SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public Inspection
Name of the organization
Alexian Brothers Medical Center
 
Employer identification number

36-2596381
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) . . . 		  1,525 4,466,129 0 4,466,129 0.99 %
b Medicaid (from Worksheet 3, column a) . . . . .   24,779 51,172,942 31,634,616 19,538,326 4.33 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 26,304 55,639,071 31,634,616 24,004,455 5.32 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   53,164 330,454 7,066 323,388 0.07 %
f Health professions education (from Worksheet 5) . . .   1,329 1,264,240 300,000 964,240 0.21 %
g Subsidized health services (from Worksheet 6) . . . .   145 420,980 0 420,980 0.09 %
h Research (from Worksheet 7) .     0 0 0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .   137 171,746 0 171,746 0.04 %
j Total. Other Benefits . . 0 54,775 2,187,420 307,066 1,880,354 0.42 %
k Total. Add lines 7d and 7j . 0 81,079 57,826,491 31,941,682 25,884,809 5.74 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 0 0 0 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did 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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,406,255
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
240,626
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
199,343,321
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
243,265,269
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-43,921,948
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Alexian Brothers Medical Center
800 Biesterfield Road
Elk Grove Village,IL600073397
www.alexianbrothershealth.org/abmc
0002238 		X X       X X      
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Alexian Brothers Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.amitahealth.org/about-us/community-benefit/alexian-brothers-elk-grove-village
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Alexian Brothers Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.alexianbrothershealth.org/pay-my-bill
b
www.alexianbrothershealth.org/pay-my-bill
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
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Part VFacility Information (continued)

Billing and Collections
Alexian Brothers Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Alexian Brothers Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 8
Schedule H (Form 990) 2016
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Alexian Brothers Medical Center. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY HOSPITALS PARTICIPATING IN THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL (MCHC) LED HOSPITAL COALITION; AND INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK AS WELL AS THE COMMUNITY OVERALL. TWENTY-NINE AGENCIES/INDIVIDUALS PROVIDED COMMENT. INPUT FROM THE FOLLOWING ORGANIZATIONS WAS GATHERED during the period August to October 2016: A SAFE HAVEN FOUNDATION ANTOICH AREA HEALTHCARE ACCESSIBILITY ALLIANCE AUSTIN CHILDCARE PROVIDERS NETWORK CHICAGO DEPARTMENT OF PUBLIC HEALTH DUPAGE COUNTY HEALTH DEPARTMENT DUPAGE FEDERATION ON HUMAN SERVICES REFORM ELMHURST CUSD 205 ENLACE CHICAGO ERIE FAMILY HEALTH CENTER/ERIE HEALTHREACH WAUKEGAN HEALTHCARE FOUNDATION OF NORTHERN LAKE COUNTY ILLINOIS DEPARTMENT OF PUBLIC HEALTH, BELLWOOD REG OFFICE LAKE COUNTY FOREST PRESERVES LAKE COUNTY HEALTH DEPARTMENT LAKE COUNTY COMMUNITY HEALTH CENTER LORETTO HOSPITAL METROPOLITAN CHICAGO HEALTHCARE COUNCIL NAPERVILLE SCHOOL DISTRICT 203 NEW MOMS, INC. NORTHWEST COMMUNITY HEALTHCARE NORTHWEST COMPASS, INC. NORTHWESTERN LAKE FOREST HOSPITAL PCC COMMUNITY WELLNESS CENTER PEOPLE'S RESOURCE CENTER ST. JOSEPH SERVICES UNITED WAY OF METROPOLITAN CHICAGO VILLAGE OF ADDISON VILLAGE OF ARLINGTON HEIGHTS WEST HUMBOLDT PARK DEVELOPMENT COUNCIL WHEELING TOWNSHIP GENERAL ASSISTANCE OFFICE THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS (INCLUDING AFRICAN-AMERICAN, ARABIC, ASIAN, AUTISTIC CHILDREN, THE DISABLED, EASTERN EUROPEAN, ELDERLY, ETHNIC MINORITIES, HISPANIC, THE HOMELESS, IMMIGRANTS, INDIAN, JAPANESE, LGBT POPULATION, LOW-INCOME RESIDENTS, MULTILINGUAL, MULTIRACIAL, NON-ENGLISH SPEAKING, POLISH, RUSSIAN, SOUTH AMERICAN, UNDOCUMENTED, UNINSURED/UNDERINSURED, WOMEN, YOUTH), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING AFRICAN-AMERICAN, THE DISABLED, ELDERLY, EX-OFFENDERS, FREE CARE, HISPANIC, THE HOMELESS, IMMIGRANTS, LGBT COMMUNITY, LOW-INCOME, MEDICAID/MEDICARE, THE MENTALLY ILL, NON-ENGLISH SPEAKING ADULTS, PREGNANT TEENS, SUBSTANCE ABUSERS, UNDOCUMENTED, UNINSURED/UNDERINSURED, VETERANS, YOUNG ADULTS, YOUTH).
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Alexian Brothers Medical Center. The other hospital facilities with which the reporting hospital conducted its CHNA include: Adventist LaGrange Memorial Hospital St. Alexius Medical Center Alexian Brothers Behavioral Health Hospital Franciscan St. James Health Ingalls Memorial Hospital Little Company of Mary Hospital and Health Care Centers Loretto Hospital Northwest Community Healthcare Northwestern memorial Hospital Palos Community Hospital Rush Oak Park Hospital Rush University Medical Center Saint Anthony Hospital St. Bernard Hospital and Health Care Center Swedish Covenant Hospital The University of Chicago Medicine Thorek Memorial Hospital Adventist Glen Oaks Hospital Adventist Hinsdale Hospital Edward Hospital & Health Services Elmhurst Memorial Healthcare Central Dupage Hospital Northwestern Lake Forest Hospital Adventist Bolingbrook Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Alexian Brothers Medical Center. ISSUE: CANCER ABMC RUNS A COMPREHENSIVE CANCER INSTITUTE IN THE IMMEDIATE SERVICE AREA. ABMC PARTNERED WITH THE CANCER INSTITUTE BOUTIQUE IN ELK GROVE VILLAGE, IL, WHICH OFFERS PRIVATE CONSULTATIONS AND FITTINGS FOR WIGS, POST-SURGICAL GARMENTS AND PROSTHESES. FREE SUPPORT GROUPS THAT FOCUS ON EDUCATION, SUPPORT AND POSITIVE COPING WERE PROVIDED TO PATIENTS AND COMMUNITY MEMBERS. THE SUPPORT GROUPS WERE LED BY LICENSED PROFESSIONALS THAT FACILITATE THE SESSIONS, WHICH WERE DESIGNED TO PROVIDE AN OPEN, SAFE AND ENCOURAGING ENVIRONMENT FOR THE SHARING OF COMMON EXPERIENCES, TIPS AND LAUGHTER. SUPPORT GROUPS WERE FOCUSED ON THE FOLLOWING: -ALL CANCER NETWORKING GROUP - NO MATTER WHAT TYPE OF CANCER, THERE ARE SIMILAR EXPERIENCES AND CONCERNS. PATIENTS GAIN VALUABLE INFORMATION, TIPS AND ADVICE TO MAINTAIN A POSITIVE FOCUS. FAMILIES AND/OR CAREGIVERS ARE ALSO WELCOME. -BRAIN CANCER SURVIVORS GROUP - THIS GROUP WAS FOR PATIENTS, SURVIVORS, FAMILY MEMBERS AND CAREGIVERS TO LEARN MORE ABOUT BRAIN TUMORS, SHARE EXPERIENCES AND RECEIVE SUPPORT. -BREAST CANCER SUPPORT GROUP - CONNECTING WITH OTHERS PROVIDES AN OUTLET TO LEARN HELPFUL TIPS FOR COPING WITH TREATMENT SIDE EFFECTS AND SHARE LAUGHTER AND ENCOURAGEMENT. THIS GROUP WAS FOR ANYONE AFFECTED BY BREAST CANCER, FROM A NEW DIAGNOSIS THROUGH SURVIVORSHIP. -LUNG CANCER NETWORKING GROUP - BY NETWORKING, THE GROUP FOCUSES ON HELPING EACH OTHER COPE WITH THE WAYS LUNG CANCER HAS AFFECTED OUR LIVES. PATIENTS AND LOVED ONES OFTEN FIND IT HELPFUL TO TALK WITH OTHERS WHO UNDERSTAND THE FEELINGS THAT COME WITH THIS PARTICULAR DIAGNOSIS. -YOUNG WOMEN'S SUPPORT GROUP (50 & YOUNGER) - IN THIS PHASE OF LIFE, WOMEN'S ROLES INCLUDE BEING SINGLE YOUNG WOMEN, YOUNG WIVES, MOTHERS, AND BEGINNING OR SOLIDIFYING THEIR CAREERS. IN THIS GROUP, WOMEN RECEIVE EMOTIONAL SUPPORT FROM OTHER WOMEN WHO CAN SHARE THEIR PAST EXPERIENCES. SPECIAL PROGRAMS FOR SURVIVORS, FAMILY, FRIENDS AND CAREGIVERS PROVIDED A NO CHARGE OR FOR A NOMINAL FEE: -LOOK GOOD...FEEL BETTER - WOMEN AND MEN LEARN FROM VOLUNTEER BEAUTY PROFESSIONALS HOW TO DEAL WITH THE APPEARANCE-RELATED SIDE EFFECTS OF CANCER TREATMENT. -BREAST SELF-EXAM COMMUNITY OR ONE-ON-ONE SESSIONS MAMMACARE - WOMEN LEARN HOW TO GIVE THEMSELVES A BREAST SELF-EXAM (BSE) USING THE MAMMACARE METHOD IN EITHER A COMMUNITY SETTING WITH OTHER WOMEN OR IN A ONE-ON-ONE SESSION. WOMEN LEARNED BY PRACTICING ON LIFE-LIKE BREAST MODELS THAT TEACH THE DIFFERENCE BETWEEN NORMAL BREAST TISSUE AND LUMPS. -FREE SKIN SCREENING EVENTS ABHS, THE CORPORATE SITE FOR ABMC, HELD THREE SKIN SCREENING EVENTS IN THE BEGINNING OF SUMMER 2017. THIS WAS A PARTNERSHIP WITH THE AMERICAN CANCER SOCIETY AND THE AMERICAN ACADEMY OF DERMATOLOGY. DERMATOLOGISTS OFFERED FREE, FULL-BODY SKIN SCREENINGS TO ANYONE AGE 18 OR OLDER. ISSUE: CHRONIC KIDNEY DISEASE OUR EFFORTS AT ADDRESSING CHRONIC KIDNEY DISEASE CONTINUE TO BE INCLUDED IN ALL OF OUR EDUCATION, PREVENTION, SCREENING AND TREATMENT OF TYPE II DIABETES ISSUE: HIV/AIDS ABHS, CORPORATE MEMBER OF ABMC, CONTINUES TO BE A PERMANENT, VOTING MEMBER OF THE CATHOLIC CHARITIES HIV/AIDS TASK FORCE FOR THE CHICAGO ARCHDIOCESE AND IS AN HIV/AIDS PROGRAM SERVICES ADVISORY COMMITTEE. THIS TASK FORCE COLLABORATES WITH AGENCIES, INSTITUTIONS AND INDIVIDUALS WHO PROVIDE HIV/AIDS SERVICES, EDUCATION AND MINISTRY IN THE CHICAGO AREA TO CARRY OUT THE HEALING MISSION OF THE CATHOLIC CHURCH. THIS APPROACH BEGINS WITH HOUSING, THE CORNERSTONE OF HEALTHCARE AND AN INTEGRAL PART OF ABHS. STABLE HOUSING PROVIDES A FOUNDATION FOR PEOPLE TO GET A FRESH START. IT PROVIDES PLACE TO RECEIVE COUNSELING, CARE, AND TO RECONNECT WITH FAMILY. IT'S A PLACE TO BE PART OF A SUPPORTIVE COMMUNITY THAT OFFERS COMPREHENSIVE SERVICES. ABHS OFFERS CLIENTS A WIDE ARRAY OF SUPPORTIVE SERVICES. INDIVIDUAL SESSIONS AND GROUP SERVICES WERE PROVIDED IN ALL AREAS, INCLUDING SPIRITUAL CARE, LIFE SKILLS, AND PSYCHOSOCIAL SUPPORT GROUPS SUCH AS HIV-SUPPORT AND SUBSTANCE USE COUNSELING. THE PROGRAMS WERE FOCUSED ON TREATING THE WHOLE INDIVIDUAL, THROUGH A HOLISTIC RANGE OF SERVICES FOCUSED ON RECOVERY AND SUPPORT. THESE INCLUDE THE FOLLOWING: COMPREHENSIVE CASE MANAGEMENT; SUBSTANCE USE COUNSELING; OCCUPATIONAL; THERAPY; SPIRITUAL CARE; AND, AFTER CARE ABHS REPRESENTS CHICAGO DEPARTMENT OF PUBLIC HEALTH (CDPH) ON ISSUES RELATED TO HIV/AIDS. ISSUE: IMMUNIZATION AND INFECTIOUS DISEASES OUR INFECTION PREVENTIONISTS LED FREE BACK-TO-SCHOOL PRESENTATIONS REGARDING THE IMPORTANCE OF VACCINES FOR INFLUENZA, PNEUMONIA AND SHINGLES. ABMC PROVIDES EVERY PATIENT UPON DISCHARGE THE OPPORTUNITY TO RECEIVE A FLU VACCINE. ABMC REQUIRES EVERY EMPLOYEE TO HAVE A FLU VACCINE FOR THE PROTECTION OF OUR PATIENTS UNLESS THEY WERE MEDICALLY EXCUSED. THE EMPLOYED PHYSICIAN GROUP SERVING ABMC URGES EVERY PATIENT TO HAVE A FLU VACCINATION. ABHS, CORPORATE MEMBER OF ABMC, PROVIDES A FREE IMMUNIZATION CLINIC EACH QUARTER TO ANY MEMBER OF THE COMMUNITY. ISSUE: INFANT HEALTH AND FAMILY PLANNING A VARIETY OF PROGRAMS WERE OFFERED TO PATIENTS, FAMILY AND CAREGIVERS AT NO CHARGE OR FOR A NOMINAL FEE. THEY INCLUDE. -A 3-HOUR BREASTFEEDING CLASSES OFFERED TO NEW PARENTS. -SIBLINGS AND GRANDPARENTS PREPARATIONS CLASSES OFFERED TO FAMILY MEMBERS. -CAR SEAT SAFETY CLASSES OFFERED TO EXPECTING PARENTS. -PREPARED CHILDBIRTH CLASSES PROVIDED TO NEW PARENTS THAT COVERS LABOR AND DELIVERY, OBSTETRIC INTERVENTIONS, MEDICATIONS, CESAREAN, DELIVERY, NEWBORN CARE AND FEELINGS. -GESTATIONAL DIABETES CLASSES OFFERED TO PREGNANT WOMEN TO MONITOR GLUCOSE, EATING CORRECTLY AND MANAGE MEDICATION. ISSUES: INJURY AND VIOLENCE, POTENTIALLY DISABLING CONDITIONS EMERGENCY ROOMS AT ABMC HAVE BEEN TRAINED ON IDENTIFYING AND SUPPORTING HUMAN TRAFFICKING SURVIVORS. A SURVEY CONDUCTED BY THE COALITION TO ABOLISH SLAVERY & TRAFFICKING (CAST) FOUND OVER HALF OF LABOR AND SEX TRAFFICKING SURVIVORS SURVEYED HAD ACCESSED HEALTH CARE AT LEAST ONCE WHILE BEING TRAFFICKED. THIS SHOWS AN OPPORTUNITY FOR EMERGENCY DEPARTMENTS, FIRST RESPONDERS AND EMT STAFF TO DETECT POTENTIAL SITUATIONS. ABMC PROVIDED FREE SURVIVORS SUPPORT GROUP TO THOSE WHO HAVE EXPERIENCED A STROKE, HEAD INJURY OR OTHER NEUROLOGICAL INJURY. FAMILY, FRIENDS AND CAREGIVERS WERE ALL WELCOME TO ATTEND AT NO CHARGE ISSUES: MENTAL HEALTH, SUBSTANCE ABUSE ABMC INITIATED A THREE-YEAR (3) PLAN WITH KENNETH YOUNG CENTER TO FUND A CLINICIAN ON THE CHILD TEAM SERVING CHILDREN (PRIMARILY UNDER 14 OR YOUNGER). FUNDING FROM AMITA HEALTH HELPED KEEP 10 PATIENTS FROM BEING WAITLISTED BACK TO A LIST OF 141 CHILDREN WAITING TO RECEIVE COUNSELING SERVICES WHILE HELPING RETAIN 10 PATIENTS IN ROUTINE PROCEDURE. SUBSTANCE ABUSE PROGRAMMING IS DISSEMINATED THROUGH ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL, A HOSPITAL AFFILIATED WITH ABMC. ISSUE: NUTRITION, PHYSICAL ACTIVITY AND WEIGHT ABMC ALONG WITH ITS MEMBER HOSPITAL, SAMC, OFFER THE GONOODLE PROGRAMMING TO THE SCHAUMBURG AND ELGIN AREA SCHOOL DISTRICTS. GONOODLE IS AN ONLINE SUITE OF PROGRAMS DESIGNED TO IMPROVE CHILDREN'S PHYSICAL ACTIVITY AND NUTRITION. THIS INCLUDES OVER 50 SCHOOLS WITH AVERAGE OF 14,000 STUDENTS PARTICIPATING IN GONOODLE ACTIVITIES ON A MONTHLY BASIS. GONOODLE CREATES AN ENGAGING AND FUN ENVIRONMENT WHERE CHILDREN MOVE AROUND THE CLASSROOM, INCREASING THEIR PHYSICAL ACTIVITY TIME WHILE LEARNING THEIR CURRICULUM MATERIAL. NATIONALLY, THE UTILIZATION OF GONOODLE SHOWED 23% GREATER IMPROVEMENT IN READING SCORES, 50% GREATER IMPROVEMENT IN MATH SCORES AND 13% IMPROVEMENT IN CHILDHOOD WEIGHT (AS MEASURED BY BMI) COMPARED TO CHILDREN WHO DIDN'T PLAY GONOODLE. ISSUES: TYPE II DIABETES, HEART DISEASE AND STROKE, ABMC ALONG WITH ITS MEMBER HOSPITAL, SAMC, PARTNERED WITH GOLDEN CORRIDOR FAMILY YMCA IN ELGIN AND SCHAUMBURG TO LAUNCH THE DIABETES PREVENTION PROGRAM (DPP) FOR THE AT-RISK POPULATION AND THOSE WHO WERE UNDERINSURED. THE GOAL OF THE DPP PROGRAM IS FOR PARTICIPANTS TO LOSE 5-7% OF BODY WEIGHT (2% BMI DECREASE) DURING THE PROGRAM AND MAINTAIN THE WEIGHT AFTER THE PROGRAM. THE PROGRAM ALSO AIMS TO INCREASE PHYSICAL ACTIVITY OF PARTICIPANTS TO 150 MINUTES PER WEEK. BOTH HOSPITALS OFFER FINANCIAL SUPPORT IN INITIATING THE DPP PROGRAM WHILE OFFERING FINANCIAL AID TO THE PARTICIPANTS THUS TARGETING PARTICIPANTS WHOM WERE UNDERINSURED. OFFERING DIABETES CARE AND CHRONIC MANAGEMENT SERVICES IN THE COMMUNITIES BATTLING HIGH RATES OF THESE DISEASES IMPROVES ACCESS TO HEALTH CARE.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Alexian Brothers Medical Center. AS A PREVENTION METHOD, ABMC'S SENIOR & COMMUNITY RESOURCE CENTER OFFERED EDUCATIONAL AND OUTREACH SERVICES TO THE SENIORS OF THE COMMUNITY AT NO CHARGE. THESE COMMUNITY PROGRAMS INCLUDE BLOOD SCREENING, CHOLESTEROL SCREENING, OSTEOPOROSIS SCREENING, MEMORY SCREENING. THESE SERVICES WERE OFFERED AT VARIOUS LOCATIONS SUCH AS THE LOCAL LIBRARY, ABMC, THE SENIOR CENTER AND LOCAL YMCA TO MAKE SURE THE SERVICES REACH THE ONES WITH NEED IN THE COMMUNITY. THESE COMMUNITY HEALTH SCREENINGS HAVE PROVIDED FREE EDUCATIONAL CARE TO OVER 2,000 COMMUNITY MEMBERS. REGISTERED NURSES FROM AMITA HEALTH PROVIDE MONTHLY, FREE BLOOD PRESSURE SCREENINGS. AMBC OFFERED DIABETES EDUCATIONAL PROGRAMS THROUGH A MENTOR PROGRAM MEET AND GREET AND ALSO OFFERED DIABETES 101 CLASS TO SCHOOL NURSES AND STAFF. ABMC OFFERED BI-MONTHLY BLOOD PRESSURE SCREENINGS TO PREVENT HYPERTENSION-RELATED HEALTH RISKS TO THE COMMUNITY. THE HOSPITAL PROVIDED BLOOD PRESSURE SCREENING TO OVER HUNDREDS PEOPLE IN THE COMMUNITY. THE SENIOR & COMMUNITY RESOURCE CENTER OFFERED FREE SEMINARS FOR ANYONE WHO WAS IN NEED OF ASSITANCE. THESE SEMINARS INCLUDE: -STROKE: WHAT YOU NEED TO KNOW - CONCENTRATING ON SIGNS AND SYMPTOMS OF STROKE, THE TIME WINDOWS FOR TREATMENTS AND CURRENT STROKE THERAPIES WHICH CAN REDUCE THE RISK OF STROKE FOR THE SENIORS OF THE COMMUNITY. WHAT'S YOUR QUESTION? CARDIOLOGY & DIABETES - NURSE LED PANEL DESIGNED TO ANSWER QUESTIONS FROM THE COMMUNITY MEMBERS ON ISSUES AROUND CARDIOLOGY AND DIABETES. -PREVENTION OF CARDIOVASCULAR DISEASE - CARDIAC SPECIALIST DR. SAMY PROVIDED INFORMATION ON RISK FACTORS, PREVENTION MEASURES AND WARNING SIGNS OF CARDIOVASCULAR DISEASE IN ORDER TO HAVE A HEALTHY HEART FOR LIFE. THE SENIOR & COMMUNITY RESOURCE CENTER PARTNERED WITH THE ELK GROVE PARK DISTRICT TO OFFER "FOREVER YOUNG YOGA". THIS CLASS WAS TAILORED FOR SENIORS; PROVIDES BREATHING TECHNIQUES, GRADUAL STRETCHING, AND RELAXATION IN ORDER TO REDUCE STRESS, ADDRESS CHRONIC HEALTH CONDITIONS AND IMPROVE CIRCULATION. A GOOD PHYSICAL ACTIVITY LEVEL ALONE CANNOT TACKLE THE ISSUES RELATED TO PREVENTABLE DISEASES BUT A COMBINATION OF A NUTRITIONAL MEAL CAN. THE SENIOR & COMMUNITY RESOURCE CENTER PARTNERED WITH JEWEL OSCO'S REGISTERED DIETICIAN TO OFFER AN INFORMATIVE GROCERY STORE TOUR TO COMMUNITY MEMBERS. THIS CLASS FOCUSED ON TEACHING PARCIPANTS HOW TO COOK THE RIGHT COMBINATION OF FOODS ALONG WITH VARIOUS HERBS AND SPICES TO CUT DOWN ON SODIUM INTAKE WHILE MAINTAINING A DELICIOUS RECIPE. SUGGESTIONS WERE PROVIDED ON HOW TO SPICE UP MEALS BY USING INGREDIENTS MANY PEOPLE ALREADY HAVE IN THEIR PANTRIES AT HOME. ON TOP OF SHOWING WHAT WAS AVAILABLE AT THE STORE, THE SENIOR AND COMMUNITY RESOURCE CENTER ALSO OFFERS FOOD CLASSES CONCENTRATING ON THE SEASON GOODS AND HOW TO COOK HEALTHY OPTIONS WITH THE SEASONAL FRUITS AND VEGETABLES. ISSUE: RESPIRATORY DISEASES ABMC RUNS A TOP-OF-THE-LINE LUNG DIAGNOSTIC CENTER, WHICH PROVIDES ADVANCED DIAGNOSTIC TESTING SERVICES, INCLUDING PULMONARY FUNCTION TESTING, INTEGRATED CARDIOPULMONARY EXERCISE TESTING AND UPPER AIRWAY EVALUATION FOR VOCAL CORD DYSFUNCTION SYNDROME. A NEWLY DEVELOPED CT LUNG CANCER SCREENING PROGRAM HAS SERVED HUNDREDS OF PATIENTS AND INCLUDES SPIROMETRY SCREENING FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). ISSUE: SEXUALLY TRANSMITTED DISEASES ABMC DOES NOT PROVIDE SPECIFIC PROGRAMMING FOR THIS ISSUE BUT PROVIDES REFERRALS TO PRIMARY CARE FOR ANY COMMUNITY MEMBER NEEDING ASSISTANCE.