2012-10-30T13:05:53-05:00 2011-12-31 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 606064301 990 2011-01-01 364251846 St Alexius Medical Center STAL 8478432000 1555 Barrington Road Hoffman Estates IL 60169 Edward Goldberg 8478432000 2012-10-30 1 Laura Gillespie P00855604 3124861000 2011 2016-02-24 21:20:13Z Sherri L Vincent 1555 Barrington Road Hoffman Estates IL 60169 333463356 0 0928 X www.alexianbrothershealth.org X 1998 IL St. Alexius carries out the healing mission of the Catholic Church (See Schedule O).St. Alexius ("St. Alexius", "SAMC", or "the Organization")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 the those we are called to serve. 10 7 0 572 980596 427468 0 0 311897363 331214990 700 168638 1154374 935675 313052437 332319303 0 0 0 0 122536142 128010392 0 0 0 166846063 185191980 289382205 313202372 23670232 19116931 238416375 284290966 80103066 91155084 158313309 193135882 X St. Alexius Medical Center ("St. Alexius", "SAMC", or "the Organization") 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 the those we are called to serve. 0 0 167605543 149645733 St. Alexius Medical CenterSt. Alexius Medical Center (SAMC) is a 339-bed acute care hospital located in Hoffman Estates, Illinois that has provided outstanding healthcare to the residents of the Chicago's northwest suburbs for more than 30 years. Located at 1555 Barrington Road, SAMC is ranked one of the best regional hospitals by U.S. News and World Report.In 2011, SAMC treated 18,500 inpatients, performed 3,400 inpatient surgeries, performed 7,400 outpatient surgeries and delivered 3,100 newborns. Our medical staff includes approximately 1,000 physicians, representing 60 medical and surgical specialties. (See Schedule O for continuation).SAMC is a full-service hospital with a Neurosciences Institute, Cancer Institute, Heart & Vascular Institute, as well as additional specialties in Older Adult, Pediatrics, Bariatric Surgery, Orthopedics and Obstetrics. The Alexian Brothers Women & Children's Hospital is under construction on the campus of SAMC and is expected to open in Spring 2013. SAMC has received Disease Specific Certification from The Joint Commission in Stroke, Heart Failure, and Knee and Hip Joint Replacement. In addition, we are a HealthGrades Top 50 Hospital, and have received the Blue Cross Blue Star of Distinction.SAMC provides care for all, including the financially disadvantaged, uninsured, underinsured, homeless persons and those who receive public aid. In 2011, SAMC provided $9.1 million of charity care at cost. This was in addition to other community benefit services amounting to $2.5 million dollars, $14 million dollars of unreimbursed Medicare costs to patients, $3.4 million dollars of bad debt expense at cost and $8.3 million dollars of unreimbursed Medicaid at cost. About the Alexian Brothers Health SystemSt. Alexius Medical Center is a member hospital of the Alexian Brothers Health System, a comprehensive and diversified healthcare organization headquartered in the northwest suburbs of Chicago, serving more than two million people. The Alexian Brothers Health System 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.Clinical InstitutesCancer InstituteThe Cancer Institute provides comprehensive oncology services across the entire Alexian Brothers Hospital Network. Accredited by the American College of Surgeons as a Comprehensive Community Hospital Program, our Cancer Institute boasts five-year survival rates that exceed the American Cancer Society's national statistics for breast, ovarian, lung and colon cancers. The comprehensive treatment care center at SAMC utilizes cutting-edge technologies, including 64-slice Computed Tomography (CT) Scan, and Breast Magnetic Resonance Imaging (MRI) as diagnostic tools. At SAMC, radiation therapy can be delivered through the following techniques: Cone Beam CT, Intensity Modulated Radiation Therapy, Image Guided Radiotherapy, Rapid Arc, Advanced High Dose Rate Brachytherapy and MammoSite Breast Therapy Treatment. SAMC is accredited by The American College of Surgeons Commission on Cancer as a Comprehensive Community Cancer Center. In addition, the National Accreditation Program for Breast Centers has accredited SAMC.Heart & Vascular Institute The Heart & Vascular Institute offers high-level cardiovascular care. Starting with a community-based screening program, our continuum of care includes a full-range of non-invasive testing for the rapid detection of heart and vascular disease. Services include diagnostic and interventional cardiology, electrocardiograms (EKG), echocardiography, stress tests, holter monitoring, angiograms angioplasty and stent placement, tilt table tests, cardio version and pacemaker insertion.Neurosciences Institute The Neurosciences Institute offers the latest medical advances and technology to help patients with neurological conditions. Our spectrum of care includes advanced diagnostic procedures, treatment strategies, and proven approaches to help patients achieve high quality of life. In addition, we are working to provide scientific insight into how to lower the risk of developing certain neurological diseases. Services include Acute Stroke Care Services, Epilepsy Center, Neurosurgery, Pediatric Neuropsychological Services and Stroke Prevention. SAMC is a Primary Stroke Center.ServicesDiagnostic Services Our diagnostic services include the latest technology and practices, which are accredited by nationally recognized agencies and association, such as The American Diabetes Association, American College of Radiology, The College of American Pathologists and The Joint Commission. Diagnostic services offered include:- Diagnostic imaging (general X-ray, CT, MRI, ultrasound, nuclear medicine)- Breast Care Services (screening and diagnostic mammography, breast biopsy ultrasound, stereotactic breast biopsy, bone densitometry, genetic counseling, MammaCare breast self examination instructions)- Cardiology (cardiac catheterization, electrophysiology, EKG, stress testing, elechocardiography, holter monitoring of arrhythmias)- Pulmonary Diagnostics (arterial blood gas analysis, pulse oximetry, bedside spirometry, peak flow monitoring, ventilator care)- Gastroenterology (gastroscopy, colonoscopy, bronchoscopy)- Laboratory/Pathology (chemistry, microbiology, hematology, histology, cytology, phlebotomy, transfusion services)Emergency ServicesEmergency medical care is provided 24/7 for all ages and types of patients, regardless of the ability to pay for such services. The Emergency Department is designated a Level II Trauma Center. In addition, a helipad allows for rapid transport of critical cases to a Level I facility. Our physicians voluntarily participate on the Emergency Department call roster. It is the belief of the medical staff that physicians who want to serve patients voluntarily will perform to a higher standard than those physicians mandated to do so. In addition, SAMC has established a program called "CN EmergiKids," wherein Board-Certified Pediatric Emergency physicians are available to treat pediatric patients in the Emergency Department. The specialized pediatric treatment area includes child-sized equipment, colorful decoration and toys to provide children with a comforting environment.ObstetricsSAMC's caring obstetrical team has the experience and expertise to address the needs of the families we serve. Our highly trained staff includes a multi-lingual group of board certified obstetricians and OB/GYNs who offer expert prenatal and post-delivery care, and lactation educators who are specialists in breastfeeding. As a state-designated Level III Neonatology Intensive Care Unit, SAMC offers 24-hour coverage by board certified neonatologists - a pediatrician with special training in the care of healthy newborns as well as those with special needs. The new Alexian Brothers Women & Children's Hospital will feature an expanded level three Neonatal Intensive Care Unit, Labor and Delivery and Mother Baby Units as well as 8 Pediatric Intensive Care Beds, 4 step down, 20 pediatric beds and 16 Neonatal Intensive Care Beds.Older AdultOur Older Adult Services are designed to provide an innovative, seamless continuum of care for older adults from wellness, to early detection of disease, through inpatient and post-acute care. Our overall goal is to optimize the quality of life, addressing the physical, emotional, social and spiritual needs of older adults. OrthopedicsRecognized as one of the leading centers for orthopedics in the Midwest, our Orthopedic Services enlists a comprehensive leading-edge approach to the prevention, assessment, treatment and rehabilitation of musculoskeletal injuries, including aching backs, arthritis pain, sports injuries, and work injuries. We offer treatment and services for Emergency Fractures, Foot and Ankle, Hand and Upper Extremity, Wrist, Shoulder and Elbow, Partial Joint Replacements with Alternative Options, Sports Medicine, Surgical Spine Procedures, Pediatric Care and Total Joint Replacement and Reconstruction. 115459620 180588661 Outpatient Services performed in 2011:7,416 outpatient surgeries129,212 Diagnostic images including general X-ray, CT, MRI, Mammography, Ultrasound, and Nuclear Medicine798,594 laboratory tests54,780 Emergency Room visitsThe complete description of Alexian Brothers Medical Center Outpatient Programs is included with the Inpatient Programs in line 4a. 283065163 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 373 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 IL X Deborah L Mau 8475902671 3040 West Salt Creek Lane Arlington Heights IL 600051069 X Calvin H Fischer DO 1.00 X X 23075 251096 28880 Kathleen Gilmer 1.00 X X 0 0 0 Lawrence Herforth 1.00 X X 0 0 0 Brother Daniel McCormick CFA 1.00 X X 0 0 0 Patricia Merryweather 1.00 X 0 0 0 James Mortimer 1.00 X 0 0 0 James Pawlikowski MD 1.00 X 20725 12088 0 Thomas Palmer 1.00 X 0 0 0 Arthur Nazarian MD 1.00 X 12575 4125 0 Brother Theodore Loucks CFA 1.00 X X 0 0 0 Edward Goldberg 40.00 X 0 628028 170831 James Sances 1.00 X 0 642540 143947 Virginia Golembiewski 1.00 X 0 69801 16144 Robin Chopp 40.00 X 0 332750 47626 Jim Lewandowski 1.00 X 0 372210 66995 Linda Baker 20.00 X 0 204857 61442 Konstantinikov Denev 40.00 X 0 297119 21000 Robert Arensman 40.00 X 0 503735 24314 Robert Maganini 40.00 X 0 396491 16689 Scott Neeley 40.00 X 0 431634 20259 Erik Iversen 40.00 X 0 290525 21019 Patrice Marks 1.00 X 0 136004 30367 Christine Budzinsky 1.00 X 0 280057 67572 Linda Gump 1.00 X 0 231993 390392 56375 5085053 1127477 0 1 1 0 Sodexho Inc & Affiliates 9801 Washington Blvd Suite 7174 Gaithersburg MD 208780000 Dietary Services 2832108 Medical Staffing Network 3139 Paysphere Circle Chicago IL 606740000 Staffing Services 1421466 HLS Wheeling 45 W Hintz Wheeling IL 600900000 Linen and Laundry services 917148 Xanitos PO Box 95000-3290 Philadelphia PA 191950000 Enviromental Services 722278 Executive Health Resources 15 Campus Boulevard Newton Square PA 190730000 Consulting Services 626285 24 General Hospital Svcs 622110 206867269 206867269 Medicare & Medicaid 622110 120776884 120776884 Capitation 900099 1040162 1040162 Laboratory Services 621500 980596 980596 Restr. Funds Utilized 900099 195007 195007 1355072 1355072 331214990 168638 168638 2079728 1144053 935675 935675 935675 332319303 330234394 980596 1104313 56375 56375 105188218 97315996 7872222 3904340 3610207 294133 11537197 10668043 869154 7324262 6772489 551773 369187 369187 62537 62537 27590538 25805851 1784687 113892 75888 38004 8994762 4481041 4513721 13511 12160 1351 13410942 12069848 1341094 496297 459412 36885 191852 126096 65756 7371814 6634633 737181 11598747 10438872 1159875 8660489 7794440 866049 Medical Supplies 44718883 44718883 0 0 ABHS/ABHN Managm't Fee 34696589 25192842 9503747 0 Bad Debt Expense 16239784 16239784 0 0 Medicaid Tax 8747464 8747464 0 0 1914692 1901214 13478 313202372 283065163 30137209 0 15140975 28208956 31883614 40046643 1492390 797856 4374049 4013144 719700 778830 315920125 140850828 153074985 175069297 22000000 25000000 9730662 10376240 238416375 284290966 20170376 16073232 59932690 75081852 80103066 91155084 X 157973575 192473359 339734 662522 0 158313310 193135882 238416375 284290966 X 19116931 15705641 X 0 1 1 X 0 X 11000000 11000000 96306896 29949172 66357724 12792672 3963073 8829599 101544492 83046456 18498036 94276065 23892127 70383938 175069297 Beneficial Interest in Alexian Brothers Health System, Inc. Investment Trust 25000000 F 25000000 Due to Third Party Payors 32861882 Due to Affiliates 32296943 Reserve for Outstanding Insurance Losses 9768142 Other Current Liabilities 154885 75081852 Description of Uncertain Tax Positions Under FIN 48: Part X: St. Alexius does not file a separate audit report, but is part of the Alexian Brothers Health System consolidated audit report. There were no uncertain tax positions, and as a result there was no disclosure related to FIN 48 (ASC740) in the December 31, 2011 audit report. 1 1 1 X 1 X 600.000000000000 1 1 1 0 1 1 4266 9142038 9142038 0.03080 48492 56940379 48567626 8372753 0.02820 52758 66082417 48567626 17514791 0.05900 8 14068 369861 550 369311 0.00120 5 1503 844441 500 843941 0.00280 2 553 1265201 1265201 0.00430 2 250 516 516 0.00000 17 16374 2480019 1050 2478969 0.00830 17 69132 68562436 48568676 19993760 0.06730 1 430 6251 6251 0.00000 1 70 5349 5349 0.00000 3 36729 19473 19473 0.00010 1 500 703 703 0.00000 6 37729 31776 31776 0.00010 0 3448000 2520000 87677218 101753955 -14076737 X 1 1 1 Hoffman Estates Surgery Center LLC Ancilliary Surgery Center 0.40000 0.00000 0.60000 1 1 St Alexius Medical Center

1555 Barrington Road Hoffman Estates IL 60169

X X X St Alexius Medical Center 1 1 1 200.000000000000 1 600.000000000000 1 X X X X X X 1 1 X X X 1 0 1 X 0 0 2 St Alexius Outpatient Center

347 W Golf Road Schaumburg IL 60195

Diagnostic imaging services and Physical Therapy Rehabilitation Services St Alexius Breast Care Center Bartlett

864 W Stearns Bartlett IL 60103

Mammography and Dexa bone scan imaging services Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 16239784. Part I, Line 3c: Every uninsured person, regardless of income receives an automatic 15% discount off of charges. Persons who earn less than 600% of federal poverty guidelines are given more significant discounts, depending on their individual situations.Federal Poverty Level - Patient Discount Uninsured:0-200% 100%201-300% 75%301-400% 67.5%401-500% 67.5%501-600% 67.5%>600% 15%Part I, Line 6a: Alexian Brothers Hospital Network ("ABHN") prepares and files the Annual Non-Profit Hospital Community Benefit Plan Report with the Attorney General's Office of the State of Illinois. This report is prepared on a consolidated basis and includes data for Alexian Brothers Medical Center ("ABMC"), St. Alexius Medical Center ("St. Alexius") and Alexian Brothers Behavioral Health Hospital ("ABBHH").Part I, Line 7 - The following costing methodologies were used:- Charity at cost - a cost to charge methodology based on the filed Medicare cost report was used to calculate costs.- Unreimbursed Medicaid - costs are calculated using the 2011 filed Medicaid cost report.- Other benefits - costs are determined by activity reported in accordance with guidelines published by the Catholic Health Association; costs could include the value of hourly wages, costs of materials, value of space loaned to community groups for meetings, and indirect costs where applicable.Part I, Line 7g: St. Alexius has not included costs attributable to a physician clinic as part of subsidized health services.Part II: In 2011, St. Alexius concentrated most of its resources in other areas of community benefit that were not "community building" as described by the Catholic Health Association.Part III, Line 4: At the ABHN hospitals, including St. Alexius, management manually reviews all self-pay accounts greater than $5,000 (where the patient has chosen not to cooperate with our charity process) prior to placing the accounts for bad debt. Through this process, we examine credit data and then proactively grant an average of 80% charity to these accounts prior to placing the accounts in bad debt. Approximately $9,264,745 of accounts with balances less than $5,000 are placed annually into bad debt without going through this labor intensive process. We believe the larger accounts represent an adequate sample population which could be extrapolated to the $9.3 million. Therefore, we assume that 80% or $7,411,796 at charges ($2,520,011 at cost) of our bad debt likely would meet the criteria of our charity program if we allocated the resources to manually review the accounts prior to bad debt placement.Discounts and payments are not included in bad debt expense in the financial statements for St. Alexius unless the payment is a recovery of amounts previously written off as bad debt. Recoveries are classified as a decrease to bad debt expense.St. Alexius is part of the Alexian Brothers Health System (ABHS) consolidated audit. There is no footnote specific to bad debt expense in the audit. St. Alexius' share of bad debt expense for ABHS in 2011 was $16,239,784 at charges ($3,448,000 at cost). Cost is determined in the same manner as charity at cost.Part III, Line 8: Medicare costs are allocated by cost center in accordance with Medicare regulations.The question of whether or not Medicare reimbursement below cost should be treated as a community benefit has been debated for a number of years, pre and post healthcare reform. Some argue that most hospitals find it very difficult to achieve the required level of efficiency in a labor intensive service to provide for a positive margin. Others claim that positive margin or not, Medicare is essential to the overall financial health of hospitals due to the necessary volumes it supplies for a positive return, and therefore benefits the hospital as much as the community. Our view of the future status of Medicare is that regardless of reimbursement, St. Alexius, as part of ABHN, will serve this part of our community with the same compassion and responsiveness to need as we always have done. In our opinion, a systematic degradation of reimbursement that is already less than the cost of providing the service for the vast majority of hospitals is an expectation on the part of the federal government to provide a substantial community benefit to a population that is growing and requiring more resources. It is for these reasons that we believe that the cost over reimbursement of Medicare should be considered community benefit. Part III, Line 9b: It is the policy of ABHN, including St. Alexius, to offer patients a payment plan and/or charity assistance when it becomes known or even suspected that a patient needs financial assistance. Financial counselors are notified and every attempt is made to contact and work with the patient or their family to help them complete an application with compassion and dignity. Financial counselors work with patients to help determine if there are any third party payers which may be available to help the patient meet their obligations. We work with the patient to determine if they are eligible for federal programs including Medicaid, state funded programs including crime victims, alternative insurance including COBRA, Worker's Compensation and/or other specialized grant programs such as our mammography grant program for low income women. In the event no third party programs are identified, we then work with the patient to help them apply for charity discounts and payment plans. At St. Alexius, three full-time financial counselors each work with approximately 7,500 patients per year. In addition, all bills and statements include information regarding charity. St. Alexius Medical Center Part V, Section B, Line 13g: All bills and statements include information regarding charity. The front of our statements includes this message: "If you are an uninsured Illinois resident and meet certain income requirements, you may qualify for a discount through our Alexian Assistance program in accordance with the Hospital Uninsured Patient Discount Act (effective April 1, 2009). For additional information, please contact us at 866-690-3370 or AlexianAssistance@alexian.net".The back of our statement includes this message: "If paying this bill presents a financial hardship, you may be eligible for financial assistance. Alexian Brothers Hospital Network provides assistance to patients in need of financial aid to help pay for their hospital bills. You may obtain an application by calling our staff at the number below or you may download the forms from the internet at www.alexianbrotherhealth.org."In addition, all uninsured patients receive a letter from our Patient Financial services once we complete a process of attempting to identify alternative coverage for uninsured patients. This letter is sent at the beginning of our statement cycle for each uninsured patient. The text of the letter is:"Thank you for choosing St. Alexius Medical Center as your healthcare provider. Your account currently has a balance of $xx; additional charges may be pending.We have no record that you have health insurance to help in paying your bill. If you have insurance, please provide the necessary information by filling out the stub above and faxing a copy of your insurance card to 847-483-7058, Attn: Correspondence Team.If you had insurance that ended within the last 60 days, you may be eligible for COBRA coverage from a former employer. Please contact your former employer to determine if you are eligible.Our staff accepts payment by major credit card over the phone, cash payments through a registrar at the hospital, or payment by check or credit card using the payment coupon above.If you are unable to pay the total amount at this time, please call us. We are happy to accept a reasonable monthly payment plan to resolve your balance. Our payment plans carry no interest charges or pre-payment penalties.If paying this bill presents a financial hardship, you may be eligible for financial assistance. Alexian Brothers Hospital Network provides assistance to patients in need of financial aid to help pay their hospital bills. You may obtain an application by calling our staff at the number below or you may download the forms from the internet at www.alexianbrothershealth.org." St. Alexius Medical Center Part V, Section B, Line 