Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
Alexian Brothers Behavioral Health Hospital
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3040 West Salt Creek Lane
 
Room/suite
City or town, state or country, and ZIP + 4
Arlington Heights, IL600051069
D Employer identification number

36-4251848
E Telephone number

G Gross receipts $ 62,118,414
F Name and address of principal officer:
Clayton Ciha
1650 Moon Lake Blvd
Hoffman Ests,IL601691010
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.alexianbrothershealth.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1998
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: ABBHH carries out the healing mission of the Catholic Church (See Schedule O)ABBHH carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health needs of those we are called to serve.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 7
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 807
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 57,789,678 61,802,882
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 0 0
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 170,516 315,532
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 57,960,194 62,118,414
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 35,880,950 37,479,454
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 26,582,134 26,215,671
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 62,463,084 63,695,125
19 Revenue less expenses. Subtract line 18 from line 12...... -4,502,890 -1,576,711
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 37,947,574 38,047,838
21 Total liabilities (Part X, line 26)............ 9,030,071 12,148,608
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 28,917,503 25,899,230
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signature
Big Right Arrow
Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4
Big Right Arrow




EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: 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 needs of those we are called to serve.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 29,738,146 including grants of $   ) (Revenue $ 36,088,557 )
Inpatient Care: During 2010 ABBHH had 6,101 admissions with an average length of stay of 7.6 days. ABBHH provided care to approximately 800 adolescents, 4,250 adults and over 1,050 geriatric patients. ABBHH offers comprehensive behavioral health services, from prevention and early intervention to treatment and aftercare. It is ABBHH's goal to help individuals of all ages to learn ways to manage mental health and substance abuse problems. ABBHH is the first hospital in the nation to have been awarded Disease Specific Care Certification in four separate psychiatric specialties: Depression, Chemical Dependency, Eating Disorder and Self Injury.
4b (Code:   ) (Expenses $ 6,048,628 including grants of $   ) (Revenue $ 15,402,785 )
Outpatient Programs: ABBHH offers Partial Hospitalization Programs (PHP), or day treatment programs to 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 2010, ABBHH served over 3,195 cases with more than 35,000 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). These low intensity level of care are offered to all age groups for all psychiatric and addiction needs. In 2010, we served 1,611 cases and offered 16,471 units of service.
4c (Code:   ) (Expenses $ 8,653,177 including grants of $   ) (Revenue $ 7,440,718 )
Group Practice: A team of experienced psychiatrists, psychologists, social workers and professional counselors with extensive sub-specialty certifications provide outpatient therapy to individuals, couples and families. ABBHH patients also utilize this outpatient care after discharge from the hospital. During 2010, there were almost 90,000 outpatient visits in the Group Practice.
(Code:   ) (Expenses $ 5,150,540 including grants of $   ) (Revenue $ 1,156,965 )
Other program services include providing daily educational services to our school aged inpatients and outpatients, providing assessment specialists in our affiliated hospital's emergency rooms to assess patients with psychiatric and behavioral issues and help determine proper treatment of those patients, providing evening programs for former patients and their families that need continual support from our professional staff, and providing educational programs that are open to all clinical professionals in the area.
4d Other program services. (Describe in Schedule O.)
(Expenses $ 5,150,540 including grants of $   ) (Revenue $ 1,156,965 )
4e Total program service expensesMediumBullet$ 49,590,491
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part I
Click to see attachment
.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
149
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
807
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
10
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
Bernadette B Herrera
3040 West Salt Creek Lane
Arlington Heights,IL600053557
(847) 590-2502
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Anthony D'Agostino MD
Director
40.00 X           327,017 1,388 47,521
(2) Renato Delos Santos MD
Director
1.00 X           0 0 0
(3) Kathleen Gilmer
Vice Chairperson
1.00 X   X       0 0 0
(4) Lawrence Herforth
Chairperson
1.00 X   X       0 0 0
(5) Br Theodore Loucks CFA
Secretary
1.00 X   X       0 0 0
(6) Delia Aldridge
Director
40.00 X           155,213 0 22,954
(7) Br Daniel McCormick CFA
Director
1.00 X           0 0 0
(8) Patricia Merryweather
Director
1.00 X           0 0 0
(9) James Mortimer
Director
1.00 X           0 0 0
(10) Thomas Palmer
Director
1.00 X           0 0 0
(11) Francine McGouey
President and CEO
40.00     X       0 340,517 71,916
(12) David Jones
Chief Financial Officer
30.00     X       0 185,090 42,361
(13) James Sances
Treasurer
1.00     X       0 622,253 134,046
(14) Virginia Golembiewski
Assistant Secretary
1.00     X       0 67,752 15,425
(15) Jim Lewandowski
Vice President
1.00       X     0 358,777 63,763
(16) Clifton Saper
Program Director
40.00       X     142,149 0 32,276
(17) Michael Brilliant
Doctor
40.00         X   403,674 0 30,132
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Mark Lerman
Medical Director of Research
40.00         X   580,710 0 30,051
(19) Maumtaz Raza
Doctor
40.00         X   419,550 0 30,203
(20) Gregory Teas
Doctor
40.00         X   265,907 0 27,653
(21) Siddhartha Kumar
Doctor
40.00         X   248,991 0 18,015
(22) Dean Grant
Former Officer
0.00           X 0 404,813 57,146
(23) Mark Frey
Former Officer
0.00           X 0 794,003 188,333














