SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
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OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
ST MARYS MEDICAL GROUP LLC
 
Employer identification number

26-1356310
Return Reference Explanation
Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY ASCENSION HEALTH AND ITS SUBSIDIARY ORGANIZATIONS. ASCENSION HEALTH IS THE NATIONAL HEALTH SYSTEM PARENT. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY ST. VINCENT MEDICAL GROUP, INC. AND ITS SUBSIDIARY ORGANIZATIONS. ST. VINCENT MEDICAL GROUP, INC. IS THE SOLE CORPORATE MEMBER OF ST. MARY'S MEDICAL GROUP, LLC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 4 Significant changes to organizational documents Effective January 9, 2018, the sole corporate member of St. Mary's Medical Group, LLC was changed from St. Mary's Health, Inc. to St. Vincent's Medical Group, Inc.
Form 990, Part VI, Line 6 Classes of members or stockholders ST. MARY'S MEDICAL GROUP, LLC HAS A SINGLE CORPORATE MEMBER, ST. VINCENT'S MEDICAL GROUP, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ST. MARY'S MEDICAL GROUP, LLC HAS A SINGLE CORPORATE MEMBER, ST. VINCENT'S MEDICAL GROUP, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S MEDICAL GROUP, LLC
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S MEDICAL GROUP, LLC'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST. VINCENT'S MEDICAL GROUP, INC.
Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
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 VIII, Line 11d Other Miscellaneous Revenue Miscellaneous Revenue - Total Revenue: 35188, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 35188;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers with Alpha Fund - 29659421;
Form 990, Part XII, Line 2b audited financial statements The activity of St. Mary's Medical Group, LLC is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Mary's Medical Group, LLC is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Mary's Medical Group, LLC.
Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant St. Mary's Medical Group, LLC is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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