2025-11-13T15:15:04-06:00 2024-12-31 990 2024-01-01 364147189 FAIRVIEW HEIGHTS MEDICAL GROUPSC C/O BJC MEDICAL GROUP LC FAIR 3149967601 2 MEMORIAL DRIVE 220 ALTON IL 62002 JOHN T ELLENA MD PRESIDENT/SECY/DIRECTOR 3149967601 2025-11-13 1 2024 2025-03-06 01:10:19Z BJC MEDICAL GROUP OF ILLINOIS JOHN T ELLENA MD 2 MEMORIAL DRIVE 220 ALTON IL 62002 167657984 0 X N/A X 1997 IL PROVIDE HEALTHCARE SERVICES TO PATIENTS 1 0 1047 0 0 0 0 0 148188435 167657984 0 0 0 0 148188435 167657984 0 8100 0 0 104884763 117019823 0 0 0 43303672 50630061 148188435 167657984 0 0 29789138 33779586 26397048 31907971 3392090 1871615 AS AN AFFILIATE OF BJC HEALTH SYSTEM (BJC), FAIRVIEW HEIGHTS MEDICAL GROUP SC IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES IT SERVES THROUGH LEADERSHIP, EDUCATION, INNOVATION AND EXCELLENCE IN MEDICINE. 0 0 158480769 8100 167657984 DURING THE YEAR, THE ORGANIZATION PROVIDED QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. THE ORGANIZATION HAD 651,016 VISITS DURING 2024. 158480769 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 71 0 1 1047 1 0 0 0 0 0 0 0 0 0 0 X 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X DIANNE NEWMAN 3142862057 670 MASON RIDGE CENTER DR STE 300 ST LOUIS MO 63141 ELLENA JOHN MD PRES/SECY/DIRECTOR 1.00 39.00 X X 0 711842 8581 KANDULA PRASAD MD PHYSICIAN 40.00 X 1369659 14788 3430 JAMOUS ABDULSALAM MD PHYSICIAN 40.00 X 1339101 0 14839 OMOTOLA AARON MD PHYSICIAN 40.00 X 1284892 0 19095 STIRTON JOHN W MD PHYSICIAN 40.00 X 1018313 23400 18029 TIWARI SUMIT MD PHYSICIAN 40.00 X 868475 0 16211 5880440 750030 80185 278 0 1 0 CHG COMPANIES INC COMPHEALTH 7259 S BINGHAM JUNCTION BLVD MIDVALE UT 84047 PHYSICIAN STAFFING 2796126 INTERIM PHYSICIANS 12647 OLIVE BLVD SUITE ST LOUIS MO 63141 PHYSICIAN STAFFING 2434524 WEATHERBY LOCUMS 6451 NORTH FEDERAL HIGHWAY FORT LAUDERDALE FL 33308 PHYSICIAN STAFFING 1610588 ALTON DOCTORS BUILDING LP ONE PROFESSIONAL DRIVE ALTON IL 62002 LEASING 678942 EXCHANGERIGHT NLP 67 MASTER LESSEE LLC 1055 E COLORADO BLVD PASADENA CA 91106 LEASING 321892 12 PROGRAM SERVICE REV 621110 109273742 109273742 SERVICES TO AFFILIATES 621110 58384242 58384242 167657984 167657984 167657984 0 0 8100 8100 97370369 97370369 4616745 4616745 9171043 9171043 5861666 5861666 13455988 13455988 640719 640719 715090 715090 7450646 7450646 63810 63810 13185 13185 149384 149384 2810782 2810782 5807308 5807308 MEDICAL SUPPLIES 8840448 8840448 RECRUITMENT 577430 577430 EQUIP RENTAL & MAINT 359197 359197 DUES & SUBSCRIPTIONS 43355 43355 9702719 525504 9177215 167657984 158480769 9177215 0 5207 1082 7689877 8396131 180000 500000 825834 903893 22653588 15880141 7402063 6773447 13686157 17205033 29789138 33779586 6119200 8245854 20277848 23662117 26397048 31907971 X 3392090 1871615 3392090 1871615 29789138 33779586 X 0 -1520475 X 0 1 X 1 0 X 12681683 8277143 4404540 61606 44410 17196 9910299 7558588 2351711 6773447 DEFERRED COMPENSATION 9532139 RIGHT OF USE ASSETS 7672894 17205033 DEFERRED COMPENSATION 9539870 LONG TERM OTHER OPER LEASE 6480656 MALPRACTICE RESERVE 7641591 23662117 0 0 0 0 0 0 0 0 0 KANDULA PRASAD MD PHYSICIAN 1246611 1625 119484 0 3564 13163 0 0 3402 28 1373061 14816 0 0 JAMOUS ABDULSALAM MD PHYSICIAN 1250686 0 84375 0 4040 0 0 0 14839 0 1353940 0 0 0 OMOTOLA AARON MD PHYSICIAN 1245074 0 38909 0 909 0 0 0 19095 0 1303987 0 0 0 STIRTON JOHN W MD PHYSICIAN 958346 23400 59157 0 810 0 0 0 17919 110 1036232 23510 0 0 TIWARI SUMIT MD PHYSICIAN 756348 0 111504 0 623 0 0 0 16211 0 884686 0 0 0 ELLENA JOHN MD PRES/SECY/DIRECTOR 0 641803 0 55649 0 14390 0 0 0 8581 0 720423 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDED INCENTIVE PAYMENTS THAT ARE CALCULATED USING A PERCENT OF BASE PAY AFTER CERTAIN PERFORMANCE AND OPERATING GOALS ARE MET. THE AMOUNT OF INCENTIVE PAYMENTS DO NOT ACCRUE TO THE BENEFIT OF THE INDIVIDUALS UNTIL AFTER THE FINANCIAL RESULTS HAVE BEEN DETERMINED FOR THE CALENDAR YEAR. SCH J PART 1, LINE 3 THE COMPENSATION AND BENEFIT AMOUNTS OF THE ORGANIZATION'S OFFICER AND TOP MANAGEMENT OFFICIALS ARE DETERMINED BY AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF BJC HEALTH SYSTEM. THIS COMMITTEE IS COMPRISED OF INDEPENDENT PERSONS AND USES COMPENSATION CONSULTING STUDIES AND BENCHMARKING DATA PROVIDED BY AN INDEPENDENT MANAGEMENT CONSULTANT TO ESTABLISH COMPENSATION AMOUNTS AND GUIDELINES. THE PROCESS INCLUDES A VALIDATION OF JOB DESCRIPTIONS AS WELL AS REPORTING ALL FORMS OF COMPENSATION. THE CONSULTANT USES SURVEY DATA TO DETERMINE MARKET RATES OF BASE SALARY AND OTHER SHORT AND LONG TERM INCENTIVES FOR THE BJC HEALTH SYSTEM CEO AND OTHER SENIOR EXECUTIVES. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES, AND SUBSEQUENTLY RECONCILES EXECUTIVE COMPENSATION AS WELL AS DELIBERATES ON THE REASONABLENESS OF THE DATA. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE MEETINGS. FORM 990, PART IV, LINE 20 FAIRVIEW HEIGHTS MEDICAL GROUP, S.C. (ORGANIZATION) IS AN ILLINOIS PROFESSIONAL SERVICE CORPORATION ORGANIZED TO SATISFY THE REQUIREMENTS UNDER THE ILLINOIS MEDICAL PRACTICE ACT. THE ORGANIZATION EMPLOYS LICENSED PHYSICIANS TO PROVIDE HEALTH CARE SERVICES TO PATIENTS. THE ORGANIZATION IS NOT A LICENSED HOSPITAL WITHIN THE STATE OF ILLINOIS AND DOES NOT OPERATE ONE OR MORE FACILITES THAT SATISFY THE DEFINITION OF A HOSPITAL. ACCORDINGLY, THE ORGANIZATION IS NOT REQUIRED TO COMPLETE AND FILE FORM 990, SCHEDULE H. FORM 990, PART V, LINE 1 NUMBER REPORTED IN BOX 3 FORM 1096 THE ORGANIZATION IS AN AFFILIATE OF BJC HEALTH SYSTEM (BJC), A SUPPORTING ORGANIZATION DESCRIBED IN CODE SECTION 509(A)(3). BJC ASSUMES RESPONSIBILITY FOR REMITTING ALL PAYMENTS TO VENDORS THROUGH A CENTRALIZED ACCOUNTS PAYABLE SYSTEM. BJC ALSO ASSUMES RESPONSIBILITY FOR REPORTING THESE PAYMENTS TO THE IRS USING ITS EIN AS THE COMMON PAYOR ON FORM(S) 1099, 1098, 5498, AND W-2G. THE AMOUNT REPORTED ON LINE 1, IF ANY, REFLECTS THE NUMBER OF FORMS FILED BY BJC HEALTH SYSTEM (EIN 43-1617558) ON BEHALF OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OFFICERS, DIRECTORS OR KEY EMPLOYEES OF THE ORGANIZATION AND BJC HEALTH SYSTEM (BJC) MAY ALSO SERVE ON THE BOARDS OF OTHER RELATED OR UNRELATED ORGANIZATIONS. ADDITIONALLY, CERTAIN FAMILY MEMBERS OF OFFICERS, DIRECTORS OR KEY EMPLOYEES MAY, DURING THE NORMAL COURSE OF BUSINESS YET CONSISTENT WITH ITS STATED EXEMPT PURPOSE, ENGAGE IN TRANSACTIONS IN WHICH POTENTIAL CONFLICTS OF INTEREST COULD EXIST. THESE OFFICERS, DIRECTORS, KEY EMPLOYEES AND RELATED PERSONS DISCLOSE THESE POTENTIAL CONFLICTS TO BJC HEALTH SYSTEM ANNUALLY AND DO NOT PARTICIPATE IN DECISIONS IN WHICH THEY HAVE SUCH CONFLICTS. SUCH CONFLICTS AND RELATIONSHIPS ARE REVIEWED TO ENSURE THAT ANY PAYMENTS RECEIVED OR AMOUNTS PAID DO NOT EXCEED THE FAIR MARKET VALUE OF THE GOODS AND SERVICES RECEIVED BY THE REPORTING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PREPARES DRAFT COPIES OF FORM 990 AND ATTACHMENTS FOR REVIEW BY MEMBERS OF MANAGEMENT. AFTER RESOLVING ANY OPEN ITEMS, THE FINAL DRAFT RETURNS ARE MADE AVAILABLE TO THE BOARD FOR REVIEW. QUESTIONS AND COMMENTS THAT ARISE DURING THE REVIEW OF THE FORMS ARE ADDRESSED IN ADVANCE OF SUBMISSION TO THE APPROPRIATE TAXING AUTHORITIES. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH THE POLICY BY ISSUING ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE REMINDING COVERED INDIVIDUALS OF THEIR OBLIGATIONS TO DISCLOSE POTENTIAL CONFLICTS AND REQUESTING THAT THEY COMPLETE A CONFLICTS OF INTEREST QUESTIONNAIRE. THE QUESTIONNAIRE REQUIRES THE DISCLOSURE OF CONFLICTS AND AN ATTESTATION TO THEIR CONTINUING OBLIGATION TO DISCLOSE SAID CONFLICTS SHOULD THE NEED ARISE. THE RESULTS OF THE CONFLICTS OF INTEREST QUESTIONNAIRE ARE REVIEWED BY A CENTRALIZED COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION TAKEN AS NECESSARY. SHOULD THE ORGANIZATION BECOME AWARE OF A CONFLICT NOT PREVIOUSLY REPORTED, ITS GENERAL COUNSEL WOULD INVESTIGATE THE ISSUE AND RESPOND IN ACCORDANCE WITH THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE NET ASSETS AND ACTIVITIES OF FAIRVIEW HEIGHTS MEDICAL GROUP, S.C. (THE ORGANIZATION) ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BJC HEALTH SYSTEM AND AFFILIATES (BJC). BJC AND THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE FOR INSPECTION BY THE GENERAL PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. FORM 990, PART XI, LINE 9: ENTITY TRANSFERS TO FROM AFFILIATES -1,520,475. ALTON MEMORIAL HEALTH SERVICES FOUNDATION 1109 N OXFORDSHIRE LANE EDWARDSVILLE IL 62025 371177053 SUPPORT TO AMH IL 501(C)(3) LINE 12C, III-FI ALTON MEMORIAL HOSPITAL 1 ALTON MEMORIAL HOSPITAL CHARITABLE TRUST PO BOX 0634 MILWAUKEE WI 53201 376039185 SUPPORT TO AMH IL 501(C)(3) LINE 12D, III-O ALTON MEMORIAL HOSPITAL 1 BARNES JEWISH ST PETERS & PROGRESS WEST FOUNDATION 10 HOSPITAL DRIVE ST PETERS MO 63376 454471497 SUPPORT TO BJSPH & PWHC MO 501(C)(3) LINE 7 BJSPH & PWHC 1 CHRISTIAN HOSPITAL FOUNDATION 11155 DUNN ROAD SUITE 300 N ST LOUIS MO 63136 431947644 SUPPORT TO CHNE MO 501(C)(3) LINE 7 CHRISTIAN HOSPITAL NENW 1 FOUNDATION FOR BARNES-JEWISH HOSPITAL 1001 HIGHLANDS PLAZA DR WEST SUITE ST LOUIS MO 63110 431648435 SUPPORT TO BJH MO 501(C)(3) LINE 7 BARNES-JEWISH HOSPITAL 1 MEMORIAL FOUNDATION INC 4500 MEMORIAL DRIVE BELLEVILLE IL 62226 371186034 SUPPORT TO PMMCI IL 501(C)(3) LINE 7 PROTESTANT MEMORIAL MEDICAL CENTER INC 1 MEMORIAL GROUP INC 4500 MEMORIAL DRIVE BELLEVILLE IL 62226 371186035 SUPPORT TO MFI & PMMCI IL 501(C)(3) LINE 12C, III-FI N/A 0 MISSOURI BAPTIST HEALTHCARE FOUNDATION 3015 N BALLAS ROAD ST LOUIS MO 63131 431472026 SUPPORT TO MBMC MO 501(C)(3) LINE 7 MISSOURI BAPTIST MEDICAL CENTER 1 MISSOURI BAPTIST HOSPITAL OF SULLIVAN AUXILIARY INC 751 SAPPINGTON BRIDGE RD SULLIVAN MO 63080 431349641 SUPPORT TO MBHS MO 501(C)(3) LINE 10 MISSOURI BAPTIST HOSP OF SULLIVAN 1 PARKLAND HEALTH CENTER FOUNDATION 1101 WEST LIBERTY ST FARMINGTON MO 63640 900424964 SUPPORT TO PHC MO 501(C)(3) LINE 12A, I PARKLAND HEALTH CENTER 1 ST LOUIS CHILDREN'S HOSPITAL FOUNDATION ONE CHILDRENS PLACE ST LOUIS MO 63110 431626863 SUPPORT TO SLCH MO 501(C)(3) LINE 7 ST LOUIS CHILDREN'S HOSPITAL 1 SAINT LUKE'S FOUNDATION 901 E 104TH STREET KANSAS CITY MO 64131 446014699 SUPPORT TO SLHS MO 501(C)(3) LINE 7 SAINT LUKES HEALTH SYSTEM 1 SAINT LUKE'S CUSHING HOSPITAL INC (TERM'D 2024) 5830 NW BARRY ROAD KANSAS CITY MO 64154 480543792 HEALTHCARE SERVICES MO 501(C)(3) LINE 3 SAINT LUKES HEALTH SYSTEM 1 WINDSOR CARE INCORPORATED (TERM'D 2024) 4301 MADISON AVENUE KANSAS CITY MO 64111 205284328 HEALTHCARE SERVICES MO 501(C)(3) LINE 10 SAINT LUKES HEALTH SYSTEM 1 THE HEART CARE INSTITUTE LLC 1020 NORTH MASON ROAD ST LOUIS MO 63141 431870517 MEDICAL SERVICES MO N/A 0 0 GAMMA KNIFE CENTER AT BARNES JEWISH HOSP LLC ONE BARNES-JEWISH HOSP PLAZA ST LOUIS MO 63110 431846941 OUTPATIENT CARE SERVICES MO N/A 0 0 THE REHABILITATION INSTITUTE OF ST LOUIS LLC 9001 LIBERTY PARKWAY BIRMINGHAM AL 35242 631254288 MEDICAL SERVICES AL N/A 0 0 THE REHABILITATION INSTITUTE OF SOUTHERN ILLINOIS LLC 9001 LIBERTY PARKWAY BIRMINGHAM AL 35242 834553991 MEDICAL SERVICES AL N/A 0 0 CHILDREN'S DISCOVERY INSTITUTE LLC 4901 FOREST PARK AVE ST LOUIS MO 63108 SEARCH FOR CURES OF PEDIATRIC DISEASES MO N/A 0 0 Y-SIHVI LLC 4500 MEMORIAL DRIVE BELLEVILLE IL 62226 371385862 PHYSICAL THERAPY & FITNESS IL N/A 0 0 SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP 4500 MEMORIAL DRIVE BELLEVILLE IL 62226 823633320 COMMERCIAL REAL ESTATE IL N/A 0 0 ST LOUIS HEALTHCARE SUPPORT SERVICES LLC 4901 FOREST PARK AVE ST LOUIS MO 63108 372121486 SUPPORT SERVICES MO N/A 0 0 SAINT LUKE'S SURGICENTER-LEE'S SUMMIT LLC PO BOX 7010 OVERLAND PARK KS 66207 470853481 MEDICAL SERVICES KS N/A 0 0 MEDICAL PLAZA PARTNERS LP 901 E 104TH KANSAS CITY MO 64131 431357824 OWN & OPERATE MEDICAL OFFICE BUILDING MO N/A 0 0 SAINT LUKE'S - GI DIAGNOSTICS LLC 4321 WASHINGTON STE 5700 KANSAS CITY MO 64111 274142549 MEDICAL SERVICES MO N/A 0 0 SAINT LUKE'S NORTH SURGERY CENTER LLC 901 E 104TH KANSAS CITY MO 64131 920591506 MEDICAL SERVICES MO N/A 0 0 SAINT LUKE'S RADIATION THERAPY-LIBERTY LLC 901 E 104TH KANSAS CITY MO 64131 473793070 MEDICAL SERVICES MO N/A 0 0 SAINT LUKE'S SOUTH SURGERY CENTER LLC PO BOX 7010 OVERLAND PARK KS 66207 201721929 MEDICAL SERVICES KS N/A 0 0 SAINT LUKE'S SOUTH PAIN MANAGEMENT CENTER LLC 7651 W 159TH STREET OVERLAND PARK KS 66223 863451115 MEDICAL SERVICES KS N/A 0 0 KANSAS CITY ORTHPAEDIC INSTITUTE LLC 3651 COLLEGE BLVD LEAWOOD KS 66211 481197295 MEDICAL SERVICES KS N/A 0 0 ATG ASSURANCE COMPANY LTD PO BOX 1109 GRAND CAYMAN GEORGETOWN GR CAYMAN CJ KY1-1002 980599167 INSURANCE CJ N/A C 0 MB MEDICAL SERVICES INC 3015 N BALLAS ROAD ST LOUIS MO 63131 431437404 HEALTHCARE SERVICES MO N/A C 0 PF SERVICES INC 11155 DUNN ROAD ST LOUIS MO 63136 431237767 MANAGEMENT SERVICES MO N/A C 0 ACTIVUM SG FEEDER FUND VII LP ORDNANCE HOUISE 31 PIER ROAD ST. HELIER JE JE4 8PW 981641958 INVESTMENT HOLDINGS JE N/A C 0 SAINT LUKES HEALTH SYSTEM RISK RETENTION GROUP 901 E104TH ST KANSAS CITY MO 64131 371471890 INSURANCE SC N/A C 0 ST LUKES HEALTH VENTURES INC 901 E104TH ST KANSAS CITY MO 64131 431278476 ACCOUNTING MO N/A C 0 MEDICAL PLAZA MANAGEMENT INC 901 E104TH ST KANSAS CITY MO 64131 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C 0 SAINT LUKES HEALTH SYSTEM INSURANCE LTD 113 SOUTH CHURCH RD GEORGETOWN GR CAYMAN CJ CAPTIVE CJ N/A C 0 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC A 149384 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC I 591331 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC H 411214 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC K 578965 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC J 4592537 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC M 7293045 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC L 19295486 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC O 61062042 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC Q 430799053 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC P 318386142 BJC HEALTH SYSTEMPHYSICIAN GROUPS LC S 109364775 SCHEDULE R, PART II THE FILING ORGANIZATION IS AN AFFILIATE OF BJC HEALTH SYSTEM BUT IS NOT INCLUDED THE GROUP EXEMPTION FOR BJC HEALTH SYSTEM. PER THE INSTRUCTIONS, AN ORGANIZATION THAT ISN'T INCLUDED IN A GROUP EXEMPTION ISN'T REQUIRED TO LIST IN PART II A RELATED ORGANIZATION THAT IS INCLUDED IN A GROUP EXEMPTION. THUS, MEMBERS OF THE BJC HEALTH SYSTEM GROUP EXEMPTION ARE NOT REPORTED ON SCH R FOR THE FILING ORGANIZATION.