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ALVERNO PROVENA HOSPITAL LABORATORIES INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
ALVERNO PROVENA HOSPITAL LABORATORIES INC (EIN 20-3238867)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-10-31
IRS object ID
201433049349301153
Schema version
2013v3.1
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)
Return2014-10-31T13:56:14-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203238867EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Alverno Provena Hospital Laboratories IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% STEVE WOJNICKIInCareOfNm
Business Name ControlALVEBusinessNameControlTxt
Phone2199893857PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12434 Interstate Plaza DriveAddressLine1
Address Line2SuiteAddressLine2
CityHammondCity
StateINState
ZIP Code46324ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVEN WOJNICKIPersonNm
Person TitleVP OF FINANCE AND CFOPersonTitleTxt
Phone2199893857PhoneNum
Signature2014-10-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMollie P LonghousePreparerPersonNm
PTINP00294881PTIN
Phone2199893857PhoneNum
Preparation2014-10-10PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSAMUEL C TERESE JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12434 INTERSTATE PLAZA DRIVEAddressLine1
CityHAMMONDCity
StateINState
ZIP Code46324ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$134,973,305GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ALVERNOCLINICALLABS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionBRINGING CHRIST'S MINISTRY TO THOSE WE SERVE THROUGH TIMELY HIGH-QUALITY LAB TESTING TO OUR 25 NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$134,349,891PYProgramServiceRevenueAmt
CY Program Service Revenue$133,821,464CYProgramServiceRevenueAmt
PY Investment Income$318,608PYInvestmentIncomeAmt
CY Investment Income$201,183CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$134,668,499PYTotalRevenueAmt
CY Total Revenue$134,022,647CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$134,951,083PYOtherExpensesAmt
CY Other Expenses$134,213,095CYOtherExpensesAmt
PY Total Expenses$134,951,083PYTotalExpensesAmt
CY Total Expenses$134,213,095CYTotalExpensesAmt
PY Revenues Less Expenses-$282,584PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$190,448CYRevenuesLessExpensesAmt
Total Assets BOY$17,706,609TotalAssetsBOYAmt
Total Assets EOY$20,361,818TotalAssetsEOYAmt
Total Liabilities BOY$17,556,609TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,211,818TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$150,000NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$150,000NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBRINGING CHRIST'S MINISTRY TO THOSE WE SERVE THROUGH TIMELY HIGH-QUALITY LABORATORY TESTING TO OUR 25 NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$126,260,488ExpenseAmt
Revenue$133,821,464RevenueAmt
DescALVERNO PROVENA HOSPITAL LABORATORIES, INC.'S (APHL) PRIMARY FUNCTION IS TO PROVIDE LABORATORY TESTING SERVICES TO ITS TWENTY-FIVE (25) AFFILIATED NOT-FOR-PROFIT HOSPITALS AND AFFILIATES LOCATED THROUGHOUT ILLINOIS AND INDIANA. THE ORGANIZATION MAINTAINS A STRATEGIC PLAN THAT IS STRUCTURED ON THE FOLLOWING FIVE AREAS: STEWARDSHIP, PEOPLE, SERVICE, GROWTH, AND QUALITY. (CONTINUED IN SCHEDULE O)Desc
Total Program Service Expenses$126,260,488TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document70IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSTEVE WOJNICKIPersonNm
Phone2199893857PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12434 INTERSTATE PLAZA DRIVEAddressLine1
CityHAMMONDCity
StateINState
ZIP Code46324ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JOEL HOFF
SECRETARY1.01.0Yes (X)Yes (X)$0$0$0
THOMAS GRYZBEK
CHAIR1.01.0Yes (X)Yes (X)$0$0$0
ROBERT BIEDRON
TREASURER1.01.0Yes (X)Yes (X)$0$0$0
DAVID DILORETO MD
VICE CHAIR1.01.0Yes (X)Yes (X)$0$0$0
SAMUEL C TERESE JR
PRESIDENT/CEO32.08.0Yes (X)Yes (X)$0$426,388$33,514
RICHARD FERRANS MD
DIRECTOR1.01.0Yes (X)$0$0$0
ROGER BARKSDALE
DIRECTOR1.01.0Yes (X)$0$0$0
ANTHONY FILER
DIRECTOR1.01.0Yes (X)$0$0$0
VICKI REZAI MD
DIRECTOR1.01.0Yes (X)$0$0$0
MARK FRITSCH MD
DIRECTOR1.01.0Yes (X)$0$0$0
STEVEN G WOJNICKI
CFO32.08.0Yes (X)$0$260,213$36,463
BERNARD H HENRY
VP OF HUMAN RESOURCES32.08.0Yes (X)$0$218,620$10,718
MARSHA COOPER
VP OF HOSPITALS32.08.0Yes (X)$0$195,969$15,565
ALEX WLODZIMIERSKI
LAB DIRECTOR III40.0$0$132,828$25,051Yes (X)
VIVIAN SARASHINSKY
LAB DIRECTOR II40.0$0$130,340$16,763Yes (X)
SYED ALI
LAB DIRECTOR III40.0$0$122,847$23,793Yes (X)
LYNN M CHEESEMAN
LAB DIRECTOR III40.0$0$121,565$19,571Yes (X)
JOYCE HUBBE
LAB DIRECTOR II40.0$0$119,791$11,870Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,728,561TotReportableCompRltdOrgAmt
Total Other Compensation$193,308TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
PROFESSIONAL CLINICAL LABORATORIES
113 E 4TH STREETMICHIGAN CITYIN46360LAB & MANAGEMENT$22,667,430
ALVERNO CLINICAL LABORATORIES LLC
2434 INTERSTATE PLAZA DRIVEHAMMONDIN46324LAB & MANAGEMENT$11,779,267
QUEST DIAGNOSTICS
PO BOX 740709ATLANTAGA303740709REFERENCE LAB$1,988,192
MAYO MEDICAL LABORATORIES
PO BOX 9146MINNEAPOLISMN554809146REFERENCE LAB$545,051
AMERIPATH INDIANAPOLIS PC
13179 COLLECTION CENTER DRIVECHICAGOIL606930131REFERENCE LAB$455,024
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescLAB SERVICES FOR PATRON HOSPITALSDesc
Business621500BusinessCd
Total Revenue Column$133,821,464TotalRevenueColumnAmt
Related Or Exempt Func Income$133,821,464RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$133,821,464TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$201,183TotalRevenueColumnAmt
Exclusion$201,183ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$950,658GrossSalesOfInventoryAmt
Cost Of Goods Sold$950,658CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$134,022,647TotalRevenueColumnAmt
Related Or Exempt Func Income$133,821,464RelatedOrExemptFuncIncomeAmt
Exclusion$201,183ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,029TotalAmt
Management And General$17,029ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$87,753TotalAmt
Management And General$87,753ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$29,218,789TotalAmt
Program Services$27,877,860ProgramServicesAmt
Management And General$1,340,929ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$572,709TotalAmt
Program Services$572,709ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$72,181TotalAmt
Program Services$72,181ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$8,235TotalAmt
Program Services$8,235ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$148,221TotalAmt
Program Services$148,221ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,452TotalAmt
Program Services$13,452ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$99TotalAmt
Program Services$99ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$212,186TotalAmt
Program Services$212,186ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
COMPENSATION PAID BY ACL$68,592,476$64,594,262$3,998,214
MEDICAL SUPPLIES$19,130,835$19,130,835$0
REFERENCE LABORATORY$9,279,991$9,279,991$0
EQUIPMENT RENT & MAINTENANCE$2,526,350$2,526,350

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,332,789TotalAmt
Program Services$1,824,107ProgramServicesAmt
Management And General$2,508,682ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$134,213,095TotalAmt
Program Services$126,260,488ProgramServicesAmt
Management And General$7,952,607ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,660,144BOYAmt
EOY$5,100EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$370,030BOYAmt
EOY$104,559EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$398,380BOYAmt
EOY$264,384EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$827,047BOYAmt
EOY$577,120EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,328LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,328LandBldgEquipAccumDeprecAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,005,502BOYAmt
EOY$15,289,000EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,445,506BOYAmt
EOY$4,121,655EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,706,609BOYAmt
EOY$20,361,818EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,295,721BOYAmt
EOY$9,367,315EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,260,888BOYAmt
EOY$10,844,503EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,556,609BOYAmt
EOY$20,211,818EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$150,000BOYAmt
EOY$150,000EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$150,000BOYAmt
EOY$150,000EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,706,609BOYAmt