19d: St. Alexius Medical Center uses the State of Illinois, Hospital Uninsured Patient Discount Act guidelines which specify that eligible patients should be charged 135% of hospital costs which for SAMC approximates 32% of charges. Part V, Section A: In Part V of Schedule H, St. Alexius reports that it has one licensed hospital (an acute care medical/surgical hospital) and one emergency room. Part VI, Line 2: Part VI, Line 3: Part VI, Line 4: Part VI, Line 5: Part VI, Line 6: Part VI, Line 2: As part of ABHN, St. Alexius has been performing Community Health Assessments for our primary and secondary service areas since 2002. The first document was produced internally and contained secondary data only (data collected by local, state and federal agencies). The following two Community Health Assessments for the years 2006 and 2009 have been performed by an outside research firm in order to capture secondary and primary data (original date compiled in this case via telephone survey).In identifying priorities for community action and designing strategies for implementation, a variety of criteria are applied to the consideration process, including:Impact - The degree to which the issue affects or excerbates other quality of life and health-related issues. Example, poor nutrition leads to overweight and Type II diabetes.Magnitude - The number of persons affected, also taking into account variance from benchmark data. Example, number of adults diagnosed with asthma in our region still below national benchmarks, but much higher compared to our own benchmarks.Seriousness - The degree to which the problem leads to death, disability or impairs one's life.Feasibility - The ability of organizations to reasonably impact the issue, given available resources.Consequences of Inaction - The risk of exacerbating the problem by not addressing it at the earliest opportunity.The 2009 Community Health Assessment surveyed fifty-six zip codes representing a total population of more than 1,800,000 persons. Primary research was conducted by telephone survey of 1,000 households. This is a very robust sample size and the sample was stratified and weighted to assure that the maximum rate of error was +/-3% at the 95% confidence level. Secondary data was gathered from the Census Update, Claritas population projections, the National Center for Health Statistics, Illinois Department of Public Health, Department of Health and Human Services and County Health Departments.St. Alexius has a long tradition of providing continuing education to those healthcare professionals in the community with whom we collaborate to provide the highest quality, most seamless healthcare possible. One such example is the training of Emergency Medical Service personnel, or EMS providers. Heart attack and stroke are the number 1 and number 3 respectively most common causes of death in the St. Alexius service area (2009 Community Health Analysis, Alexian Brothers Hospital Network). The chance of surviving a heart attack or stroke can be markedly increased if EMS providers are trained in the identification, early treatment and field communication with hospital personnel. St. Alexius hosts two distinct programs dedicated to the training and continuing education of first responders. The first program is as host of a clinical site for Basic Emergency Medical Technicians (EMT-Bs) and for Emergency Medical Technician-Paramedics (EMT-Paramedics). EMT-Bs are required to perform 16 hours of clinical training in a hospital setting during a 10 week period. Typically, there are 40 to 60 students in each group. The EMT-Bs are individually paired with a nursing assistant preceptor for every hour of training. The EMTs are taught basic clinical assessments, learning to take vital signs, administering oxygen, wound care and other skills that are performed by basic first responders. In 2011, St. Alexius rotated 140 EMTs through their clinical training at approximately 8 hours per student. EMT-Paramedics have a separate education track at a higher clinical level than the EMT-Bs. The Paramedics are precepted by Registered Nurses or Physicians as required. The Paramedics are taught advanced, life saving clinical skills such as intubation, emergency obstetrics, cardiac defibrillation, and similar education for pediatric patients via St. Alexius's pediatric emergency room physicians. Overall, St. Alexius provided 187 students with 3,783 hours of education at no cost to the community or the students. The second program provided by St. Alexius is continuing education for Emergency Medical personnel at their physical site. Every month dedicated Registered Nurses from St. Alexius provide 18 classes or 45 hours of continuing education at four fire stations in our community. These nurses work with the regional emergency services coordinator to teach, train and test every first responder on a continual basis so that every person in our community has the best possible chance at surviving a medical emergency. This program is also provided at no charge to the municipalities or the participants. In fact, St. Alexius donates the cost of the administration of the tests (paid to the regional coordinating hospital) for 6 classes per month. In total, the Registered Nurses provided 165 classes or 412 hours of continuing education for the benefit of the community in 2011. In addition to the in-hospital support, there is also Advisory Board membership.- Two St. Alexius administrators are on the Harper College School of Nursing Advisory Board.- A St. Alexius administrator chairs the Elgin Community College School of Nursing Advisory Board.Since 2002, the National Breast Cancer Foundation has provided funding to St. Alexius for the purpose of providing mammogram screenings to under-insured and uninsured women who could not otherwise afford the service. In 2011, over 887 screenings and referrals as necessary were provided, resulting in community benefit of about $123,000. St. Alexius organized a group of providers in four counties that would accept referrals for further treatment as necessary at no cost. This program has grown each year with both new and repeat patients availing themselves of this important early detection screening.The number of uninsured persons in our community has risen to almost 14%, up from 9.3% in 2006. Lack of access to preventive screenings can lead to late diagnosis of serious disease such as colon cancer. St. Alexius Medical Center collaborated with Hanover Township and staff physicians to offer free colonoscopies for uninsured persons at high risk for the disease including those over 60, of African American descent or those with a family history. Hanover Township served as the referral source for all patients seen. St. Alexius provided the facilities while two gastroenterologists, an anesthesiologist, a nurse anesthetist and several staff associates all volunteered their time. Most patients were cancer free, but one man had a cancerous lesion which was asymptomatic and removed. Part VI, Line 3: St. Alexius uses multiple methods of communicating its mission of providing care to all who need it regardless of ability to pay. Signs posted at registration clearly point out that charity care or financial assistance is available. ABHS's website, the main website for all System hospitals, including St. Alexius, features information on how to apply for charity care on-line. In the hospital setting, we employ three financial counselors