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.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Presence RHC Corporation
Employer identification number
36-2235165
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Presence RHC Corporation
Employer identification number
36-2235165
Return Reference
Explanation
FORM 990, PART I
MISSION STATEMENT INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST, WE PRESENCE HEALTH, A CATHOLIC HEALTH SYSTEM, PROVIDE COMPASSIONATE, HOLISTIC CARE WITH A SPIRIT OF HEALING AND HOPE IN THE COMMUNITIES WE SERVE. FORM 990, PART III, QUESTION 1 MISSION STATEMENT INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST, PRESENCE HEALTH PROVIDES ADMINISTRATIVE MANAGEMENT AND OTHER SUPPORT TO AFFILIATE CATHOLIC-SPONSORED HOSPITALS, NURSING HOMES, AND OTHER HEALTH CARE PROVIDERS, TO ENABLE THEM TO PROVIDE COMPASSIONATE, HOLISTIC CARE WITH A SPIRIT OF HEALING AND HOPE IN THE COMMUNITIES THEY SERVE. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION PRESENCE RHC CORPORATION RECEIVES MANAGEMENT FEE INCOME FOR THE SERVICES IT PROVIDES TO THE ORGANIZATIONS IN THE SYSTEM. BY CENTRALIZING THESE SERVICES, PRESENCE HEALTH IS ABLE TO PREVENT DUPLICATION AND BETTER UTILIZE SCARCE RESOURCES. FOR EXAMPLE, CERTAIN ACCOUNTING, HUMAN RESOURCES, AND INFORMATION TECHNOLOGY ARE SERVICES PROVIDED CENTRALLY THROUGH PRESENCE RHC CORPORATION. IT MANAGES THE PRESENCE HEALTH CARE WEBSITE (WWW.presencehealth.ORG) WHICH OFFERS INFORMATION ON MATTERS SUCH AS PRESENCE HEALTHS FINANCIAL ASSISTANCE PROGRAM, AND EDUCATIONAL PROGRAM. PRESENCE RHC CORPORATION OFFERS OTHER SERVICES SUCH AS RES-INFO, A WIDELY UTILIZED PRESENCE HEALTH CARE TELEPHONE SERVICE/CONTACT CENTER THAT PROVIDES NURSE ADVICE, HEALTH INFORMATION, AND HEALTH CARE CLASS REGISTRATION TO CALLERS.
FORM 990, PART I, QUESTION 5, AND PART V, QUESTION 2
COMPENSATION AND FORM W-3 TRANSMITTAL OF WAGES AND TAX STATEMENT STATEMENT PRESENCE RHC CORPORATION (THE "CORPORATION") REPORTS 0 EMPLOYEES ON FORM 990, PART I, QUESTION 5 AND FORM 990, PART V, QUESTION 2A AS IT IS NOT REQUIRED TO FILE FORM W-3, TRANSMITTAL OF WAGES AND TAX STATEMENT. THE CORPORATION'S COMPENSATION IS PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES THE FORMS W-2 AND W-3, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC.
FORM 990, PART V, QUESTION 1A
FORM 1096 TRANSMITTAL OF U.S. INFORMATION RETURNS PRESENCE RHC CORPORATION (THE "CORPORATION") REPORTS 0 ON FORM 990, PART V, QUESTION 1A AS IT IS NOT REQUIRED TO FILE FORM 1096, TRANSMITTAL OF U.S. INFORMATION RETURNS. ALL OF THE CORPORATION'S ACCOUNTS PAYABLE REPORTABLE ON FORM 1096 ARE PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES ALL FORMS 1099, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC.
FORM 990, PART VI, QUESTION 4
CHANGES TO ORGANIZATIONAL DOCUMENTS THE BYLAWS OF THE CORPORATION WERE AMENDED EFFECTIVE DECEMBER 6, 2013 TO CLARIFY MEMBER'S POWERS AND TO FURTHER FACILITATE UNIFORMITY IN ORGANIZATION BETWEEN ENTITIES FROM THE RESURRECTION AND PROVENA HEALTHCARE SYSTEMS INTO ONE SYSTEM, KNOWN AS PRESENCE HEALTH.
