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)
WFH - ALL SAINTS INC |
391264986 | 3 | No | 44,745,339 | 0 | |
| (B)
WHEATON FRANCISCAN HOME HEALTH AND HOSPICE INC |
391559428 | 3 | No | 964,482 | 0 | |
| (C)
WHEATON FRANCISCAN MEDICAL GROUP INC |
391791586 | 3 | No | 11,739,626 | 0 | |
| (D)
WHEATON FRANCISCAN LABORATORIES INC |
391701402 | 9 | No | 0 | 0 | |
| (E)
WFH PHARMACY ENT & FRAN WOODS INC |
391613624 | 9 | No | 2,492,927 | 0 | |
| (F)
WFH - ST FRANCIS INC |
390907740 | 3 | No | 19,248,121 | 0 | |
| (G)
WHEATON FRANCISCAN INC |
390816857 | 3 | No | 46,581,504 | 0 | |
| (H)
WFH - TERRACE AT ST FRANCIS INC |
391486775 | 9 | No | 0 | 0 | |
| (I)
WFH - FRANKLIN INC |
562592868 | 3 | No | 6,758,931 | 0 | |
| (J)
MARIANJOY REHABILITATION HOSPITAL AND CLINICS INC |
362680776 | 3 | No | 7,583,952 | 0 | |
| (K)
REHABILITATION MEDICINE CLINIC INC |
363236791 | 3 | No | 1,133,234 | 0 | |
| (L)
CANTICLE MINISTRIES INC |
364091836 | 7 | No | 0 | 0 | |
| (M)
SET MINISTRIES INC |
391618277 | 9 | No | 0 | 0 | |
| (N)
ST CATHERINES HOSPITAL INC |
390855075 | 3 | No | 0 | 0 | |
| (O)
UPENDO VILLAGE NFP |
331007368 | 9 | No | 0 | 0 | |
| (P)
COVENANT MEDICAL CENTER INC |
421264647 | 3 | No | 31,591,544 | 0 | |
| (Q)
MERCY HOSPITAL OF FRANCISCAN SISTERS INC |
421178403 | 3 | No | 1,732,448 | 0 | |
| (R)
SARTORI MEMORIAL HOSPITAL INC |
420758901 | 3 | No | 5,464,140 | 0 | |
| (S)
ASSISI HOMES-BATAVIA APARTMENTS INC |
363914084 | 9 | No | 0 | 0 | |
| (T)
ASSISI HOMES-COLONY PARK INC |
364039278 | 9 | No | 0 | 0 | |
| (U)
ASSISI HOMES-CONSTITUTION HOUSE INC |
364049150 | 9 | No | 0 | 0 | |
| (V)
ASSISI HOMES-JEFFERSON COURT INC |
391771526 | 9 | No | 0 | 0 | |
| (W)
ASSISI HOMES-KENOSHA INC |
391814815 | 9 | No | 0 | 0 | |
| (X)
ASSISI HOMES-SAXONY INC |
391790498 | 9 | No | 0 | 0 | |
| (Y)
ASSISI HOMES OF GURNEE INC |
363942336 | 9 | No | 0 | 0 | |
| (Z)
ASSISI HOMES OF ILLINOIS INC |
363803443 | 9 | No | 0 | 0 | |
| (AA)
ASSISI HOMES OF NEENAH INC |
363767250 | 9 | No | 0 | 0 | |
| (AB)
CANTICLE PLACE INC |
363957850 | 9 | No | 0 | 0 | |
| (AC)
CATHERINE MARIAN HOUSING INC |
391657098 | 9 | No | 0 | 0 | |
| (AD)
CLARE GARDENS |
237200039 | 9 | No | 0 | 0 | |
| (AE)
CLARE OF ASSISI HOMES-WESTMINSTER INC |
742740978 | 9 | No | 0 | 0 | |
| (AF)
DAYSPRING VILLA INC |
363933908 | 9 | No | 0 | 0 | |
| (AG)
FRANCIS HEIGHTS INC |
840626174 | 9 | No | 0 | 0 | |
| (AH)
MARIAN HOUSING CENTER INC |
391515867 | 9 | No | 0 | 0 | |
| (AI)
MARIAN PARK |
362750105 | 9 | No | 0 | 0 | |
| (AJ)
RIDGEWAY PLACE INC |
421416064 | 9 | No | 0 | 0 | |
| (AK)
VILLA MARIA INC |
841347868 | 9 | No | 0 | 0 | |
| (AL)
VILLA ST CLARE INC |
391769395 | 9 | No | 0 | 0 | |
| (AM)
ASSISI HOMES-LASALLE MANOR INC |
800623447 | 9 | No | 0 | 0 | |
| Total 39 | 180,036,248 | |||||
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 Supplemental Info | Part IV Section A Line 1: Our supported organizations are not normally listed by name in the governing documents. Wheaton Franciscan Services, Inc. is a Tier I parent organization, and due to long-standing historical relationships as well as relationships that are officially delineated in our organizational charts, supported all organizations at the Tier II and Tier III level that are not themselves supporting organizations. This support was extended only through March 1, 2016, when various transfers were done to transfer these supported organizations to new parent supporting organizations. Wheaton Franciscan Services, Inc. provided this support by way of corporate oversight and related administrative and program services such as Investment and Treasury Services among many others, which result in monetary equity transfers and intercompany journal entries that provided support. Part IV Section A Line 5a The Wheaton Franciscan Sisters engaged in a process of discernment regarding the future of their ministries in light of the changing health care and housing environment and their ability to continue oversight of the System. They explored a number of options during this process and made the decision that the ministries would be best served in the long term under new sponsorship. Ultimately, they determined that to position the ministries for ongoing success, they would seek out the optimal organization for each region and division during the first half of calendar year 2016. As a result, several organizations ceased to be supported organizations during the current reporting period. All organizations listed on Sch A Part VI ceased to be supported organizations as indicated below: Wheaton's Southeast Wisconsin Region was transferred to Ascension on March 1, 2016. Marianjoy Rehabilitation Hospital was sold to Northwestern Medicine on March 1, 2016. Wheaton's Iowa Region was transfered to Mercy Health Network on May 1, 2016. In addition, management of the Franciscan Ministries Inc properties transferred to Mercy Housing by June 30, 2016. The Properties themselves transfer upon approval by HUD. Part IV Section A Line 6: Through March 1, 2016 Wheaton Franciscan Services, Inc. was a Tier I