Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
Alexian Village of Milwaukee Inc |
391351584 | 9 | No | 0 | 0 | |
| (B)
Alexian Brothers Senior Neighbors |
620646376 | 7 | No | 0 | 0 | |
| (C)
Alexian Village of Tennessee |
621136742 | 9 | No | 0 | 0 | |
| (D)
Alexian Brothers Lansdowne Village |
431470362 | 9 | No | 0 | 0 | |
| (E)
Seton Manor Inc |
232960726 | 9 | No | 0 | 0 | |
| (F)
Alexian Brothers Sherbrooke Village |
431592502 | 9 | No | 0 | 0 | |
| (G)
Alexian Brothers Community Services |
364344423 | 9 | No | 0 | 0 | |
| (H)
Borgess Nursing Home Inc |
382555589 | 9 | No | 0 | 0 | |
| (I)
St Joseph's Ministries Inc |
521835288 | 9 | No | 0 | 0 | |
| (J)
Carondelet Long-Term Care Facilities Inc |
742505427 | 9 | No | 0 | 0 | |
| (K)
St Catherine's Laboure Manor |
591878316 | 9 | No | 0 | 0 | |
| (L)
Via Christi Healthcare Outreach Program for Elders Inc |
481236589 | 9 | No | 0 | 0 | |
| (M)
Via Christi Village Ponca City Inc |
731153337 | 9 | No | 0 | 0 | |
| (N)
Via Christi Village Hays Inc |
202828680 | 9 | No | 0 | 0 | |
| (O)
Via Christi Village Manhattan Inc |
481078862 | 9 | No | 0 | 0 | |
| (P)
Via Christi Village McLean Inc |
481247723 | 9 | No | 0 | 0 | |
| (Q)
Via Christi Village Pittsburg Inc |
743070971 | 9 | No | 0 | 0 | |
| (R)
Cornerstone Assisted Living Inc |
481241079 | 9 | No | 0 | 0 | |
| (S)
Via Christi Village Georgetown Inc |
481129325 | 9 | No | 0 | 0 | |
| (T)
OUR LADY OF PEACE INC |
161608735 | 9 | Yes | 0 | 0 | |
| (U)
PROVIDENCE PARK INC |
611759304 | 9 | Yes | 0 | 0 | |
| Total 21 | 0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 11g (VI) AMOUNT OF OTHER SUPPORT | ASCENSION HEALTH SENIOR CARE PROVIDES A VARIETY OF NONCASH CENTRALIZED SYSTEM OFFICE SUPPORT IN FURTHERANCE OF THE MISSION OF THE ASCENSION SPONSOR AND THE OTHER SUPPORTED ORGANIZATIONS LISTED IN PART I. |
| Schedule A, Part IV, Section A, Line 11a POWER TO APPOINT DIRECTORS | The Ascension Sponsor (the Canonical sponsor which was formed by the founding religious sponsors and which has been conferred public juridic personality by decree of The Congregation for Institutes of Consecrated Life and Societies of Apostolic Life of the Roman Catholic Church) determines the philosophy, mission, vision, values and expectations of the System, and appoints the board for Ascension Health Alliance, delegating that appointment power within the System, with the Ascension Sponsor retaining ultimate control over governance matters. |
| Schedule A, Part IV, Section A, Line 11b CONTROL BY SUPPORTED ORGANIZATIONS | The Ascension Sponsor (the Canonical sponsor which was formed by the founding religious sponsors and which has been conferred public juridic personality by decree of The Congregation for Institutes of Consecrated Life and Societies of Apostolic Life of the Roman Catholic Church) determines the philosophy, mission, vision, values and expectations of the System, and, as applied within a framework of delegation, retains ultimate control of governance within the System. In answering "no" to Part IV, Section B, Line 2, the organization is considering the Ascension Sponsor's direct control as well as its ultimate control over the other supported organizations throughout the System. |
| Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name | ASCENSION HEALTH SENIOR CARE (ASCENSION SENIOR LIVING) IS ORGANIZED AND AT ALL TIMES SHALL BE OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL IN THE UNITED STATES, ST. LOUISE PROVINCE, THE CONGREGATION OF ST. JOSEPH, THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET, THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE - AMERICAN PROVINCE, AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE BY AND THROUGH ASCENSION HEALTH MINISTRIES (ASCENSION SPONSOR), AND, PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE AFFILIATED ORGANIZATIONS PROVIDED THAT SUCH ORGANIZATIONS ARE DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE AND ARE CLASSIFIED AS PUBLIC CHARITIES UNDER SECTIONS 509(A)(1) AND 509(A)(2) OF THE CODE. SUCH SUPPORTED ORGANIZATIONS ARE LISTED AT PART I. THE ORGANIZATION ALSO SUPPORTS ASCENSION SPONSOR, THE CANONICAL SPONSOR WHICH WAS FORMED BY THE FOUNDING SPONSORS AND WHICH HAS BEEN CONFERRED PUBLIC JURIDIC PERSONALITY BY DECREE OF THE CONGREGATION FOR INSTITUTES OF CONSECRATED LIFE AND SOCIETIES OF APOSTOLIC LIFE OF THE ROMAN CATHOLIC CHURCH. |
