2024-05-14T13:32:36-05:00 2023-06-30 351750664 DAUBY O'CONNOR & ZALESKI LLC 501 CONGRESSIONAL BLVD 300 CARMEL IN 46032 990 2022-07-01 363438977 LAVERNA TERRACE HOUSING CORPORATION LAVE 3172718888 18927 HICKORY CREEK DRIVE 300 MOKENA IL 60448 LISA MUSGRAVE SENIOR VICE PRESIDENT 3172718888 2024-05-14 1 LISA MUSGRAVE 999009999 0 JESSICA COOPER P01011828 3178485700 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PROVENA LAVERNA TERRACE LISA MUSGRAVE 4600 EDMUNDSON RD ST LOUIS MO 63134 513149 0 X N/A X 1982 IN PROVIDE AFFORDABLE HOUSING FACILITIES FOR LOW-INCOME ELDERLY AND HANDICAPPED INDIVIDUALS. 3 1 0 2 0 0 318303 296574 212210 214844 -2716 -42669 814 1250 528611 469999 0 0 0 0 0 0 0 0 0 580741 542140 580741 542140 -52130 -72141 4251296 4153322 147182 121349 4104114 4031973 PROVIDE AFFORDABLE HOUSING FACILITIES FOR LOW-INCOME ELDERLY AND HANDICAPPED INDIVIDUALS. 0 0 493034 172944 THE ORGANIZATION PROVIDES AFFORDABLE HOUSING TO LOW-INCOME SENIOR INDIVIDUALS. THE ORGANIZATION OWNS & OPERATES A 51 UNIT APARTMENT COMMUNITY. THE RENTS CHARGED TO TENANTS ARE SUBSIDIZED AND REGULATED BY THE U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT. AS PART OF THE ASCENSION CATHOLIC HEALTH MINISTRY, THE FILING ORGANIZATION SERVED IN SUPPORT OF ASCENSION'S COMMITMENT TO BOTH CARE FOR PATIENTS AND COMMUNITIES AND SUPPORT CAREGIVERS AND OTHER ASSOCIATES THROUGH THE CHALLENGES OF THE COVID-19 GLOBAL PANDEMIC IN 2020, 2021, & 2022. 493034 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 IN X X DOMINION REALTY INC 3172718888 8355 ROCKVILLE ROAD INDIANAPOLIS IN 46234 DAVID BORDO BOARD MEMBER 40.00 5.00 X 0 794363 48810 BRAD S FOLEY BOARD CHAIR 1.00 43.00 X X 0 0 0 KAREN LAUER BOARD MEMBER 40.00 5.00 X 0 38671 6131 DANIEL STRICKER PRESIDENT & CEO, ASCENSION 1.00 50.00 X 0 1429457 25705 LISA ANN MUSGRAVE SENIOR VP 1.00 50.00 X 0 418580 25944 MICHAEL GORDON CFO 1.00 40.00 X 0 547100 42377 0 3228171 148967 0 0 1 0 0 296574 296574 RENTAL INCOME 531110 214844 214844 214844 481 481 43150 -43150 -43150 -43150 TENANT CHARGES 531110 1250 1250 1250 469999 172944 0 481 29988 29988 16098 16098 2510 2510 10425 10425 165392 165392 5208 2188 3020 961 961 193965 193965 MGMT CO EMPLOYEE CHARGE 117263 117263 BAD DEBTS 330 330 542140 493034 49106 0 16040 99970 8261 4549 332 340 6186877 2280225 4069547 3906652 137626 99931 19490 41880 4251296 4153322 61085 99210 117 2559 65491 0 20489 19580 147182 121349 X 4104114 4031973 4104114 4031973 4251296 4153322 -72141 0 X X 0 1 X 1 1 1 X 283488 297710 252236 318303 296574 1448311 207887 206353 206683 212210 214844 1047977 491375 504063 458919 530513 511418 2496288 23526 23526 0 23526 23526 2472762 865 679 262 162 481 2449 865 679 262 162 481 2449 6950 550 775 814 1250 10339 499190 505292 459956 531489 513149 2509076 0.98550 0.98720 0.00100 0.00090 X SCHEDULE A, PART III, LINE 12: INCLUDED ON PAGE 9 IN CURRENT YEAR OTHER REVENUE LINE 7C IS A LOSS ON DISPOSAL OF DEPRECIABLE ASSETS OF $43,150. THE LOSS IS NOT BEING INCLUDED ON SCHEDULE A, PART III, LINE 12 BECAUSE IT DOES NOT MEET THE DEFINITION OF SUPPORT AS DEFINED IN SECTION 509(D) OF THE INTERNAL REVENUE CODE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 68281 68281 5366826 1640480 3726346 741205 629180 112025 10565 10565 0 3906652 ACCRUED MGMT FEE PAYABLE 2499 SECURITY DEPOSITS 17081 19580 X 513149 43150 43150 469999 0 469999 585290 43150 43150 542140 0 542140 PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND STATE INCOME TAX AND HAS BEEN CLASSIFIED AS AN OTHER THAN PRIVATE FOUNDATION. ACCORDINGLY, NO PROVISION FOR FEDERAL AND STATE TAXES ON REVENUE AND INCOME HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. GENERALLY, THE FEDERAL AND STATE TAX RETURNS WERE SUBJECT TO EXAMINATIONS FROM THE THREE YEARS AFTER THE LATER OF THE ORIGINAL OR EXTENDED DUE DATE OR THE DATE FILED WITH THE APPLICABLE TAX AUTHORITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN / LOSS ON DISPOSAL 43,150. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN / LOSS ON DISPOSAL 43,150. 0 0 0 0 0 0 0 0 0 DANIEL STRICKER PRESIDENT & CEO, ASCENSION 0 875500 0 283444 0 270513 0 6296 0 19409 0 1455162 0 0 DAVID BORDO BOARD MEMBER 0 624450 0 142500 0 27413 0 19825 0 28985 0 843173 0 0 MICHAEL GORDON CFO 0 438596 0 100980 0 7524 0 19825 0 22552 0 589477 0 0 LISA ANN MUSGRAVE SENIOR VP 0 363090 0 40000 0 15490 0 14725 0 11219 0 444524 0 0 SCHEDULE J, PART I, LINE 3: DETERMINATION OF COMPENSATION OF ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF PRESENCE HEALTH NETWORK, THE ULTIMATE PARENT OF THE CORPORATION. SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF PRESENCE HEALTH NETWORK, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. PRESENCE HEALTH NETWORK USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE BOARD. SCHEDULE J, PART I, LINE 4A: SEVERANCE PAYMENTS: PRESENCE HAS THREE SEVERANCE PLANS DEPENDING UPON LEVEL. THESE PLANS ALLOW INDIVIDUALS WHOSE JOBS HAVE BEEN ELIMINATED AND WHO HAVE NOT BEEN ABLE TO FIND A SIMILAR POSITION WITHIN THE SYSTEM TIME TO TRANSITION. THE NUMBER OF WEEKS OF WAGE CONTINUATION ARE BASED UPON LENGTH OF SERVICE. THE PLANS ARE NOT FUNDED. SCHEDULE J, PART I, QUESTION 4B: PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: IN ORDER TO ENHANCE THE ABILITY OF PRESENCE HEALTH TO ATTRACT AND RETAIN QUALIFIED MANAGEMENT PERSONNEL BY PROVIDING ELIGIBLE EXECUTIVES WITH ADDITIONAL RETIREMENT BENEFITS ON A DEFERRED BASIS, PRESENCE HEALTH NETWORK MAINTAINS AN UNFUNDED SUPPLEMENTAL RETIREMENT PLAN (THE "PLAN") FOR A SELECT GROUP OF MANAGEMENT, WHICH IS INTENDED TO COMPLY WITH SECTION 457(F), AND SECTION 409A OF THE INTERNAL REVENUE CODE. THE PLAN, PRESENCE HEALTH NETWORK CREDITS TO SUCH ELIGIBLE EXECUTIVE'S RETIREMENT ACCOUNT AN AMOUNT BASED ON A PERCENTAGE OF SALARY. EARNINGS AND/OR LOSSES ON INVESTMENTS ARE CREDITED AT A RATE EQUAL TO THE RATE OF RETURN OVER THE SAME PERIOD ON INVESTMENT OPTIONS SLECTED BY THE ELIGIBLE EXECUTIVE. ELIGIBLE EXECUTIVES ARE ENTITLED TO RECEIVE BENEFITS ON THE EARLIEST OF (I) JANUARY 1 OF THE THIRD CALENDAR YEAR BEGINNING AFTER THE YEAR IN WHICH SUCH CONTRIBUTION IS CREDITED, (II) ATTAINING AGE 62, OR (III) ATTAINING THE AGE OF 60 IF THE ELIGIBLE EXECUTIVE HAS COMPLETED TEN (10) YEARS OF SERVICE. FORM 990, PART VI, SECTION A, LINE 3 PROVENA LAVERNA TERRACE IS MANAGED BY NATIONAL CHURCH RESIDENCES. NATIONAL CHURCH RESIDENCES HAS A PROJECT OWNER'S AND MANAGEMENT AGENT'S CERTIFICATION FOR MULTIFAMILY HOUSING PROJECTS WITH THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. UNDER THIS CERTIFICATION, HUD HAS APPROVED NATIONAL CHURCH RESIDENCES TO MANAGE THE PROVENA LAVERNA TERRACE COMMUNITY. THE MANAGEMENT CONTRACT ENCOMPASSES THE DAY TO DAY OPERATIONS OF THE PROJECT INCLUDING, BUT NOT LIMITED TO, COLLECTION OF RENTS, MAINTENANCE OF FACILITIES, SUPERVISION OF STAFF, AND ONGOING SUPPORT FOR BOTH THE OWNERS AND TENANTS AS NEEDED IN ORDER TO ESTABLISH A SAFE, SANITARY AND AFFORDABLE ENVIRONMENT. FORM 990, PART VI, SECTION B, LINE 11B DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS WHICH MAY INCLUDE, AS NEEDED, FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO DESIGNATED MANAGEMENT TEAM MEMBERS WITH EXPERIENCE IN TAX IN LIEU OF THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, AS WELL AS THAT OF ANY OTHER OFFICERS OR SENIOR EXECUTIVES (IF ANY), IS DIRECTED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION'S BOARD COMMITTEE RESPONSIBLE FOR COMPENSATION OVERSEES THE PROCESS, UTILIZING INDEPENDENT DELEGEES WITHIN THE ORGANIZATION AS APPROPRIATE, DEPENDING ON THE ROLE. IN SOME CASES, THE PROCESS MAY UTILIZE COMPARABILITY DATA AND ANALYSIS FROM A NATIONAL THIRD-PARTY COMPENSATION FIRM; OR, IF MORE APPROPRIATE FOR THE ROLE, IT MAY INSTEAD UTILIZE OTHER APPLICABLE SOURCES OF MARKET COMPARABILITY DATA AS NEEDED TO VERIFY REASONABLENESS. THE PROCESS ALSO INCLUDES CONTEMPORANEOUS SUBSTANTIATION OF THE ANALYSIS AND DECISION REGARDING THE COMPENSATION ARRANGEMENT. COMPENSATION IS REVIEWED AT LEAST ANNUALLY AND THE PROCESS IS ADMINISTERED TO ASSURE INDEPENDENCE, AVOID CONFLICTS OF INTEREST, ENSURE REASONABLENESS AND MARKET COMPARABILITY OF TOTAL COMPENSATION, AND TO OTHERWISE ABIDE BY PERTINENT LAWS AND REGULATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND TAX RETURNS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S OFFICERS AND DIRECTORS ARE RESPONSIBLE FOR OVERSEEING THE AUDIT PROCESS, REVIEWING THE FINANCIAL STATEMENTS AND FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 472360513 JOINT OPERATING COMPANY IL 501(C)(3) LINE 12B, II N/A 0 ALEXIAN BROTHERS AMBULATORY GROUP C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364336931 PHYSICIAN SERVICES IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364251848 BEHAVIORAL HEALTH HOSPITAL IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS BONAVENTURE HOUSE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363527899 HOUSING AND SUPPORTIVE CARE SERVICES FOR PERSONS WITH HIV/AIDS IL 501(C)(3) LINE 10 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363045007 OUTPATIENT COMMUNITY MENTAL HEALTH SERVICES IL 501(C)(3) LINE 10 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS HOSPITAL NETWORK C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363276552 SUPPORTS THE PROVISION OF HEALTHCARE SERVICES FOR RELATED CORPORATIONS IL 501(C)(3) LINE 12C, III-FI ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS MEDICAL CARE GROUP NFP C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 471930457 PHYSICIAN SERVICES IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS MEDICAL CENTER C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 362596381 ACUTE CARE HOSPITAL IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS MEDICAL GROUP SPECIALTY CARE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 811110738 SPECIALTY PHYSICIAN PRACTICE GROUP IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS OF SAN JOSE INC C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 941530037 ACUTE CARE HOSPITAL (SOLD IN 1998) TX 501(C)(3) LINE 12A, I ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS SERVICES INC 3040 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 431295333 HUD HOUSING MO 501(C)(3) LINE 10 ALEXIAN BROTHERS HEALTH SYSTEM 1 ALEXIAN BROTHERS SPECIALTY GROUP C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 800710751 SPECIALTY PHYSICIAN PRACTICE GROUP IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 ASCENSION HEALTH C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 311662309 NATIONAL HEALTH SYSTEM MO 501(C)(3) LINE 12A, I ASCENSION HEALTH ALLIANCE 0 ASCENSION HEALTH ALLIANCE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(C)(3) LINE 12A, I N/A 0 SAVELLI PROPERTIES INC C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363308965 OWNS OR LEASES PROPERTIES WHERE HEALTHCARE SERVICES ARE DELIVERED IL 501(C)(2) ALEXIAN BROTHERS HEALTH SYSTEM 1 ST ALEXIUS MEDICAL CENTER C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364251846 ACUTE CARE HOSPITAL IL 501(C)(3) LINE 3 ALEXIAN BROTHERS HEALTH SYSTEM 1 PRESENCE CARE TRANSFORMATION CORPORATION C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363366652 MGMT SUPPORT IL 501(C)(3) LINE 12C, III-FI ALEXIAN BROTHERS HEALTH SYSTEM 1 PRESENCE HEALTH PARTNERS SERVICES C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 362644178 HEALTH CARE IL 501(C)(3) LINE 12B, II ALEXIAN BROTHERS HEALTH SYSTEM 1 PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364195126 HEALTH CARE IL 501(C)(3) LINE 3 PRESENCE CARE TRANSFORMATION CORPORATION 1 PRESENCE BEHAVIORAL HEALTH C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 362709982 HEALTH CARE IL 501(C)(3) LINE 3 PRESENCE CARE TRANSFORMATION CORPORATION 1 PRESENCE AMBULATORY SERVICES C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364286236 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE CARE TRANSFORMATION CORPORATION 1 PRESENCE CHICAGO HOSPITALS NETWORK C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 362235165 HEALTH CARE IL 501(C)(3) LINE 3 PRESENCE CARE TRANSFORMATION CORPORATION 1 PRESENCE HEALTHCARE SERVICES C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363330928 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE CARE TRANSFORMATION CORPORATION 1 RAINBOW HOSPICE AND PALLIATIVE CARE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363296367 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE CARE TRANSFORMATION CORPORATION 1 MEDICARE VALUE PARTNERS C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 363495969 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE HEALTH PARTNERS SERVICES 1 PRESENCE HOME CARE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 460483581 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE CARE TRANSFORMATION CORPORATION 1 PRESENCE CARE HOME C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 460483587 HEALTH CARE IL 501(C)(3) LINE 10 PRESENCE CARE TRANSFORMATION CORPORATION 1 ALVERNO PROVENA HOSPITAL LABORATORIES INC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46234 203238867 HEALTH CARE IN 501(C)(3) LINE 3 PRESENCE CENTRAL & SUBURBAN HOSPITALS NETWORK AND PRESENCE CHICAGO HOSPITAL 1 ALEXIAN 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HEALTH CLINICALLY INTEGRATED NETWORK LLC 200 S WACKER DRIVE CHICAGO IL 60606 800967178 MANAGED CARE IL N/A C 0 PRESENCE SERVICE CORPORATION C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 364314354 MEDICAL IL N/A C 0 PRESENCE VENTURES INC 100 NORTH RIVER ROAD DES PLAINES IL 60016 371168085 MEDICAL IL N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0