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ObjectId: 202043219349307959 - Submission: 2020-11-16
TIN: 35-1330472
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
19
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
Employer identification number
35-1330472
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
ST FRANCIS INSURANCE SERVICES LLC
1600 ALBANY STREET
BEECH GROVE
,
IN
46107
20-0048077
INSURANCE
IN
1,180,782
0
FRANCISCAN
(2)
SPECIALTY PHYSICIANS OF ILLINOIS LLC
333 DIXIE HIGHWAY
CHICAGO HEIGHTS
,
IL
60411
05-0540914
PHYSICIAN
IL
28,543,889
11,627,244
FRANCISCAN
(3)
FAITH HOPE AND LOVE CANCER CENTER LLC
1250 SOUTH CREASY LN STE A
LAFAYETTE
,
IN
47905
68-0612977
MEDICAL SRVCS
IN
4,677,791
0
FRANCISCAN
(4)
ST FRANCIS MEDICAL GROUP LLC
5330 E STOP 11 RD
INDIANAPOLIS
,
IN
46237
26-3877295
MEDICAL SRVCS
IN
28,534,000
0
FRANCISCAN
(5)
FRANCISCAN PHO CENTRAL INDIANA LLC
1515 DRAGOON TRAIL
MISHAWAKA
,
IN
46544
82-2534628
ACCOUNT. CARE
IN
23,284,000
0
FRANCISCAN
(6)
FRANCISCAN PHO NORTHERN INDIANA LLC
1515 DRAGOON TRAIL
MISHAWAKA
,
IN
46544
82-2537889
ACCOUNT. CARE
IN
26,019,000
0
FRANCISCAN
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
HILLS INSURANCE COMPANY INC
1515 DRAGOON TRAIL
MISHAWAKA
,
IN
46544
03-0372512
CAPTIVE INS
VT
501(C)(3)
12-TYPE 1
FRANCISCAN
Yes
(2)
SISTERS OF ST FRANCIS OF PERPETUAL ADOR
PO BOX 766
MISHAWAKA
,
IN
46546
35-1328145
RELIGIOUS
IN
501(C)(3)
1
NA
No
(3)
ST ALEXIS HOSPITAL ASSOCIATION
PO BOX 1290
MISHAWAKA
,
IN
46546
34-0714485
SUPPORT ALEXA
OH
501(C)(3)
3
FRANCISCAN
Yes
(4)
FRANCISCAN HEALTH FOUNDATION INC
1515 DRAGOON TRAIL
MISHAWAKA
,
IN
46544
35-1955283
FUNDRAISING
IN
501(C)(3)
7
FRANCISCAN
Yes
(5)
FRANCISCAN VNS HOME CARE INC
4701 N KEYSTONE AVE S418
INDIANAPOLIS
,
IN
46205
35-0868199
HOME HEALTH
IN
501(C)(3)
10
FRANCISCAN
Yes
(6)
FRANCISCAN PERSONAL CARE INC
4701 N KEYSTONE AVE S418
INDIANAPOLIS
,
IN
46205
35-2107306
HEALTHCARE
IN
501(C)(3)
10
FRANCISCAN
Yes
(7)
FRANCISCAN HEALTH RENSSELAER INC
1104 E GRACE ST
RENSSELAER
,
IN
47978
47-3825106
HEALTH SRVCS
IN
501(C)(3)
3
FRANCISCAN
Yes
(8)
FRANCISCAN ACO INC
700 E SOUTHPORT ROAD
INDIANAPOLIS
,
IN
46227
35-1904455
HEALTHCARE
IN
501(C)(3)
12-TYPE 1
FRANCISCAN
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Page 2
Schedule R (Form 990) 2019
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
FRANCISCAN SURGERY CENTER LLC
421 N EMERSON AVE
BEECH GROVE
,
IN
46143
35-2128334
MEDICAL SERVICES
IN
FRANCISCAN
RELATED
10,124,041
6,944,117
No
0
No
50.000 %
(2)
LAFAYETTE HEART PROGRAM HOLDINGS LLC
1501 HARTFORD STREET
LAFAYETTE
,
IN
47904
38-3750811
MEDICAL SERVICES
IN
FRANCISCAN
RELATED
4,239,937
14,397,410
No
0
No
51.000 %
(3)
ST FRANCIS MOORESVILLE SURGERY CTR LLC
1215 HADLEY ROAD SUITE 100
MOORESVILLE
,
IN
46158
20-2256900
MEDICAL SERVICES
IN
FRANCISCAN
RELATED
1,966,592
2,020,011
No
0
No
52.590 %
(4)
ST FRANCIS RADIATION THERAPY CENTERS LLC
421 N EMERSON AVE
GREENWOOD
,
IN
46143
77-0663631
MEDICAL SERVICES
IN
FRANCISCAN
RELATED
4,971,105
6,759,145
No
0
No
88.950 %
(5)
ST FRANCIS IMAGING CTR (GREENWOOD) LLC
421 N EMERSON AVE
GREENWOOD
,
IN
46143
20-4607426
IMAGING SERVICES
IN
FRANCISCAN
RELATED
600,133
557,266
No
0
No
60.000 %
(6)
TONN & BLANK CONSTRUCTION LLC
1623 GREENWOOD AVENUE
MICHIGAN CITY
,
IN
46360
26-3919039
CONSTRUCTION
IN
FHC
RELATED
1,967,594
38,144,954
No
25,214
No
71.120 %
(7)
MAJOR HOSP CARDIAC DIAGNOSTICS LLC
2451 INTELLIPLEX DR
SHELBYVILLE
,
IN
46176
20-8715441
MEDICAL SERVICES
IN
FRANCISCAN
RELATED
504,212
267,457
No
0
No
53.600 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
FRANCISCAN HOLDING CORPORATION
1515 DRAGOON TRAIL
MISHAWAKA
,
IN
46544
36-3593505
HOLDING CO.
IN
FRANCISCAN
C CORP
851,192
89,814,700
100.000 %
Yes
Schedule R (Form 990) 2019
Page 3
Schedule R (Form 990) 2019
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
Yes
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
FRANCISCAN HEALTH FOUNDATION INC
C
4,902,575
FMV
(2)
FRANCISCAN SURGERY CENTER LLC
B
90,000
FMV
(3)
FRANCISCAN SURGERY CENTER LLC
C
11,189,353
FMV
(4)
LAFAYETTE HEART PROGRAM HOLDINGS LLC
C
4,239,937
FMV
(5)
MAJOR HOSPITAL CARDIAC DIAGNOSTICS
C
500,000
FMV
(6)
ST FRANCIS IMAGING CENTER (GREENWOOD) LLC
C
649,680
FMV
(7)
ST FRANCIS MOORESVILLE SURGERY CENTER LLC
C
1,514,975
FMV
(8)
ST FRANCIS RADIATION THERAPY CENTERS LLC
C
5,514,722
FMV
(9)
TONN AND BLANK CONSTRUCTION LLC
C
10,413,400
FMV
Schedule R (Form 990) 2019
Page 4
Schedule R (Form 990) 2019
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2019
Page 5
Schedule R (Form 990) 2019
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2019
Additional Data
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