FORM 990, PART VI, QUESTION 6
MEMBERS OR SHAREHOLDERS THE CORPORATION HAS ONE MEMBER, PRESENCE HEALTH NETWORK, WHICH SHARES AN IDENTICAL BOARD OF DIRECTORS WITH THE CORPORATION.
FORM 990, PART VI, QUESTION 7A
PERSONS WITH AUTHORITY TO ELECT MEMBERS OF THE GOVERNING BODY THE BOARD OF DIRECTORS OF THE CORPORATION CONSIST OF THOSE INDIVIDUALS WHO THEN SERVE AS THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION'S SOLE MEMBER, PRESENCE HEALTH NETWORK (PHN). THE MEMBERS OF THE PHN'S BOARD OF DIRECTORS ARE APPOINTED BY PHN'S CORPORATE MEMBER, A BODY CURRENTLY CONSISTING OF TEN CATHOLIC RELIGIOUS WOMEN, EACH OF WHOM IS A MEMBER OF ONE OF THE FIVE SPONSORING MEMBER CONGREGATIONS OF PHN AND ITS AFFILIATES.
FORM 990, PART VI, QUESTION 7B
DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS THE FOLLOWING POWERS OVER THE CORPORATION AND ITS AFFILIATES ARE RESERVED TO AND SHALL BE EXERCISED EXCLUSIVELY BY PRESENCE HEALTH NETWORK (THE "MEMBER"): A) APPROVE THE CORPORATION'S OR AFFILIATE'S SALE, TRANSFER, LEASE (OTHER THAN IN THE ORDINARY COURSE OF BUSINESS AND FOR LEASE TERMS OF TEN (10) YEARS OR LESS) OR ENCUMBRANCE (INCLUDING THE INCURRENCE OF DEBT RESULTING IN AN ENCUMBRANCE) OF STABLE PATRIMONY OF ANY OF THE SPONSORS IN AN AMOUNT IN EXCESS OF THE STABLE PATRIMONY LIMIT; B) APPROVE AMENDMENTS TO THE CORPORATION'S OR AFFILIATE'S ORGANIZATIONAL DOCUMENTS, FOLLOWING APPROVAL BY THE BOARD OF DIRECTORS IF REQUIRED UNDER THE ACT; C) APPROVE ANY MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR AFFILIATE, EXCEPT FOR MERGERS OR CONSOLIDATIONS WITH OTHER SYSTEM AFFILIATES, FOLLOWING APPROVAL BY THE BOARD OF DIRECTORS IF REQUIRED UNDER THE ACT; D) APPROVE THE CREATION OF AFFILIATES; E) APPROVE ANY CHANGE IN THE CORPORATE OR PRIMARY BUSINESS NAME OR LOGO OF THE CORPORATION OR AFFILIATE; F) APPROVE THE CORPORATION'S OR AFFILIATE'S EXPENDITURE OF FUNDS NOT PROVIDED FOR IN AN APPROVED BUDGET ABOVE THRESHOLDS TO BE DETERMINED FROM TIME TO TIME BY THE MEMBER OR EXPENDITURE OF FUNDS OR DIVESTITURE OF ASSETS NOT PROVIDED FOR IN A SYSTEM STRATEGIC AND FINANCIAL PLAN; G) APPROVE THE CORPORATION'S OR AFFILIATE'S INCURRENCE OF DEBT ABOVE THRESHOLDS TO BE DETERMINED FROM TIME TO TIME BY THE MEMBER; H) APPROVE THE CORPORATION'S OR AFFILIATE'S ENTRY INTO MATERIAL CONTRACTS OR PURCHASES, LITIGATION OR OTHER LEGAL SETTLEMENTS, BENEFITS PACKAGES, OR OTHER BUSINESS AFFAIRS ABOVE LIMITS SET FROM TIME TO TIME BY THE MEMBER; I) APPOINT AND REMOVE THE CORPORATION'S OR AFFILIATE'S BOARD OF DIRECTORS; J) APPOINT AND REMOVE THE CHAIR OF THE CORPORATION'S OR AFFILIATE'S BOARD OF DIRECTORS; AND K) EXERCISE ALL POWERS OF THE MEMBERS OR OWNERS OF ALL MEMBERS OF THE RESURRECTION GROUP EXCEPT TO THE EXTENT OTHERWISE DELEGATED BY THE MEMBER.