parent supporting organization that was part of a controlled group of healthcare provider organizations. As such, a common occurrence was to have intercompany journal entries resulting in support being provided to other supporting organizations within the group (that may themselves have provided additional support to one or more of the same supported organization). Note that effective March 1, 2016, a system reorganization was done that transferred substantially all of the organizations that were part of Wheaton Franciscan Healthcare to new system parent supporting organizations that are not considered to be related to Wheaton Franciscan Services, Inc after that date. Wheaton Franciscan Services, Inc. was transferred to the Wheaton Franciscan Sisters Corporation and will no longer be considered a supporting organization for future reporting periods. Part IV Section D Line 1: By the last day of the 5th month (Nov 30th) following the close of the tax year (June 30th) a formal letter is drafted by the Tax Compliance Department, which provides the details of all support provided to each supported organization by each supporting organization for the most recently completed fiscal year. This letter is provided to all system Senior Vice Presidents as the means in meeting these notification requirements. Final support amounts are calculated as part of 990 preparation, and full copies of all 990's are provided via a board portal to all supported organizations. Any changes to bylaws, articles, or other governing documents are also provided with the filing of the 990, if required, and all information is available earlier upon request. Part IV Section D Line 3: Under the direction of the parent organization Wheaton Franciscan Services, Inc., the common boards of certain supported organizations along with their investment committees, investment managers, and other committees overseeing various functions, have input on all investment policies and decisions as they relate to the group of controlled healthcare organizations making up Wheaton Franciscan Healthcare which existed through March 1, 2016. Due to the number of supported organizations that existed up through this date, and the sheer size of the system, not all supported organizations participated in these decisions. A substantial reorganization occurred on March 1, 2016 and going forward these relationships will change. Part IV Section E Lines 3a-3b: Wheaton Franciscan Services, Inc. and its supported organizations had several members of its governing bodies that served on common boards through March 1, 2016. These members held reserved powers that included, but were not limited to, the election of members of the governing body, election of officers, approval of certain financial expenditures in accordance with policies, and approval of budgets and strategic plans. These approvals were based on recommendations from the governing body up through March 1, 2016, when a substantial reorganization occurred. |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Supplemental Information to Form 990 | Part IV Lines 12a-12b and Part XII Lines 2a-2c: Beginning March 1, 2016 a system reorganization took place, and organizations that were formerly managed and governed by Wheaton Franciscan Services, Inc. were transferred to other parent organizations that were outside the Wheaton Franciscan Healthcare System. As a result, a system or stand-alone review or audit was not completed for Fiscal 2016. Part V Line 1a and Part VII Section B Line 1-2: Wheaton Franciscan Healthcare streamlined their reporting of IRS Forms 1099-MISC so that most 1099-MISC are now reported using the FEIN number of the parent organization or of a related organization. The actual expense continues to be paid by, or transferred to, the individual entity which is normally a subsidiary or related organization to the organization(s) issuing the 1099. For this reason, the reader may notice on some 990s that there are top 5 independent contractors reported, but no 1099s are reported. Likewise on the 990s of the organization(s) reporting number of 1099s, there may be a disproportionate share of 1099s reported as compared with the actual expenses and top 5 independent contractors reported. Part VI Section A Line 4: The organizations Bylaws were amended in May 2016 from two (2) classes of members to solely the individuals that serve as the Provincial Directress and the Provincial Councilors of the Wheaton Franciscan Sisters. Part VI Section A Lines 6-8b: WFSI had two members, the Class I Members and the Sponsor Member Board. Effective April 2016 this changed to one member, the individuals that serve as the Provincial Directress and the Provincial Councilors of the Wheaton Franciscan Sisters, which holds several reserved powers over WFSI. These reserved powers include, but are not limited to, the election of members of the governing body and election of officers, and amendments to governing documents; these approvals are based on recommendations from the governing body. Part VI, Section B, Line 11a and 11b: Ministries that were affiliates of Wheaton Franciscan Healthcare during the fiscal year ending June 30, 2016 used a multiple-level review process on all IRS Forms 990 to ensure accurate and timely filing for all organizations. Under the direction of the Tax Manager, the Accounting Departments in each region prepare Forms 990, 990-T, and associated state filings. When complete, the return is first reviewed by a Senior-Level (or higher) associate in the Finance Department, who focuses on income statement and balance sheet items, and schedules where transactions of this type might be reported. If discrepancies are found, the item will be corrected prior to the next step in the review process. Once cleared through Finance, the return is provided to the Tax Department, where the Tax Manager concentrates primarily on consistency of reporting between all returns, accuracy of tax related information, and narrative explanation of any outliers. Again, any problems or questions are investigated and corrected. Depending on the level of complexity of the year in question, as well as the individual issues specific to that filing, certain returns may be selected for outside review by a public accounting firm. This decision will vary from year to year based on many factors, and sometimes outside review is not utilized at all. Also, certain schedules, such as Schedule H or Schedule J may be reviewed by committees, such as the Community Benefit Team or the Compensation Committee in selected years. The board has also asked for formal presentations on various 990 topics over the years. This decision will vary from year to year, again based on many factors. Once all levels of review have been completed, the Tax Manager (or the designated employee in the applicable region) will schedule an appointment with the signer of the 990. This is normally a Senior Vice President or CFO of the applicable region, who will perform an additional, normally high level review prior to signing the return. Once signed, the return is cleared to provide to members of the Board of Directors, who at a later date but prior to efiling, are provided access to all 990s throughout their assigned region via an online portal. Additionally, as a courtesy, any individual who is listed on any 990 as a reportable individual will also receive access to the portal, where they can view the 990 if they so choose, prior to it being filed with the IRS. Part VI Section B Line 12a-c: The organization has a Conflict of Interest policy which states that if at any time, an officer or a director become aware that the board may discuss or act upon any transaction or arrangement which may have any bearing of any kind upon, or may relate in any manner to, a financial interest of the individual, the financial interest must be disclosed. All associates of the organization must disclose a potential conflict of interest any time one arises. The disclosures are reviewed and a determination is made as to whether a conflict of interest exists and how it might be managed. Additionally, as part of an annual process, conflict of interest questionnaires are sent out to all Officers, Directors, and other individuals in key positions using software designed to capture this information. The responses are analyzed in order to determine information on potential conflicts, as well as information on business and family relationships and other disclosures required to be made on IRS Forms 990. Responses to these questions are reviewed by the Vice President of Compliance and the Manager of Tax Compliance, and follow up action, if any, is documented within the software. Non-responders are reminded of their outstanding disclosure requirement automatically through the software system. Responses to questions continue to be reviewed and documented throughout this time period. Approximately 1 month prior to the filing deadline of IRS Form 990, responses to date are compiled. Any response requiring disclosure is entered into the information return. The remaining non responder names are determined, and a letter, along with the actual Conflict of Interest Policy, is sent to the Chairperson of each board. The letter lists current non responders, as well as any Officer or Board member that has disclosed a financial interest that might pose a potential conflict of interest. Depending upon the nature of the financial interest and work done by the board, several actions may be considered first, the board member with a financial interest would need to voluntarily excuse him or herself from the deliberations and/or voting on such a matter. If not, the board may, if necessary, determine that the subjects financial interest was an actual conflict of interest, in which case the board member would be informed by the board Chairperson that he or she would not be allowed to vote in any such matters due to this real or perceived conflict of interest. Minutes of the board meeting would document this decision process, and reflect whatever action(s) are ultimately taken. Part VI Section