1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,401,062 2,774,593 779,519
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet27
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Sodexho Inc & Affiliates
9801 Washington Blvd Suite 7174
Gaithersburg,MD20878
Dietary and Environmental Services 2,567,416
Comphrehensive Pharmacy Services Inc
6409 Quail Hollow Road
Memphis,TN38120
Pharmacy Service 771,315
HLS Wheeling LLC
45 W Hintz Road
Wheeling,IL60090
Laundry & Linen Services 170,026
PRA Behavioral LLC
1701 E Woodfield Rd
Schaumburg,IL60173
Professional Service 110,986
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet4
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet  
 Program Service Revenue Business Code
2a Patient Service Rev 622,210 33,655,489 33,655,489    
b Medicare/ Medicaid Rev 622,210 17,865,585 17,865,585    
c Group Practice 624,190 7,440,718 7,440,718    
d Research Revenue 541,900 1,882,961     1,882,961
e School Reimbursements 900,099 505,650 505,650    
f All other program service revenue . 452,479 452,479    
g Total. Add lines 2a–2f........MediumBullet 61,802,882
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet        
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Cafeteria Revenue 900,099 139,893     139,893
b Restricted Fund Utiliz 900,099 122,408 122,408    
c Course & Workshop Fees 900,099 35,345 35,345    
d All other revenue .... 17,886 11,351   6,535
e Total. Add lines 11a–11d ......MediumBullet 315,532
12 Total revenue. See Instructions....MediumBullet 62,118,414 60,089,025 0 2,029,389
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 482,230 482,230    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 30,534,880 25,298,691 5,236,189  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 1,037,397 895,053 142,344  
9 Other employee benefits ....... 3,369,221 2,906,920 462,301  
10 Payroll taxes ........... 2,055,726 1,739,946 315,780  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 146,004   146,004  
c Accounting ........... 75,691   75,691  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 6,090,740 4,061,786 2,028,954  
12 Advertising and promotion .... 98,157   98,157  
13 Office expenses ....... 650,875 216,710 434,165  
14 Information technology ...... 152   152  
15 Royalties ..        
16 Occupancy ........... 1,860,707 905,505 955,202  
17 Travel ............ 296,616 249,109 47,507  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 69,665 16,128 53,537  
20 Interest ........... 1,200,528   1,200,528  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,202,679 962,143 240,536  
23 Insurance .............. 1,480,757 1,110,586 370,171  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a Medicaid Tax 5,207,651 5,207,651 0 0
b Management Fees 4,935,984 2,703,287 2,232,697 0
c Provision for Bad Debt 1,676,037 1,676,037 0 0
d Medical Supplies 1,159,722 1,151,080 8,642 0
e Miscellaneous Dues 61,811 7,329 54,482 0
f All other expenses 1,895 300 1,595  
25 Total functional expenses. Add lines 1 through 24f 63,695,125 49,590,491 14,104,634 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation
       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 213,451 1 1,147,962
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 7,217,732 4 6,887,650
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 143,374 8 153,140
9 Prepaid expenses and deferred charges ............ 157,989 9 93,757
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 34,762,550
b Less: accumulated depreciation. ..... 10b 10,105,821 25,083,417 10c 24,656,729
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 5,000,000 12 5,000,000
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 131,611 15 108,600
16 Total assets. Add lines 1 through 15 (must equal line 34)... 37,947,574 16 38,047,838
Liabilities 17 Accounts payable and accrued expenses . 4,169,641 17 5,217,649
18 Grants payable ..........   18  
19 Deferred revenue .......... 21,780 19 6,762
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 4,838,650 25 6,924,197
26 Total liabilities. Add lines 17 through 25..... 9,030,071 26 12,148,608
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 28,886,081 27 25,845,615
28 Temporarily restricted net assets ..... 31,422 28 53,615
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 28,917,503 33 25,899,230
34 Total liabilities and net assets/fund balances ..... 37,947,574 34 38,047,838
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
62,118,414
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
63,695,125
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-1,576,711
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
28,917,503
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-1,441,562
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
25,899,230
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........
     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,400,000 1,400,000
b Buildings ................   26,173,066 5,124,570 21,048,496
c Leasehold improvements ............   192,502 133,770 58,732
d Equipment ................   6,277,978 4,450,779 1,827,199
e Other .................   719,004 396,702 322,302
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 24,656,729
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) Beneficial interest in Alexian Brothers Health System, Inc. Investment Trust
5,000,000 F








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 5,000,000
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
Due to Third Parties 3,149,113
Accounts Receivable Credit Balances 865,197
Due to Affiliates 1,212,167
Other Current Liabilities 30,530
Reserve for Insurance Loss 1,667,190




Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 6,924,197
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Description of Uncertain Tax Positions Under FIN 48: Part X: ABBHH does not file a separate audit report, but is part of the Alexian Brothers Health System consolidated audit report. The text of the FIN48 (ASC740) footnote in this audit report is as follows: On January 1, 2008, the Corporations adopted Interpretation No. 48, Accounting for Uncertainty in Income Taxes, included in FASB ASC Subtopic 740-10, Income Taxes - Overall. ASC Subtopic 740 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, the Corporations must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of December 31, 2010 and 2009, the Corporations do not have a liability for unrecognized tax benefits.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) ..
  712 674,375   674,375 1.090 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) .
  1,079 8,841,758 4,272,907 4,568,851 7.370 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs .....
  1,791 9,516,133 4,272,907 5,243,226 8.460 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
13 41,098 1,319,299 14,725 1,304,574 2.100 %
f Health professions education
(from Worksheet 5) ..
3 1,937 240,744   240,744 0.390 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7) 1 43 42,190 5,900 36,290 0.060 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) ..
           
jTotal Other Benefits ... 17 43,078 1,602,233 20,625 1,581,608 2.550 %
kTotal. Add lines 7d and 7j. .. 17 44,869 11,118,366 4,293,532 6,824,834 11.010 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1 79 1,011   1,011 0 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 1 79 1,011   1,011  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
726,000
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
16,000
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
16,574,334
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
15,303,868
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
1,270,466
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership%
(e) Physicians'
profit % or stock
ownership %
11 None
 
       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Alexian Brothers Behavioral Health Hosp
1650 Moon Lake Blvd
Hoffman Estates,IL601690000
X               Pyschiatric Facility
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    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%301-400% 67.5%401-500% 67.5%501-600% 67.5%>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 2010 filed Medicare cost report was used to calculate cost.- Unreimbursed Medicaid - costs are calculated using the 2010 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 I, Line 7g: ABBHH has not included costs attributable to a physician clinic as part of subsidized health services.
    Part I, L7 Col(f): The amount of bad debt expense included in Part IX, Line 25, column (A) that was removed from the calculation was $1,676,000.Part II: In 2010, 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 4: 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 5% of the accounts, or $16,000 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.ABBHH is part of the Alexian Brothers Health System ("ABHS") consolidated audit. The footnote that references bad debt expense in the 2010 ABHS consolidated audit is as follows:"The corporations also provide a significant amount of uncompensated care to their uninsured and underinsured patients, which is reported as provision for bad debts, and not included in the amounts reported above. During the years ended December 31, 2010 and 2009, the corporationsreported provision for bad debts of $29,843,000 and $26,969,000, respectively, at charges which equate to $7,020,000 and $7,502,000 at cost (based on an overall cost to charge ratio)."ABBHH's share of bad debt expense for ABHS in 2010 was $1,676,000 at charges ($726,000 at cost).
    Part III, Line 8: Medicare costs are allocated by cost center in accordance with Medicare regulations.The question of whether or not Medicare reimbursement below cost should be treated as a community benefit has been debated for a number of years, pre and post healthcare reform. Some argue that most hospitals find it very difficult to achieve the required level of efficiency in a labor intensive service to provide for a positive margin. Others claim that positive margin or not, Medicare is essential to the overall financial health of hospitals due to the necessary volumes it supplies for a positive return, and therefore benefits the hospital as much as the community. Our view of the future status of Medicare is that regardless of reimbursement, ABBHH, as part of Alexian Brothers Hospital Network, will serve this part of our community with the same compassion and responsiveness to need as it always has done. In our opinion, a systematic degradation of reimbursement that is already less than the cost of providing the service for the vast majority of hospitals is an expectation on the part of the federal government to provide a substantial community benefit to a population that is growing and requiring more resources. It is for these reasons that we believe that the cost over reimbursement of Medicare should be considered community benefit.
    Part III, Line 9b: It is the policy of ABHN, 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. The registration staff works with patients during their course of treatment to determine if the patient qualifies for charity. The staff will help patients fill out the necessary paperwork to apply for charity at that time. The Business Office staff also works with patients after discharge if it is determined that they need charity subsequent to discharge. In addition, all bills and statements include information regarding charity.
    Part VI, Line 2: As part of ABHN, ABBHH has been performing Community Health Assessments for its primary and secondary service areas since 1998. The first document was produced internally and contained secondary data only (data collected by local, state and federal agencies). The following three Community Health Assessments for the years 2002, 2006 and 2009 have been performed by an outside research firm in order to capture secondary and primary data (original data compiled in this case via telephone survey).In identifying priorities for community action and designing strategies for implementation, a variety of criteria are applied to the consideration process, including:Impact - The degree to which the issue affects or exacerbates other quality of life and health-related issues. Example, poor nutrition leads to overweight and type II diabetes.Magnitude - The number of persons affected, also taking into account variance from benchmark data. Example, number of adults diagnosed with asthma in our region still below national benchmarks, but much higher compared to our own benchmarks.Seriousness - The degree to which the problem leads to death, disability or impairs one's life.Feasibility - The ability of organizations to reasonably impact the issue, given available resources.Consequences of Inaction - The risk of exacerbating the problem by not addressing at the earliest opportunity.The 2009 Community Health Assessment surveyed fifty-six zip codes representing a total population of more than 1,800,000 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 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.ABBHH utilizes the community health assessment to track data regarding the incidence and prevalence of widespread chronic disease such as depression in the community 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 agenices such as schools, police departments, and social service providers. One such instance is in regards to depression amongst teens. In 2010, ABBHH was contacted by multiple school districts in its 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. The media is filled with stories across the country about bullying in our schools, communities, the workplace, and even families. Recent studies support the notion that bullying and violence have serious consequences (Espelage and Horn (2007) School Bullying prevention: From research-based explanations to empirically based solutions. In S. Brown and R. Lent (Eds.) Handbook of Counseling Psychology, Hoboken N.J. Wiley). Statistics suggest that 30% of all children have been bullied. In our community, we are finding that by middle school, 88% of students have been victimized and our local middle schools are reporting that bullying is worse in middle schools than in high school. There have been recent increases in cyber bullying. All too frequently, such bullying has led to suicide attempts or completed suicides.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 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. Because bullying is such a serious and growing problem, ABBHH created a coalition of providers from across the community known as the Community Coalition Against Violence (Alternatives to Bullying and Suicide). The coalition includes police departments, social service agencies, school districts, psychologists, psychiatrists, parents and school age children 12-18 years. The "products" that have been developed or will be developed are as follows: 1. A Resource Center/Clearinghouse with materials integral to the coalitian including articles, books, DVDs, and interactive software to be utilized by internal staff and external community agencies. 2. Establish an "Academy for Violence Prevention & Upstander Development" which involves collaboration with internal and external groups to achieve the following research based goals. a. To destigmatize the request for help in situations where bullying, depression, suicidal thinking or other mental health concerns occur. b. To decrease access to potentially dangerous or lethal means to harm oneself or others (including weapons in schools, internet programs used for cyber bullying, unsafe railroad crossings, access to potentially lethal over-the-counter medications, etc.). c. To Support the training of "upstanders" - teaching community members to not merely be bystanders, but to "take a stand", "make a difference", empathize with the struggles and despair of others, and be proactive. 3. Refine the "Upstander" modules we use in ABBHH treatment of adolescents/teens programs and measure short and long term effectiveness for our patients, families and staff so generalizations of these techniques in the community is a possibility. 4. Provide needs assessments to schools that are interested in utilizing our expertise in designing anti-bullying, anti-suicide, "diversity acceptance training", or anti-violence programs in their facilities to meet recent state guidelines. Following the assessment , we can tailor appropriate student, teacher, and parent educational programs for the school depending on programs it already provides, the culture of the school, and gaps in service. 5. Provide program evaluation and follow up tools to schools and agencies to measure effectiveness of initiatives.