FORM 990, PART VI, QUESTION 11B
FORM 990 REVIEW PROCESS THE DRAFT FORM 990 IS PREPARED BY THE CORPORATION'S ACCOUNTING FIRM WITH ASSISTANCE FROM THE SYSTEM FINANCE DEPARTMENT. THE RETURN IS THEN REVIEWED BY MANAGEMENT, INCLUDING SENIOR LEADERS FROM LEGAL, COMPLIANCE, HUMAN RESOURCES AND THE SYSTEM CEO FOR ACCURACY AND COMPLETENESS. AS NECESSARY, MANAGEMENT CONSULTS WITH EXTERNAL LEGAL AND OTHER EXPERTS TO ASSURE ACCURACY. THE FINAL FORM 990 IS PROVIDED TO THE CORPORATION'S BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, LINE 12C
PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF PRESENCE HEALTH NETWORK AND ALL OF ITS AFFILIATED MINISTRIES (COLLECTIVELY "PRESENCE HEALTH") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY DIRECTOR, TRUSTEE, OFFICER, CORPORATE MEMBER APPOINTEE, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SENIOR LEADERS, AND OTHERS IN A RECENT POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PRESENCE HEALTH ("INTERESTED PERSONS"), AND CLARIFY THE STANDARDS OF CONDUCT, DUTIES AND OBLIGATIONS OF INTERESTED PERSONS IN THE CONTEXT OF POTENTIAL CONFLICTS OF INTEREST BY PROVIDING A METHOD FOR DISCLOSING AND RESOLVING SUCH POTENTIAL CONFLICTS. NO PRESENCE HEALTH ENTITY WILL ENGAGE IN ANY CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS DISINTERESTED MEMBERS OF THE APPLICABLE BOARD OF DIRECTORS OR OTHER GOVERNING BODY DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF PRESENCE HEALTH HAVE BEEN IMPLEMENTED. TO FACILITATE THIS POLICY, ALL INTERESTED PERSONS HAVE A CONTINUING OBLIGATION TO PROMPTLY DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE. ALL DISCLOSURES MUST BE PROVIDED TO THE SYSTEM COMPLIANCE OFFICER AND GENERAL COUNSEL IN A WRITTEN DESCRIPTION OF THE MATERIAL FACTS. DISCLOSURE SHALL BE ON A CONFLICTS OF INTEREST QUESTIONNAIRE OR SIMILAR FORMAT AS DESCRIBED IN THE CONFLICTS OF INTEREST POLICY. ALL INTERESTED PERSONS SHALL ALSO COMPLETE A QUESTIONNAIRE BASED ON THE ASSUMPTION OF THE BOARD (OR OTHER RELEVANT) POSITION, AND THEREAFTER ON AT LEAST AN ANNUAL BASIS OR WHEN AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT ARISES. AT ANY TIME THAT AN ACTUAL, APPARENT OR A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE CORPORATION'S BOARD OF DIRECTORS, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A DISCLOSURE STATEMENT BY AN INTERESTED PERSON, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE SUBJECT INTERESTED PERSON, THE CORPORATION'S BOARD OR APPLICABLE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, ONLY DISINTERESTED DIRECTORS/COMMITTEE MEMBERS VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT IS FOUND TO EXIST THE INTERESTED PERSON WILL GENERALLY BE REQUIRED TO RECUSE HIM OR HERSELF DURING ANY MEETING IN WHICH THE BOARD OF DIRECTORS OR APPLICABLE COMMITTEE CONDUCTS THE EVALUATION OF THE SUBJECT TRANSACTION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. TO ENSURE THAT THE PRESENCE HEALTH OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS EXEMPT STATUS, TRANSACTIONS INVOLVING INTERESTED PERSONS ARE ONLY APPROVED IF, AFTER EXERCISING REASONABLE DUE DILIGENCE, THE BOARD DETERMINES THEY ARE FAIR AND REASONABLE, TAKING INTO ACCOUNT FACTORS SUCH AS WHETHER PRESENCE HEALTH COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT. HOWEVER, LENDING MONEY OR GUARANTYING AN OBLIGATION OF A DIRECTOR, OFFICER, OR EMPLOYEE OF PRESENCE HEALTH (EXCLUSIVE OF CUSTOMARY INSURANCE COVERAGE FOR ACTS DONE IN CONNECTION WITH SUCH INDIVIDUAL'S SERVICE TO OR EMPLOYMENT BY PRESENCE HEALTH) IS STRICTLY PROHIBITED.
FORM 990 PART VI, QUESTIONS 15A AND 15B, AND PART V, QUESTION 2A
COMPENSATION AND APPROVAL PROCESS FOR OFFICERS AND KEY EMPLOYEES COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY ITS BOARD OF DIRECTORS AND APPLIED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS OF THE CORPORATION'S SOLE MEMBER, PRESENCE HEALTH NETWORK. THE CORPORATION USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE SYSTEM PARENT'S HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION BY APPROVING ALL COMPONENTS OF EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE SYSTEM PARENT AND PRHCC BOARDS.
FORM 990, PART VI, LINE 19
DOCUMENT AVAILABILITY THE CORPORATION'S ARTICLES OF INCORPORATION ARE ON FILE WITH THE STATE OF ILLINOIS. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE CORPORATION, TOGETHER WITH ITS AFFILIATES, ARE AVAILABLE FROM THE NATIONAL DISSEMINATION AGENT AS REQUIRED BY PRESENCE HEALTH SYSTEM'S BOND DOCUMENTS. CONFLICTS OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE PUBLIC, HOWEVER A SUMMARY OF THE CURRENT POLICY IS ANNUALLY INCLUDED IN SCHEDULE O OF THE CORPORATION'S FORM 990.
FORM 990, PART VII, SECTIONS A & B
COMMON PAYMASTER PRESENCE RESURRECTION MEDICAL CENTER ("PRMC") (FEIN 36-3330926) ACTS AS THE AGENT FOR THE CORPORATION. CASH IS SWEPT FROM THE CORPORATION ON A DAILY BASIS TO PRMC AND PRMC ISSUES ALL PAYROLL AND ACCOUNTS PAYABLE CHECKS ON BEHALF OF AND AS AGENT FOR THE CORPORATION AND THE APPROPRIATE ACCOUNTING ENTRIES ARE RECORDED. FORM 990, PART IX, LINE 11G TOTAL AMOUNT EXCEEDING 10% OF PART IX, LINE 25 CONSULTING $38,756,771 COLLECTION FEES $4,044,916 OUTSIDE SERVICES $23,321,765 PURCHASED MAINTENANCE $621,547 L GILBRAITH - GOVERNMENT FEES $16,865 PHYSICIANS - EXTERNAL $14,508 ----------- TOTAL $66,776,373 FORM 990, PART IX, LINE 23 INSURANCE EXPENSE INSURANCE EXPENSE WAS ($269,425) DUE TO A REDUCTION IN EXPENSE BOOKED FOLLOWING A REVISED ACTUARIAL EVALUATION OF SELF-INSURANCE.
FORM 990, PART XI, LINE 5
UNREALIZED GAINS AND LOSSES THE CHANGE IN THE UNREALIZED GAIN (LOSSES) ON THE RESURRECTION HEALTH CARE INVESTMENT PORTFOLIO IS RECORDED IN ITS ENTIRETY IN THE BOOKS AND RECORDS OF PRESENCE RHC CORPORATION. FORM 990, PART XI, LINE 9 CHANGE IN NET ASSETS OR FUND BALANCES PROPERLY Restricted Net Assets $34,823 Bethlehem Woods and Retirement Community and Casa San Carlo Retirement Community's Net Assets (76,943,201) ------------- TOTAL (76,908,378)
FORM 990, PART XII, LINE 2B
AUDITED FINANCIAL STATEMENTS AN INDEPENDENT ACCOUNTANT ANNUALLY AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF PRESENCE HEALTH NETWORK AND ITS AFFILIATES. THE AUDIT OPINION IS ISSUED ON THE CONSOLIDATED FINANCIAL STATEMENTS AND EACH AFFILIATE IS NOT SEPARATELY AUDITED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.