who are available to work with patients and we also have Medicaid application specialists to assist patients that may qualify. A Community Outreach Director is employed by ABHN to serve patients who need help understanding and accessing community health services. This individual works with patients at St. Alexius and the other ABHN hospitals. In addition, all bills and statements include information regarding charity.Part VI, Line 4: St. Alexius, a member hospital of the ABHN, serves Chicago's northwest suburbs spanning the counties of McHenry, Lake, Kane, DuPage and Cook. With more than 1.8 million residents overall, the primary service area alone is comprised of nearly 20 communities with a diverse demographic and ethnic base.The zip codes/communities served include:Primary Service Area Center:60007 Elk Grove Village 60010 Barrington60018 Des Plaines 60056 Mount Prospect60067 Palatine 60101 Addison60103 Bartlett 60106 Bensenville60107 Streamwood 60108 Bloomingdale60110 Carpentersville 60120 Elgin60133 Hanover Park 60139 Glendale Heights60143 Itasca 60169 Hoffman Estates60172 Roselle 60173 Schaumburg60191 Wood Dale 60192 Hoffman Estates60193 Schaumburg 60194 Schaumburg60195 Schaumburg 60004 Arlington Heights60005 Arlington Heights 60008 Rolling Meadows60013 Cary 60014 Crystal Lake60016 Des Plaines 60047 Lake Zurich60050 McHenry 60073 Round Lake60074 Palatine 60089 Buffalo Grove60090 Wheeling 60098 Woodstock60102 Algonquin 60118 Dundee 60123 Elgin 60124 Elgin60126 Elmhurst 60136 Gilberts60137 Glen Ellyn 60140 Hampshire60142 Huntley 60148 LombardSecondary Service Area:60156 Lake in the Hills 60157 Medinah60175 St. Charles 60177 South Elgin60181 Villa Park 60185 West Chicago60187 Wheaton 60188 Carol Stream60634 Chicago 60707 Elmwood ParkThe primary not-for-profit community hospitals that also serve this area include: Northwest Community Hospital, Sherman Hospital, Provena Saint Joseph Hospital, Central DuPage Hospital, Elmhurst Memorial Hospital, Advocate Good Shepherd Hospital and Advocate Lutheran General Hospital. ABHN has referral arrangements with academic medical centers including: Children's Memorial Hospital, Loyola University Medical Center, University of Chicago Medical Center and Rush University Medical Center.St. Alexius' racial/ethnic distribution for 2008 (Claritas) within its service area is as follows:Race Population PercentageWhite 1,300,192 69.2%Hispanic 337,866 18.0%Asian 155,757 8.3%Black 53,787 2.9%Two Plus 26,776 1.4%Indian 2,298 0.1%Other 1,653 0.1%Pacific Is 568 0.0% Total: 1,878,897 100.0%The median age for 2008 was 37.1 years.Overall median age: 37.1Median Age Male: 36.0Median Age Female: 38.2The average annual household income for 2008 was $74,160.The communities ABHN serves enjoy a relatively positive health status. In comparison to the whole of Illinois and the nation, incidence of heart disease, stroke, cancers and most other diseases are favorable. However, access to care, insurance status and other health indicators are trending negatively. For example, ABHN's 2009 Community Health Assessment Survey found that one in every ten community residents is having difficulty getting an appointment to see a doctor for primary care. Summary highlights from the survey included the following additional points of concern/interest.Access to Care- Among respondents 18 to 64, 13.6% have no health insurance. This is a sharp rise from 2002 at 7.3% and 9.3% in 2006.- A total of 11.9% of adults in the service area said that cost prevented them from seeing a physician, a steep increase from 5.8% in 2002.The northwest suburban area is home to the corporate headquarters for AT&T, Motorola and Sears, and has a significant manufacturing and industrial base. It is thought that due to the recent economic recession, a significant number of community residents may have lost their jobs and subsequently their insurance coverage thereby worsening the trend. 8.1% of community residents are currently reporting being (one or more years) out of work. As mentioned previously, ABHN provides assistance to patients to help patients take advantage of the various benefits and services available through ABHN. As access to health insurance expands because of new legislation, we will help to support and guide patients as appropriate.Part VI, Line 5: St. Alexius's governing body is the Quality Council. The Quality Council reports up through the Alexian Brothers Health System Board of Governors. The majority of the Quality Council members live and work in the community and serve to support the mission and values of the Alexian Brothers. St. Alexius extends medical staff privileges to all qualified physicians in our community and endeavors to provide them with the safest and most technologically advanced environment possible through the effective use of surplus funds. As necessary, St. Alexius recruits medical specialists and subspecialists who provide the expertise for emerging technologies that advance patient care.St. Alexius strives to fully serve the community through participation in government sponsored healthcare programs such as Medicare, Medicaid, CHAMPUS, and Tricare. Community members also use St. Alexius as a conduit for volunteering as evidenced by almost 700 volunteers (comprising almost 60,000 hours of service) who assist with patient services, administration and the gift shop.Part VI, Line 6: St. Alexius is an affiliate of Alexian Brothers Health System ("ABHS"). ABHS is the national member and ultimate parent of St. Alexius. ABHS, with its corporate offices located in Arlington Heights, Illinois, is sponsored by Alexian Brothers of America, Inc., a Roman Catholic religious order of men committed to caring for the sick, the aged, the poor and the dying for more than seven centuries. The basic Judeo-Christian beliefs that inspired the founders of this worldwide Catholic religious congregation sustain its ministry today; to promote the physical, mental, spiritual and social well-being of individuals of all creeds, races, nationalities and socioeconomic levels served through this health care ministry.ABHS carries out its exempt purposes by coordinating and managing the activities of the regional corporations for which it is the National Member. Through these regional corporations, ABHS provides healthcare and other services to communities in suburban Chicago, Illinois; St. Louis, Missouri; Milwaukee, Wisconsin; and Signal Mountain and Chattanooga, Tennessee. As a charitable organization, it is recognized that not all individuals possess the ability to purchase essential medical services and further that our mission is to serve the community with respect to providing healthcare services and healthcare education. Therefore, in keeping with ABHS' commitment to serve all members of its communities, free care and/or subsidized care, care to persons covered by government programs at or below cost, and health activities and programs to support the community are considered and provided when appropriate. These activities include wellness programs, community education programs, special programs for the elderly and medically underserved, and a variety of broad community support activities including but not limited to educational affiliations, health screenings, counseling programs, continuing medical education (CME) programs and donations to community groups.For example, ABHN owns and operates a community mental health center that serves primarily lower income, uninsured or underinsured or Medicaid recipients. This facility treats the chronically mentally ill with counseling, medication and social support. The center is supported through state grants, philanthropy and is subsidized by ABHN. Because of the uptick in depression, we have experienced more demand for services combined with less support from the state which has strained our resources. However, ABHN remains committed to this program and the members of the community that it serves.Another program offered to the community through ABHN is Alexian Brothers Parish Services (ABPS, formerly Interfaith Parish Support Services/IPSS). ABPS was created in response to the faith community's requests for services to support the mental health needs of their parishes, to serve as a bridge between faith communities and our healthcare ministry. ABPS has active partnerships with 70 faith communities. Clinical professionals from ABPS provide consultation around mental health concerns, support group facilitation or consultation, speakers for women's or men's ministries, retreats, labyrinth walks, suicide prevention, pro-social (anti-bullying) programming, staff trainings and congregational health ministry development provided by a Faith Community Nurse. The following are two specific examples of the partnerships ABPS has with parishes:- School Social Worker and Counselor: ABPS partners with parochial schools to provide direct support services to the students, not usually available in a private school setting. There are two programs: school social worker/counselor to assist students with their academic, social, emotional or faith development, and resource teacher to provide special educational support. Students in parochial schools do not have access to supportive services from a public school due to cut backs and financial restraints school districts are facing. In 2011, ABPS had partnerships with 18 different Catholic Schools, poviding 31 days of social work services and 5 days of resource teacher services; collectively serving 7,600 students. During the school year preventative programs are provided on various topics: pro-social skills (anti-bullying), conflict resolution, resilience training, empathy, friendship skills, mental health awareness, drug abuse prevention, personal responsibility, and leadership development. - Interfaith Counseling Services: ABPS partners with 10 local faith communities to provide spiritually integrated therapy, the parish provides the space (at no charge) and ABPS provides the clinical professional to provide services out in the community. In 2011, over 2,300 hours of therapy have been offered in four languages: English, Polish, Spanish, and Tagalog. Services are offered for a fee and a sliding fee scale may be available based upon financial need.SAMC subsidized ABPS at $364,000 in 2011. This allowance allows ABPS to continue to grow its ministry and serve the community in more locations. By supporting local communities through spiritually integrated therapy, school outreach, and parish support, ABPS seeks to bring healing and hope to individuals and families with their needs, whether physical, mental or spiritual.One of our most valuable community services is performed by the Alexian Brothers Behavioral Health Hospital. Twenty-four hours a day, seven days per week, a crisis intervention service is available to anyone in the community either by phone or in person. Master's prepared clinicians provide, on average, a 35 minute screening conisting of a brief social history and a current functionality determination. The outcome is behavioral health treatment recommendations as well as referrals as needed. This program provided over 16,000 screenings in 2011 and is considered invaluable by regional mental health professionals and first responders.Net community benefits expense for ABHS in 2011 is as follows:Charity Care at Cost - $17,759,062Language Assistant Services - $707,502Excess of Government Sponsored Health Care Cost Over Reimbursement - Medicaid - $27,733,877Donations - $190,093Education - $2,384,921Government Sponsored Program Services - $0Subsidized Health Services - $1,669,456Other Community Benefit Programs - $3,887,754Total Charity Care and Community Benefits - $54,332,665Information has been included for all exempt entities in ABHS. The information for the hospitals included has been calculated on a basis consistent with the requirement for the Illinois Attorney General Community Benefit report.In addition, ABHS reported bad debt expense (at cost) of $10,169,004 in 2011 and excess of Medicare costs over reimbursement of $58,208,836 in 2011.Certain affiliated entities within ABHS and the services they provide, are described below:Alexian Brothers Medical Center - An acute care hospital located in Elk Grove Village, Illinois that provides inpatient, outpatient and emergency services, including specialties in the areas of cardiology, neurosciences/stroke, orthopedics, oncology, bariatrics, hospice and home health services.Alexian Brothers Behavioral Health Hospital - A behavioral health hospital located in Hoffman Estates, Illinois that provides inpatient and outpatient psychiatric services, including specialties in chemical dependency, eating disorders and self-injury programs.Alexian Brothers Center for Mental Health - Provides community mental health services in northwest suburban Chicago, including vocational training programs, transitional living programs, partial hospital programs and nursing home programs.Alexian Brothers Bonaventure House - Provides supportive services and transitional housing for persons that are HIV positive and in active addiction recovery.Alexian Brothers Hospital Network - The area member for Illinois hospitals and related entities, ABHN provides community education classes, health screenings and counseling and other services on a sliding fee scale to surrounding communities and performs research activities geared towards improving the health of those we serve.Alexian Brothers Ambulatory Group - Provides a multitude of ambulatory services to suburban Chicago, including primary care physician services; pediatric physician services; older adult physician services; other specialty physician services; occupational health services; and immediate care services; also provides wellness services through its various locations and practices.Alexian Brothers Specialty Group - Provides cardiology services through employment of cardiologists to suburban Chicago residents.Alexian Village of Milwaukee, Inc. - A continuing care retirement community located in Milwaukee, Wisconsin; provides all levels of care to residents and community members, including skilled nursing care, adult day care services, assisted living and care for those with Alzheimer's disease and dementia.Alexian Village of Tennessee - A continuing care retirement community located in Signal Mountain, Tennessee; provides all levels of care to residents and community members, including skilled nursing care, assisted living and care for those with Alzheimer's disease and dementia.Alexian Brothers Lansdowne Village and Alexian Brothers Sherbrooke Village - Skilled nursing facilities located in St. Louis, Missouri; provides nursing care, assisted living and care for those with Alzheimer's disease and dementia, rehabilitation services and transitional care services (Lansdowne only).Alexian Brothers Community Services - Programs for All Inclusive Care for the Elderly (PACE) located in St. Louis, Missouri and Chattanooga, Tennessee; provides care for frail, elderly, Medicaid eligible individuals; provides primary care, daily activities and transportation services; also coordinates care when hospitalization or placement in a skilled nursing facility is required.Alexian Brothers Senior Neighbors - Provides community based services to seniors in Chattanooga, Tennessee.Alexian Brothers Services, Inc. - Housing and Urban Development (HUD) housing project in St. Louis, Missouri. Part VI, Line 7: Alexian Brothers Hospital Network ("ABHN") prepares and files the Annual Non-Profit Hospital Community Benefit Plan Report with the Attorney General's Office of the State of Illinois. This report is prepared on a consolidated basis and includes data for Alexian Brothers Medical Center ("ABMC"), St. Alexius Medical Center ("St. Alexius") and Alexian Brothers Behavioral Health Hospital ("ABBHH"). 0 1 0 0 0 0 0 0 0 Calvin H Fischer DO 23075 251096 0 0 0 0 0 7926 0 20953 23075 279975 0 0 Edward Goldberg 0 461729 0 112010 0 54289 0 107200 0 63631 0 798859 0 21449 James Sances 0 477155 0 136544 0 28841 0 115746 0 28202 0 786488 0 28841 Robin Chopp 0 262925 0 43606 0 26219 0 29082 0 18544 0 380376 0 9719 Jim Lewandowski 0 280338 0 56701 0 35171 0 35309 0 31686 0 439205 0 12354 Linda Baker 0 164954 0 28241 0 11662 0 28417 0 33025 0 266299 0 5811 Konstantinikov Denev 0 297119 0 0 0 0 0 7264 0 13736 0 318119 0 0 Robert Arensman 0 503735 0 0 0 0 0 10006 0 14308 0 528049 0 0 Robert Maganini 0 396491 0 0 0 0 0 9818 0 6871 0 413180 0 0 Scott Neeley 0 431634 0 0 0 0 0 0 0 20259 0 451893 0 0 Erik Iversen 0 290525 0 0 0 0 0 4900 0 16119 0 311544 0 0 Patrice Marks 0 118969 0 14642 0 2393 0 14134 0 16234 0 166372 0 0 Christine Budzinsky 0 227438 0 34555 0 18064 0 41615 0 25957 0 347629 0 14206 Linda Gump 0 188062 0 30561 0 13370 0 361700 0 28692 0 622385 0 13370 Supplemental Information Part III Part I, Line 3: St. Alexius follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee. All of the items in Schedule J, Part I, Line 3 are used by the Committee to establish compensation for the CEO of the organization. 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 amount accrued in 2011 was included in income in Schedule J for the following individuals: James Sances - $52,060 Edward Goldberg - $55,673 Robin Chopp - $5,201 Christine Budzinsky - $3,047 Jim Lewandowski - $5,297 Program Service Statement Form 990, Part III, Line 4a, Program Service Accomplishments (cont'd): Pediatrics Our pediatric services offer care by physicians, nurses and staff who have expertise in pediatric medical care. Our staff of pediatricians includes more than 60 sub-specialists covering a wide range of medicine, including many who are board certified and fellowship trained in their specialties. Child Life Specialists are available to help children and their families adjust to the hospital setting. The Pediatric Intensive Care Unit (PICU) is ready and equipped for critical situations. Hospital Intensivists, who are board certified pediatricians with additional training in the care of severely ill children, work with each child's pediatrician or family practitioner to provide care for the patient while in the PICU. Special Outpatient Services - Cancer Program: Diagnostics, chemotherapy & surgery - Community Outreach: Health education classes/programs & health screenings - Diabetes Program: Treatment and education - Outpatient Rehabilitation - Hospice Services - Sleep Lab - Asthma Education Program - Procedure Clinic: For patients undergoing procedures requiring a short hospital stay (no more than 12 hours). Procedures include blood transfusions, arteriogram, outpatient chemotherapy, antibiotic therapy and pain management. - Rehabilitation: Physical, Occupational & Speech Therapy - Physician Referral - Volunteer Program - Golden Circle: Lifestyle & social issues for adults age 50 and over Surgical Services Surgical procedures are performed in our state-of-the-art facility. We offer a wide-range of procedures in orthopedic, gynecology, urology, general surgery, podiatry, ear, nose and throat, pain management, neurosurgery, cosmetic surgery, oral/maxillofacial, and ophthalmology. Weight Management Alexian Brothers Advanced Loss Weight Solutions offer expert medical treatment, behavioral support and surgical interventions for weight loss such as Lap Band, sleeve gastrectomy, "Optifast" and gastric bypass surgery. The American Society for Bariatric Surgery (ASBS), the largest society for this specialty, named the SAMC Bariatric surgery program a nationally designated "Center of Excellence." The Blue Cross Blue Shield Association has also identified SAMC as a Designated Center for Bariatric Surgery. Form 990, Part VI, Section A, line 6 There are 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 7a Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of St. Alexius. Form 990, Part VI, Section A, line 7b Alexian Brothers Health System has principal authority with respect to the following matters: - Adoption or amendment of the Articles of Incorporation; - Amendment of the Bylaws as provided by Statute; - Appointment and removal of Directors and Executive Officers; - Adoption, amendment and repeal of fundamental statements of mission, philosophy, spirit, vision, values, and charity policy, and the sponsorship of apostolic activities; - Any plan of merger, consolidation, dissolutions, sale or lease of all or substantially all of the assets of St. Alexius; - The annual capital and operating budget and the Strategic Plan of St. Alexius; - Other certain reserved powers which Alexian Brothers Health System may designate. Form 990, Part VI, Section B, line 11 St. Alexius Medical Center ("St. Alexius") is an affiliate of Alexian Brothers Health System ("ABHS" or "the System"), which is a Catholic health system. ABHS is the National Member and ultimate parent for each entity within the System. St. Alexius's Form 990 goes through an intensive review process at the System's Corporate level prior to being filed with the IRS. The entire Form 990 is reviewed by St. Alexius's financial officer. The Form 990 is also reviewed at the System Corporate level by the Chief Accounting Officer for the System. The Vice President and General Counsel for the System reviews all sections of the Form 990 with the exception of the compensation section. The Vice President of Human Resources for ABHS reviews all compensation disclosures for each entity in ABHS. These reviews are conducted before the Form 990 is signed and filed with the IRS. In addition, there is also a Compensation Committee that reports to the ABHS Board of Governors. This Committee reviews the Compensation disclosures for all entities in the System. St. Alexius's board reports to the ABHS Board of Governors, which has ultimate oversight of the activities of all entities within the System. The Audit Committee of ABHS Board of Governors has responsibility for and oversight of the Tax Compliance process. The Audit Committee provides oversight for the Form 990 process for the entire System and reviews detailed Forms 990 for the System as requested. It then reports back to the ABHS Board of Governors on the results of these activities. The Forms 990 not reviewed by the Audit Committee are available to the Audit Committee members upon request. The Audit Committee did review the 2011 Form 990 for St. Alexius. Form 990, Part VI, Section B, line 12c St. Alexius Medical Center collects annual attestations from board members, officers, directors and key employees. The attestations are reviewed by the St. Alexius compliance officer and any noted conflicts are shared with the St. Alexius Chief Executive Officer. The conflicts are also reviewed by the System's Vice President, Corporate Responsibility Officer. The Audit Committee of the ABHS Board of Governors monitors and receives reports on the completion of this process. Form 990, Part VI, Section B, line 15 St. Alexius follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee. Form 990, Part VI, Section C, line 19 St. Alexius's financial statements are available through the office of the Illinois Attorney General. Conflicts of Interest and St. Alexius's governing documents are not made available to the public. Form 990, Part VII: Average hours devoted to related organizations when related compensation is reported: -James Sances worked 40 hours per week for Alexian Brothers Health System; -James Lewandowski worked 40 hours per week for Alexian Brothers Health System; -Virginia Golembiewski worked 40 hours per week for Alexian Brothers Health System; -Calvin H. Fischer worked 40 hours per week for Alexian Brothers Ambulatory Group; -Linda Baker worked 20 hours per week for Alexian Brothers Medical Center; -All others listed in Part VII devoted 100% of their time to St. Alexius. Form 990, Part VII, Column E: Description of reasonable effort made to obtain compensation from related organization: Payroll records are kept that identify which officers/key employees are paid by a related entity. These documents also show the organization being charged for the officer's/key employee's services. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Equity Transfers-Alexian Brothers Health System: 14,966,150. Contributions to Restricted Funds 938,000. Restricted Funds Released to Operations -198,509. Total to Form 990, Part XI, Line 5: 15,705,641. Part VIII, Line 3; Shedule D, Part VII The amount reflected as dividends and interest reflects St. Alexius's share of interest, dividends and realized gains/losses from St. Alexius'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 ABHS and acts as an internal mutual fund. Details of gains and losses are shown on the Form 990 of ABHSIT. Alexian Brothers of America Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 362606768 Religious order of Roman Catholic men TX 501(c)(3) Line 1 N/A 0 Brothers of St Alexius Health and Welfare Fund Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 362976617 Provides for health & welfare payments for religious sponsor TX 501(c)(3) Line 1 Alexian Brothers of America Inc 1 Alexian Brothers Bonaventure House 825 Wellington Ave Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 60005 363260495 Supports the provision of healthcare services for related corporations for w IL 501(c)(3) Line 11c, III-FI Alexian Brothers of America Inc 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 501(c)(3) Line 11c, III-FI Alexian Brothers Health System 1 Alexian Brothers of America Investment Trust 3040 W Salt Creek Lane Arlington Heights IL 60005 364390471 Manages pooled investments of related not-for-profit entities IL 501(c)(3) Line 11c, III-FI Alexian Brothers of America Inc 1 Alexian Brothers of Chicago 3040 W Salt Creek Lane Arlington Heights IL 60005 Inactive Corporation IL 501(c)(3) Line 9 Alexian Brothers of America Inc 1 Alexian Brothers of San Jose Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 941530037 Acute care hospital (sold in 1998) TX 501(c)(3) Line 3 Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 431295333 HUD housing MO 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Brothers Community Services 425 Cumberland Street Suite 110 Chattanooga TN 37404 364344423 Provides comprehensive and coordinated community based services IL 501(c)(3) 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 501(c)(3) Line 7 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 60005 364484290 Supports the provision of healthcare for related corporations IL 501(c)(3) Line 11c, III-FI Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 392039667 Community outreach WI 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 431470362 Skilled nursing facility MO 501(c)(3) Line 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO 501(c)(3) 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 501(c)(3) Line 11c, III-FI Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX 501(c)(3) Line 3 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 501(c)(3) Alexian Brothers Health System 1 Alexian Brothers Behavioral Health Hospital 1650 Moon Lake Blvd Hoffman Estates IL 60194 364251848 Behavioral health hospital IL 501(c)(3) Line 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 60005 364336931 Physician services IL 501(c)(3) Line 3 Alexian Brothers Health System 1 Alexian Brothers of St Louis Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 430653236 Acute care hospital (sponsorship transferred in 1997) MO 501(c)(3) Line 3 Alexian Brothers Health System 1 Alexian Brothers Specialty Group 3040 W Salt Creek Lane Arlington Heights IL 60005 800710751 Specialty physician practice group IL 501(c)(3) Line 3 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 501(c)(3) Line 7 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Elk Grove Village IL 60007 300221481 Rehabilitation Hospital IL N/A N/A 0 0 Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 870783164 Provision of NeuroMeg services IL N/A N/A 0 0 Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 60005 363853289 Medical office Building IL N/A N/A 0 0 Workplace Solutions LLC 1100 East Woodfield Rd Schaumburg IL 60173 364095007 Provision of EAP services IL N/A N/A 0 0 Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights DE 60005 363978153 Manages managed care contracts DE N/A N/A 0 0 Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 861115516 Ownership of Gamma Knife IL N/A N/A 0 0 St Alexius Center for Sleep Health LLC 665 W North Ave Lombard IL 60148 205876371 Operation of sleep labs IL St Alexius Medical Center Related -17529 189932 0 0 0.52500 Thelen Corporation 3040 W Salt Creek Lane Arlington Heights IL 60005 363266316 Owns/ leases property; joint venture partner IL N/A C Edessa Insurance Company Ltd 3040 W Salt Creek Lane Arlington Heights IL 60005 Captive insurer located in Bermuda BD N/A C Alexian Brothers Health Providers Association Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363853286 Messenger model IPA IL N/A C Alexian Village of Elk Grove 3040 W Salt Creek Lane Arlington Heights IL 60005 352211303 Tax credit financed housing IL N/A C 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 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 Alexian Brothers Health System P 35822440 Fair Market Value Alexian Brothers Hospital Network O 28598033 Fair Market Value Alexian Brothers Health System Q 14943574 Fair Market Value Alexian Brothers Medical Center O 791927 Fair Market Value Alexian Brothers Behavioral Health Hospital O 1468740 Fair Market Value Alexian Brothers Behavioral Health Hospital P 703182 Fair Market Value Savelli Properties Inc L 273143 Fair Market Value Schedule R, Part V, Line 2: St. Alexius tracks all transactions with related organizations in the general ledger or subsidiary schedules to the general ledger. Amounts are valued based on the fair market value of the transaction.