woodfield RoadSchaumburgIL60173364095007Provision of EAP servicesILN/A
Bonaventure Medical Foundation LLC
3040 W Salt Creek LaneArlington HeightsIL60005363978153Manages managed care contractsDEN/A
Neurosciences Equipment LLC
3040 W Salt Creek LaneArlington HeightsIL60005861115516Ownership of Gamma KnifeILN/A
St Alexius Center for Sleep Health LLC
1300 S Main StreetLombardIL60148205876371Operation of sleep labILN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Thelen Corporation
3040 W Salt Creek LaneArlington HeightsIL60005363266316Owns/leases property; joint venture partnerILN/AC0
Alexian Brothers Health Providers Association Inc
3040 W Salt Creek LaneArlington HeightsIL60005363853286Messenger model IPAILN/AC0
Alexian Brothers Corpus Christi Housing Project LLC
3040 W Salt Creek LaneArlington HeightsIL60005943465394Tax credit financed housingILN/AC0
Alexian Village of Elk Grove
3040 W Salt Creek LaneArlington HeightsIL60005352211303Tax credit financed housingILN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Alexian Brothers Health System
P411839FMV
Alexian Brothers Hospital Network
P612252FMV
Alexian Brothers Health System
R246733FMV