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Alexian Brothers Medical Center. ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY. THE FRONT OF OUR STATEMENT INCLUDES THIS MESSAGE: "IF YOU ARE AN UNINSURED ILLINOIS RESIDENT AND MEET CERTAIN INCOME REQUIREMENTS, YOU MAY QUALIFY FOR A DISCOUNT THROUGH OUR ALEXIAN ASSISTANCE PROGRAM IN ACCORDANCE WITH THE STATE OF ILLINOIS, HOSPITAL UNINSURED PATIENT DISCOUNT ACT (EFFECTIVE APRIL 1, 2009). FOR ADDITIONAL INFORMATION, PLEASE CONTACT US AT 866-690-3370 OR ALEXIANASSISTANCE@ALEXIAN.NET". THE BACK OF OUR STATEMENT INCLUDES THIS MESSAGE: "IF PAYING THIS BILL PRESENTS A FINANCIAL HARDSHIP, YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALEXIAN BROTHERS HOSPITAL NETWORK PROVIDES ASSISTANCE TO PATIENTS IN NEED OF FINANCIAL AID TO HELP PAY FOR HIS/HER HOSPITAL BILLS. YOU MAY OBTAIN AN APPLICATION BY CALLING OUR STAFF AT THE NUMBER BELOW OR YOU MAY DOWNLOAD THE FORMS FROM THE INTERNET AT WWW.ALEXIANBROTHERSHEALTH.ORG". IN ADDITION, ALL UNINSURED PATIENTS RECEIVE A LETTER FROM OUR PATIENT FINANCIAL SERVICES DEPARTMENT ONCE WE COMPLETE A PROCESS OF ATTEMPTING TO IDENTIFY ALTERNATIVE COVERAGE FOR UNINSURED PATIENTS. THIS LETTER IS SENT AT THE BEGINNING OF OUR STATEMENT CYCLE FOR EACH UNINSURED PATIENT. THE TEXT OF THE LETTER IS: "THANK YOU FOR CHOOSING ALEXIAN BROTHERS MEDICAL CENTER AS YOUR HEALTHCARE PROVIDER. YOUR ACCOUNT CURRENTLY HAS A BALANCE OF $XX; ADDITIONAL CHARGES MAY BE PENDING. WE HAVE NO RECORD THAT YOU HAVE HEALTH INSURANCE TO HELP IN PAYING YOUR BILL. IF YOU HAVE INSURANCE, PLEASE PROVIDE THE NECESSARY INFORMATION BY FILLING OUT THE STUB ABOVE AND FAXING A COPY OF YOUR INSURANCE CARD TO 847-483-7058, ATTN: CORRESPONDENCE TEAM. IF YOU HAD INSURANCE THAT ENDED WITHIN THE LAST 60 DAYS, YOU MAY BE ELIGIBLE FOR COBRA COVERAGE FROM A FORMER EMPLOYER. PLEASE CONTACT YOUR FORMER EMPLOYER TO DETERMINE IF YOU ARE ELIGIBLE. ABMC 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. ALEXIAN BROTHERS HEALTH SYSTEM'S (ABHS) WEBSITE, THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS, INCLUDING ABMC, FEATURES INFORMATION ON HOW TO APPLY FOR CHARITY CARE ONLINE. IN THE HOSPITAL SETTING, WE EMPLOY FOUR FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING CHARITY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2016
Page 9
Schedule H (Form 990) 2016
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 Alexian Rehabilitation Hospital
955 Beisner Road
Elk Grove Village,IL600073397 		Healthcare Services
2 Alexian Brothers Hospice Residence
1000 Martha Street
Elk Grove Village,IL60007 		Healthcare Services
3 ABMC Diagnostic Imaging
1339 West Lake Street
Addison,IL60101 		Diagnostic Imaging Services
4 ABMC Cardiovascular Imaging
1555 Barrington Road
Hoffman Estates,IL60169 		Diagnostic Imaging Services
5 ABMC Diagnostic Imaging
1060 South Elmhurst Road
Mount Prospect,IL60056 		Diagnostic Imaging Services
6
7
8
9
10
Schedule H (Form 990) 2016
Page 10
Schedule H (Form 990) 2016
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Schedule H, Part I, Line 3c FAP Eligibility 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 - 0-200% Patient Discount Uninsured - 100% Federal Poverty Level - 201-300% Patient Discount Uninsured - 73% Federal Poverty Level - 301-600% Patient Discount Uninsured - 73% Federal Poverty Level - >600% Patient Discount Uninsured - 59.3%
Schedule H, Part VI, Line 7 State of Filing for Community Benefit 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 ("SAMC") and Alexian Brothers Behavioral Health Hospital ("ABBHH").
Schedule H, Part I, Line 6a NAME OF RELATED ORGANIZATION THAT PREPARED COMMUNITY BENEFIT REPORT ALEXIAN BROTHERS HOSPITAL NETWORK (ABHN), EIN#36-3276552, 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 (SAMC) AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL (ABBHH).
Schedule H, Part V, Section B, Line 22 Charges for FAP ALEXIAN BROTHERS MEDICAL CENTER USES THE STATE OF ILLINOIS HOSPITAL INSURED PATIENT DISCOUNT ACT GUIDELINES WHICH SPECIFY THAT ELIGIBLE PATIENTS SHOULD BE CHARGED 135% OF HOSPITAL COSTS.
Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization.
Schedule H, Part I, Line 7g Subsidized Health Services Alexian Brothers Medical Center has not included costs attributable to a Physician Clinic as part of subsidized health services.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The following costing methodologies were used: - Charity at cost - a cost to charge methodology based on the filed 2017 Medicare cost report was used to calculate costs. - Unreimbursed Medicaid - costs are calculated using the 2017 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
Schedule H, Part II Community Building Activities The community building efforts include economic development opportunities with chambers; providing internships and scholarships to local colleges; sponsoring fundraisers for community organizations.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Alexian Brothers Medical Center follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology The ABHS hospitals, including ABMC, proactively work to presumptively assess and grant charity to all uninsured patients prior to sending these patients their first statement. We screen all uninsured patients against credit score data in order to presumptively apply our charity policy. Based on this process, approximately 96% of our uninsured patient population is defined as eligible and we process a partial charity adjustment on their accounts. The average discount given to the uninsured patient population is 81%. In prior years, we limited our proactive efforts to only those accounts with balances > $5,000. Under that scenario, we estimated that 1/3 of our bad debt placements may have been eligible for charity care discounts. Now that we have a more comprehensive presumptive charity program, many more accounts are granted charity earlier in the process and prior to bad debt placement. Therefore, we estimate that approximately 10% of our current bad debt placements would be eligible for additional charity if we had a full presumptive charity process across 100% of our selfpay after insurance accounts. Discounts and payments are not included in bad debt expense in the financial statements for ABMC unless the payment is a recovery of amounts previously written off as bad debt. Recoveries are classified as a decrease to bad debt expense.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE (WHICH INCLUDE THE ACTIVITY OF Alexian Brothers Medical Center): THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING ECONOMIC CONDITIONS, HISTORICAL EXPERIENCE, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED THE HEALTH MINISTRY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HEALTH MINISTRY'S POLICIES.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare costs are allocated by cost center in accordance with Medicare regulations. Healthcare Reform has resulted in billions of dollars being removed from health provider payments, mostly hospital payments. This is a trend that will continue for at least another six years. The systematic degradation of reimbursement that is already less than the cost of providing the service for the vast majority of hospitals needs to be considered community benefit to accurately represent the enormous contributions that hospitals make toward easing government burden in caring for an enormous and growing number of its citizens.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance It is the policy of ABHS, including ABMC, to offer patients a payment plan and/or charity assistance when it becomes known or even suspected that a patient needs financial assistance. Financial counselors are notified and every attempt is made to contact and work with the patient or their family to help them complete an application with compassion and dignity. Financial counselors work with patients to help determine if there are any third party payers which may be available to help the patient meet their obligations. We work with the patient to determine if they are eligible for federal programs including Medicaid, state funded programs including crime victims, alternative insurance including COBRA, Worker's Compensation and or other specialized grant programs such as our mammography grant program for low income women. In the event no third party programs are identified, we then work with the patient to help them apply for charity discounts and payment plans. At ABMC, four full-time financial counselors each work with approximately 7,700 patients per year. Two of four counselors are fluent in Spanish, and translators are used for other languages. In addition, all bills and statements include information regarding charity.
Schedule H, Part V, Section B, Line 16a FAP website - Alexian Brothers Medical Center: Line 16a URL: www.alexianbrothershealth.org/pay-my-bill;
Schedule H, Part V, Section B, Line 16b FAP Application website - Alexian Brothers Medical Center: Line 16b URL: www.alexianbrothershealth.org/pay-my-bill;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Alexian Brothers Medical Center: Line 16c URL: www.alexianbrothershealth.org/pay-my-bill;
Schedule H, Part VI, Line 2 Needs assessment ABMC USES EXISTING SECONDARY DATA SOURCES TO COMPLEMENT THE RESEARCH QUALITY OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT. Data were obtained from the following sources: Center for Applied Research and Environmental Systems (CARES) * Centers for Disease Control & Prevention, Office of Infectious Disease, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention * Centers for Disease Control & Prevention, Office of Public Health Science Services, Center for Surveillance, Epidemiology and Laboratory Services, Division of Health Informatics and Surveillance (DHIS) * Centers for Disease Control & Prevention, Office of Public Health Science Services, National Center for Health Statistics * Community Commons * Connecticut Department of Public Health * ESRI ArcGIS Map Gallery * National Cancer Institute, State Cancer Profiles * OpenStreetMap (OSM) * US Census Bureau, American Community Survey * 10 * US Census Bureau, County Business Patterns * US Census Bureau, Decennial Census * US Department of Agriculture, Economic Research Service * US Department of Health & Human Services * US Department of Health & Human Services, Health Resources and Services Administration (HRSA) * US Department of Justice, Federal Bureau of Investigation * US Department of Labor, Bureau of Labor Statistics Secondary data indicators reflect county-level data for Cook, Lake, and DuPage counties. While this assessment is quite comprehensive, it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. It must be recognized that these information gaps might in some ways limit the ability to assess all of the community's health needs. For example, certain population groups - such as the homeless, institutionalized persons, or those who only speak a language other than English or Spanish - are not represented in the survey data. Other population groups - for example, pregnant women, lesbian/gay/bisexual/transgender residents, undocumented residents, and members of certain racial/ethnic or immigrant groups - might not be identifiable or might not be represented in numbers sufficient for independent analyses. In terms of content, this assessment was designed to provide a comprehensive and broad picture of the health of the overall community.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Multiple methods are used at ABMC to communicate 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. Alexian Brothers Health System's (ABHS) website, the main website for all System hospitals, including ABMC, features information on how to apply for charity care on-line. In the hospital setting, we employ four financial counselors who are available to work with patients and we also have Medicaid application specialists to assist patients that may qualify. In addition, all bills and statements include information regarding charity
Schedule H, Part VI, Line 4 Community information IN THE ABMC SERVICE AREA, THE POPULATION IS SLIGHTLY OLDER WITH 15.4% OF RESIDENTS OVER AGE 65 AS COMPARED TO 13.9% IN ILLINOIS. 19.2% OF THE POPULATION IS HISPANIC, A HIGHER PERCENTAGE AS COMPARED TO 16.7% IN ILLINOIS AND 17.4% IN THE US. THE COMMUNITY'S SOCIAL DETERMINANTS ARE FAIRLY AVERAGE, EXCEPT THAT THERE ARE 7.6% OF RESIDENTS THAT IS CONSIDERED "LINGUISTICALLY ISOLATED" IE DO NOT SPEAK ENGLISH. NEARLY 15% OF THE POPULATION LIVES AT OR BELOW 100% OF THE POVERTY LEVEL AND 32.3% ARE AT OR BELOW THE 200% OF THE POVERTY LEVEL, REPRESENTING 2,174,865 INDIVIDUALS. IN THE ASSESSMENT, IT IS MOST OFTEN THESE INDIVIDUALS THAT HAVE DIFFICULTY ACCESSING SERVICES AND HAVE POORER OVERALL HEALTH, AND SO OUR EFFORTS TO PROVIDE THE COMMUNITY WITH NEEDED SERVICES SHOULD BE DIRECTED IN MOST CASES TOWARDS THIS POPULATION.
Schedule H, Part VI, Line 5 Promotion of community health ABMC's governing body is the Board of Directors. The Board of Directors report up through the Alexian Brothers Health System Board of Governors. The majority of the Board of Directors members live and work in the community and serve to support the mission and values of the Alexian Brothers. ABMC extends medical staff privileges to all qualified physicians in our community and endeavors to provide them with the safest and most technologically advanced environment possible through the effective use of surplus funds. Some of our surplus funds have been used to purchase technology for non-invasive brain mapping and non-invasive technology for treating brain tumors in prior years. As necessary, ABMC recruits medical specialists and subspecialists who provide the expertise for emerging technologies that advance patient care. ABMC strives to fully serve the community through participation in government sponsored healthcare programs such as Medicare, Medicaid, Champus and Tricare. ABMC also participates in research and education.
Schedule H, Part VI, Line 6 Affiliated health care system Alexian Brothers Medical Center, d/b/a AMITA Health Alexian Brothers Medical Center, Elk Grove Village, is a member hospital of Alexian Brothers Health System (ABHS), a comprehensive and diversified healthcare organization located in Arlington Heights, Illinois, a community in Chicago's northwestern suburbs. A ministry organization of Ascension, the largest Catholic health system in the nation, ABHS consists of two acute-care hospitals, three specialty hospitals, a community mental health center, clinical institutes, diagnostic imaging facilities and the Alexian Brothers Ambulatory Group, d/b/a Alexian Brothers Medical Group, which is part of the AMITA Health Medical Group. Adventist Health System Sunbelt Healthcare Corporation and Ascension Health, the sponsors of Adventist Midwest Health (AMH) and ABHS, respectively, entered into an Affiliation Agreement that established the Joint Operating Company, Alexian Brothers-AHS Midwest Region Health Co., which became operational Feb. 1, 2015. The purpose of the Joint Operating Company is to provide a financially and operationally integrated organization for the common management and operation of the healthcare facilities and operations of AMH and ABHS, while preserving the Adventist and Catholic identities and mission priorities that define AMH and ABHS, respectively. In April 2015, AMITA Health was announced as the d/b/a for Alexian Brothers-AHS Midwest Region Health Co. The word AMITA is inspired by words from several languages: friendship in Italian, honesty and truth in Hebrew, and spiritual light and boundlessness in Hindi. These words reflect the organization's core values of friendship, truth and mutual respect for all, as well as its faith-based call to healing. The covered affiliates within AMITA Health provide the community with a full range of comprehensive healthcare services and access to the most advanced medical technology. Their healthcare professionals are passionate about delivering exceptional healthcare and are proud of the powerful, cutting-edge technology offered by the system. The covered affiliates within AMITA Health also offer a wide range of community health services, corporate wellness programs, preventive care and education. As charitable organizations, they recognize that not everyone can afford essential medical services and that their mission is to serve the community by providing healthcare services and healthcare education. Therefore, in keeping with AMITA Health's commitment to serving 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. Certain covered affiliates within AMITA Health, and the services they provide, are described below: ABHS Affiliates AMITA Health Alexian Brothers Medical Center Elk Grove Village - An acute-care hospital located in Elk Grove Village, Illinois, that provides inpatient, outpatient and emergency services, including specialties such as bariatrics, cardiology, gastroenterology, gastrointestinal surgery, geriatrics, home health, hospice, interventional radiology, nephrology, neurosciences/stroke, oncology, orthopedics, pulmonology and urology. AMITA Health Alexian Brothers Rehabilitation Hospital, Elk Grove Village - A specialty-care hospital located in Elk Grove Village, Illinois, that operates in partnership with the Rehabilitation Institute of Chicago DBA Shirley Ryan AbilityLab. The hospital provides inpatient, day rehabilitation and outpatient care, including physical, occupational and speech therapy and numerous specialty services. AMITA Health St. Alexius Medical Center, Hoffman Estates - An acute-care hospital located in Hoffman Estates, Illinois, that provides inpatient, outpatient and emergency services, including specialties such as bariatrics, cardiology, diabetes and endocrinology, gastroenterology, gastrointestinal surgery, geriatrics, nephrology, neurosciences/stroke, oncology, orthopedics, pediatrics, pulmonology and urology. AMITA Health Alexian Brothers Women & Children's Hospital, Hoffman Estates - A specialty-care hospital on the campus of AMITA Health St. Alexius Medical Center located in Hoffman Estates, Illinois, that provides obstetrics care and advanced pediatric care and treats premature infants in a Level III neonatal intensive care unit. The hospital also specializes in the emergency transport of critically ill babies from outside hospitals. AMITA Health Alexian Brothers Behavioral Health Hospital - A behavioral health hospital located in Hoffman Estates, Illinois, that provides comprehensive inpatient, partial hospitalization (day treatment), and outpatient behavioral health services, including specialties in chemical dependency, eating disorders and self-injury programs. The hospital's continuum of services includes prevention, early intervention, treatment, after-care and psychiatric research. Alexian Brothers Center for Mental Health - A provider of community mental health services in northwest suburban Chicago, including vocational training programs, transitional living programs and partial hospitalization programs. Foglia Family Foundation Residential Treatment Center - A residential treatment center located in Elk Grove Village, Illinois, for people struggling with obsessive-compulsive disorder (OCD), anxiety and addictions. The center specializes in treating multisymptomatic patients, providing services such as individual therapy, group therapy, virtual reality treatments and psychiatric care/medication management. Alexian Brothers Bonaventure House and Alexian Brothers Bettendorf Place, LLC, d/b/a Alexian Brothers Housing and Health Alliance - A provider of housing and health and support services for homeless individuals living with HIV/AIDS and other chronic diseases. The Alliance offers more than 250 units of transitional, permanent and scattered-site housing from Joliet, Illinois, to Chicago and Waukegan, Illinois. Alexian Brothers Ambulatory Group, d/b/a Alexian Brothers Medical Group - A provider of ambulatory services to suburban Chicago, including primary-care physician services, specialty-care physician services and pediatric physician services. Alexian Brothers Medical Group is part of AMITA Health Medical Group, the physician enterprise comprised of employed physicians from ABHS and AMH. Alexian Brothers Specialty Group - A provider of cardiology services to suburban Chicago residents through cardiologists employed by ABHS. AMH Affiliates AMITA Health Adventist Medical Center, Bolingbrook - An acute-care hospital located in Bolingbrook, Illinois, that provides inpatient, outpatient and emergency services, including specialties such as bariatrics, cardiology, gastroenterology, geriatrics, home health, hospice, interventional radiology, neurology, oncology, pediatrics and stroke care. AMITA Health Adventist Medical Center, GlenOaks - An acute-care hospital located in Glendale Heights, Illinois, that provides inpatient, outpatient and emergency services, including specialties such as behavioral healthcare, cardiology, gastroenterology, interventional radiology, obstetrics, oncology, ophthalmology, orthopedics and podiatry. AMITA Health Adventist Medical Center, Hinsdale - An acute-care hospital located in Hinsdale, Illinois, that provides inpatient, outpatient and emergency services, including a Level III neonatal intensive care unit and specialties such as behavioral healthcare, heart/vascular, home health, hospice, gastroenterology, gastrointestinal surgery, geriatrics, interventional radiology, nephrology, neurosciences/stroke, oncology, orthopedics and pediatrics. AMITA Health Adventist Medical Center, La Grange - An acute-care hospital located in La Grange, Illinois, that provides inpatient, outpatient and emergency services, including specialties such as endocrinology, gastroenterology, geriatrics, heart/vascular, home health, hospice, interventional radiology, neurology, obstetrics, oncology, orthopedics, pediatrics, rheumatology and urology. Adventist Health Partners - A provider of ambulatory services to suburban Chicago, including primary-care physician services, specialty-care physician services and pediatric physician services. Adventist Health Partners is part of AMITA Health Medical Group, the physician enterprise comprised of employed physicians from ABHS and AMH.
Schedule H, Part VI, Line 7 State filing of community benefit report IL
Schedule H (Form 990) 2016
Additional Data


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