EOY$20,361,818EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$190,448ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$190,448NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,328OtherCostOrOtherBasisAmt
Depreciation$5,328DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescMONEY MARKET FUNDDesc
Book Value$15,289,000BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$15,289,000TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM PROVENA FACILITIES$158,435
DUE FROM FRANCISCAN FACILITIES$467,935
DUE FROM RESURRECTION FAC.$2,936,015
DUE FROM ACL, LLC$559,270
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,121,655TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO FRANCISCAN FACILITIES$4,510,117
DUE TO PROVENA FACILITIES$2,120,051
RETIREMENT BENEFIT LIABILITY$1,365,849
DUE TO PCL, LLC$11,942
DUE TO MISC RELATED PARTY$2,836,544
FieldValueIRS element (for citing)
Total Liability$10,844,503TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$135,163,753TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$190,448NetUnrealizedGainsInvstAmt
Other Revenue$950,658OtherRevenueAmt
Revenue Not Reported$1,141,106RevenueNotReportedAmt
Revenue Subtotal$134,022,647RevenueSubtotalAmt
Total Revenue Per Form990$134,022,647TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$135,163,753TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$950,658OtherExpensesIncludedAmt
Expenses Not Reported$950,658ExpensesNotReportedAmt
Expenses Subtotal$134,213,095ExpensesSubtotalAmt
Total Expenses Per Form990$134,213,095TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2APHL INC. HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE ("THE CODE") SECTION 501(E) AND THE LAWS OF THE STATES IN WHICH IT OPERATES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. THE COMPANY RECOGNIZES INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST AND INCOME TAX EXPENSE, RESPECTIVELY. THE COMPANY HAS NO AMOUNTS ACCRUED FOR INTEREST OR PENALTIES AS OF DECEMBER 31, 2013 AND 2012. DUE TO ITS TAX-EXEMPT STATUS, THE COMPANY IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE COMPANY DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. TAX RETURNS FILED BY THE COMPANY ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE COMPANY ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED DECEMBER 31, 2009 AND PRIOR.
SCHEDULE D, PART XI, LINE 2DCOST OF GOODS SOLD $950,658
SCHEDULE D, PART XII, LINE 2DCOST OF GOODS SOLD $950,658

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SAMUEL C TERESE JR
PRESIDENT/CEO$0$320,666$0$94,701$0$11,021$0$15,075$0$18,439$0$459,902$0$0
STEVEN G WOJNICKI
CFO$0$206,175$0$45,515$0$8,523$0$17,937$0$18,526$0$296,676$0$0
BERNARD H HENRY
VP OF HUMAN RESOURCES$0$170,752$0$38,346$0$9,522$0$10,718$0$0$0$229,338$0$0
MARSHA COOPER
VP OF HOSPITALS$0$130,780$0$33,678$0$31,511$0$7,658$0$7,907$0$211,534$0$0
ALEX WLODZIMIERSKI
LAB DIRECTOR III$0$125,947$0$0$0$6,881$0$11,345$0$13,706$0$157,879$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationALVERNO CLINICAL LABORATORIES, LLC (ACL), A RELATED ORGANIZATION IS THE PAY AGENT FOR ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (APHL). ACL USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR APHL'S TOP MANAGEMENT OFFICIALS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTSAPHL'S LONG TERM OBJECTIVE IS TO CONTINUE TO GROW SO AS TO PROVIDE QUALITY LABORATORY SERVICES TO OUR PATRON FAITH BASED HOSPITALS. IN SO DOING, APHL'S LONG TERM OBJECTIVE IS TO CONTROL COSTS, AND TO INCREMENT THE NUMBER OF TESTS AVAILABLE, WITH A FOCUS ON HIGHLY RELIABLE SCIENTIFIC TEST RESULTS WHILE BUILDING A CULTURE OF SERVICE. APHL SEEKS TO ATTRACT A WORK FORCE DEDICATED TO SERVICE OF ITS PATIENTS. APHL'S SHORT TERM OBJECTIVES INCLUDE THE ENHANCEMENT OF THE COST MODEL TO IMPROVE THE RELATIVE VALUE UNIT THAT CAPTURES THE COMPLEXITY AND QUANTITATES THE PRODUCTION COST SO AS TO PROVIDE THE COOPERATIVE WITH AN INTEGRATED DELIVERY SYSTEM TO PROVIDE FOR PATIENT NEEDS ON THE PRODUCTION SIDE. THE USE OF LEAN CONCEPTS PROMOTES THE ELIMINATION OF WASTE AND THE EFFICIENT FLOW OF PRODUCTION. SCORE CARDS ARE IN PLACE AND MONITORED FOR QUALITY INTERVENTION NEED. APPROXIMATELY 10,705 TESTS A DAY ARE PERFORMED AT THE CENTRAL LABORATORY WHILE MAINTAINING RAPID RESPONSE LABORATORIES AT EACH HOSPITAL SITE. EACH LABORATORY SITE IS INSPECTED BY CAP AND PROVIDED A CERTIFICATION IN ADDITION TO THE INTERNAL APHL QUALITY DEPARTMENT INSPECTIONS AND PROGRAMS PROMOTING EXCELLENCE IN LABORATORY SCIENCE.
PART VI, SECTION A, LINE 6THE ORGANIZATION HAS TWO CLASSES OF MEMBERS, VOTING AND NON-VOTING. THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS, REFERRED TO AS "PARTICIPANT HOSPITALS", AND ONE CLASS OF NON-VOTING MEMBERS, REFERRED TO AS "PATRON HOSPITALS". EACH "PARTICIPANT" HAS THE RIGHT TO APPOINT BOARD MEMBERS WHO HAVE THE RIGHT TO VOTE ON ALL MATTERS PRESENTED TO THE MEMBERS OF THE CORPORATION, INCLUDING THE ELECTION OF DIRECTORS. THE "PATRONS" DO NOT HAVE VOTING RIGHTS. CURRENTLY, APHL, INC. HAS THREE PARTICIPANTS AND NO PATRONS.
PART VI, SECTION A, LINE 7APARTICIPANT HOSPITAL SYSTEM REPRESENTATIVES ARE APPOINTED BY THE PARTICIPANT HOSPITAL SYSTEM OF APHL'S PARENT ORGANIZATIONS. THE PARTICIPANT HOSPITAL SYSTEM REPRESENTATIVES CAN ACT ON BEHALF OF THE PARTICIPANT HOSPITAL SYSTEM CEO ON ALL MATTERS.
PART VI, SECTION A, LINE 7BTHE PARTICIPANT HOSPITAL SYSTEMS SHALL HAVE THE EXCLUSIVE POWER TO: A) APPROVE THE ADMISSION OF ADDITIONAL PARTICIPANTS OF THE CORPORATION; B) APPOINT AND REMOVE DIRECTORS AND FILL VACANCIES ON THE BOARD OF DIRECTORS; C) APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION; D) APPROVE AMENDMENTS AND/OR RESTATEMENTS FROM TIME TO TIME TO THE ARTICLES PROPOSED BY THE BOARD OF DIRECTORS; E) APPROVE AMENDMENT OR REPEAL OF THE BYLAWS AND THE ADOPTION OF NEW BYLAWS; F) APPROVE THE SALE, LEASE, PURCHASE, EXCHANGE, OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION OR THE DISPOSITION OF ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; G) APPROVE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER CORPORATION; H) APPROVE THE PLAN FOR ALLOCATION AND DISTRIBUTION OF THE CORPORATION'S PROPERTY UPON DISSOLUTION IF NOT OTHERWISE PROVIDED FOR UNDER THE BYLAWS; I) APPROVE PARTICIPANTS' REQUIRED CAPITAL CONTRIBUTIONS TO THE CORPORATION OR DUES PAYABLE TO THE CORPORATION; J) APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION IN EXCESS OF AMOUNTS DETERMINED FROM TIME TO TIME BY THE PARTICIPATNS; K) ADOPT THE ANNUAL CAPITAL AND OPERATING BUDGETS OF THE COMPANY, AND ANY MATERIAL DEVIATIONS THEREFROM, SUCH ANNUAL BUDGETS TO INCLUDE ANY PREVIOUSLY APPROVED CAPITAL CONTRIBUTIONS; L) ADOPT THE STRATEGIC PLANS FOR THE CORPORATION AND APPROVE ANY MATERIAL CHANGES TO THE SERVICES OFFERED BY THE CORPORATION WHICH ARE NOT EXPRESSLY IDENTIFIED IN THE PREVIOUSLY APPROVED STRATEGIC PLANS; M) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF, ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; AND N) APPROVE ANY AMENDMENTS TO THE COOPERATIVE SERVICES AGREEMENT AMONG THE CORPORATION AND THE PARTICIPANTS, EFFECTIVE AS OF JULY 1, 2005 OR SUCH OTHER DATE AGREED UPON BY THE PARTICIPANTS.
PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S MANAGEMENT. THEN A FINAL DRAFT OF THE FULL FORM 990, INCLUDING APPLICABLE SCHEDULES, IS MADE AVAILABLE TO THE FINANCE COMMITTEE AT A REGULARLY SCHEDULED MEETING WITH OUR TAX ADVISORS PRESENT. EACH REMAINING MEMBER OF THE BOARD OF GOVERNANCE IS ALSO PROVIDED A FINAL DRAFT OF THE FULL FORM 900 FOR REVIEW. THESE REVIEWS OCCUR PRIOR TO FILING WITH THE IRS.
PART VI, SECTION B, LINE 12CCOVERED PERSONS: ALL MANAGEMENT PERSONNEL AND MEMBERS OF THE BOARD OF DIRECTORS ARE COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. MANAGEMENT PERSONNEL INCLUDE SUPERVISORS THROUGH THE PRESIDENT/CEO OF THE ORGANIZATION. POLICY SUMMARY: THE CONFLICT OF INTEREST POLICY IS SENT OUT TO COVERED PERSONS FOR REVIEW. EACH PERSON IS REQUIRED TO COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE AND RETURN IT. IT IS THE RESPONSIBILITY OF HUMAN RESOURCES AND THE EXECUTIVE ASSISTANT TO ENSURE THE QUESTIONNAIRES ARE RETURNED AND COMPLETED. THE COMPLETED QUESTIONNAIRES ARE FORWARDED TO THE VICE PRESIDENT OF HUMAN RESOURCES FOR REVIEW TO DETERMINE IF CONFLICTS EXIST. AN INTERESTED PERSON HAS A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT, TRANSACTION OR ARRANGEMENT IN WHICH ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (APHL) IS (OR WOULD BE, IF APPROVED) A PARTY IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH A BUSINESS, INVESTMENT, FAMILY OR OTHER RELATIONSHIP: A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY INVOLVED IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; B) A COMPENSATION ARRANGEMENT WITH AN INDIVIDUAL OR ENTITY INVOLVED IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, AN INDIVIDUAL OR ENTITY WITH WHICH APHL IS NEGOTIATING SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; OR D) A FIDUCIARY POSITION (E.G., MEMBER, OFFICER, DIRECTOR, COMMITTEE MEMBER) WITH RESPECT TO AN ENTITY IN SUCH CONTRACT, TRANSACTION OR ARRANGEMENT; OR E) A NON-ECONOMIC AFFILIATION OR RELATIONSHIP, DIRECTLY (OR INDIRECTLY, THROUGH A THIRD PARTY) WITH AN INDIVIDUAL OR ENTITY WITH WHICH APHL IS NEGOTIATING OR MAINTAINS A CONTRACT. TRANSACTION OR ARRANGMENT SUCH THAT THE AFFILIATION OR RELATIONSHIP COULD RENDER THE INTERESTED PERSON INCAPABLE OF MAKING A DECISION WITH ONLY THE BEST INTERESTS OF APHL IN MIND. IN ADDITION, AN INTERESTED PERSON HAS A CONFLICT OF INTEREST IN ANY EXISTING OR POTENTIAL COMPENSATION ARRANGEMENT BETWEEN APHL AND THAT INTERESTED PERSON OR ANY BUSINESS, INVESTMENT OR FAMILY MEMBER RELATED TO THAT PERSON. FOR PURPOSES OF THIS SECTION, COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION, AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. SERVICE OF INDIVIDUALS ON THE BOARD OF DIRECTORS FOR ALVERNO PROVENA HOSPITAL LABORATORIES, INC. (AND COMMITTEES THEREOF), BOARDS OR COMMITTEES OF THE MEMBER ORGANIZATIONS OR EMPLOYMENT BY A MEMBER ORGANIZATION OR ALVERNO CLINICAL LABORATORIES, A RELATED ORGANIZATION, IS NOT CONSIDERED A CONFLICT OF INTEREST, AS DEFINED IN THE POLICY. THE VP OF HUMAN RESOURCES COMPILES THE RESULTS AND FORWARDS THE RESULTS TO THE CEO. THE ASSESSMENTS OF ANY POTENTIAL CONFLICT ARE MADE IN COLLABORATION WITH LEGAL COUNSEL AS APPROPRIATE. THE CEO REVIEWS ANY CONFLICTS WITH THE BOARD DURING A SCHEDULED BOARD MEETING. POLICY VIOLATIONS: IF THE BOARD OR MANAGERS HAS REASON TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO COMPLY WITH THE DISCLOSURE OBLIGATIONS OF THIS POLICY, THE BOARD OF MANAGERS SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND PROVIDE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF SUCH A PERSON AND CONDUCTING FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OF MANAGERS SHALL DETERMINE WHETHER SUCH PERSON HAS IN FACT, VIOLATED THE DISCLOSURE REQUIREMENTS OF THE CONFLICT OF INTEREST POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE REMOVAL (IF THE INTERESTED PERSON IS A BOARD OR COMMITTEE MEMBER, DIRECTOR OR MANAGEMENT EMPLOYEE) OR TERMINATION (IF THE INTERESTED PERSON IS AN EMPLOYEE OF ALVERNO PROVENA HOSPITAL LABORATORIES, INC., ALVERNO CLINICAL LABORATORES, LLC OR A MEMBER ORGANIZATION). RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT ARE DETERMINED ON A CASE BY CASE BASIS BY THE CEO IN COLLABORATION WITH LEGAL COUNSEL. AS OF THIS DATE, NO MATERIAL CONFLICTS OF INTEREST HAVE BEEN IDENTIFIED. IF A MATERIAL CONFLICT IS IDENTIFIED IN THE FUTURE, THAT PERSON WOULD BE REQUIRED TO RECLUSE THEMSELVES FROM PARTICIPATING IN DECISIONS AND/OR VOTING PRIVILEGES DIRECTLY RELATED TO THE CONFLICT.
PART VI, SECTION B, LINE 15ATHE ORGANIZATION'S TOP MANAGMENT OFFICIAL IS PAID BY ALVERNO CLINICAL LABORATORIES, LLC, A RELATED ORGANIZATION; THEREFORE, THIS QUESTION HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. THE BOARD OF DIRECTORS APPOINTED A COMPENSATION COMMITTEE, WHICH IS A SUB-COMMITTEE OF THE BOARD. THE BOARD ENGAGED AN OUTSIDE CONSULTING GROUP TO CONDUCT A MARKET REVIEW OF EXECUTIVE COMPENSATION AND PREPARE A COMPARATIVE ANALYSIS BASED ON ALVERNO'S EXECUTIVE PAY LEVELS. AS A RESULT OF THE ANALYSIS, THE CONSULTING GROUP DEVELOPED A REUBTTABLE PRESUMPTION OF REASONABLENESS LETTER UNDER THE INTERMEDIATE SANCTION REGULATIONS OF THE INTERNAL REVENUE SERVICE. THE TOTAL COMPENSATION PACKAGE WAS APPROVED IN ADVANCE BY THE BOARD, AND NO INDIVIDUALS WHO HAD AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT PARTICIPATED IN THE DELIBERATIONS. THE BOARD ADEQUATELY AND CONTEMPORANEOUSLY DOCUMENTED THE BASIS FOR ITS DETERMINATION. THIS PROCESS IS PERFORMED PERIODICALLY, AND WAS LAST UNDERTAKEN DURING THE FIRST QUARTER OF 2011 FOR THE PRESIDENT/CEO, VICE PRESIDENT OF HUMAN RESOURCES, CHIEF FINANCIAL OFFICER, AND VICE PRESIDENT OF HOSPITALS. IN ADDITION, THE COMPENSATION GUIDELINES AND PHILOSOPHY ACCORDING TO CURRENT INDUSTRY STANDARDS AND THE REBUTTABLE PRESEUMPTION OF REASONABLENESS LETTER. THE BOARD OF DIRECTORS RECOMMENDS THE APPROVAL OF THE LINE-BY-LINE OPERATING BUDGET ON AN ANNUAL BASIS. THESE PROCESSES ARE DOCUMENTED IN THE RESPECTIVE COMPENSATION COMMITTEE/BOARD MEETING MINUTES AND WERE LAST PERFORMED IN 2011.
PART VI, SECTION B, LINE 15BTHE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES ARE PAID BY ALVERNO CLINICAL LABORATORIES, LLC, A RELATED ORGANIZATION; THEREFORE, THIS QUESTION HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A.
PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990 PART IX LINE 11GDESCRIPTION:PCL LAB SERVICES TOTAL FEES:23431774
FORM 990 PART IX LINE 11GDESCRIPTION:ACL MANAGEMENT SERVICES TOTAL FEES:4508027
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SVS-OTHER TOTAL FEES:1270797
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:8191

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ALVERNO CLINICAL LABORATORIES LLCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line12434 INTERSTATE PLAZA DRAddressLine1
CityHAMMONDCity
StateINState
ZIP Code46324ZIPCode
FieldValueIRS element (for citing)
EIN203240648EIN
Primary Activitiesmanagement svcsPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd