2015-05-07T14:31:17-05:00 2014-06-30 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 606064301 990 2013-07-01 364251848 Alexian Brothers Behavioral Health Hospital ALEX 8478185100 3040 West Salt Creek Lane Arlington Heights IL 600051069 Clayton Ciha President & CEO 8477558004 2015-05-06 1 Laura Gillespie P00855604 3124861000 2015-04-27 2013 2016-02-25 16:41:14Z Clayton Ciha 1650 Moon Lake Blvd Hoffman Est IL 60169 76839807 0 0928 X www.alexianbrothershealth.org X 1998 IL Psychiatric Hospital 9 6 0 12 0 0 246202 258793 70933112 75940421 -15117 0 429123 640593 71593320 76839807 0 0 0 0 42083284 42821200 0 0 0 27207571 27702541 69290855 70523741 2302465 6316066 34167143 39386326 12953114 12950103 21214029 26436223 X Alexian Brothers Behavioral Health Hospital ("ABBHH") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health and housing needs of those we are called to serve. 0 0 30988088 42763095 Inpatient Programs: In fiscal 2014, ABBHH had 6,039 admissions with an average length of stay of 7.8 days. ABBHH provided care to approximately 1,400 adolescents, 3,630 adults and 1,000 geriatric patients. ABBHH offers the complete continuum of behavioral health services, from prevention and early intervention to treatment and aftercare. Our goal is to help individuals of all ages learn ways to manage mental health and substance abuse problems. ABBHH is accredited by The Joint Commission and licensed by the Division of Alcohol and Substance Abuse, which means we meet the highest standards of mental health and substance abuse treatment. 9498841 21004395 Outpatient Programs: ABBHH offers Partial Hospitalization Programs (PHP), day treatment programs for adolescent and adult patients whose symptoms are stabilized and under control. The PHP programs offer a highly intense treatment regimen over a short period of time in order to help individuals move comfortably back into the community. In fiscal 2014, ABBHH served more than 3,800 cases with more than 37,800 visits related to these cases in child/adolescent, adult, eating disorder, self-injury, chemical dependency, obsessive compulsive disorder and school refusal programs. ABBHH also offers Intensive Outpatient Programs (IOP). This low intensity level of care is offered to all age groups for all psychiatric and addiction needs. (See Schedule O.)In the twelve month period ended June 30, 2014, we served over 2,200 cases and offered approximately 21,600 units of service. 10177569 7952722 Group Practice: A team of experienced psychiatrists, psychologists, social workers and professional counselors, with extensive sub-specialty certifications, provide therapy to individuals, couples and families. ABBHH patients also utilize this outpatient care after discharge. In fiscal 2014, there were approximately 91,700 outpatient visits in the Group Practice. 8184772 2550606 The Access Department at Alexian Brothers Behavioral Health Hospital (ABBHH) offers mental health assessments and level of care screenings free of charge to those in need. In fiscal 2014, this department provided more than 15,600 screenings to children, adolescents, adults and older adults. Alexian Brothers Parish Services works to foster healing and wholeness to those who need it through professional counseling, education services and healthcare guidance within the framework of the mission of the Alexian Brothers. 8184772 2550606 58849270 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X David B Jones 8478185100 3040 West Salt Creek Lane Arlington Heights IL 600053557 Lawrence Herforth Director and Chairperson 1.00 1.00 X X 0 0 0 Kathleen Gilmer Director and Vice Chairperson 1.00 1.00 X X 0 0 0 Brother Daniel McCormick CFA Director and Secretary 1.00 1.00 X X 0 0 0 Clayton Ciha Ex-Officio Member & President/CEO 50.00 1.00 X X 0 332166 65458 Christopher D'Agostino MD Director 50.00 0.00 X 0 274110 20379 Gregory Teas MD Director 50.00 0.00 X 0 380527 29230 Thomas Palmer Director 1.00 1.00 X 0 0 0 Dominic Mangone Director (start 5/14) 1.00 1.00 X 0 0 0 James Mortimer Director (end 8/13) 1.00 1.00 X 0 0 0 Patricia Merryweather Director 1.00 1.00 X 0 0 0 David Jones Treasurer 17.00 33.00 X 0 203179 39376 Donna Gauthier Assistant Secretary 1.00 40.00 X 0 74489 15715 Christopher Novak Chief Operating Officer 50.00 0.00 X 0 209035 50884 Clifton Saper Executive Director, Outpatient Svcs 50.00 0.00 X 0 162978 36830 Scott Peterson Vice President, Human Resources 1.00 50.00 X 0 342755 38484 Mark Lerman Psychiatrist 50.00 0.00 X 0 742637 26495 Michael Brilliant Psychiatrist 50.00 0.00 X 0 435895 24041 Mumataz F Raza Psychiatrist 50.00 0.00 X 0 424128 25237 Syed Salahuddin Psychiatrist 50.00 0.00 X 0 360546 17581 Renato De Los Santos Psychiatrist 50.00 0.00 X 0 502300 7460 Delia Aldridge Former Officer 50.00 0.00 X 0 193598 21800 Jim Lewandowski Former Key Employee 0.00 0.00 X 0 722305 15727 0 5360648 434697 0 1 1 0 0 258793 258793 Patient Service Rev 622210 40478525 40478525 Medicare/Medicaid Rev 622210 23998832 23998832 Group Practice 624190 7952722 7952722 Research Revenue 541900 2124834 2124834 School Reimbursements 900099 1289360 1289360 96148 96148 75940421 Professional Fees 900099 243850 243850 Cafeteria Revenue 722210 185363 185363 Course & Workshop Fees 611710 63580 63580 147800 147800 640593 76839807 74270817 0 2310197 35677883 30160952 5516931 958984 840118 118866 3823375 3349467 473908 2360958 2034958 326000 12175 12175 -40500 -40500 9269 9269 6110708 3174955 2935753 153522 153522 694681 226219 468462 45909 45909 1802590 1358297 444293 400765 266837 133928 55755 46517 9238 834972 834972 973971 779177 194794 1344541 1272535 72006 Management Fees 9017903 9017903 0 0 Medicaid Tax 5354648 5354648 0 0 Medical Supplies 803896 803896 0 0 Dues 123729 0 123729 0 4007 4007 70523741 58849270 11674471 0 2285408 5914750 7572621 8872037 92650 111225 103878 334478 26383553 2354845 23896788 24028708 215798 125128 34167143 39386326 4044726 3078976 1144620 141127 7763768 9730000 12953114 12950103 X 21120157 26436223 93872 0 21214029 26436223 34167143 39386326 X 6316066 -1093872 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9269 9269 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Alexian Brothers Behavioral Health Hospital does not participate in or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office. 1540000 1540000 22542411 1622198 20920213 50828 4188 46640 2174162 722158 1452004 76152 6301 69851 24028708 Est Paybles Under 3rd Party Reimbursement 2700527 Due to Affiliates 5205384 Other Current Liabilities 40916 Reserve for Outstanding Insurance Losses 1783173 9730000 X Part X, Line 2: From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Alexian Brothers Behavioral Health Hospital: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2014. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 703 363750 363750 0.00520 907 10126101 7004626 3121475 0.04430 1610 10489851 7004626 3485225 0.04950 7 92915 2733084 256427 2476657 0.03510 3 4517 893549 57705 835844 0.01190 0 1 91 5809 5809 0.00010 1 150 3869 3869 0.00010 12 97673 3636311 314132 3322179 0.04720 12 99283 14126162 7318758 6807404 0.09670 1 1330 2480 2480 0.00000 1 2399 15219 150 15069 0.00020 1 2 92 92 0.00000 3 3731 17791 150 17641 0.00020 0 619107 61911 17905929 17715153 190776 X 1 1 1 1 Alexian Brothers Behavioral Health Hospi 1650 Moon Lake Boulevard Hoffman Estates IL 601691010 www.alexianbrothers.org/abbhh 0005009 X Psychiatric Hospital Alexian Brothers Behavioral Health Hospi 1 1 X X X X X X X X X 12 1 1 1 X www.alexianbrothershealth.org/abbhh X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X X X X X 1 1 X X X 1 0 X X X X 0 X X 0 0 Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 3: As part of the Community Health Needs Assessment, four focus groups were held in June, 2012. The focus groups were distributed geographically throughout the region, including three groups with a county-level focus, and another focusing on the needs of residents specifically in North Cook County. In total, 31 key informants took part, including physicians, other health professionals, social service providers and community leaders. Each of the county-level groups also included representatives with expertise in public health. The focus groups provided qualitative as opposed to quantitative data and were designed to gather input from participants regarding their informed opinions and perceptions of the health of the residents in the area. Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 4: The other hospital facilities with which the reporting hospital conducted its CHNA include:Adventist Midwest Health- Adventist La Grange Memorial Hospital- Adventist GlenOaks Hospital - Adventist Hinsdale HospitalAlexian Brothers Health System - Alexian Brothers Medical Center- St. Alexius Medical Center Cadence Health - Central DuPage HospitalEdward Hospital Elmhurst Memorial Hospital Franciscan St. James HealthIngalls Health System - Ingalls Memorial HospitalLa Rabida Children's HospitalLittle Community of Mary Hospital & Health Care Centers Northwest Community HospitalNorthwestern Lake Forest HospitalNorthwestern Memorial HospitalPalos Community HospitalPresence Health- Holy Family Medical Center- Our Lady of the Resurrection Medical Center- Resurrection Medical Center- Saint Francis Hospital- Saint Joseph Hospital- Saints Mary and Elizabeth Medical CenterRush University Medical Center - Rush Health - Rush Oak Park Hospital Saint Anthony Hospital Saint Bernard Hospital and Health Care CenterSwedish Covenant Hospital Thorek Memorial Hospital University of Chicago Medical Center University of Illinois Hospital & Health System Vanguard Health Systems MacNeal HospitalWeiss Memorial Hospital Westlake Hospital West Suburban Medical Center Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 5d: The Implementation Strategy was also made widely available at the following link:http://www.alexianbrothershealth.org/CommunityNeeds Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 7: Disproportionate Unmet Community Health Needs Identified:- Access to Health Care Services - under and uninsured, cost of medication, lack of access to specialty care- Prevalence of Cancer - Chronic Kidney Disease*- Diabetes - Heart Disease/Stroke* - Low Birth Weight - Mental Health & Mental Disorders - Nutrition and Obesity*- Oral Health - Pneumonia/Influenza Death *Related to, caused by or exacerbated by Type II DiabetesMental Health and Access to Services were consistently the major issues for our community. These observations validated our own community experience and the quantitative data within the study. Mental health access is being addressed through Alexian Brothers Behavioral Health Hospital (ABBHH). Access to healthcare will be improved through the Affordable Care Act, but there is still a need to support access through the provision of specialty physician care in partnership with Federally Qualified Health Centers.Type II Diabetes was selected as a high priority focus by Alexian Brothers Medical Center (ABMC) and St. Alexius Medical Center (St. Alexius) because many of the other community needs are directly or indirectly related. Chronic kidney disease, heart disease and stroke, nutrition and weight status are affected or even caused by Type II Diabetes. In the Emergency Departments of ABMC and St. Alexius, many low income and Hispanic patients seek care for untreated diabetes and have no medical home (access to health care services). Additionally, persons with Type II Diabetes complicated by co-morbidities are unable to access specialty endocrinologist care as often, the specialists will not accept the very low reimbursement offered by Medicaid. Low birth weight is being addressed via partnerships with the March of Dimes. Oral health is beginning to be provided by Federally Qualified Health Centers and did not meet feasibility criteria related to financial or clinical resources. Regarding cancer, one issue in the Community Health Analysis was a reduction in the number of women receiving mammograms. This is likely an artifact of confusion regarding screening recommendations and will be monitored to determine if there is a trend. The other issue is prevalence of cancer overall. This is likely due to the aging population in some parts of our service area; therefore, the number of existing cases may rise as people live longer with these cancers. This issue will require further investigation and trending to understand if this is actually a negative finding or just an artifact.Pneumonia and influenza vaccines are given a high priority in quality and outcome measures in the Alexian Brothers Accountable Care Organization and employed physician practices. In addition, all Alexian employees are required to be vaccinated for influenza to protect our patients. A Pneumonia vaccine is made available to all geriatric inpatients and all those over 18 are offered a flu vaccine. Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 14g: All bills and statements include information regarding charity. The front of the statement 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 the 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.alexianbrothershealth.org".In addition, all uninsured patients receive a letter from our Patient Financial services department once we complete a process of attempting to identify alternative coverage for uninsured patients. This letter is sent at the beginning of the statement cycle for each uninsured patient. The text of the letter provides as follows:"Thank you for choosing Alexian Brothers Behavioral Health Hospital 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."ABBHH 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. Alexian Brothers Health System's (ABHS) website, the main website for all System hospitals, including ABBHH, features information on how to apply for charity care on-line. In the hospital setting, we employ individuals who are available to work with patients and we also have Medicaid application specialists to assist patients that may qualify. In addition, all bills and statements include information regarding charity. Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 19d: Alexian Brothers Behavioral Health Hospital is a psychiatric hospital which does not operate a typical medical surgical emergency room. Patients may arrive at the psychiatric hospital seeking an assessment or treatment for concerns ranging from danger to self or others to traditional outpatient mental health services. For those patients that do arrive in crisis, the hospital is capable of accepting and treating these patients. Factors that will determine whether a patient can be admitted include occupancy levels and bed availability. The hospital does follow the federal IMD exclusion regulation, which does not allow the hospital to treat patients covered under Medicaid that are of an Adult age (22-64). Patients that meet the requirements for admission to the psychiatric facility are admitted regardless of their insurance coverage or the ability to make payment. Alexian Brothers Behavioral Health Hospital Part V, Section B, Line 20d: Alexian Brothers Behavioral Health Hospital uses the State of Illinois, Hospital Uninsured Patient Discount Act guidelines which specify that eligible patients should be charged 135% of hospital costs. 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 Uninsured0-200% 100%201-300% 75%301-600% 70%>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 2014 filed Medicare cost report was used to calculate cost.- Unreimbursed Medicaid - costs are calculated using the 2014 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 II, Community Building Activities: In the twelve months ended June 30, 2014, ABBHH 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 3: Management works very closely with individuals to determine if they qualify for charity. However, not everyone who is eligible for charity completely cooperates with the process, and as a result, management cannot identify all charity cases with 100% certainty. Based on a sample of accounts reviewed that were originally classified as bad debt expense, management believes that 10% of the accounts, or $61,911 at cost, of our bad debt expense would meet the criteria of our charity program if patients shared their financial condition.Discounts and payments are not included in bad debt expense in the financial statements for ABBHH unless the payment is a recovery of amounts previously written off as bad debt. Recoveries are classified as a decrease to bad debt expense. Part III, Line 4: ABBHH is part of the Ascension Health Alliance consolidated audit. The footnote that references bad debt expense can be found on page 19 of the audited financial statements.ABBHH's share of bad debt expense for ABHS for the twelve months ended June 30, 2014 was $1,739,065 at charges ($619,107 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.Healthcare Reform has resulted in billions of dollars being removed from health provider payments, mostly hospital payments. This is a trend that will continue for at least another seven years. The systematic degradation of reimbursement that is already less than the cost of providing the service for the vast majority of hospitals needs to be considered community benefit to accurately represent the significant contributions that hospitals make toward easing government burden in caring for a growing number of its citizens. Part III, Line 9b: It is the policy of ABHS, including ABBHH, 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 his/her 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 that may be available to help the patient meet his/her 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. In addition; all bills and statements include information regarding charity. Part VI, Line 2: The 2012 Community Health Needs Assessment surveyed thirty-eight zip codes representing a total population of more than 2,400,000 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 U.S. 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. As part of the Community Health Needs Assessment, four focus groups were held in June, 2012. The focus groups were distributed geographically throughout the region, including three groups with a county-level focus, and another focusing on the needs of residents specifically in North Cook County. In total, 31 key informants took part, including physicians, other health professionals, social service providers and community leaders. Each of the county-level groups also included representatives with expertise in public health. The focus groups provided qualitative as opposed to quantitative data and were designed to gather input from participants regarding their informed opinions and perceptions of the health of the residents in the area. While this assessment is quite comprehensive, it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. It should be recognized that these information gaps might in some ways limit the ability to assess all of the community's health needs. For example, certain population groups such as the homeless or those who only speak a language other than English or Spanish are not represented in the survey data. In terms of content, this assessment was designed to provide a comprehensive and broad picture of the health of the overall community. The following are examples of meeting community need not necessarily identified in the CHNA but through routine interactions with schools, social service agencies or churches. Alexian Brothers Behavioral Health Hospital (ABBHH) utilizes the community health assessment to track data regarding the incidence and prevalence of widespread chronic disease in the community such as depression, as well as, access to treatment. However, to effectively respond to some issues the community health assessment must be combined with input and data from other agencies such as schools, police departments, and social service providers. One such instance is with regard to depression amongst teens. In 2010 ABBHH was contacted by multiple school districts in our service area for help with suicide prevention amongst students. Based upon data collected from the schools, it became clear that the root cause was bullying.In our own programming at ABBHH, we are seeing an unprecedented degree of reported school and community violence, intimidation of those with special needs, sexual orientation issues, weight problems/eating disorders, or from those in minority groups. Over the years we have treated the bullies, the victims and the bystanders in our programs, as well as provided consultation to families, schools, workplaces and communities impacted by such violence. At ABBHH, we have historically seen patients who report school and community violence and intimidation/harassment of people with special needs, sexual orientation issues, weight problems/eating disorders, other mental illnesses, or those in minority groups. We have treated the perpetrators, the victims, and the bystanders in our programs, as well as provided consultation to families, schools, workplaces, and communities impacted by such violence.We have expanded our scope of interest in the community from bullying to violence in general. In addition to our participation in the Coalition for a Psychologically Healthy Community, we have re-tooled our internal behavioral health committee ("Stand Up Against Violence Everyone, Everywhere") to provide trainings for our Associates and Community Members on date rape, domestic violence, relational aggression, and workplace violence. The committee also reviews proposed anti-violence legislation drafted by the State Legislature.We created a virtual Resource Center which can be found at www.c4phc which includes links to books, articles, videos, and events. We also continue to refine the "Up-stander" modules used in the ABBHH treatment of Children and Adolescents. Plus we have been providing "Culture of Compassion" and Leadership Development programs to schools interested in utilizing our psychological expertise in violence prevention. Part VI, Line 3: Multiple methods are used at ABBHH to communicate 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 ABBHH, features information on how to apply for charity care on-line. In the hospital setting, we employ individuals who are available to work with patients to help them apply for charity with dignity. In addition, Alexian Brothers Center for Mental Health (ABCMH), an affiliated community mental health center, employs an individual who works for both ABCMH and ABBHH to help families of our child and adolescent patients apply for Medicaid when appropriate. In addition, all bills and statements include information regarding charity care options. Part VI, Line 4: A description of the geography served by zip code and mapping is available for each hospital on our website, www.alexianbrothershealth.org under the community benefit section, choose desired hospital, pages 7-8.The demographics of the population served is available for each hospital on our website, www.alexianbrothershealth.org under the community benefit section, choose desired hospital, page 10. Part VI, Line 5: ABBHH's governing body is known as 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, ABBHH extends medical staff privileges to interested and qualified psychiatrists in our community and endeavors to provide them with the safest and most advanced psychiatric interventions available. ABBHH strives to fully serve the community through participation in government as well as sponsored healthcare programs such as Medicare, Medicaid, and Tricare, and participating in research and education.Pharmaceutical based research includes the persistent disorders of schizophrenia, bipolar disorder and major depressive disorder, as well as research in the disorders of adolescents and childhood. ABBHH also operates a center for evidence based practice which researches the efficacy of treatment through outcomes based measurement. On average, ABBHH has 20 research trials at any given time. Part VI, Line 6: ABBHH is an affiliate of Alexian Brothers Health System (ABHS). ABHS is the national member and ultimate parent of ABBHH. ABHS, with its corporate offices located in Arlington Heights, Illinois, is sponsored by Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, throughtout the United States and the District of Columbia.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 community, 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.Net community benefits expense for ABHS in 2014 is as follows:Charity Care at Cost - $21,397,164Language Assistant Services - $638,260Excess of Government Sponsored Health Care Cost Over Reimbursement -Medicaid - $44,099,925Donations - $145,028Education - $2,546,552Subsidized Health Services - $2,225,984Other Community Benefit Programs - $7,490,327Total Charity Care and Community Benefits - $78,543,240Information has been included for all exempt entities in ABHS. The information for the hospitals included has been calculated on a basis consistent with the requirements for the Illinois Attorney General Community Benefit report.In addition, ABHS reported bad debt expense (at cost) of $10,141,843 in the twelve months ended June 30, 2014 and excess of Medicare costs over reimbursement of $51,883,429 in 2014.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.St. Alexius Medical Center - An acute care hospital located in Hoffman Estates, Illinois that provides inpatient, outpatient and emergency services, including specialties in the areas of cardiology, neurosciences, orthopedics, oncology, bariatrics and pediatrics.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 and Alexian Brothers Bettendorf Place, LLC - Provides supportive services, transitional and permanent supportive housing for persons with HIV/AIDS.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 Services, Inc. - 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). 1 0 0 0 0 0 0 0 0 Clayton Ciha Ex-Officio Member & President/CEO 0 251527 0 69206 0 11433 0 32152 0 33306 0 397624 0 11433 Christopher D'Agostino MD Director 0 274110 0 0 0 0 0 9658 0 10721 0 294489 0 0 Gregory Teas MD Director 0 318977 0 44050 0 17500 0 14773 0 14457 0 409757 0 0 David Jones Treasurer 0 164048 0 30857 0 8274 0 11269 0 28107 0 242555 0 8274 Christopher Novak Chief Operating Officer 0 169216 0 33816 0 6003 0 17817 0 33067 0 259919 0 6003 Clifton Saper Executive Director, Outpatient Svcs 0 147879 0 15099 0 0 0 22825 0 14005 0 199808 0 0 Scott Peterson Vice President, Human Resources 0 302795 0 39960 0 0 0 14311 0 24173 0 381239 0 0 Mark Lerman Psychiatrist 0 742637 0 0 0 0 0 5644 0 20851 0 769132 0 0 Michael Brilliant Psychiatrist 0 435895 0 0 0 0 0 15102 0 8939 0 459936 0 0 Mumataz F Raza Psychiatrist 0 424128 0 0 0 0 0 15128 0 10109 0 449365 0 0 Syed Salahuddin Psychiatrist 0 360546 0 0 0 0 0 6880 0 10701 0 378127 0 0 Renato De Los Santos Psychiatrist 0 502300 0 0 0 0 0 0 0 7460 0 509760 0 0 Delia Aldridge Former Officer 0 193598 0 0 0 0 0 11971 0 9829 0 215398 0 0 Jim Lewandowski Former Key Employee 0 0 0 0 0 722305 0 0 0 15727 0 738032 0 722305 Part I, Line 3 Alexian Brothers Health System, a related organization of Alexian Brothers Behavioral Health Hospital, uses the following methods to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Compensation survey or study - Approval by the Board or Compensation Committee Part I, Line 4a: The following individuals listed in Schedule J received the referenced amount of change in control payments in calendar year 2013. The payments under a change-of-control arrangement are made in connection with retirement that changed the terms of employment resulting from a change in control of the organization: Jim Lewandowski - $689,832 Anthony D'Agostino Father of Director 299975 Employment 0 Health Plus Physicians Organization Chief Medical Officer 151482 Capitation 0 Schedule L, Part IV: Dr. Teas is a Director of Health Plus Physicians Organization. ABBHH received capitation and administrative payment totaling $151,482 from this IPA in FY14. Form 990, Part V, Line 1a: Alexian Brothers Health System, a related organization of Alexian Brothers Behavioral Health Hospital, uses a common bank account to compensate all independent contractors within the Health System. The number attributable to each organization is not easily distinguished. The total number of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of the Alexian Brothers Health System Form 990. Form 990, Part VI, Section A, line 2 Donna Gauthier, Clayton Ciha, Clifton Saper, Christopher D'Agostino, Gregory Teas, David Jones, Scott Peterson and Christopher Novak have a business relationship due to joint employment by a common health system entity. Form 990, Part VI, Section A, line 6 Alexian Brothers Behavioral Health Hospital has two classes of members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Hospital Network (the "Area Member"). Form 990, Part VI, Section A, line 7a Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of Alexian Brothers Behavioral Health Hospital. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Alexian Brothers Behavioral Health Hospital's financial information or corporation as a whole are subject to approval by the National Member, Alexian Brothers Health System. Form 990, Part VI, Section B, line 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 conflicts 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 CEO the process, performed by Alexian Brothers Health System, a related organization of Alexian Brothers Behavioral Health Hospital, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee of the Board of Governors of Alexian Brothers Health System reviewed and approved the compensation. In the review of the compensation, the compensation of the CEO was compared to the compensation of those in positions in other similarly situated organizations that hold the same or a similar title. During the review and approval of the compensation, the documentation of the decision was recorded in the Compensation Committee minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other similarly situated organizations' employees that hold the same or similar title. During the review and approval of the compensation by the Compensation Committee, documentation of the decision was recorded in the minutes. Form 990, Part VI, Section C, line 19 The financial statements of Alexian Brothers Behavioral Health Hospital are available through the Office of the Illinois Attorney General. Conflicts of Interest statements and the governing documents of Alexian Brothers Behavioral Health Hospital are not made available to the public. Form 990, Part XI, line 9: Working Capital Transfer -1,093,872. Part XII, Line 2b - Audit Disclosure: The financial statements of Alexian Brothers Behavioral Health Hospital were audited on a consolidated basis. The Audit Committee of the Board of Governors of Alexian Brothers Health System has been delegated the responsibility to oversee the audited financial statements and the selection of the independent accountants that audit the financial statements. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 60005 363260495 Supports provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Alexian Brothers Bonaventure House 825 Wellington Avenue Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 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 Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Specialty Group 3040 W Salt Creek Lane Arlington Heights IL 60005 800710751 Specialty physician practice group IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers of San Jose Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 941530037 Acute care hospital (sold in 1998) TX Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 60005 364484290 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 431295333 HUD housing MO Section 501(c)(3) Schedule A, 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 Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Community Services 425 Cumberland Street Suite 110 Chattanooga TN 37404 364344423 Provides comprehensive & coordinated community based services IL Section 501(c)(3) Schedule A, 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 Section 501(c)(3) Schedule A, Line 7 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 392039667 Community outreach WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Lansdowne Village 4624 Lansdowne St Louis MO 63116 431470362 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 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 Section 501(c)(2) N/A 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 Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 St Alexius Medical Center 1555 Barrington Road Hoffman Estates IL 60194 364251846 Acute care hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 60005 364336931 Physician services IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Road Elk Grove Village IL 60007 300221481 Rehabilitation Hospital IL N/A Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 870783164 Provision of NeuroMeg Services IL N/A Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 60005 363853289 Medical Office Building IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages Managed Care Contracts DE N/A Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 861115516 Ownership of Gamma Knife IL N/A St Alexius Center for Sleep Health LLC 1300 S Main Street Lombard IL 60148 205876371 Operations of Sleep Lab IL N/A Thelen Corporation 3040 W Salt Creek Lane Arlington Heights IL 60005 363266316 Owns/leases property; joint venture partner IL N/A C 0 Alexian Brothers Health Providers Association Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363853286 Messenger model IPA IL N/A C 0 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 Alexian Village of Elk Grove 3040 W Salt Creek Lane Arlington Heights IL 60005 352211303 Tax credit financed housing IL N/A C 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 Alexian Brothers Health System P 7222603 FMV Alexian Brothers Hospital Network P 3772612 FMV Alexian Brothers Health System R 1000000 FMV Alexian Brothers Health System J 776008 FMV Alexian Brothers Health System S 14505573 FMV Alexian Brothers Health System C 258793 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