| Schedule A, Part IV, Section A, Line 2 Supported Org. Without IRS Status 509(a)1 or (2) | SUPPORTED ORGANIZATIONS NOT REQUIRED TO OBTAIN A SEPARATE IRS DETERMINATION OF STATUS ARE EITHER CONSIDERED AN INSTRUMENTALITY OF THE CATHOLIC CHURCH (ASCENSION SPONSOR) OR ARE INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AND HAVE BEEN VERIFIED TO BE DESCRIBED IN EITHER 509(a)(1) or 509(a)(2) ACCORDING TO THEIR MOST RECENT FORM 990 FILING. |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 6 Classes of members or stockholders | ASCENSION HEALTH SENIOR CARE d.b.a. ASCENSION SENIOR LIVING HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | ASCENSION HEALTH SENIOR CARE d.b.a. ASCENSION SENIOR LIVING HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH WHO HAS THE AUTHORITY TO APPOINT AND REMOVE DIRECTORS AND EXECUTIVE OFFICERS OF ASCENSION SENIOR LIVING . |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Ascension Health Senior Care d.b.a. ASCENSION SENIOR LIVING, has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals' evaluation debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board Member's questions. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization's Conflict of Interest Policy is monitored as part of the system-wide procedures and not at the organizational level. The system-wide procedures are as follows: 1. At time of appointment and annually thereafter, all interested persons, including board and committee members, complete a disclosure statement which addresses actual or potential conflicts of interest. 2. The disclosure statement is done electronically and the return of the completed statement is a condition of continued appointment, employment, or participation with the organization. 3. All actual conflicts are investigated, and resolved by the chief governance officer and the corporate responsibility officer, with the results shared with the chief executive of the organization. 4. Periodic reviews are conducted by governance, compliance, and internal audit to ensure the organization is operating consistent with the policy and enforcing the policy's terms. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization will provide any documents open to public inspection upon request. |
| Form 990, Part IX, Line 11g Other Fees | Purchased Services - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Other Professional Fees - Total Expense: 10181012, Program Service Expense: 10181012, Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | TRANSFERS TO AFFILIATES - VCVI - -1516588; TRANSFERS TO AFFILIATES - ABSM - -4259799; OTHER NET AFFILIATE TRANSFERS - 29537585; TRANSFER TO AFFILIATES - ABSM TO AHSC TO CLEAR TB - 19594528; |
| FORM 990, PART VI, LINE 15 PROCESS FOR DETERMINING COMPENSATION | In determining compensation of officers paid by the filing organization or by related organizations, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The applicable Compensation Committees REVIEWED AND APPROVED THE COMPENSATION. In the review of the compensation, the compensation of the official was compared to the compensation of those in positions in other similarly situated organizations that hold the same or a similar title. During the review and approval of the compensation, the documentation of the decision was recorded in the Compensation Committee minutes. The individual was not present when his compensation was decided. |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |