2011-11-15T15:31:57-06:00 2010-12-31 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2010-01-01 351330472 FRANCISCAN ALLIANCE INC FRAN 5742563935 1515 DRAGOON TRAIL MISHAWAKA IN 465444710 KEVIN LEAHY 2011-11-15 2673303000 2010 2016-03-07 17:11:31Z KEVIN D LEAHY 1515 DRAGOON TRAIL MISHAWAKA IN 46544 2340085536 false 0928 X WWW.FRANCISCANALLIANCE.ORG X 1974 IN SEE SCHEDULE O 15 10 17948 1932 8598784 838484 2961811 7740999 2130494692 2202782422 35143923 102463339 19837651 10406749 2188438077 2323393509 107000 6454468 0 0 974892428 1038668750 162820 160348 416797 1088603998 1085499963 2063766246 2130783529 124671831 192609980 3425158537 3688293018 1698138394 1822214702 1727020143 1866078316 X THE PURPOSES FOR WHICH FRANCISCAN ALLIANCE, INC. IS FORMED ARE: TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND, IN PARTNERSHIP WITH OTHERS, TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN ALLIANCE, INC. THE REVENUES OF FRANCISCAN ALLIANCE, INC. ALLOW FOR THE OPERATION OF HEALTH CARE FACILITIES WHERE THE PURPOSE IS TO RESPECT LIFE AND TO PRESERVE HEALTH AS WELL AS TREAT ILLNESS AND INJURY. THIS ALLOWS FOR THE ACCOMPLISHMENT OF THE CORPORATE MINISTRY WHICH HAS THE FOLLOWING CENTRAL CONCERNS: COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS, WELLNESS AND THE PREVENTION OF ILLNESS, RESTORATION TO HEALTH, AND THE ACCEPTANCE OF DEATH AS THE FINAL ST false false 1884294212 6454468 2194474829 FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. PLEASE VIEW "OUR GIVING JOURNAL" AT WWW.FRANCISCANALLIANCE.ORG/COMMUNITYBENEFIT WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." THE REPORT LOCATED AT WWW.FRANCISCANALLIANCE.ORG/COMMUNITYBENEFIT REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED, IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT THE ORGANIZATION'S COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE SERVE. AS DETAILED IN THE REFERENCED REPORT, A SUMMARY OF THE COMMUNITY BENEFIT OF FRANCISCAN ALLIANCE, INC. IS AS FOLLOWS: BENEFITS FOR THE POOR --------------------- CHARITY CARE $ 63,647,941 UNPAID COST OF MEDICAID 126,070,323 COMMUNITY SERVICES 3,695,914 ----------- $ 193,414,178 BENEFITS FOR THE COMMUNITY -------------------------- OTHER COMMUNITY BENEFITS $ 68,810,434 UNPAID COST OF MEDICARE 151,816,864 ------------ $ 220,627,298 TOTAL BENEFITS $ 414,041,476 TOTAL BENEFITS $ 414,041,476 1884294212 true true false true false false false false true true false false false true false false true false false false false false true true false true false true false true true true false false false false false false false false true false false false false true true true true false false true 1134 0 true 17948 true true true true BD false false false true true false false false false X 15 10 false false false false false true true true true false false true true true true true true true true true true IL IN X X MARGUERITE EICHELBERGER 5742546268 1515 DRAGOON TRAIL MISHAWAKA IN 465444710 X SISTER M ALINE SHULTZ 40.0 X 0 0 0 SISTER M CLARE REUILLE 5.0 X 0 0 0 SISTER ROSE AGNES PFAUTSCH 5.0 X 0 0 0 SISTER M ANGELA MELLADY 5.0 X 0 0 0 SISTER M MARLENE SHAPLEY 40.0 X 0 0 0 SISTER MARILYN OLIVER 5.0 X 0 0 0 KATHLEEN GOEPPINGER PHD 5.0 X 0 0 0 SISTER M MADONNA ROUGEAU 40.0 X 0 0 0 JOHN LADOWICZ 5.0 X 0 0 0 ROBERT E MCBRIDE MD 5.0 X 0 0 0 JAMES D ROGGE MD 5.0 X 0 0 0 SISTER JANE MARIE KLEIN 40.0 X X 0 0 0 SISTER M ANN KATHLEEN MAGIERA 40.0 X X 0 0 0 KEVIN D LEAHY 40.0 X X 1281329 0 298660 SISTER M CORITA LAST 40.0 X X 0 0 0 DONALD KERNER MD 10.0 X 75000 0 0 JAIRO CRUZ MD 40.0 X 239985 0 16789 SISTER LETHIA MARIE LEVEILLE 40.0 X 0 0 0 EUGENE C DIAMOND 40.0 X 720553 0 601000 ROBERT J BRODY 40.0 X 721495 0 548475 JENNIFER P MARION 40.0 X 599187 0 141639 TERRANCE E WILSON 40.0 X 541033 0 284678 SETH CR WARREN 40.0 X 615967 0 235106 ADEL S YAACOUB MD 40.0 X 773600 0 86372 DAVID MEHL MD 40.0 X 901236 0 21631 LOUIS METZMAN MD 40.0 X 1108215 0 48856 DANNY K NORDMANN MD 40.0 X 722789 0 50335 JEFFREY L PIERSON MD 40.0 X 1008105 0 33109 PETER MURPHY 0.0 X 317246 0 10923 9625740 0 2377573 915 true true false METT THERAPY 801 SOUTH BRIGGS STREET JOLIET IL 60433 PHYSICIAN FEES 7370486 KRIEG DEVAULT LLP ONE INDIANA SQUARE SUITE 2800 INDIANAPOLIS IN 462042079 LEGAL SERVICES 3380676 MEDICAL REIMBURSEMENTS OF AMERICA 7105 MOORES LANE BRENTWOOD TN 37027 BILLING SERVICES 2768975 PRICEWATERHOUSECOOPERS LLP PO BOX 75647 CHICAGO IL 606755647 AUDIT, TAX & CONSULT 2349769 TOTAL RENAL CARE PO BOX 403008 ATLANTA GA 303743008 DIALYSIS 2315809 140 81876 80000 728494 6850629 0 7740999 PATIENT AND OTHER REVENUES 900099 2067965289 2066901684 0 1063605 PREMIUM REVENUE 900099 78548031 78548031 0 0 PHARMACY 446110 49154087 46166654 975954 2011479 CAFETERIA 722210 4156507 0 0 4156507 LAUNDRY 812300 2958508 0 2638956 319552 2202782422 102467832 102467832 22343 22343 0 10507237 5162423 5344814 5344814 2858460 2486354 10950703 10977539 -26836 -26836 -26836 317727 81876 291455 26272 26272 0 312399 260610 51789 51789 OTHER OPERATING REVENUE 900099 4983874 4983874 4983874 2323393509 2194474829 8598784 112578897 6454468 6454468 0 0 0 13609591 7208347 6401244 0 0 801098485 726579695 74457209 61581 33110267 29931503 3168990 9774 139009703 122088530 16899040 22133 51840704 46257689 5578393 4622 7403098 6109649 1293449 0 3865749 476437 3389312 0 1874865 177818 1697047 0 361767 711 361056 0 160348 160348 0 0 0 0 141801125 114941151 26714378 145596 11216640 3459364 7757276 0 172725185 150329468 22395717 0 75042913 75042913 0 0 0 46306005 42406919 3891970 7116 2449256 1626281 822951 24 0 754096 394997 359099 0 36209462 36209462 0 0 0 102023429 93388960 8629359 5110 33340077 28300497 5039580 0 MEDICAL SUPPLIES/ DRUGS 145801127 145789789 11338 0 PURCHASED SERVICES 111770292 86121755 25648537 0 BAD DEBT EXPENSE 82004618 81077788 926830 0 REPAIRS AND MAINTENANCE 25495616 24424183 1071433 0 FEDERAL UBI AND STATE TAXES 1136488 0 1136488 0 83918155 55495838 28421824 493 2130783529 1884294212 246072520 416797 157692856 191029979 237847559 245465370 1377713 722368 36054555 36514501 34022222 46044255 2581529162 1211864762 1312451118 1369664400 1386156920 1587928706 108142918 113044850 82870192 23403699 68542484 74474890 3425158537 3688293018 147387242 225422597 4453778 287404 1143033343 1134004299 5910162 11071886 397353869 451428516 1698138394 1822214702 X 1700419628 1846308597 11570294 10793940 15030221 8975779 1727020143 1866078316 3425158537 3688293018 X 192609980 -53551807 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 30174 true 257503 false true 74090 361767 false false SCHEDULE C, PART IV Franciscan Alliance, Inc. ("FRANCISCAN") engages in insubstantial amounts of lobbying activities. FRANCISCAN makes grants to other organizations that lobby on its behalf including various health and hospital associations. FRANCISCAN also engages in direct contact with legislators and their staffs on topics related to FRANCISCAN's healthcare mission. 15030221 267000 6321442 8975779 14207054 568167 255000 15030221 13918880 1795174 -1507000 14207054 1.00000 false false 85131439 85131439 1070703453 555939448 514764005 27178378 8559683 18618695 1153977565 633583784 520393781 244538327 13781847 230756480 1369664400 0 DUE TO THIRD PARTY PAYORS 11015523 ACCRUED PAYROLL 29430046 OTHER SHORT & LONG TERM LIABILITIES 65961591 ACCRUED PROF & GEN'L LIABILITY 9512176 ACCRUED PENSION LIABILITY 255644380 ACCRUED INTEREST PAYABLE 0 SWAP VALUATION 56453623 MINORITY INTEREST 22369896 ASSET RETIREMENT OBLIGATION 1041281 451428516 2323393509 2130783529 192609980 54185923 -107737730 -53551807 139058173 2278505766 54185923 -104527544 -50341621 2328847387 -5453878 -5453878 2323393509 2136237407 5453878 5453878 2130783529 2130783529 PART V, LINE 4 FRANCISCAN ALLIANCE, INC. USES ITS ENDOWMENT FUNDS FOR CAPITAL EXPENDITURES FOR EQUIPMENT, CAPITAL PROJECTS, OR OTHER CAPITAL NEEDS; MEDICAL EDUCATION PROGRAMS; AND HEALTH CARE PROGRAMS FOR MEDICAL AND PATIENT SERVICES IN ACCORDANCE WITH ANY STIPULATED DONOR RESTRICTIONS. PART XI, LINE 8 EQUITY IN EARNINGS OF AFFILIATES $ 15,570,886 MINORITY INTEREST IN AFFILIATES 532,433 NET ASSETS RELEASED FOR OPERATIONS 556,680 NET ASSETS RELEASED FROM RESTRICTION 3,990,000 EQUITY TRANSFERS TO/FROM AFFILIATES 285,984 CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE (64,639,000) CHANGE IN PENSION & POST-RETIREMENT BENEFITS OTHER THAN NET PERIODIC PENSION COSTS INCLUDED IN ACCRUED PENSION LIABILITY (45,071,000) OTHER CHANGES IN NET ASSETS (15,753,527) NET ASSET RECLASS 3,620,778 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS (776,522) CHANGE IN PERMANENTLY RESTRICTED NET ASSETS (6,054,442) ------------- TOTAL OTHER CHANGES IN NET ASSETS (107,737,730) PART XII, LINE 2D EQUITY IN EARNINGS OF AFFILIATES $ 15,570,886 NET ASSETS RELEASED FROM OPERATIONS 556,680 NET ASSETS RELEASED FROM RESTRICTION 3,990,000 TRANSFER TO AFFILIATES 285,984 MINORITY INTEREST IN AFFILIATES 532,433 CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE (64,639,000) CHANGE IN PENSION & POST-RETIREMENT BENEFITS OTHER THAN NET PERIODIC PENSION COSTS INCLUDED IN ACCRUED PENSION LIABILITY (45,071,000) OTHER CHANGES IN NET ASSETS (15,753,527) ----------- TOTAL REVENUE/EXPENSE ON BOOKS NOT ON RETURN (104,527,544) PART XII, LINE 4B RENT EXPENSE $ (5,162,423) SPECIAL EVENTS EXPENSE (291,455) ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS (5,453,878) PART XIII, LINE 2D RENT EXPENSE $ 5,162,423 SPECIAL EVENTS EXPENSE 291,455 ----------- TOTAL EXPENSES ON BOOKS NOT ON RETURN 5,453,878 X X X X X X true LAURUS BRUNI SEE PART IV DEVELOPMENT SERVICES false 0 142431 0 THE ALFORD GROUP 1603 ORRINGTON AVE EVANSTON IL 602013841 CAP. CAMP. CONSULTING false 0 17917 0 0 160348 0 IL IN NIR GALA 399603 81876 317727 5000 202110 4500 79845 0 399603 81876 317727 5000 202110 4500 79845 291455 26272 SCHEDULE G, PART I, LINE 2 FRANCISCAN ALLIANCE, INC. COMPENSATES THIS PROFESSIONAL FUNDRAISER BUT CONTRIBUTIONS AND GRANTS ARE RECEIVED BY A RELATED TAX-EXEMPT ORGANIZATION, ST. JAMES COMMUNITY FOUNDATION. ST. JAMES COMMUNITY FOUNDATION RECEIVED $749,610 IN CONTRIBUTIONS AND GRANTS DURING 2010. true true X true X 220. true X 0 true false true true 63647941 0 63647941 0.02990 200687441 74617118 126070323 0.05920 4982201 2157576 2824625 0.00130 269317583 76774694 192542889 0.09040 5279664 407384 4872280 0.00230 22389625 6898631 15790994 0.00740 100667776 59086490 41581286 0.01950 1033504 417177 616327 0.00030 8564707 70947 8493760 0.00400 137935276 66880629 71354647 0.03350 407252859 143655323 263897536 0.12390 1160 0 1160 0.00000 2500 0 2500 0.00000 8150 0 8150 0.00000 1548 0 1548 0.00000 56133 84 56049 0.00000 77573 5061 72512 0.00000 3721418 2791678 929740 0.00040 80042 0 80042 0.00000 3948524 2796823 1151701 0.00050 true 27889935 0 363277710 515094574 -151816864 X true true SEE PART VI 14 1 FRANCISCAN ST FRANCIS HEALTH -