    Part VI, Line 3: 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. 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") employs an individual who works for both ABCMH and ABBHH who helps the 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: ABBHH, a member hospital of the ABHN, serves Chicago's northwest suburbs spanning the counties of McHenry, Lake, Kane, DuPage and Cook. With more than 1.8 million residents overall, the primary service area alone is comprised of nearly 20 communities with a diverse demographic and ethnic base.The zip codes/communities served include: Primary Service Area60007 Elk Grove Village 60004 Arlington Heights 60010 Barrington 60005 Arlington Heights60018 Des Plaines 60008 Rolling Meadows60056 Mount Prospect 60013 Cary60067 Palatine 60014 Crystal Lake60101 Addison 60016 Des Plaines60103 Bartlett 60047 Lake Zurich60106 Bensenville 60050 McHenry60107 Streamwood 60073 Round Lake60108 Bloomingdale 60074 Palatine60110 Carpentersville 60089 Buffalo Grove60120 Elgin 60090 Wheeling60133 Hanover Park 60098 Woodstock60139 Glendale Heights 60102 Algonquin60143 Itasca 60118 Dundee60169 Hoffman Estates 60123 Elgin60172 Roselle 60124 Elgin60173 Schaumburg 60126 Elmhurst60191 Wood Dale 60136 Gilberts60192 Hoffman Estates 60137 Glen Ellyn60193 Schaumburg 60140 Hampshire60194 Schaumburg 60142 Huntley60195 Schaumburg 60148 LombardABBHH is the largest, most comprehensive Behavioral Health Hospital in our area. There are a number of for-profit facilities but services are limited to adolescent Medicaid only. Most state hospitals have significantly reduced operations and staffed beds, so ABBHH accepts referrals as opposed to referring to other institutions.ABBHH's racial/ethnic distribution for 2008 (Claritas) within its service area is as follows:Race Population PercentageWhite 1,300,192 69.2%Hispanic 337,866 18.0%Asian 155,757 8.3%Black 53,787 2.9%Two Plus 26,776 1.4%Indian 2,298 0.1%Other 1,653 0.1%Pacific Is 568 0.0%Total: 1,878,897 100.0%The median age for 2008 was 37.1 years.Overall median age: 37.1Median Age Male: 36.0Median Age Female: 38.2The average annual household income for 2008 was $74,160.The communities ABHN serves enjoy a relatively positive health status. In comparison to the whole of Illinois and the nation, incidence of heart disease, stroke, cancers and most other diseases are favorable. However, access to care, insurance status and other health indicators are trending negatively. For example, ABHN's 2009 Community Health Assessment Survey found that one in every ten community residents is having difficulty getting an appointment to see a doctor for primary care. Summary highlights from the survey included the following additional points of concern/interest.Access to Care:- Among respondents 18 to 64, 13.6% have no health insurance. This is a sharp rise from 2002 at 7.3% and 9.3% in 2006.- A total of 11.9% of adults in the service area said that cost prevented them from seeing a physician, a steep increase from 5.8% in 2002.The northwest suburban area is home to the corporate headquarters for AT&T, Motorola and Sears, and has a significant manufacturing and industrial base. It is thought that due to the recent economic recession, a significant number of community residents may have lost their jobs and subsequently their insurance coverage thereby worsening the trend. 8.1% of community residents are currently reporting being (one or more years) out of work. As mentioned previously, ABHN provides assistance to patients to help patients take advantage of the various benefits and services available through ABHN. As access to health insurance expands because of new legislation, we will help to support and guide patients as appropriate.Part VI, Line 5: ABBHH's governing body is 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 all qualified physicians 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 15-20 research trials at any given time.Part VI, Line 6: ABBHH is an affiliate of ABHS. ABHS is the national member and ultimate parent of ABBHH. ABHS, with its corporate offices located in Arlington Heights, Illinois, is sponsored by Alexian Brothers of America, Inc., a Roman Catholic religious order of men committed to caring for the sick, the aged, the poor and the dying for more than seven centuries. The basic Judeo-Christian beliefs that inspired the founders of this worldwide Catholic religious congregation sustain its ministry today; to promote the physical, mental, spiritual and social well-being of individuals of all creeds, races, nationalities and socioeconomic levels served through this health care ministry.
    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.For example, ABHN owns and operates a community mental health center that serves primarily lower income, uninsured or underinsured or Medicaid recipients. This facility treats the chronically mentally ill with counseling, medication and social support. The center is supported through state grants, philanthropy and is subsidized by ABHN. Because of the uptick in depression, we have experienced more demand for services combined with less support from the state which has strained our resources. However, ABHN remains committed to this program and the members of the community that it serves.Another program offered to the community through ABHN is Interfaith Parish Support Services (IPSS). IPPS was created to provide a bridge between faith communities and our healthcare ministry. We have active partnerships with 70 churches, synagogues and places of worship. The following are examples of ongoing IPSS programs:- School Social Worker and Counselor: IPSS provides school social workers and counselors in parochial schools that provide on-site care not usually available in this setting. The children would not receive on site services through the public schools due to cut backs and financial restraints. These services are provided to 18 schools with nearly 7,000 students collectively. During the school year, preventive/educational programs are held on anti-bullying, drug avoidance, mental health awareness, and preparing for high school. Resource teachers are provided for five schools where children are failing academically. In every case, the school has reached out to IPSS with the request for services.- With support from congregations, IPSS provides faith based counseling services in ten local churches. In 2010, over 2,675 hours of therapy have been offered in four languages: Tagalog, Spanish, English and Polish. Because the church donates the space and phone, we are able to offer these services at a fraction of normal costs. Alexian Brothers Hospital Network subsidized IPSS at $381,000 in 2010. This subsidy allows IPSS to continue to grow its ministry and serve the community in more locations. By addressing both the medical and spiritual dimensions of healthcare, we are offering the resources the community needs to help children, adults and families live healthy lives.One of our most valuable community services is performed by the ABBHH. Twenty-four hours a day, seven days per week, a crisis intervention service is available to anyone in the community either by phone or in person. Master's prepared clinicians provide, on average, a 35 minute screening consisting of a brief social history and a current functionality determination. The outcome is behavioral health treatment recommendations as well as referrals as needed. This program provided over 12,000 screenings in 2010 and is considered invaluable by regional mental health professionals and first responders.Net community benefits expense for ABHS in 2010 is as follows:Charity Care at Cost - $16,000,775Language Assistant Services - $398,760Excess of Government Sponsored Health Care Cost Over Reimbursement - Medicaid - $23,111,389Donations - $188,677Education - $2,080,725Government-Sponsored Program Services - $25,512Subsidized Health Services - $4,390,443Other Community Benefit Programs - $2,271,155 Total Charity Care and Community Benefits - $48,467,436 Information 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 $8,766,221 in 2010 and excess of Medicare costs over reimbursement of $53,562,576 in 2010.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 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 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; 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 Senior Neighbors - Provides community based services to seniors in Chattanooga, Tennessee.Alexian Brothers Services, Inc. - HUD housing project in St. Louis, Missouri.Part VI, Line 7: 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 ABMC, St. Alexius and ABBHH.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Anthony D'Agostino MD (i)
(ii)
321,893
1,388
2,624
0
2,500
0
34,300
0
13,221
0
374,538
1,388
0
0
(2) Delia Aldridge (i)
(ii)
155,213
0
0
0
0
0
7,314
0
15,640
0
178,167
0
0
0
(3) Francine McGouey (i)
(ii)
0
242,424
0
63,810
0
34,283
0
54,784
0
17,132
0
412,433
0
31,363
(4) David Jones (i)
(ii)
0
148,537
0
25,000
0
11,553
0
18,834
0
23,527
0
227,451
0
7,894
(5) James Sances (i)
(ii)
0
462,621
0
132,244
0
27,388
0
111,754
0
22,292
0
756,299
0
27,388
(6) Jim Lewandowski (i)
(ii)
0
272,185
0
50,985
0
35,607
0
32,953
0
30,810
0
422,540
0
12,292
(7) Michael Brilliant (i)
(ii)
369,186
0
34,488
0
0
0
14,354
0
15,778
0
433,806
0
0
0
(8) Mark Lerman (i)
(ii)
478,915
0
101,795
0
0
0
10,252
0
19,799
0
610,761
0
0
0
(9) Maumtaz Raza (i)
(ii)
347,185
0
72,365
0
0
0
10,148
0
20,055
0
449,753
0
0
0
(10) Gregory Teas (i)
(ii)
264,559
0
1,348
0
0
0
14,576
0
13,077
0
293,560
0
0
0
(11) Siddhartha Kumar (i)
(ii)
232,491
0
0
0
16,500
0
9,975
0
8,040
0
267,006
0
0
0
(12) Dean Grant (i)
(ii)
0
0
0
0
0
404,813
0
34,300
0
22,846
0
461,959
0
17,323
(13) Mark Frey (i)
(ii)
0
565,468
0
165,000
0
63,535
0
143,387
0
44,946
0
982,336
0
33,766



Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Information Part III Part I, Line 3: Schedule J, Part I, Line 3: ABBHH follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee. All of the items in schedule J, Part I, Line 3 are used by the Committee to establish compensation for the CEO of the organization. Part I, Line 4a: The following individual listed in Schedule J was paid the referenced amount of severance in 2010: Dean Grant received severance of $389,358. Part I, Line 4b: Alexian Brothers Health System offers a Supplemental Employee Retirement Plan to all employees who participate in the executive benefits program and whose compensation exceeds the IRS allowable limit for a qualified pension plan. The amount accrued in 2010 was included in income in Schedule J for the following individuals: Mark Frey - $68,038 James Sances - $48,808 Jim Lewandowski - $4,547 Francine McGouey - $7,814
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Christopher D'Agostino DO Son of Director - Anthony D'Agostino 242,985 Employee   No
(2) Christine Floroelis Sister of Director - Renato DeLosSantos 49,226 Employee   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Identifier Return Reference Explanation
Form 990, Part VI, Section A, line 4   Effective as of November 1, 2010, the bylaws of ABBHH were amended to streamline governance of the Hospital operations, facilitate the objectives of the Alexian Brothers Health System Strategic Plan, enhance the governance focus on the patient safety, quality of patient care, medical staff affairs, accreditation and compliance matters at each Hospital, and to consolidate those reserved powers for the governance authorities for Hospital operations at Alexian Brothers Health System as the National Member.
Form 990, Part VI, Section A, line 6   ABBHH 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 ABBHH.
Form 990, Part VI, Section A, line 7b   Alexian Brothers Health System has principal authority with respect to the following matters: - Adoption or amendment of the Articles of Incorporation; - Amendment of the Bylaws as provided by the Statute; - Appointment and removal of Directors and Executive Officers; - Adoption, amendment and repeal of fundamental statements of mission, philosophy, spirit, vision, values and charity policy, and the sponsorship of apostolic activities; - Any plan of merger, consolidation, dissolution, sale or lease of all or substantially all of the assets of the Alexian Brothers Behavioral Health Hospital; - The annual capital and operating budget and the Strategic Plan of the Alexian Brothers Behavioral Health Hospital; and - Other certain reserved powers which Alexian Brothers Health System may designate.
Form 990, Part VI, Section B, line 11   ABBHH is an affiliate of Alexian Brothers Health System ("ABHS" or "the System"), which is a Catholic health system. ABHS is the National Member and ultimate parent for each entity within the System. ABBHH's Form 990 goes through an intensive review process at the System's Corporate level prior to being filed with the IRS. The entire Form 990 is reviewed by ABBHH's financial officer and the CEO. The Form 990 is also reviewed at the System Corporate level by the Chief Accounting Officer for the System. The Vice President and General Counsel for the System reviews all sections of the Form 990 with the exception of the compensation section. The Vice President of Human Resources for ABHS reviews all compensation disclosures for each entity in ABHS. These reviews were conducted before the Form 990 was signed and filed with the IRS. In addition, there is also a Compensation Committee that reports to the ABHS Board of Governors. This Committee reviews the Compensation disclosures for all entities in the System. ABBHH's board reports to the ABHS Board of Governors, which has ultimate oversight of the activities of all entities within the System. The Audit Committee of the ABHS Board of Governors has responsibility for and oversight of the Tax Compliance process. The Audit Committee provides oversight of the Form 990 process for the entire System and reviews detailed Forms 990 for the System on a rotating basis. It then reports back to the ABHS Board of Governors on the results of these activities. The Forms 990 not reviewed by the Audit Committee are available to the Audit Committee members upon request. The Audit Committee did review the 2010 Form 990 for ABBHH.
  Form 990, Part VI, Section B, line 12c ABBHH collects annual attestations from board members, officers, directors and key employees. The attestations are reviewed by the ABBHH compliance officer and any conflicts are shared with the ABBHH Chief Executive Officer. The conflicts are also reviewed by the System's Vice President of Compliance and Internal Audit. The Audit Committee of the ABHS Board of Governors monitors and receives reports on the completion of this process.
  Form 990, Part VI, Section B, line 15 ABBHH follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation of the CEO and other officers and executives of the Corporation. This function is performed by the Compensation Committee of the Board of Governors of ABHS, which is composed of independent board members. The process includes review of comparability data, retention of an outside compensation consultant, and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee.
  Form 990, Part VI, Section C, line 19 ABBHH's financial statements are available through the Office of the Illinois Attorney General. Conflicts of Interest and the ABBHH's governing documents are not made available to the public.
Average hours devoted to related org(s) when related comp is reported: Form 990, Part VII: - Mark Frey worked 30 hours per week for Alexian Brothers Hospital Network and 10 hours per week for Alexian Brothers Health System; - James Sances worked 40 hours per week for Alexian Brothers Health System; - Virginia Golembiewski worked 40 hours per week for Alexian Brothers Health System; - David Jones worked 30 hours per week for ABBHH and 10 hours per week for Alexian Brothers Center for Mental Health; - Jim Lewandowski worked 40 hours per week for Alexian Brothers Health System. - Dean Grant is a former officer. - All others listed in Part VII devote 100% of their time to ABBHH.
  Form 990, Part VII, Column E (Reaspnable Effort): Payroll records are kept that identify which officers/key employees are paid by a related entity. These documents also show the organization being charged for the officer's/key employee's services.
  Form 990, Part VIII, Line 3; Schedule D, Part VII: The amount reflected as dividends and interest reflects ABBHH's share of interest, dividends and realized gains/losses from ABBHH's beneficial share in the Alexian Brothers Health System, Inc. Investment Trust (ABHSIT). ABHSIT is a related entity whose purpose is to pool the investments of the not-for-profit entities in ABHS and acts as an internal mutual fund. Details of gains and losses are shown on the Form 990 of ABHSIT.
Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 577. Donated services and use of facilities: 21,616. Working Capital Transfer; -1,463,755. Total to Form 990, Part XI, Line 5: -1,441,562.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Alexian Brothers Behavioral Health Hospital
 
Employer identification number

36-4251848
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) Alexian Brothers of America Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-2606768
Religious order of Roman Catholic men TX 501(c)(3) 1 N/A
 
No
(2) Brothers of St Alexius Health and Welfare Fund Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-2976617
Provides for health & welfare payments for religious sponsor TX 501(c)(3) 1 Alexian Brothers of America Inc
 
Yes
 
(3) Alexian Brothers Bonaventure House

825 Wellington Ave

Chicago,IL60657
36-3527899
Housing and supportive care services for persons with HIV/AIDS IL 501(c)(3) 9 Alexian Brothers of America Inc
 
Yes
 
(4) Alexian Brothers Health System

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-3260495
Supports the provision of healthcare services for related corporations IL 501(c)(3) 11, III-FI Alexian Brothers of America Inc
 
Yes
 
(5) Alexian Brothers Health System Inc Investment Trust

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-3801585
Manages pooled investments of related not-for-profit entities IL 501(c)(3) 11, III-FI Alexian Brothers Health System
 
Yes
 
(6) Alexian Brothers of America Investment Trust

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-4390471
Manages pooled investments of related not-for-profit entities IL 501(c)(3) 11, III-FI Alexian Brothers of America Inc
 
Yes
 
(7) The Alexian Brothers Hospital School of Nurses

3040 W Salt Creek Lane

Arlington Heights,IL60005
Inactive corporation IL 501(c)(3) 9 Alexian Brothers of America Inc
 
Yes
 
(8) Alexian Brothers of Chicago

3040 W Salt Creek Lane

Arlington Heights,IL60005
Inactive corporation IL 501(c)(3) 9 Alexian Brothers of America Inc
 
Yes
 
(9) Alexian Brothers of San Jose Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
94-1530037
Acute care hospital (sold in 1998) TX 501(c)(3) 3 Alexian Brothers Health System
 
Yes
 
(10) Alexian Brothers Services Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
43-1295333
HUD housing MO 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(11) Alexian Village of Milwaukee Inc

9301 N 76th St

Milwaukee,WI53223
39-1351584
Continuing care retirement community WI 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(12) Alexian Brothers Community Services

425 Cumberland St Suite110

Chattanooga,TN37404
36-4344423
Provides comprehensive and coordinated community based services IL 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(13) Alexian Brothers Senior Neighbors

250 East 10th Street

Chattanooga,TN37402
62-0646376
Supports the provision of community services for senior citizens TN 501(c)(3) 7 Alexian Brothers Health System
 
Yes
 
(14) Alexian Village of Tennessee

437 Alexian Way

Signal Mountain,TN37377
62-1136742
Continuing care retirement community TN 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(15) Alexian Brothers Senior Ministries

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-4484290
Supports the provision of healthcare services for related corporations IL 501(c)(3) 11, III-FI Alexian Brothers Health System
 
Yes
 
(16) Alexian Elderly Services Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
39-2039667
Community outreach WI 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(17) Alexian Brothers Lansdowne Village

4624 Lansdowne

St Louis,MO63116
43-1470362
Skilled nursing facility MO 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(18) Alexian Brothers Sherbrooke Village

4005 Ripa Ave

St Louis,MO63125
43-1592502
Skilled nursing facility MO 501(c)(3) 9 Alexian Brothers Health System
 
Yes
 
(19) Alexian Brothers Hospital Network

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-3276552
Supports the provision of healthcare services for related corporations IL 501(c)(3) 11, III-FI Alexian Brothers Health System
 
Yes
 
(20) Alexian Brothers Medical Center

800 Biesterfield Rd

Elk Grove Village,IL60007
36-2596381
Acute care hospital TX 501(c)(3) 3 Alexian Brothers Health System
 
Yes
 
(21) Savelli Properties Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-3308965
Owns or leases properties where healthcare services are delivered IL 501(c)(2) N/A Alexian Brothers Health System
 
Yes
 
(22) Alexian Brothers Center for Mental Health

3350 W Salt Creek Lane

Arlington Heights,IL60005
36-3045007
Outpatient community mental health services IL 501(c)(3) 7 Alexian Brothers Health System
 
Yes
 
(23) St Alexius Medical Center

1555 Barrington Road

Hoffman Estates,IL60194
36-4251846
Acute care hospital IL 501(c)(3) 3 Alexian Brothers Health System
 
Yes
 
(24) Alexian Brothers Ambulatory Group

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-4336931
Physician Services IL 501(c)(3) 3 Alexian Brothers Health System
 
Yes
 
(25) Chicago Catholic Healthcare System Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
36-3693486
Inactive corporation IL 501(c)(3) 9 Alexian Brothers Hospital Network
 
Yes
 
(26) Alexian Brothers of St Louis Inc

3040 W Salt Creek Lane

Arlington Heights,IL60005
43-0653236
Acute care hospital (sponsorship transferred in 1997) MO 501(c)(3) 3 Alexian Brothers Health System
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) Alexian Rehabilitation Services LLC

935 Beisner Road
Elk Grove Village,IL60007
30-0221481
Rehabilitation hospital IL N/A
N/A       No     No  
(2) Illinois NeuroMeg Center LLC

3040 W Salt Creek Lane
Arlington Heights,IL60005
87-0783164
Provision of NeuroMeg services IL N/A
N/A       No     No  
(3) Elk Grove MOB Limited Partnership

3040 W Salt Creek Lane
Arlington Heights,IL60005
36-3853289
Medical office building IL N/A
N/A       No     No  
(4) Workplace Solutions LLC

1100 E Woodfield Rd
Schaumburg,IL60173
36-4095007
Provision of EAP services IL N/A
N/A       No     No  
(5) Bonaventure Medical Foundation LLC

3040 W Salt Creek Lane
Arlington Heights,IL60005
36-3978153
Manages managed care contracts DE N/A
N/A       No   Yes    
(6) Neurosciences Equipment LLC

3040 W Salt Creek Lane
Arlington Heights,IL60005
86-1115516
Ownership of Gamma Knife IL N/A
N/A       No     No  
(7) Alexian Cardiovascular Institute Equipment LLC

3040 W Salt Creek Lane
Arlington Heights,IL60005
30-0307978
Lease and sub-lease of 64-slice CT equipment IL N/A
N/A       No     No  
(8) St Alexius Center for Sleep Health LLC

665 W North Ave
Lombard,IL60148
20-5876371
Operation of sleep labs IL N/A
N/A       No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) Thelen Corporation
3040 W Salt Creek Lane
Arlington Heights,IL60005
36-3266316
Owns/leases property; joint venture partner IL N/A
C      
(2) Edessa Insurance Company Ltd
3040 W Salt Creek Lane
Arlington Heights,IL60005
Captive insurer located in Bermuda BD N/A
C      
(3) Alexian Village of Elk Grove
3040 W Salt Creek Lane
Arlington Heights,IL60005
35-2211303
Tax credit financed housing IL N/A
C      
(4) Alexian Brothers Health Providers Association Inc
3040 W Salt Creek Lane
Arlington Heights,IL60005
36-3853286
Messenger model IPA IL N/A
C      
(5) Alexian Brothers Corpus Christi Housing Project LLC
3040 W Salt Creek Lane
Arlington Heights,IL60005
94-3465394
Tax credit financed housing IL N/A
C      




Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Alexian Brothers Health System

O 1,476,049 FMV
(2) Alexian Brothers Hospital Network

O 4,098,572 FMV
(3) Alexian Brothers Health System

O 1,200,528 FMV
(4) Alexian Brothers Health System

R 1,463,755 FMV
(5) Alexian Brothers Health System

J 557,067 FMV
(6) Alexian Brothers Medical Center

P 536,430 FMV
(7) Alexian Brothers Medical Center

O 71,023 FMV
(8) St Alexius Medical Center

P 1,476,904 FMV
(9) St Alexius Medical Center

O 666,978 FMV
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all
partners
section
501(c)(3)
organizations?
(e)
Share of
end-of-year
assets
(f)
Disproprtionate allocations?
(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: