2012-05-14T09:55:19-05:00 2011-06-30 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2010-07-01 651257719 Ascension Health Information Services ASCE 3147338000 PO Box 45998 St Louis MO 631455998 Mark Barner 3147338000 2012-05-11 1 Alicia Janisch 5137847100 2010 2016-02-24 21:20:13Z Mark Barner PO Box 45998 St Louis MO 631455998 577010400 0 0928 X www.ascensionhealth.org X 2005 MO Information technology support organization for over 30 multiple location healthcare systems. 3 1 2190 1 568093 -304938 0 0 555401336 576633527 2584829 375131 159877 1742 558146042 577010400 0 0 0 0 124132559 183983037 0 0 0 422528456 407961095 546661015 591944132 11485027 -14933732 74900817 87853837 99345995 92437345 -24445178 -4583508 X Ascension Health Information Services is an information technology support organization for over thirty multiple location, multiple corporation healthcare systems organized and operated by its parent, Ascension Health, to fulfill the mission and purpose defined by the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph and the Congregation of St. Joseph of Carondelet. 0 0 548395621 576067176 Ascension Health Information Services (AHIS) was formed to provide information technology (I.T.) and application support services to the member entities of Ascension Health. AHIS services are funded by the affiliated entities through the collection of service fees. In return and in addition to providing I.T. and application support services, AHIS provides an array of services including strategic leadership, development of strategies around I.T. investments, consolidation of I.T. contracts, and efficient and cost-effective installation and support for system investments. Ascension Health, a tax-exempt entity, is the parent of this organization and all member entities are related to the sponsors of Ascension Health. 548395621 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 183 0 1 2190 1 1 1 0 0 0 0 0 0 0 0 0 X 3 1 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IN MO X Rob Binek 3147338252 4600 Edmundson Road St Louis MO 63134 X Robert J Henkel Sch O 50.00 X X 0 2010505 64747 Mark Barner Sch O 50.00 X X 0 969543 22436 Sister Bernice Coreil 1.00 X 0 0 0 Stanley P Simpson 50.00 X 474345 0 22879 Claudia Allen 50.00 X 589894 0 44902 Timothy Stettheimer 50.00 X 569887 0 37620 Mary Paul 50.00 X 661504 0 49256 Gerald R Lewis 50.00 X 558107 0 30337 Gregory Jones 50.00 X 705030 0 47195 Christopher A Young 50.00 X 566863 0 34795 Sudarshan M Suvarna 50.00 X 621161 0 28844 Alan Wyman 50.00 X 281235 0 29456 George Dix End 111910 50.00 X 319657 0 8346 Frank Negro End 83109 0.00 X 234255 0 18089 Mark Amey End 82109 0.00 X 266658 0 19151 Sherry Browne End 123108 0.00 X 0 338985 480 5848596 3319033 458533 249 1 1 0 Cerner 2800 Rockcreek Pkwy Kansas City MO 64117 Clinical Fdn Ste Soft Maint/Hosting/Cons 61709427 Dell (Sch O) PO Box 67601 Dallas TX 752676021 Application Hosting & IT Support Svcs 60472068 Computer Science Corporation 1109 S Green River Evansville IN 47715 Application Hosting & Software Maint 22865396 McKesson Information System PO Box 409521 Atlanta GA 303849521 Clinical Fdn Ste Soft Maint/Hosting/Cons 15138126 Siemens Medical Solutions 51 Valley Stream Pkwy Malvern PA 19355 Software Maint & IT Consulting Svcs 12278884 176 Service Fees 900099 576633527 576065434 568093 576633527 375131 375131 1742 1742 1742 577010400 576067176 568093 375131 3038731 3038731 149849869 146452318 3397551 9549329 9410169 139160 10672145 10124167 547978 10872963 10815417 57546 32515385 32515385 165522160 163575004 1947156 21618498 21615623 2875 168696808 168682899 13909 526037 443943 82094 2765924 2603939 161985 1048326 711629 336697 232498 232498 1099465 1099465 4334 4334 Equip Rent/Maintenance 7103014 7102877 137 0 Contracted Services 5879067 1728756 4150311 0 Employment/Recruitment 495743 387696 108047 0 Taxes 238149 238127 22 0 Professional Dues 56056 53183 2873 0 159631 79180 80451 591944132 548395621 43548511 0 33231563 21659039 13061483 15916489 26557854 29601117 3962039 2890414 1573367 1071625 15891427 476550 3714140 74900817 87853837 83367933 79952267 51922 15926140 12485078 99345995 92437345 X 0 0 0 0 -24445178 -4583508 -24445178 -4583508 74900817 87853837 X -14933732 34795402 X 0 1 1 X 0 X X X 0 0 0 See Part IV 311662309 See Part IV 1 591944132 1 591944132 Schedule A, Part IV, Supplemental Information: Part I, Line 11(i): Name of Supported Organizations: Northeast, Southeast, East Central and West Central provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph and the Congregation of St. Joseph of Carondelet and their affiliated organizations provided that such organizations are described under Section 501(c)(3) of the Code and are classified as public charities under Sections 509(a)(1) and 509(a)(2) of the Code. 1900779 1889788 10991 77160 39257 37903 1984100 961369 1022731 1071625 Pension and Deferred Compensation Liability 12485078 12485078 X 1 1 1 1 0 0 0 0 0 0 0 Robert J Henkel Sch O 0 992892 0 899414 0 118199 0 39060 0 25687 0 2075252 0 77939 Mark Barner Sch O 0 455938 0 431724 0 81881 0 12250 0 10186 0 991979 0 0 Stanley P Simpson 278077 0 156595 0 39673 0 11025 0 11854 0 497224 0 0 0 Claudia Allen 339915 0 202864 0 47115 0 28550 0 16352 0 634796 0 0 0 Timothy Stettheimer 324430 0 198817 0 46640 0 16937 0 20683 0 607507 0 0 0 Mary Paul 368024 0 220605 0 72875 0 33825 0 15431 0 710760 0 0 0 Gerald R Lewis 325151 0 168648 0 64308 0 11025 0 19312 0 588444 0 0 0 Gregory Jones 347288 0 325393 0 32349 0 24181 0 23014 0 752225 0 0 0 Christopher A Young 322548 0 197035 0 47280 0 15066 0 19729 0 601658 0 0 0 Sudarshan M Suvarna 276677 0 69422 0 275062 0 9452 0 19392 0 650005 0 0 0 Alan Wyman 214543 0 52080 0 14612 0 11463 0 17993 0 310691 0 0 0 George Dix End 111910 227253 0 68640 0 23764 0 0 0 8346 0 328003 0 0 0 Frank Negro End 83109 0 0 0 0 234255 0 0 0 18089 0 252344 0 0 0 Mark Amey End 82109 0 0 0 0 266658 0 0 0 19151 0 285809 0 0 0 Sherry Browne End 123108 0 0 0 0 0 338985 0 0 0 480 0 339465 0 0 Part I, Line 1a With respect to the boxes checked on Part I, Question 1a, Ascension Health Information Services has various policies in place with respect to benefits provided to its executives. Benefits listed and checked under this question are considered taxable compensation. In these circumstances the value of the benefit is included in that given executive's compensation. Part I, Lines 4a-b Part I, Line 4a: Severance Payments: Mark Amey (End 8/21/09) - $266,658 Sherry Browne (End 12/31/08) - $337,719 Frank Negro (End 8/31/09) - $233,997 Part I, Line 4b: Executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. Amounts Paid: Robert Henkel - $77,939 This amount was paid by Ascension Health, a related organization, for services previously provided to Ascension Health. No amounts reported on Line 4b were paid by AHIS. Supplemental Information Part III Schedule J, Part I, Line 3: Ascension Health, a related organization of Ascension Health Information Services, uses the following to establish the compensation of the organization's Executive Director: - Compensation Committee - Independent Compensation Consultant - Compensation survey or study Form 990, Part VI, Section A, line 2 Many of the persons listed in Part VII, Section A have a "business relationship" with each other by virtue of employment with Ascension Health Information Services related entities. Form 990, Part VI, Section A, line 6 Ascension Health Information Services has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a Ascension Health Information Services has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Ascension Health Information Services. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's top management official, the process performed by Ascension Health, a related entity that paid the top management official, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health Compensation Committee of the Board engaged an independent compensation consultant to advise the Committee with respect to the compensation of the top management official. Then the Ascension Health Compensation Committee reviewed and approved the compensation. In the review of the compensation, the top management official was compared to individuals in other comparable organizations that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process performed by Ascension Health, a related organization of Ascension Health Information Services, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health Compensation Committee of the Board engaged an independent compensation consultant to advise the Committee with respect to the executive team members. Then the Ascension Health Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to individuals in other comparable organizations that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. Ascension Health Information Services performed all of the above procedures to obtain the rebuttable presumption respecting compensation arrangements (per IRC Section 4958). Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII: Officers for Ascension Health Information Services provide services to Ascension Health and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore all officers, directors, trustees, and key employees hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees represent aggregate hours worked per week for all entities. Amounts paid for the services of Sister Bernice Coreil are paid directly to her religious province; therefore, her compensation on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees is zero. Amounts Paid to Dell: Form 990, Part VII, Section B, Line 2: Amounts paid to Dell represent amounts paid for services and materials. These amounts cannot be separated. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Transfer from Ascension Health 27,000,000. Deferred Pension Cost 7,815,991. Unrealized Loss on Investment -9,357. Asset Impairment -11,232. Total to Form 990, Part XI, Line 5: 34,795,402. Ascension Health PO Box 45998 St Louis MO 631455998 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Catholic Healthcare Investment Management Company PO Box 45998 St Louis MO 631455998 273174701 Supporting Organization MO Section 501(c)(3) Schedule A, Line 11a Ascension Health 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 Ascension Health O 10372167 Actual Amount Transferred Ascension Health N 4171637 Actual Amount Transferred Ascension Health L 114411 Actual Amount Transferred Ascension Health P 14549934 Actual Amount Transferred Ascension Health K 7586299 Actual Amount Transferred Ascension Health R 27000000 Actual Amount Transferred Ascension Health R 14934047 Actual Amount Transferred