B Line 15a: The compensation of the CEO, Executive Director, or Other top official paid by the filing organization is reviewed and approved on an annual basis by the Executive Committee of the Wheaton Franciscan Services Board of Directors, an independent board, acting in a manner consistent with its conflicts of interest policy. The boards decision is informed by an opinion on market comparable compensation data provided to the board by an independent compensation expert. The organization maintains contemporaneous documentation of the substantiation of the deliberation and decision by the board. Part VI Section B Line 15a: The compensation of the CEO, Executive Director, or Other top official paid by the filing organization is reviewed and approved on an annual basis by the Executive Committee of the Wheaton Franciscan Services Board of Directors, an independent board, acting in a manner consistent with its conflicts of interest policy. The boards decision is informed by an opinion on market comparable compensation data provided to the board by an independent compensation expert. The organization maintains contemporaneous documentation of the substantiation of the deliberation and decision by the board. |
| Supplemental Information to Form 990 Continued | Part VI Section B Lines 15b: For calendar year 2015, the filing organization has paid individuals who served as either Officers or Key Employees during the reporting period. These individuals have the following compensation structure: The compensation for the organizations officers and key employees paid by the filing organization is reviewed and approved on an annual basis, as part of the WFSI Executive Compensation Plan, by the Executive Committee of the Wheaton Franciscan Services, Inc. Board of Directors the Executive Committee of the WFSI Board, an independent board, acting in a manner consistent with its conflicts of interest policy. The WFSI Boards decision is informed by an opinion on market comparable compensation data provided to the WFSI Board by an independent compensation expert. The WFSI Board maintains contemporaneous documentation of the substantiation of the deliberation and decisions it makes. Part VI Section C Line 19: Ministries that were affiliates of Wheaton Franciscan Healthcare during the fiscal year ending June 30, 2016 provided upon request certain documents including our financial statements, conflict of interest policy, and governing documents that support our tax exempt status, including, but not limited to, articles of incorporation and bylaws. During fiscal 2016, all ministries were transferred to new parent organizations and all organizations are currently working on policy review and implementation in order to adopt and streamline existing policies to those of the new parent. Part VII Column B: Ministries that were affiliates of Wheaton Franciscan Healthcare during the fiscal year ending June 30, 2016 operated as a controlled group of related healthcare organizations. As such, many employees who are at the Director level or above, or who are Officers and/or Directors of organizations where Wheaton has common boards and other overlaps in committee representations, spend significant time devoted to tasks not only for the filing organization, but also for related organizations. While there is no official time study tracking that is done, it is estimated that for each employee, tasks devoted to related organizations could approximate up to 80% or more of total hours. Part IX Lines 8-9: Certain employee benefits for affiliated organizations were centrally managed by Wheaton Franciscan Services, Inc. through March 1, 2016 and are reflected on Lines 8 and 9. The salary expense for these associates is reflected on the IRS Form 990 of the affiliated organization. Part XI Line 9 Reverse PL/GL Premiums Paid ($ 3,528,579) Deduction for PL/GL Claims Paid 1,170,000 WFIC Return of Capital-Prior Year 5,140,965 Transition Adjustment 248,159,407 Change in Equity Transfer-WFIC (10,466,623) Equity Transfer upon transition (45,553,824) Loan write-off Marianjoy 20,553,824 Total $215,475,170 Disclosure Statement Related to Forms 5471: Under the constructive ownership rules of Internal Revenue Code Sections 958(a) and (b), the taxpayer is required to file Forms 5471, Information Return of US persons with respect to certain foreign corporations, as a category 4 and/or 5 filer with respect to Wheaton Franciscan Insurance Company, FEIN #98-0691609. These filing requirements are or will be satisfied through the filing of Forms 5471 with respect to the foreign corporation on the taxpayers behalf by the US taxpayers identified below who have the same filing requirement. Taxpayer name: Wheaton Franciscan Services, Inc. Address: 26 w171 Roosevelt Road, Wheaton IL 60187 FEIN number of US Tax return with which form 5471 was filed: 36-3262111 IRS Service Center where US Tax return was or will be filed: e-filed IRS Service Center where US Tax return was or will be filed: e-filed |
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