Civic Intelligence

Presence Ambulatory Services

990 • Fiscal year 2016 • EIN 36-4286236

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 13, 2017

100 North River RoadDes Plaines, IL 60016

(630) 914-2791

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

14th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2016

Liabilities / Revenue

14th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2016

Net Margin

19th percentile

-14%

Higher net margin than 19% of similar nonprofits.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2016

Top Officer Pay

99th percentile

$811,893

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 19.1% of source-year revenue.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2016

Asset Growth

16th percentile

-7.3%

Faster asset growth than 16% of similar nonprofits.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2015 to 2016

Revenue Growth

8th percentile

-41%

Faster revenue growth than 8% of similar nonprofits.

2016 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2015 to 2016

Assets

Down

$4,698,172

Down $369,954 (-7.3%) from 2015

Net Assets

Down

$4,698,172

Down $612,635 (-12%) from 2015

Liabilities

Up

$0

Up $242,681 (+100%) from 2015

Revenue

Down

$4,258,117

Down $2,918,484 (-41%) from 2015

Expenses

Down

$4,870,752

Down $4,435,870 (-48%) from 2015

Net Income

Up

-$612,635

Up $1,517,386 (+71%) from 2015

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$100M$50M$0-$50MAssets 2011: $20,838,566Liabilities 2011: $36,102,397Net Assets 2011: -$15,263,8312011Assets 2012: $26,169,318Liabilities 2012: $45,757,164Net Assets 2012: -$19,587,8462012Assets 2013: $27,706,761Liabilities 2013: $51,917,553Net Assets 2013: -$24,210,7922013Assets 2014: $30,107,457Liabilities 2014: $57,870,500Net Assets 2014: -$27,763,0432014Assets 2015: $5,068,126Liabilities 2015: -$242,681Net Assets 2015: $5,310,8072015Assets 2016: $4,698,172Liabilities 2016: $0Net Assets 2016: $4,698,1722016Assets 2017: $4,304,625Liabilities 2017: $800Net Assets 2017: $4,303,8252017Assets 2019: $1,351,818Liabilities 2019: $60,243Net Assets 2019: $1,291,5752019Assets 2020: $1,481,891Liabilities 2020: $451,318Net Assets 2020: $1,030,5732020Assets 2021: $2,097,973Liabilities 2021: $1,488,537Net Assets 2021: $609,4362021Assets 2022: $789,103Liabilities 2022: $567,948Net Assets 2022: $221,1552022Assets 2023: $400,595Liabilities 2023: $210,993Net Assets 2023: $189,6022023Assets 2024: $539,047Liabilities 2024: $70,022Net Assets 2024: $469,0252024

Highlighted filing

2016

Assets$4,698,172
Liabilities$0
Net Assets$4,698,172

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$15M$10M$5.0M$0-$5.0MExpenses 2011: $9,822,4622011Expenses 2012: $9,345,8962012Revenue 2013: $5,968,558Expenses 2013: $10,591,504Net Income 2013: -$4,622,9462013Revenue 2014: $7,014,648Expenses 2014: $10,565,768Net Income 2014: -$3,551,1202014Revenue 2015: $7,176,601Expenses 2015: $9,306,622Net Income 2015: -$2,130,0212015Revenue 2016: $4,258,117Expenses 2016: $4,870,752Net Income 2016: -$612,6352016Revenue 2017: $5,387,491Expenses 2017: $5,392,131Net Income 2017: -$4,6402017Revenue 2019: $3,533,122Expenses 2019: $5,054,795Net Income 2019: -$1,521,6732019Revenue 2020: $2,560,043Expenses 2020: $3,051,194Net Income 2020: -$491,1512020Revenue 2021: $2,395,648Expenses 2021: $2,592,035Net Income 2021: -$196,3872021Revenue 2022: $1,336,666Expenses 2022: $1,595,610Net Income 2022: -$258,9442022Revenue 2023: $693,685Expenses 2023: $710,962Net Income 2023: -$17,2772023Revenue 2024: $314,696Expenses 2024: $303,454Net Income 2024: $11,2422024

Highlighted filing

2016

Revenue$4,258,117
Expenses$4,870,752
Net Income-$612,635
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 13, 2017
Return Version
2016v3.1
Gross Receipts
$4,258,117
Mission and Program Overview

Mission

Our mission as part of a catholic health care system is to further the healing ministry of jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve.

SEE SCHEDULE O

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$-72,674$1,508,068▲ $1,580,742
Land, Buildings, and Equipment, Net$2,126,681$1,395,781▼ $730,900
Accounts Receivable$751,825$779,186▲ $27,361
Investments Program Related$0$119,609▲ $119,609
Savings and Temporary Cash Investments$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$5,068,126$4,698,172▼ $369,954
Other Assets Total$2,262,294$895,528▼ $1,366,766
Liabilities
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Accounts Payable and Accrued Expenses$-242,681$0▲ $242,681
Total Liabilities$-242,681$0▲ $242,681
Net Assets / Fund Balance
Unrestricted Net Assets$5,310,807$4,698,172▼ $612,635
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$5,310,807$4,698,172▼ $612,635
Total Liabilities and Net Assets / Fund Balance$5,068,126$4,698,172▼ $369,954

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$1,240,539$7,810,579$9,051,118
Leasehold Improvements$5,242$1,068,897$1,074,139
Land$150,000-$150,000
Other Land Buildings-$15,811$15,811
Other Assets Org$476,996--
Compensation and Service Providers

Employees

NameTitleOtherTotal
Stephen WalterTreasurer (term 5/2016)$85,675$85,675

Board Members and Trustees

NameTitle
Leslie R SternDir/vice Chair, Pmg Practice
Julie RoknichAsst Secretary, Sys Director Sr Agc
Howard DrenthDirector Ex-offc Term 7/16 Pmg Pres
Dana GilbertDirector Interim /pres/CEO CHF Hlth
Brian D RasmusDirector, Pmg Finance Officer
Patrick QuinnAsst Treasurer (term 2/17) SVP
Paula J CampbellAsst Treasurer (term 8/16) Sfo
Patricia EddyAsst Treasurer, Sfo
Jeannie C FreySecretary Sys Ch Legl Offc
Anthony FilerTreasurer (term 1/2016), CFO
James H KelleyTreasurer, CFO

Highest Paid Contractors

ContractorServicesLocationCompensation
Midwest Imaging ProfessionalsPurchased Physician903 COMMERCE DR, Oak Brook, IL 60523$433,629
Revenue and Support

Revenue Composition

Contributions and Grants
$161,196
Program Service Revenue
$3,969,705
Investment Income
$13,269
Other Revenue
$113,947
Change in Net Assets
$-612,635
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$3,142,088
Salaries, Compensation, and Employee Benefits$1,728,664
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$1,423,667$0$0$1,423,667
Depreciation Depletion$730,900$0$0$730,900
Fees for Services Other$728,432$0$0$728,432
Occupancy$486,273$0$0$486,273
Fees for Services Management$0$276,017$0$276,017
Other Employee Benefits$150,341$0$0$150,341
Payroll Taxes$101,093$0$0$101,093
All Other Expenses$71,996--$71,996
Pension Plan Contributions$53,563$0$0$53,563
Office Expenses$33,076$0$0$33,076
Interest$29,764$0$0$29,764
Insurance$26,187$0$0$26,187
Other Expenses$17,684$0$0$17,684
Travel$2,428$0$0$2,428
Information Technology$1,498$0$0$1,498
Total Functional Expenses$4,594,735$276,017$0$4,870,752
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
Yes
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Question 4

Changes to organizational documents the corporation's articles of incorporation were amended effective january 1, 2016 to update its charitable purpose to specifically reference its activities of developing, owning and operating healthcare facilities. The corporation's bylaws were amended january 1, 2016 to reflect the corporation's charitable purposes as stated in its articles of incorporation by including the corporation's purpose statement, as well as a provision clarifying that the corporation is not permitted to use contributions to carry on activities that are not charitable, religious, scientific, or educational under section 170(c)(2). The following additional changes were made to the corporation's governance: (1) the corporation's sole member changed from "presence rhc corporation," to "presence care transformation corporation(2) the minimum and maximum amount of directors serving on the board was updated.

Form 990, Part VI, Question 6

Members or shareholders presence ambulatory services has one member, presence care transformation corporation.

Form 990, Part VI, Question 7A

Persons with authority to elect members of the governing body the corporations sole member, presence care transformation corporation, has the power to appoint members of the governing body, other than ex-officio directors.

Form 990, Part VI, Question 7B

Decisions of governing body approval by members or shareholders presence care transformation corporation (the "member"), through its board of directors, has certain general and reserved powers with respect to the following. General powers: the member shall provide oversight and support for the activities of the corporation, for the purpose of assuring that all actions of the corporation are consistent with the mission and values of the system; the purposes of the corporation; the ethical and religious directives; the presence health system strategic plan; and best practices. Reserved powers: in furtherance of the exercise of its general powers and responsibilities, the member shall have the sole power to take the actions specified below with respect to the following matters pertaining to the corporation and each hospital ministry, subject to any notices or further approvals required by applicable civil or canon law, or the member's bylaws: a. Bylaws. Amend or repeal the bylaws of the corporation. B. Officers and directors. Appoint and remove all officers of the corporation and all directors of the corporation, other than any ex-officio directors. C. Budgets. Approve capital and operating budgets, and long-term capital equipment plans for the corporation, including each hospital ministry. D. Unbudgeted expenditures. Approve unbudgeted expenditures in excess of the limit established by the member from time to time. E. Debt, sale, lease and other real property transactions. Approve any borrowing or significant incurrence of debt by the corporation in excess of the limit established by the member from time to time, or any sale, purchase, alienation, exchange, significant leases (other than in the ordinary course) or encumbrances of the corporation's real property, except those made pursuant to approved budgets. F. Real estate documents, equipment leases. Approve execution of any deeds, mortgages, bonds, or major equipment leases, except those entered into pursuant to approved budgets. G. Significant unbudgeted transactions. Approve any other significant and unbudgeted sale, purchase, exchange, lease (other than in the ordinary course) transfer, litigation or legal settlement, benefits packages, encumbrance or other disposition or other significant transaction involving the non-real-estate assets of the corporation in excess of the limit established by the member from time to time. H. Material changes in services. Approve material changes in the kind of services rendered at any hospital ministry, such as the addition or discontinuation of any major service line (e.g., obstetrics) or change in the fundamental nature of services provided by the corporation through any hospital ministry (e.g., a change requiring a different kind of license). I. Strategic plan. Approve strategic plans for the corporation and each hospital ministry, consistent with and in furtherance of system mission and values, and responsive to the needs of the communities served by the corporation and support the ability of the corporation and its affiliates to provide high-quality care and services. J. Management contracts. Approve any contract for the management of all or substantially all of the corporation or any individual hospital ministry owned by the corporation. K. Business name, logo. Approve any selection or modification of the business name or logo of the corporation or any hospital ministry or any program or division, or the use of any corporate or business name of the corporation or any hospital ministry by an entity other than the member or an affiliate. L. Administrative services. Provide or assure the provision of appropriate insurance coverage, standardized employee benefits, information systems and technology, financial management services, legal, marketing, risk management and other administrative services necessary to support the corporation's operations. M. Significant joint ventures. Approve the establishment, termination, or sale of any signi

Form 990, Part VI, Question 11B

Form 990 review process the corporation provides a complete copy of its form 990 to all members of the governing body of its ultimate parent corporation, presence health network, for review prior to filing with the irs. The board of directors of the corporation and other subsidiary organizations within the presence health system are internal limited fiduciary boards which do not receive a completed copy of the form 990 prior to filing. As a result, the corporation answers "no", to form 990, part vi, line 11a.

Form 990, Part VI, Line 12C

Procedures for addressing conflicts of interest the purpose of the conflict of interest policy is to protect the interests of presence health network and all of its affiliated ministries (collectively "presence health") when it is contemplating entering into a transaction or arrangement that might benefit the private interest of any director, trustee, officer, corporate member appointee, member of a committee with board-delegated powers, senior leaders, and others in a recent position to exercise substantial influence over presence health ("interested persons"), and clarify the standards of conduct, duties and obligations of interested persons in the context of potential conflicts of interest by providing a method for disclosing and resolving such potential conflicts. No presence health entity will engage in any contract, transaction or arrangement involving a conflict of interest unless disinterested members of the applicable board of directors or other governing body determine by a majority vote that appropriate safeguards to protect the charitable mission of presence health have been implemented. To facilitate this policy, all interested persons have a continuing obligation to promptly disclose the existence and nature of any actual, apparent, or potential conflicts of interest he/she may have. All disclosures must be provided to the system compliance officer and general counsel in a written description of the material facts. Disclosure shall be on a conflicts of interest questionnaire or similar format as described in the conflicts of interest policy. All interested persons shall also complete a questionnaire based on the assumption of the board (or other relevant) position, and thereafter on at least an annual basis or when an actual, apparent, or potential conflict arises. At any time that an actual, apparent or a potential conflict of interest is identified to the corporations board of directors, whether through the voluntary submission of a disclosure statement by an interested person, or by a disclosure by a person other than the subject interested person, the corporations board or applicable committee shall review the matter and determine whether a conflict of interest exists. Once all necessary information has been obtained, only disinterested directors/committee members vote to determine whether a conflict of interest exists. If a conflict is found to exist the interested person will generally be required to recuse him or herself during any meeting in which the board of directors or applicable committee conducts the evaluation of the subject transaction, except to answer questions as may be necessary. To ensure that the presence health operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its exempt status, transactions involving interested persons are only approved if, after exercising reasonable due diligence, the board determines they are fair and reasonable, taking into account factors such as whether presence health could obtain a more advantageous contract, transaction or arrangement. However, lending money or guarantying an obligation of a director, officer, or employee of presence health (exclusive of customary insurance coverage for acts done in connection with such individuals service to or employment by presence health) is strictly prohibited.

Form 990 Part VI, Questions 15A and 15B, and Part V, Question 2A

Compensation and approval process for officers and key employees compensation for the corporations ceo and other officers or key employees is determined in accordance with written policies and procedures adopted by the board of directors of the systems parent, presence health network ("phn"), and applied by the human resources committee of the board of directors. The board of directors uses market data compiled by an independent compensation consultant to establish base salaries and total cash compensation opportunities. The human resources committee monitors executive total compensation by approving all components of executive total compensation, and annually reviewing and approving compensation changes for each executive. The corporation answers "yes" to form 990, part vi, question 15a and 15b as phns board of directors has ultimate control over all subsidiary organizations.

Form 990, Part VI, Line 19

Document availability the corporations articles of incorporation are on file with the state of illinois. The consolidated audited financial statements of the corporation, together with its affiliates, are available from the national dissemination agent as required by presence health systems bond documents. Conflicts of interest policies are not made available to the public, however a summary of the current policy is annually included in schedule o of the corporations form 990.

Form 990, Part VII, Sections A & B

Statutory employer presence care transformation corporation ("pctc") (fein 36-3366652) acts as the agent for the corporation. Cash is swept from the corporation on a daily basis to pctc and pctc issues all payroll and accounts payable checks on behalf of and as agent for the corporation and the appropriate accounting entries are recorded.

Filing and Contact Details

Filer

Filer Name
Presence Ambulatory Services
EIN
36-4286236
In Care Of
% JAMES H KELLEY
Phone
6309142791
Address
100 NORTH RIVER ROAD, DES PLAINES, IL 60016

Signing Officer

Name
James H Kelley
Title
Treasurer
Phone
6309142791
Signed
2017-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Dana Gilbert
Formed
1997
Legal Domicile
Il
Voting Board Members
3
Independent Board Members
0
Employees
0
Volunteers
0

Preparer

Firm
Ernst & Young US Llp
Address
155 N Wacker Drive, Chicago, IL 60606
Preparer
Jacob J Zehnder
Phone
3128792000
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1

Mission statement/significant activity presence ambulatory services (pas) provides the highest quality medical care supported by full medical service units. Pas is dedicated to easy outpatient surgeries, endoscopy, and minor medical procedures.

Form 990, Part III, Question 1

MISSION STATEMENT THE CORPORATION IS PART OF THE PRESENCE HEALTH SYSTEM AND ACTS IN ACCORDANCE WITH THE PRESENCE HEALTH MISSION, WHICH IS AS FOLLOWS: INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST AND AS PART OF PRESENCE HEALTH, A CATHOLIC HEALTH SYSTEM, PRESENCE AMBULATORY SERVICES PROVIDES HEALTHCARE SERVICES IN A COMPASSIONATE, HOLISTIC MANNER IN THE SPIRIT OF HEALING AND HOPE. FORM 990, PART III, QUESTION 3 Presence Ambulatory Services contributed all of its immediate care center AND OCCUPATIONAL HEALTh assets and operations to its parent company, Presence Care Transformation Corporation, which in turn transferrerd these interests to another subsidiary in the system that operates immediate care services through a joint venture, Physcians Immediate Care.

Form 990, Part I, Question 5, and Part V, Question 2

Compensation and form w-3 transmittal of wages and tax statement presence ambulatory services (the "corporation") reports 0 employees on form 990, part i, question 5 and form 990, part v, question 2a as it is not required to file form w-3, transmittal of wages and tax statement. The corporations compensation is paid by presence care transformation corporation ("pctc"), which issues the forms w-2 and w-3, and the expense is transferred to the corporation. The compensation amounts reported in this 990 reflect the amount transferred to the corporation from pctc.

Form 990, Part V, Question 1A

Form 1096 transmittal of u.s. Information returns presence ambulatory services (the "corporation") reports 0 on form 990, part v, question 1a as it is not required to file form 1096, transmittal of u.s. Information returns. All of the corporations accounts payable reportable on form 1096 are paid by presence care transformation corporation ("pctc"), which issues all forms 1099, and the expense is transferred to the corporation. The compensation amounts reported in this 990 reflect the amount transferred to the corporation from pctc.

Form 990, Part XII, Line 2B

Audited financial statements an independent accountant annually audits the consolidated financial statements of presence health network and its affiliates. The audit opinion is issued on the consolidated financial statements and each affiliate is not separately audited. Part xii, lines 3a & 3b presence health network completes a consolidated a-133 audit which includes all entities for which it is a parent organization whether they expended federal funds during the year or not.

Form 990 Part IX Line 11G

Description:fees for servs-other total fees:728432

Financial Statement Notes

Schedule D, Part X, Line 2

Fin 48(asc740) footnote presence health recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of december 31, 2016 and 2015, presence health does not have any liabilities for unrecognized tax benefits.

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IRS990/Desc0PRESENCE AMBULATORY SERVICES (PAS) PROVIDES THE HIGHEST QUALITY CARE TO THE COMMUNITY, WHILE MAKING IT EASY TO GET SERVICES. PAS OFFERS CONVENIENT LOCATIONS, EXTENDED HOURS, AMPLE PARKING AND EXPERTISE. PAS PROVIDES EASY ACCESS TO EXPERT-LEVEL CARE AT A VARIETY OF FACILITIES, INCLUDING: IMMEDIATE CARE CENTERS, OPEN MRI AND IMAGING CENTERS, OCCUPATIONAL HEALTH, SLEEP CARE CENTERS.
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