INDIANAPOLIS 8111 SOUTH EMERSON AV INDIANAPOLIS IN 46217

X X X X X 2 FRANCISCAN ST ELIZABETH HEALTH -

LAFAYETTE EAST 1701 S CREASY LANE LAFAYETTE IN 47905

X X X 3 FRANCISCAN ST ANTHONY HEALTH -

CROWN POINT 1201 SOUTH MAIN STREET CROWN POINT IN 46307

X X X 4 FRANCISCAN ST FRANCIS HEALTH -

BEECH GROVE 1600 ALBANY STREET BEECH GROVE IN 46107

X X X X X X 5 FRANCISCAN ST MARGARET HEALTH -

HAMMOND 5454 HOHMAN AVENUE HAMMOND IN 46320

X X X X 6 FRANCISCAN ST JAMES HEALTH -

CHICAGO HEIGHTS 1423 CHICAGO ROAD CHICAGO HEIGHTS IL 60411

X X X X 7 FRANCISCAN ST ANTHONY HEALTH -

MICHIGAN CITY 301 W HOMER STREET MICHIGAN CITY IN 46360

X X X X 8 FRANCISCAN ST MARGARET HEALTH -

DYER 24 JOLIET STREET DYER IN 46311

X X X X 9 FRANCISCAN ST JAMES HEALTH -

OLYMPIA FIELDS 20201 SOUTH CRAWFOR OLYMPIA FIELDS IL 60461

X X X X X 10 FRANCISCAN ST FRANCIS HEALTH -

MOORESVILLE 1201 HADLEY ROAD MOORESVILLE IN 46158

X X X X X 11 FRANCISCAN ST ELIZABETH HEALTH -

CRAWFORDSVILLE 1710 LAFAYETTE ROAD CRAWFORDSVILLE IL 47933

X X X 12 FRANCISCAN PHYSICIANS HOSPITAL LLC

701 SUPERIOR STREET MUNSTER IN 46321

X X 13 HOME HOSPITAL

2400 SOUTH STREET LAFAYETTE IN 47904

X X X 14 FRANCISCAN ST ELIZABETH HEALTH -

LAFAYETTE CENTRAL 1501 HARTFORD ST LAFAYETTE IN 47904

X X X FRANCISCAN ST FRANCIS HEALTH - 1 FRANCISCAN ST ELIZABETH HEALTH - 2 FRANCISCAN ST ANTHONY HEALTH - 3 FRANCISCAN ST FRANCIS HEALTH - 4 FRANCISCAN ST MARGARET HEALTH - 5 FRANCISCAN ST JAMES HEALTH - 6 FRANCISCAN ST ANTHONY HEALTH - 7 FRANCISCAN ST MARGARET HEALTH - 8 FRANCISCAN ST JAMES HEALTH - 9 FRANCISCAN ST FRANCIS HEALTH - 10 FRANCISCAN ST ELIZABETH HEALTH - 11 FRANCISCAN PHYSICIANS HOSPITAL LLC 12 HOME HOSPITAL 13 FRANCISCAN ST ELIZABETH HEALTH - 14 135 IIMC

701 E COUNTY LINE ROAD SUITE 101 GREENWOOD IN 46143

PHYSICIAN PRACTICE INDIANA ORTHOPEDIC SURGERY CENTER

5255 E STOP 11 ROAD SUITE 110 INDIANAPOLIS IN 46237

AMBULATORY SURGERY CENTER FRANCISCAN SURGERY CENTER

5255 E STOP 11 ROAD SUITE 100 INDIANAPOLIS IN 46237

AMBULATORY SURGERY CENTER THE ENDOSCOPY CENTER AT ST FRANCIS

8051 S EMERSON AVENUE SUITE 150 INDIANAPOLIS IN 46237

ENDOSCOPY CENTER ST FRANCIS RADIATION THERAPY CENTERS

8111 S EMERSON AVENUE INDIANAPOLIS IN 46239

RADIATION THERAPY INDIANA HEART PHYSICIANS

5330 E STOP 11 ROAD INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE HEALTH PARTNERS

1225 E COOLSPRING AVENUE MICHIGAN CITY IN 46360

PHYSICIAN PRACTICE SOUTH EMERSON SURGERY CENTER

8141 S EMERSON AVENUE SUITE C INDIANAPOLIS IN 46237

AMBULATORY SURGERY CENTER COOPERATIVE MANAGED CARE SERVICES

9045 RIVER ROAD SUITE 250 INDIANAPOLIS IN 46240

MANAGED CARE INDIANA BLODD AND MARROW TRANSPLANTATION

1500 ALBANY STREET SUITE 911 BEECH GROVE IN 46107

BLOOD AND MARROW TRANSPLANT FRANCISCAN ST JAMES HEALTH-HOME HEALTH

1400 OTTO BOULEVARD CHICAGO HEIGHTS IL 60411

HOME HEALTH MOORESVILLE SURGERY CENTER

1215 HADLEY ROAD SUITE 100 MOORESVILLE IN 46260

AMBULATORY SURGERY CENTER ATHENS ORTHOPEDIC AND SPORTS MEDICINE

1702 LAFAYETTE ROAD CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE JOINT REPLACEMENT SURGEONS

1199 HADLEY ROAD MOORESVILLE IN 46158

PHYSICIAN PRACTICE ONCOLOGY AND HEMATOLOGY SPECIALISTS

8111 S EMERSON AVENUE SUITE A INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE SOUTH INDY MRI AND REHAB

8141 S EMERSON AVENUE SUITE A INDIANAPOLIS IN 46237

RADIOLOGY AND PHYSICAL SERVICES MOORESVILLE ENDOSCOPY CENTER

1215 HADLEY ROAD SUITE 101 MOORESVILLE IN 46158

ENDOSCOPY CENTER FAMILY PRACTICE NETWORK

9470 BROADWAY CROWN POINT IN 46307

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

2708 FERRY STREET LAFAYETTE IN 47904

PHYSICIAN PRACTICE FRANCISCAN ST JAMES HEALTH -

HEALTH WELLNESS CENTER 100 W 197 CHICAGO HEIGHTS IL 60411

WELLNESS CENTER GREENWOOD PEDIATRIC ASSOCIATES

900 AVERITT ROAD GREENWOOD IN 46143

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

915 SAGAMORE PARKWAY WEST WEST LAFAYETTE IN 47906

PHYSICIAN PRACTICE ST FRANCIS IMAGING CENTER

3147 W SMITH VALLEY ROAD SUITE D GREENWOOD IN 46143

RADIOLOGY SIGMA MEDICAL GROUP

1701 SOUTH LANE LAFAYETTE IN 47905

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

1505 SOUTH COURT STREET CROWN POINT IN 46307

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

12800 MISSISSIPPI PARKWAY CROWN POINT IN 46307

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

2421 LAPORTE AVENUE VALPARAISO IN 46385

PHYSICIAN PRACTICE AMER HEALTH NETWORK - MUNCIE

3631 N MORRISON ROAD MUNCIE IN 47304

PT, IMAGING, SURGERY ATHENS MEDICAL SPECIALIST

1630 LAFAYETTE ROAD SUITE 300 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE HEALTH PARTNERS

8865 W 400 NORTH MICHIGAN CITY IN 46360

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

3900 SAINT FRANCIS WAY STE 200 LAFAYETTE IN 47905

PHYSICIAN PRACTICE AMER HEALTH NETWORK - GROUP ONE

4880 CENTURY PLAZA ROAD SUITE 100 INDIANAPOLIS IN 46254

IMAGING AMER HEALTH NETWORK - AVON

5250 E US 36 SUITE 610 AVON IN 46123

IMAGING ATHENS CRAWFORDSVILLE FAMILY CARE

308 W MARKET STREET CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE ATHENS GREENACRES

1500 DARLINGTON AVENUE SUITE 300 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE HEALTH PARTNERS

1507 WABASH STREET MICHIGAN CITY IN 46360

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

11161 RANDOLPH STREET CROWN POINT IN 46307

PHYSICIAN PRACTICE SOUTHPORT FP AND SPORTS MEDICINE

7855 S EMERSON AVENUE SUITE P INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

1205 S MAIN STREET CROWN POINT IN 46307

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

701 SUPERIOR AVE SUITE E MUNSTER IN 46321

PHYSICIAN PRACTICE ALVERNO DURABLE MEDICAL EQUIPMENT

16149 SOUTH CLINTON STREET HARVEY IL 60426

DURABLE MEDICAL EQUIPMENT IMPACT CENTER

1201 HADLEY ROAD MOORESVILLE IN 46158

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

840 RICHARD ROAD DYER IN 46311

PHYSICIAN PRACTICE BEECH GROVE FAMILY MEDICINE

2030 CHURCHMAN AVENUE BEECH GROVE IN 46107

PHYSICIAN PRACTICE INDIANA SLEEP CENTER

701 E COUNTY LINE ROAD SUITE 207 GREENWOOD IN 46143

SLEEP CENTER HEALTH PARTNERS

810 MICHAEL DRIVE CHESTERTON IN 46304

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

CHERRY CREEK CENTER CROWN POINT IN 46307

PHYSICIAN PRACTICE NORTHRIDGE MEDICAL GROUP

1704 LAFAYETTE ROAD SUITE 8 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE DIABETES AND ENDOCRINOLOGY SPECIALISTS

5230A E STOP 11 ROAD SUITE 150 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

14785 WEST 101ST AVENUE DYER IN 46311

PHYSICIAN PRACTICE KENDRICK FAMILY MEDICINE

1001 HADLEY ROAD SUITE 101 MOORESVILLE IN 46158

PHYSICIAN PRACTICE CRAWFORDSVILLE GYN

407 E MARKET STREET SUITE 101 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE MOORESVILLE FAMILY CARE

1001 HADLEY ROAD SUITE 102 MOORESVILLE IN 46158

PHYSICIAN PRACTICE AMER HEALTH NETWORK - SLEEP (CARMEL)

12425 OLD MERIDIAN STREET SUITE A- CARMEL IN 46032

SLEEP CENTER NEUROSURGICAL SPECIALISTS

8051 S EMERSON AVENUE SUITE 300 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE GRAY ROAD FAMILY MEDICINE

7825 MCFARLAND LANE SUITE A INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE AMER HEALTH NETWORK - FRANKLIN

1300 W JEFFERSON STREET SUITE C FRANKLIN IN 46131

PT, IMAGING ORTHOPEDIC SPECIALISTS

5230A E STOP 11 ROAD SUITE 250 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE AMER HEALTH NETWORK - KOKOMO

2330 S DIXON ROAD KOKOMO IN 46902

IMAGING CENTER GROVE FAMILY MEDICINE

362 MERIDIAN PARKE LANE GREENWOOD IN 46142

PHYSICIAN PRACTICE SOUTH 31 FAMILY CARE

610 E SOUTHPORT ROAD SUITE 205 INDIANAPOLIS IN 46227

PHYSICIAN PRACTICE SOUTHEAST FAMILY MEDICINE

5136 E STOP 11 ROAD SUITE 30 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

2050 NORTH MAIN STREET CROWN POINT IN 46307

PHYSICIAN PRACTICE FRANCISCAN ST JAMES HEALTH - AMBULANCE &

EMS 20201 SOUTH CRAWFORD AVENUE OLYMPIA FIELDS IL 60461

AMBULANCE SERVICES ST MARGARET MEDICAL ASSOCIATES

8242 CALUMET AVENUE MUNSTER IN 46321

PHYSICIAN PRACTICE VASCULAR SPECIALISTS

5255 E STOP 11 ROAD SUITE 200 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST JAMES HEALTH OUTPATIENT PHARMACY

3700 203RD STREET SUITE 108 OLYMPIA FIELDS IL 60461

PHARMACY FRANKLIN TOWNSHIP FAMILY MEDICINE

8325 E SOUTHPORT ROAD SUITE 100 INDIANAPOLIS IN 46259

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

1573 N CLINE AVENUE GRIFFITH IN 46319

PHYSICIAN PRACTICE HEARTLAND CROSSING PEDIATRICS

10701 ALLIANCE DRIVE CAMBY IN 46113

PHYSICIAN PRACTICE IRVINGTON FAMILY MEDICINE

5839 E WASHINGTON STREET INDIANAPOLIS IN 46219

PHYSICIAN PRACTICE MAJOR HOSPITAL CARDIAC DIAGNOSTICS

150 WEST WASHINGTON STREET SHELBYVILLE IN 46176

CARDIOVASCULAR TESTING ATHENS ENT

1630 LAFAYETTE ROAD SUITE 500 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE EASTSIDE FAMILY MEDICINE

2056 LEBANON ROAD CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE SPINE SPECIALISTS

8051 S EMERSON AVENUE SUITE 360 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE MADISON AVE FAMILY MEDICINE

8778 S MADISON AVENUE SUITE 200 INDIANAPOLIS IN 46227

PHYSICIAN PRACTICE ATHENS PRIMARY CARE

1601 LAFAYETTE ROAD CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE AMER HEALTH NETWORK - PERU

315 W OLD KEY DRIVE IMAGING SUITE PERU IN 46970

IMAGING HEARTLAND INTERNAL MEDICINE

10701 ALLIANCE DRIVE CAMBY IN 46113

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

200 3RD COURT SE DEMOTTE IN 46310

PHYSICIAN PRACTICE COUNTY LINE PEDIATRICS

8325 S EMERSON SUITE B1 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

5530 HOHMAN AVENUE HAMMOND IN 46320

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

221 US HWY 41 SUITE I SCHERERVILLE IN 46375

PHYSICIAN PRACTICE HONEY GROVE FAMILY MEDICINE

1711 S STATE ROAD 135 SUITE C GREENWOOD IN 46143

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

297 WEST FRANCISCAN LANE SUITE 104 CROWN POINT IN 46307

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

1012 N 14TH STREET LAFAYETTE IN 47904

PHYSICIAN PRACTICE ATHENS OBGYN

1630 LAFAYETTE ROAD SUITE 200 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

2068 LUCAS PARKWAY LOWELL IN 46356

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

3875 KENSINGTON DRIVE LAFAYETTE IN 47905

PHYSICIAN PRACTICE GYNECOLOGIC ONCOLOGY SPECIALISTS

5255 E STOP 11 ROAD SUITE 310 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ATHENS WILLIAMS FAMILY PRACTICE

1660 LAFAYETTE ROAD SUITE 170 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE PLAINFIELD FAMILY MEDICINE

315 DAN HONES ROAD SUITE 100 PLAINFIELD IN 46168

PHYSICIAN PRACTICE PSYCHIATRIC SPECIALISTS

610 E SOUTHPORT ROAD SUITE 200 INDIANAPOLIS IN 46227

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

10860 MAPLE LANE SAINT JOHN IN 46373

PHYSICIAN PRACTICE FRANCISCAN IMAGING EQUIPMENT LEASING

1600 ALBANY STREET BEECH GROVE IN 46107

LEASING RADIOLOGY EQUIPMENT ST MARGARET MEDICAL ASSOCIATES

3831 HOHMAN AVENUE HAMMOND IN 46327

PHYSICIAN PRACTICE FRANCISCAN ST JAMES HEALTH CENTERS FOR

DIABETES 20201 SOUTH CRAWFORD AVEN OLYMPIA FIELDS IL 60461

DIABETES CLINIC PLEASANT VIEW FAMILY MEDICINE

12524 SOUTHEASTERN AVENUE INDIANAPOLIS IN 46259

PHYSICIAN PRACTICE AMER HEALTH NETWORK - EAGLE HIGHLANDS

6820 PARKDALE PLACE 105 INDIANAPOLIS IN 46254

IMAGING ST MARGARET MEDICAL ASSOCIATES

24 JOLIET STREET SUITE 101 DYER IN 46311

PHYSICIAN PRACTICE RHEUMATOLOGY & OSTEOPOROSIS SPECIALISTS

5255 E STOP 11 ROAD SUITE 320 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE WEIGHT LOSS SPECIALISTS

5230A E STOP 11 ROAD SUITE 190 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

10860 MAPLE LANE ST JOHN IN 46373

PHYSICIAN PRACTICE FRANCISCAN ST JAMES HEALTH - FAMILY

HEALTH TINLEY PARK 17859 S 80TH A TINLEY PARK IL 60477

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

5454 HOHMAN AVENUE HAMMOND IN 46320

PHYSICIAN PRACTICE HEALTH PARTNERS

500 W BUFFALO STREET NEW BUFFALO MI 49117

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

2400 SOUTH STREET LAFAYETTE IN 47904

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

8437 KENNEDY AVENUE HIGHLAND IN 46322

PHYSICIAN PRACTICE FAMILY PRACTICE NETWORK

5985 EAST 1015 NORTH ROSELAWN IN 46372

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

5500 HOHMAN AVENUE SUITE 2A HAMMOND IN 46320

PHYSICIAN PRACTICE MOORESVILLE AFTER HOURS CLINIC

1001 HADLEY ROAD SUITE 101 MOORESVILLE IN 46158

PHYSICIAN PRACTICE HEALTH PARTNERS

6916 W JOHNSON ROAD LAPORTE IN 46350

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

3218 DAUGHERTY DRIVE SUITE 140 LAFAYETTE IN 47909

PHYSICIAN PRACTICE BREAST SPECIALISTS

5255 E STOP 11 ROAD SUITE 250 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE HEALTH PARTNERS

607 JEFFERSON AVENUE LAPORTE IN 46350

PHYSICIAN PRACTICE INDY SOUTH AFTER HOURS CLINIC

7855 S EMERSON AVENUE SUITE P INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE SFMG REHABILITATION SPECIALISTS

8051 S EMERSON AVENUE SUITE 360 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

5454 HOHMAN AVENUE HAMMOND IN 46320

PHYSICIAN PRACTICE BEECH GROVE INTERNAL MEDICINE

2030 CHURCHMAN AVENUE BEECH GROVE IN 46107

PHYSICIAN PRACTICE SFMG PAIN SPECIALISTS

8051 S EMERSON AVENUE SUITE 360 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE BEECH GROVE AFTER HOURS CLINIC

2030 CHURCHMAN AVENUE BEECH GROVE IN 46107

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

8230 CALUMET AVENUE MUNSTER IN 46321

PHYSICIAN PRACTICE MATERNAL FETAL SPECIALISTS

8051 S EMERSON AVENUE SUITE 450B INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE PLASTIC SURGERY SPECIALISTS

8051 S EMERSON AVENUE SUITE 450 INDIANAPOLIS IN 46237

PHYSICIAN PRACTICE ST JAMES COMMUNITY HEALTH CENTER -

BEECHER 989 DIXIE HIGHWAY BEECHER IL 60401

PHYSICIAN PRACTICE NEIGHBORHOOD CLINIC

407 E MARKET STREET SUITE 101 CRAWFORDSVILLE IN 47933

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

5454 HOHMAN AVENUE HAMMOND IN 46320

PHYSICIAN PRACTICE ST MARGARET MEDICAL ASSOCIATES

19400 NORTH CREEK DRIVE LYNWOOD IL 60411

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

510 WEST JACKSON STREET MULBERRY IN 46058

PHYSICIAN PRACTICE FRANCISCAN ST JAMES HEALTH - FAMILY

HEALTH HOMEWOOD 18636 DIXIE HIGHWA HOMEWOOD IL 60430

PHYSICIAN PRACTICE SIGMA MEDICAL GROUP

212 EAST MAIN STREET BROOK IN 47922

PHYSICIAN PRACTICE PLAINFIELD SPORTS AND FAMILY MEDICINE

315 DAN JONES ROAD SUITE 150 PLAINFIELD IN 46168

PHYSICIAN PRACTICE AMER HEALTH NETWORK - SLEEP (MUNCIE)

3631 N MORRISON ROAD MUNCIE IN 47304

SLEEP CENTER REDOX REACTIVE REAGENTS

1600 ALBANY STREET BEECH GROVE IN 46107

AUTOIMMUNE DISEASE TREATMENT AMER HEALTH NETWORK - NOBLESVILLE

18051 RIVER AVENUE SUITE 103 NOBLESVILLE IN 46062

IMAGING SUPPLEMENTAL INFORMATION SCHEDULE H, PART VI, ITEM 2 NEEDS ASSESSMENT Franciscan Alliance, Inc. ("FRANCISCAN") hospitals assess the health care needs of the communities we serve by collaborating with public and private agencies to determine community health needs and how best to address them. In 2009, the Franciscan Corporate Community Benefit Committee, as well as committees in the local facilities, committed to an ongoing assessment of community health needs and priorities based upon health initiatives of the municipal, county, and state health departments, community-based assessments by other public sector partners, professional research consultant reports, and faith-based partners within the communities served. In addition, our hospitals address public agency and community group requests to provide community benefit activities and programs that meet certain specialty or hybrid needs or populations. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FRANCISCAN'S hospitals inform and educate patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under FRANCISCAN's financial assistance and charity care policy. Patients are informed of the availability of charity care in various ways: -FRANCISCAN has visible signage indicating the availability of financial assistance/charity care in inpatient and outpatient admitting/ registration areas such as our emergency departments, billing offices, admitting offices, and outpatient and physical service settings. -FRANCISCAN provides informational brochures in patient access areas that explain our payment plans and also explain our financial assistance programs. -FRANCISCAN patient statements have wording explaining our payment options and that we also offer charity care for those unable to pay the balance. -There is clear notice on our patient statements giving the patient a number to call to speak to a Customer Service Representative to get more information about charity care or our payment programs. -Onsite patient service advocates can assist with any questions regarding our financial assistance programs or assist with processing financial assistance applications. -FRANCISCAN's web site has numerous pages offering information on our financial assistance programs, a glossary of healthcare associated billing terms, and our financial assistance application. -Scheduled uninsured patients are contacted for payment arrangements prior to their service and financial assistance is offered if no other forms of payment are available. -FRANCISCAN applies for Medicaid coverage for patients where this seems applicable then approves the patient for charity care if their Medicaid application is denied. -For patients not qualifying for financial assistance under our policy, Franciscan offers low or no interest payment plans to patients interested in that program. --------------------------------------------- SCHEDULE H, PART VI, ITEM 4 COMMUNITY INFORMATION FRANCISCAN ALLIANCE SERVICES A LARGE GEOGRAPHIC AREA WHICH INCLUDES 17 COUNTIES IN INDIANA (BENTON, CARROLL, FOUNTAIN, JASPER, JOHNSON, LAKE, LAPORTE, MARION, MONTGOMERY, MORGAN, NEWTON, PORTER, SHELBY, STARKE, TIPPECANOE, WARREN AND WHITE) AND 2 COUNTIES IN ILLINOIS (COOK AND WILL). THE POPULATION OF THE COMMUNITIES THAT WE SERVE WAS ESTIMATED AT OVER 3.7 MILLION PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME OF APPROXIMATELY $64,000 IN 2010. FOR THESE COMMUNITIES, THE PERCENTAGE OF RESIDENTS BELOW THE FEDERAL POVERTY LEVEL WAS ESTIMATED AT 14.6% IN 2010. THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE SERVED BY MEDICAID WAS 17.1%. AND THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE UNINSURED WAS APPROXIMATELY 2.2%. IN COMPARISON, THE PERCENTAGES OF MEDICAID AND UNINSURED TREATED BY FRANCISCAN ALLIANCE WERE 17.4% AND 5.3% RESPECTIVELY IN 2010. THERE WERE 56 OTHER HOSPITALS IN 2010 THAT SERVE WITHIN THESE COMMUNITIES AS WELL. ----------------------------------------- SCHEDULE H, PART VI, ITEM 5 OTHER INFORMATION FRANCISCAN continues to provide access to health care services and a wide variety of community education/health and wellness programs. All of our facilities reach out to their communities by providing access to free, public web sites and online resources. Each web site provides the latest medical information to visitors, in a bi-lingual format, through the use of interactive A to Z health libraries. There are online centers that focus on information related to medical conditions in specialty areas such as the heart, bones, kidneys and nerves. They further offer condition and disease-specific information on topics like cancer, pregnancy and geriatrics that provide illustrations, graphics and narrated videos. The web sites also provide unlimited free access to online health risk assessment tools such as the heart risk assessment that uses an established algorithm to calculate risk factors for heart attack based upon user-entered parameters. The sites also offer condition-specific recommendations for managing chronic illnesses and conditions such as diabetes, high blood pressure and asthma, among others. Finally, the sites have healthy living sections that offer tips and suggestions on beginning and maintaining diet and exercise regiments to optimize healthy lifestyles. Our hospitals provide urgent care clinics within the communities they serve to help minimize cost of non-critical, emergent medical care. We engage in a tremendous amount of university-affiliated medical education and training programs including but not limited to; all levels of nursing (LPN, ASN, BSN and MSN), pharmacy, emergency medical technicians and paramedics, respiratory therapists, physical/occupational/speech therapists and internships/residencies for physicians. We also provide continuing medical education programs. Several of our hospitals participate in clinical trials, medical research programs and pharmaceutical trials. MOREOVER, THERE ARE OTHER FACTORS THAT DEMONSTRATE THAT FRANCISCAN IS OPERATED FOR A PUBLIC RATHER THAN A PRIVATE INTEREST. FRANCISCAN'S GOVERNING BODY IS COMPOSED OF INDEPENDENT MEMBERS REPRESENTING THE BROAD COMMUNITY SERVED BY FRANCISCAN. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO QUALIFIED PHYSICIANS. FRANCISCAN ALSO USES ITS SURPLUS FOR IMPROVEMENT IN PATIENT CARE, TO EXPAND AND REPLACE FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. ----------------------------------------- SCHEDULE H, PART VI, ITEM 6 ROLE OF AFFILIATES Every hospital within our system has the degree of autonomy and flexibility to meet the needs of the communities it serves. Each facility performs a mission assessment that is specifically designated for the identified health care needs within the individual service areas. The individual and regional community benefit plans are designed to be part of an overall FRANCISCAN system vision to provide for the ongoing healthcare needs of the communities we are privileged to serve. ------------------------------------------------ SCHEDULE H, PART I, LINE 3B FRANCISCAN ALLIANCE, INC. USES A SLIDING SCALE BASED ON INCOME AND ASSETS IN DETERMINING A PATIENT'S ELIGIBILITY FOR DISCOUNTED CARE AND THE DISCOUNT COULD BE UP TO 100%. ------------------------------------------------ SCHEDULE H, PART I, LINE 7, COLUMN (F) THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, LINE 25, OF $82,004,618 HAS BEEN SUBTRACTED IN CALCULATING THE PERCENTAGES REPORTED IN THIS COLUMN. ------------------------------------------------ SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES FRANCISCAN is involved in and actively participates in numerous community building activities. We work to provide quality care and community building activities by partnering with other health care providers, government agencies, and not-for-profit social service agencies to serve our communities' diverse health care needs. The community building activities offered by FRANCISCAN are provided without reimbursement, serve at-risk populations, and provide health education to key community groups. We monitor these activities for outcomes by identifying changes in health behaviors and knowledge. Some examples of community health programs Franciscan provides include: health education, health fairs, free or low cost health screening, access to healthcare services, immunization services, prescription medication assistance programs, nutritional counseling, enrollment assistance in Medicaid, free spa services for cancer patients, food assistance, transportation assistance, referral assistance, breast cancer and childhood obesity initiatives, healthy choices initiatives, childhood alcoholism prevention, and other various community outreach programs as further described in "Our Giving Journal" at www.franciscanalliance.org/communitybenefit. Additionally, several of our hospitals hav STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL,IN, true AMERICAN HEART ASSOCIATION 5108 Sagamiore Parkway West West Lafayette IN 47906 135613797 501(c)(3) 10000 0 FMV NONE GALA SPONSOR BAPTIST MEMORIAL HEALTHCARE FOUNDATION 350 N HUMPHREYS BLVD MEMPHIS TN 38120 581544781 501(C)(3) 6291110 0 FMV NONE CONTRIBUTION COMMUNITY CANCER NETWORK 2550 GREENBUSH STREET LAFAYETTE IN 47904 260467053 501(C)(3) 9000 0 FMV NONE ANNIVERSARY CAMPAIGN LAFAYETTE MEDICAL EDUCATION FOUNDATION 1501 HARTFORD STREET RM 1128A LAFAYETTE IN 47093 351314750 501(C)(3) 10000 0 FMV NONE PHYSICIAN EDUCATION CATHOLIC RELIEF SERVICES PO BOX 1790 BALTIMORE MD 21203 135563422 501(C)(3) 100000 0 FMV NONE GENERAL DONATION 5 0 PART I, LINE 2 CONTRIBUTIONS ARE GIVEN TO TAX-EXEMPT ORGANIZATIONS WHICH USE THE FUNDS FOR CHARITABLE PURPOSES IN FURTHERANCE OF MEDICAL RESEARCH, MEDICAL INITIATIVES, EDUCATION, AND/ OR COMMUNITY ACTIVITIES. PART II, LINE 1, ITEM 2 THE CORPORATION HAD ACTED AS A NONBENEFICIAL HOLDING AGENT OF A PERMANENTLY RESTRICTED ENDOWMENT. DURING 2010, THE CORPORATION TRANSFERRED APPROXIMATELY $6.0 MILLION OF THIS PERMANENTLY RESTRICTED ENDOWMENT TO THE INTENDED BENEFICIARY. X X X X X X true true false false false false false false false KEVIN D LEAHY 1219323 0 0 0 62006 0 261632 0 37028 0 1579989 0 0 0 EUGENE C DIAMOND 672980 0 0 0 47573 0 571238 0 29762 0 1321553 0 0 0 ROBERT J BRODY 672980 0 0 0 48515 0 518713 0 29762 0 1269970 0 0 0 JENNIFER P MARION 582308 0 0 0 16879 0 113106 0 28533 0 740826 0 0 0 TERRANCE E WILSON 509621 0 0 0 31412 0 257203 0 27475 0 825711 0 0 0 SETH CR WARREN 575400 0 0 0 40567 0 206673 0 28433 0 851073 0 0 0 ADEL S YAACOUB MD 735629 0 0 0 37971 0 55236 0 31136 0 859972 0 0 0 DAVID MEHL MD 900000 0 0 0 1236 0 0 0 21631 0 922867 0 0 0 LOUIS METZMAN MD 1082045 0 0 0 26170 0 24404 0 24452 0 1157071 0 0 0 DANNY K NORDMANN MD 708657 0 0 0 14132 0 33282 0 17053 0 773124 0 0 0 JEFFREY L PIERSON MD 968755 0 0 0 39350 0 27637 0 5472 0 1041214 0 0 0 PETER MURPHY 0 0 0 0 317246 0 0 0 10923 0 328169 0 0 0 JAIRO CRUZ MD 176727 0 0 0 63258 0 0 0 16789 0 256774 0 0 0 SCHEDULE J, PART II, COLUMN (C) Deferred compensation includes split-dollar life insurance, employer deferral to section 403(B) Plan, and change in present value of the qualified and, if applicable, nonqualified defined benefit plan. The value of the nonqualified defined benefit plan is subject to a significant risk of forfeiture and as such possibly may never be paid to the executives participating in the plan. No benefits have been paid out to executives participating in the nonqualified defined benefit plan. SCHEDULE J, PART I, LINE 4B Franciscan Alliance, Inc. ("FRANCISCAN") maintains a supplemental executive retirement plan. These benefits are subject to a significant risk of forfeiture and as such possibly may never be paid out to the executives participating in the plan. SCHEDULE J, PART I, LINE 4A PETER MURPHY RECEIVED A SEVERANCE PAYMENT OF $318,975 DURING 2010. INDIANA FINANCE AUTHORITY (06E) 361602316 454795DW2 2008-04-25 85150922 REFUND PRIOR ISSUE DATED 5/16/06 false false false INDIANA FINANCE AUTHORITY (08AB) 351602316 45470YAB7 2008-05-12 162960000 REFINANCING AND REFUND PRIOR ISSUE false false false INDIANA FINANCE AUTHORITY (08C) 351602316 45470YAX9 2008-09-15 291837375 REFUND PRIOR ISSUE DATED 5/2/06 false false false INDIANA FINANCE AUTHORITY (08DEFGH) 351602316 45470YBE0 2008-10-10 279345000 REFUND PRIOR ISSUE DATED 11/20/03 false false false 0 0 86190447 0 0 0 140665 0 0 41777448 0 0 2007 true false true true 0 0 162624820 0 0 0 1924820 0 0 0 0 0 true false true true 0 0 290462634 0 0 0 1505785 0 0 0 0 0 true false true true 0 0 278919324 0 0 0 503876 0 0 124873123 0 0 true false true true false true true true true 0.00100 0.00000 0.00100 true false true true true true 0.00100 0.00000 0.00100 true false true true true true 0.00800 0.00000 0.00800 true false true true true true 0.00100 0.00000 0.00100 true false false false false true false false true false false true false false false false false true false false true false false false true SCHEDULE K, PART II, LINE 13 FOR THE INDIANA FINANCE AUTHORITY 2008A/B BONDS, 2008D/E/F/G/H BONDS, 2008 I/J BONDS, AND 2009A BONDS, A YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED SINCE A SUBSTANTIAL AMOUNT OF THE FINANCED PROPERTY HAS NOT BEEN PLACED IN SERVICE AS OF THE DATE OF FILING. FOR THE INDIANA FINANCE AUTHORITY 2008C BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED. SCHEDULE K, PART III FOR THE INDIANA FINANCE AUTHORITY 2008C BONDS, PART III IS NOT COMPLETED SINCE ALL BOND PROCEEDS WERE USED TO REFUND BONDS ISSUED BEFORE JANUARY 1, 2003. SCHEDULE K, PART IV, LINE 5 For the Indiana Finance Authority 2006E, Indiana Finance Authority 2008A/B, Indiana Finance Authority 2008C, and Indiana Finance Authority 2008I/J issues, only small amounts of proceeds related to the costs of issuance were not expended at the end of the temporary periods. TONN AND BLANK CONSTRUCTION LLC COMMON DIRECTORS&OFFICERS 81661735 PURCHASE OF CONSTRUCTION SERVS false ALVERNO CLINICAL LABORATORIES LLC COMMON DIRECTORS 58499 PROVISION OF LAB SERVICES false SCHEDULE L, PART IV TONN AND BLANK CONSTRUCTION COMPANY, LLC IS A LIMITED LIABILITY COMPANY IN WHICH FRANCISCAN ALLIANCE, INC. HOLDS A MEMBERSHIP INTEREST. THE FOLLOWING CURRENT TRUSTEES AND OFFICERS OF FRANCISCAN ALLIANCE, INC. ARE ALSO BOARD MEMBERS OF TONN AND BLANK CONSTRUCTION COMPANY, LLC: SISTER JANE MARIE KLEIN AND KEVIN D. LEAHY. TONN AND BLANK CONSTRUCTION COMPANY, LLC PROVIDES CONSTRUCTION SERVICES TO FRANCISCAN ALLIANCE, INC. FOR THE CONSTRUCTION AND IMPROVEMENT OF ITS HEALTHCARE FACILITIES. ALVERNO CLINICAL LABORATORIES, LLC IS A JOINT VENTURE BETWEEN FRANCISCAN ALLIANCE, INC. AND TWO OTHER TAX-EXEMPT HEALTH SYSTEMS THAT PROVIDES LABORATORY SERVICES TO FRANCISCAN ALLIANCE, INC. AND OTHER HEALTHCARE PROVIDERS. THE FOLLOWING CURRENT TRUSTEE OF FRANCISCAN ALLIANCE, INC. IS ALSO A DIRECTOR OF ALVERNO CLINICAL LABORATORIES, LLC: ROBERT E. MCBRIDE, MD. FORM 990, PART I, LINE 1 FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. PLEASE VIEW "OUR GIVING JOURNAL" AT WWW.FRANCISCANALLIANCE.ORG/COMMUNITYBENEFIT WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." FORM 990, PART VI, SECTION A, LINE 7A THE SISTERS OF THE EASTERN PROVINCE ("PROVINCE") OF THE SISTERS OF ST. FRANCIS OF PERPETUAL ADORATION, A RELIGIOUS CONGREGATION OF WOMEN OF THE ROMAN CATHOLIC CHURCH ("CONGREGATION"), SERVING ON THE PROVINCIAL AND THE PROVINCIAL COUNCIL (COLLECTIVELY "PROVINCIAL LEADERSHIP"), THE PROVINCIAL TREASURER, THE DIRECTOR OF HEALTHCARE OF THE PROVINCE, AND SIX ADDITIONAL SISTERS APPOINTED BY THESE LISTED ABOVE SHALL BE MEMBERS OF FRANCISCAN ALLIANCE, INC. THE BOARD OF TRUSTEES SHALL CONSIST OF 15 INDIVIDUALS INCLUDING: (A) THREE TRUSTEES SHALL BE MEMBERS OF THE PROVINCIAL LEADERSHIP OF THE PROVINCE, ONE WHOM SHALL BE THE PROVINCIAL, OR HER DESIGNEE, AND THE REMAINING TWO SHALL BE ELECTED BY THE PROVINCIAL LEADERSHIP; (B) THE TREASURER OF THE PROVINCE WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (C) THE DIRECTOR OF ALL OF THE HEALTH CARE SERVICES OF THE PROVINCE, WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (D) THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; AND (E)THE MEMBERS SHALL ELECT THE REMAINING TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B NO ACTION ON THE PART OF THE BOARD OF TRUSTEES IN RESPECT OF ANY OF THE FOLLOWING MATTERS SHALL BE EFFECTIVE UNLESS THE ACTION HAS BEEN APPROVED BY A MAJORITY OF THE MEMBERS; NAMELY: (A) CORPORATE MISSION AND PHILOSOPHY; (B) APPOINTMENT OR REMOVAL OF THE CHAIRPERSON, PRESIDENT, SECRETARY, OR TREASURER OF THE CORPORATION; (C) ALIENATION OF PROPERTY AS DEFINED IN CANON LAW; OR (D) ENCUMBRANCE OF DEBT AS DEFINED BY CANON LAW. FORM 990, PART VI, SECTION B, LINE 11A THE INFORMATION TO PREPARE THE FORM 990 OF FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") IS GATHERED BY FINANCE STAFF AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN'S BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C The Corporation requires annual conflict of interest statements from each director, principal officer, members of committees with board designated powers, key employees, and operation committee members which affirms that they have received, read, and understand the conflict of interest policy and have agreed to comply with the policy. In connection with any actual or possible conflict of interest a director, principal officer or member of a committee with board designated powers must disclose the existence and nature of the financial interest to the directors and members of committees with board delegated powers considering the proposed transaction or arrangements. If after disclosure of the financial interest, the director, principal or committee member shall leave the board or committee meeting while the financial interest is discussed and vote taken. In addition, ongoing reviews and assessments are made to make certain that the Corporation operates in a manner consistent with its charitable purposes. In conducting the ongoing reviews and assessments, the Corporation uses internal and external advisors. Reviews include compensation arrangements, acquisitions, partnerships, joint venture arrangements, and agreements to provide health care products/services, etc. FORM 990, PART VI, SECTION B, LINE 15 Franciscan Alliance, Inc.'s ("Franciscan") process for determining compensation for the organization's President/CEO, officers and key employees consists of annual compensation studies obtained from up to eight different national compensation surveys. These studies are used to benchmark the organization's President/CEO, officers and key employees based on comparable positions within the healthcare industry. In addition to compensation surveys, Franciscan has periodic external reviews completed by independent compensation consultants. The Executive Committee of the Board of Trustees approves the proposed compensation and benefits at an annual compensation review meeting held each year. The organization's President/CEO recuses himself from the vote on executive compensation. FORM 990, PART XI, LINE 5 CHANGES IN NET UNREALIZED GAINS/LOSSES $ 54,185,923 EQUITY IN EARNINGS OF AFFILIATES 15,570,886 MINORITY INTEREST IN AFFILIATES 532,433 NET ASSETS RELEASED FOR OPERATIONS 556,680 NET ASSETS RELEASED FROM RESTRICTION 3,990,000 EQUITY TRANSFERS TO/FROM AFFILIATES 285,984 CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE (64,639,000) CHANGE IN PENSION & POST-RETIREMENT BENEFITS OTHER THAN NET PERIODIC PENSION COSTS INCLUDED IN ACCRUED PENSION LIABILITY (45,071,000) OTHER CHANGES IN NET ASSETS (15,753,527) NET ASSET RECLASS 3,620,778 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS (776,522) CHANGE IN PERMANENTLY RESTRICTED NET ASSETS (6,054,442) ------------- TOTAL OTHER CHANGES IN NET ASSETS (53,551,807) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER M MARLENE SHAPLEY TITLE:TRUSTEE & VP RES MGMT SVCS HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER M MADONNA ROUGEAU TITLE:TRUSTEE & VP OF MISSION - FSJH HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER JANE MARIE KLEIN TITLE:CHAIRPERSON AND TRUSTEE HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER M ANN KATHLEEN MAGIERA TITLE:TREASURER AND TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN D LEAHY TITLE:PRESIDENT AND TRUSTEE HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER M CORITA LAST TITLE:VICE PRESIDENT, SECRETARY HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONALD KERNER MD TITLE:TRUSTEE HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT J BRODY TITLE:REGIONAL CEO CIR HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SETH CR WARREN TITLE:REGIONAL CEO SSCR HOURS:6 ATHENS OUTPATIENT SERVICES LLC 1710 LAFAYETTE ROAD CRAWFORDSVILLE IN 47933 203686603 MEDICAL SRVCS IN 23412490 14702313 NA HEALTHPARTNERS MEDICAL GROUP LLC 1225 E COLLSPRING AVENUE MICHIGAN CITY IN 46320 200474054 HEALTHCARE IN 21373018 4667060 NA SIGMA MEDICAL GROUP LLC 2400 SOUTH STREET LAFAYETTE IN 47904 201716029 MEDICAL SRVCS IN 12433087 2566103 NA ST FRANCIS INSURANCE SERVICES LLC 1600 ALBANY STREET BEECH GROVE IN 46107 200048077 INSURANCE IN 334496 0 NA WELLGROUP HEALTH PARTNERS LLC 333 DIXIE HIGHWAY CHICAGO HEIGHTS IL 60411 050540914 PHYSICIAN IL 74773050 19377290 NA FAITH HOPE AND LOVE CANCER CENTER LLC 1250 SOUTH CREASY LN STE A LAFAYETTE IN 47905 680612977 MEDICAL SRVCS IN 5964630 1675499 NA ALVERNO CLINICAL LABS INC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 352060754 LAB SERVICES IN 501(C)(3) 11 - Type 1 NA HILLS INSURANCE COMPANY INC 1515 DRAGOON TRAIL MISHAWAKA IN 46544 030372512 CAPTIVE INS VT 501(C)(3) 11 - Type 1 NA SISTERS OF ST FRANCIS OF PERPETUAL ADOR PO BOX 766 MISHAWAKA IN 46546 351328145 RELIGIOUS IN 501(C)(3) 1 NA ST ALEXIS HOSPITAL ASSOCIATION PO BOX 1290 MISHAWAKA IN 46546 340714485 SUPPORT ALEXA OH 501(C)(3) 3 NA ST FRANCIS HEALTHCARE FOUNDATION 1600 ALBANY STREET - FINANCE 9010 BEECH GROVE IN 46107 351955283 FUNDRAISING IN 501(C)(3) 11 - Type 1 NA ST JAMES COMMUNITY FOUNDATION 1423 CHICAGO ROAD CHICAGO HEIGHTS IL 60411 204249251 FUNDRAISING IL 501(C)(3) 7 NA SISTERS OF ST FRANCIS N IN HEALTH FDN 1515 W DRAGOON TRAIL MISHAWAKA IN 46544 273041918 FUNDRAISING IN 501(C)(3) 11 - TYPE 1 NA SISTERS OF ST FRANCIS W IN HEALTH FDN 1515 W DRAGOON TRAIL MISHAWAKA IN 46544 FUNDRAISING IN 501(C)(3) 11 - TPYE 1 NA FRANCISCAN IMAGING EQUIPMENT LEASING LLC 1600 ALBANY STREET BEECH GROVE IN 46107 352282509 EQUIPMENT LEASING IN NA RELATED 34388 327928 false 0 false 0.59670 FRANCISCAN PHYSICIANS HOSPITAL LLC 701 SUPERIOR STREET MUNSTER IN 46321 208411919 HOSPITAL IN NA RELATED -3587835 5695957 false 0 false 0.65970 FRANCISCAN PHYSICIANS REAL PROPERTY LLC 701 SUPERIOR STREET MUNSTER IN 46321 260787231 REAL PROP LEASE IN NA RELATED 2624608 36188544 false 0 false 0.89480 FRANCISCAN SURGERY CENTER LLC 1600 ALBANY ROAD BEECH GROVE IN 46107 352128334 MEDICAL SERVS IN NA RELATED 3496854 2004240 false 0 false 0.53230 INDIANA SLEEP DISORDERS CENTER LLC 10176 W 400 N MICHIGAN CITY IN 46360 134275699 SLEEP CENTER IN NA RELATED -3968 0 false 0 false LAFAYETTE HEART PROGRAM HOLDINGS LLC 1501 HARTFORD STREET LAFAYETTE IN 47904 383750811 MEDICAL SERVS IN NA RELATED 516561 14397410 false 0 false 0.51000 ST ANTHONY HEALTH NETWORK LLC PO BOX 310 MISHAWAKA IN 465460310 351985170 PHYSICIAN SRV IN NA RELATED -38208 689894 false 0 true 0.88070 ST FRANCIS MOORESVILLE SURGERY CENTER 1215 HADLEY ROAD SUITE 100 MOORESVILLE IN 46158 202256900 MEDICAL SERVS IN NA RELATED 914327 545710 false 0 false 0.59520 ST FRANCIS RADIATION THERAPY CENTERS LLC 1600 ALBANY STREET BEECH GROVE IN 46107 770663631 MEDICAL SERVS IN NA RELATED 6683290 10238608 false 0 false 0.87000 MAJOR HOSPITAL CARDIAC DIAGNOSTICS LLC 150 West Washington Street Shelbyville IN 46176 208715441 MEDICAL SERVS IN NA RELATED 318206 89227 false 0 false 0.53600 ST FRANCIS IMAGING CTR GREENWOOD LLC 1600 ALBANY STREET BEECH GROVE IN 46107 204607426 MEDICAL SERVS IN NA RELATED 480862 714988 false 0 false 0.60000 TONN AND BLANK CONST LLC 1623 GREENWOOD AVE MICHIGAN CITY IN 46360 263919039 CONSTRUCTION IN NA RELATED 1486332 3225851 false 57153 false 0.56500 FRANCISCAN HOLDING CORPORATION 1515 DRAGOON TRAIL MISHAWAKA IN 46544 363593505 HOLDING COMP IN NA C CORP -620807 37464037 1.00000 HILLS INSURANCE COMPANY LTD 1515 DRAGOON TRAIL MISHAWAKA IN 46544 CAPTIVE INS BD NA C CORP -27387 0 0.00000 ST FRANCIS HEALTH NETWORK 112 N 17TH AVENUE SUITE 210 BEECH GROVE IN 46107 351904455 MANAGED CARE IN NA C CORP 1257 4915474 1.00000 ST JAMES PHO INC 1423 CHICAGO ROAD CHICAGO HEIGHTS IL 60411 363945083 PHYSICIAN SRV IL NA C CORP 71 1156104 0.50000 true true true true false false false false true false false false false false false true false false ALVERNO CLINICAL LABORATORIES INC B 445895 FRANCISCAN PHYSICIANS HOSPITAL LLC I 2415600 FRANCISCAN PHYSICIANS HOPSITAL LLC D 1993493 FRANCISCAN PHYSICIANS HOSPITAL LLC C 129997 FRANCISCAN PHYSICIANS HOSPITAL LLC A 210381 FRANCISCAN PHYSICIANS REAL PROPERTY LLC B 70552 FRANCISCAN SURGERY CENTER LLC C 3683050 HILLS INSURANCE COMPANY LTD B 154606 MAJOR HOSPITAL CARDIAC DIAGNOSTICS LLC C 335347 ST ALEXIS HOSPITAL ASSOCIATION C 1580684 ST FRANCIS HEALTHCARE FOUNDATION C 1492462 ST FRANCIS HEALTHCARE FOUNDATION P 830097 ST FRANCIS IMAGING CENTER (GREENWOOD) LLC C 360000 ST FRANCIS IMAGING CENTER (GREENWOOD) LLC B 97795 ST FRANCIS MOORESVILLE SURGERY CENTER LLC C 680000 ST FRANCIS RADIATION THERAPY CENTERS LLC C 7173468 ST JAMES COMMUNITY FOUNDATION B 1351502 TONN AND BLANK CONSTRUCTION LLC C 1020120 TONN AND BLANK CONSTRUCTION LLC B 1793000 TONN AND BLANK CONSTRUCTION LLC L 81661735