deaconess associations 2011 irs 990

8/21/2019 Deaconess Associations 2011 IRS 990

1/34

Form 990

Department of the TreasuryInternal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c),527,or 4947(a)(1) of the Internal Revenue Code (except black lungbenefit trust or private foundation)

The organization may have to use a copy of this return to satisfy state reporting requirements

OMB No 1545-0047

1 ( 0 ) 1 1

A For the2011calendar year, or tax year beginning 2011.and ending

Open to Public

Inspection

,20

B Check if applicable

Address change

Name change

Initial returnTerminated

Amended return

Application pending

C Name of organization DEACONESS ASSOCIATIONS, INC.

Doing Business As

Number and street (or P O box if mail is not delivered to street address)

311 STRAI GHT STREET

Room/suite

City or town, state or country, and ZIP + 4

CINCINNATI, OH 45219

D Employer identification number

31-1209377

ETelephone number

513-559-2100

GGross receipts $ 81,530,27

F Name and address of pnncipal officer

E. Anthony Woods c/o DAI, 311 Straight St, Cinti. OH 45219

I Tax-exempt status [Z] 501(c)(3) D 501(c) ( ) < (insert no ) D 4947(a)(1) or D 527

J Website: www.deaconess-healthcare.com

H(a)Is this a group returnfor affiliates? L J Yes [Z] N

H(b) Are all affiliates included? Yes D No

If "No," attach a list (see instructions)

H(c) Group exemption number

K Form of organization \7] Corporation Q Trust Q Associa tion Q Other L Year of formation 1986 MState of legal domicile OH

oeCOC

>o

CNJ.8

O -

Summary

1 Briefly describe the organization's mission or most significant activities: Deaconess Associations, Inc. serves as a holdingcompany to coordinate the activities of its non-profit subsidiaries, including the Deaconess Health Association Fund, Inc. and

Deaconess Long Term Care, Inc. The primary purpose of the Deaconess organization is to advance health care solutions.

23

4

5

6

7a

b

Check this box D if the organization discontinued its operations or disposed of more than 25% of its net assets.Number of voting members of the governing body (Part VI, line 1a)

Number of independent voting members of the governing body (PartVI,line 1b) . . . .

Total number of individuals employed in calendar year2011(Part V, line 2a)

Total number of volunteers (estimate if necessary)

Total unrelated business revenue from PartVIII,column (C), line 12

Net unrelated business taxable income from Form 990-T, line 347a7b

If8 Contributions and grants (PartVIII,line 1h)

9 Program service revenue (PartVIII,line 2g)

10 Investment income (PartVIII,column (A), lines 3, 4, and 7d)

11 Other revenue (PartVIII,column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) . . .12 Total revenueadd lines 8 through 11 (must equal PartVIII,column (A), line 12)

Prior Year Current Year

1,361,854 1,190,34

14,698,506 16,802,9

19,119 1

16,079,479 17,993,48

w0)V)

c0>axai

1314

15

16a

b

17

18

19

Grants and similar amounts paid (Part IX, column (A), lines 1-3) .Benefits paid to or for members (Part IX, column fA) line 4)

Salaries, other compensation, employee benefits (|^p)Q


2/34

Form 990 (2011) Page

S ta temen t of P rog ram Se rv i c e A c c o mp l i s hmen t s

Che ck if Sch edu le O con tai ns a resp onse to any que stio n in this Part III [

'1 Briefly descr ibe the organ izatio n's missi on:

Deaconess Associati ons, Inc. serves as a holdi ng company to coordinate the activiti es of its non-prof it subsidiaries includ ing

Deaconess Health Asso ciat ion Fund, Inc. and Deaconess Long Term Care Inc. The primary purpose of the Deaconess org anization

is to advance health care solutions by providing viable health care services and products, and releasing proceeds to support

charitable initiatives.

2 Did the organization unde rtak e any significant progr am services during the year whic h were not listed on the

prior Form 990 or 990-E Z? [7]Y es D N o

If "Yes," describe these new services on Schedule O.

3 Did the organizati on ceas e con duc tin g, or make significant changes in how it con duc ts, any prog ram

serv ices? D Y e s 0 N o

If "Yes," describe these changes on Schedule O.

4 Describ e the organ izati on's prog ram service acco mplis hmen ts for each of its three largest prog ram services, as measure d

expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount

grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4a (Code: ) (Expense s $ _2_,36l,7_45_ inc luding gran ts of $ ) (Revenu e $ 6_7.3.'3.?.8. )

Deaconess Associations, Inc. serves as a holding company to coordinate the activities of its non-profit subsidiaries including

Deaconess Health Asso ciat ion Fund, Inc. and Deaconess Long Term Care, Inc. The primary purpos e of the Deaconess organizat ion

is to advance health care solutions by providing viable health care services and products, and releasing proceeds to support

charita ble initiativ es. Operatio ns are conducted for the care, well being, and benefit of all persons in the communi ty.

4b (Code : ) (Expenses $ J??j?'.??.1.incl udin g gran ts of $ 0 ) (Revenue $ 5_!7.:_V!3 )

Deaconess Associa tions , Inc. serves as the sole owner of Deaconess Diagnostic LLC, making it a disregarded ent ity. Deaconess

Diagnostic provides Radi ology services to the commu nity and the tenants located in the Deaconess Hospital. In2011, Deaconess

Diagnostic served 524 patients from the community.

4c (Code: ) (Expenses $ including grants of $ ) (Revenue $

4d Other program services (Describe in Schedul e O.)

(Expenses $ includin g grants of $ ) (Revenue $

4e Total prog ram serv ice expenses $3,255,736

Form990 (20


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Form 990 (2011) Pag

Checklist of Required Schedules

23

10

11

ef

12a

13

14i

15

16

17

18

19

20 ab

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes,"complete Schedule A

Is the organization required to completeSchedule B, Schedule of Contributors (see instructions)? . . .Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition tocandidates for public office? If "Yes," complete Schedule C, Parti

Section 501(c)(3) organizations.Did the organization engage in lobbying activities, or have a section 501(h)

election in effect during the tax year?If "Yes," complete Schedule C, Part II

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,Part III

Did the organization maintain any donor advised funds or any similar funds or accounts for which donorshave the right to provide advice on the distribution or investment of amounts in such funds or accounts?If"Yes," complete Schedule D, Part I

Did the organization receive or hold a conservation easement, including easements to preserve open space,the environment, historic land areas, or historic structures?If "Yes," complete Schedule D, Part II . . .Did the organization maintain collections of works of art, historical treasures, or other similar assets?If "Yes,"complete Schedule D, Part III

Did the organization report an amount in Part X, line 21 ; serve as a custodian for amounts not listed in PartX; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes,"

complete Schedule D, Part IV .Did the organization, directly or through a related organization, hold assets in temporarily restricted

endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V . .

If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI,

VII, VIII,IX, or X as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes,"complete Schedule D, Part VI . . .

Did the organization report an amount for investmentsother securities in Part X, line 12 that is 5% or moreof its total assets reported in Part X, line 16?If "Yes," complete Schedule D, Part VII

Did the organization report an amount for investmentsprogram related in Part X, line 13 that is 5% or moreof its total assets reported in Part X, line 16?If "Yes," complete Schedule D, Part VIII

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assetsreported in Part X, line 16?If "Yes," complete Schedule D, Part IX

Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," completeScheduleD,PartXDid the organization's separate or consolidated financial statements for the tax year include a footnote that addresses

the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?If"Yes,"complete ScheduleD,PartX .

Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," completeScheduleD,Parts XI, XII, andXIII

Was the organization included in consolidated, independent audited financial statements for the tax year9 If"Yes,"and iftheorganization answered"No" toline12a,then completing ScheduleD,PartsXI, XII, and XIIIisoptional

Is the organization a school described in section 170(b)(1)(A)(n)?If "Yes," complete Schedule E . . . .

Did the organization maintain an office, employees, or agents outside of the United States?

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,

fundraising, business, investment, and program service activities outside the United States, or aggregate

foreign investments valued at $100,000 or more? If "Yes," complete Schedule F,Parts I and IV . . . .

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any

organization or entity located outside the United States? If "Yes," complete Schedule F, Parts II and IV . .Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance

to individuals located outside the United States? If "Yes," complete Schedule F, Parts III and IV . .

Did the organization report a total of more than $15,000 of expenses for professional fundraising services onPart IX, column (A), lines 6 and 11e?If "Yes," complete Schedule G, Part I(see instructions) . . .Did the organization report more than $15,000 total of fundraising event gross income and contributions on

PartVIII,lines 1c and 8a?If "Yes," complete Schedule G, Part II

Did the organization report more than $15,000 of gross income from gaming activities on PartVIII,line 9a?

If "Yes," complete Schedule G, Part III

Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?

10

11a

11b

11c

11d

11e

11f

12a

12b

13

14a

14b

15

16

17

18

19

20a

20b

Yes N

Form990(2


4/34


Checklist of Required Schedules (continued)Yes

21 Did the organization report more than $5,000 of grants and other assistance to any government or organizationin the United States on Part IX, column (A), line1 ?If "Yes," complete ScheduleI, Parts I and II 21

22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United Stateson Part IX, column (A), line 2?If "Yes," complete ScheduleI,Parts I and III 22

23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of theorganization's current and former officers, directors, trustees, key employees, and highest compensatedemployees? If "Yes," complete Schedule J . . . 23

24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than$100,000 as of the last day of the year, that was issued after December 31 , 2002?If "Yes," answer lines 24bthrough 24d and complete Schedule K. If "No," go to line 25 24a

b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . 24bc Did the organization maintain an escrow account other than a refunding escrow at any time during the year

to defease any tax-exempt bonds? 24c

d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? . . 24d25a Section501(c)(3) and501(c)(4) organizations.Did the organization engage in an excess benefit transaction

with a disqualified person during the year?If "Yes," complete Schedule L, Part I 25a

b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prioryear, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?If "Yes," complete Schedule L, Part I 25b

26 Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, ordisqualified person outstanding as of the end of the organization's tax year?If"Yes,"complete ScheduleL,PartII . . 26

27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee,substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlledentity or family member of any of these persons? If 'Yes," complete Schedule L, Part III 27

28 Was the organization a party to a business transaction with one of the following parties (see Schedule L,Part IV instructions for applicable filing thresholds, conditions, and exceptions):

a A current or former officer, director, trustee, or key employee?If "Yes," complete Schedule L, Part IV 28ab A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete

Schedule L, Part IV 28b

c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof)was an officer, director, trustee, or direct or indirect owner?If "Yes," complete Schedule L, Part IV . . 28c

29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M 29

30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualifiedconservation contributions? If "Yes," complete Schedule M . . . 30

31 Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,Parti 31

32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes,"complete Schedule N, Part II 32

33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulationssections301.7701-2 and301.7701-3?If "Yes," complete Schedule R, Parti 33

34 Was the organization related to any tax-exempt or taxable entity?If "Yes," complete Schedule R, Parts II, III,IV, andV, line 1 . 34

35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 35ab Did the organization receive any payment from or engage in any transaction with a controlled entity within the

meaning of section 512(b)(13)? If "Yes," complete ScheduleR, PartV, line 2 . . . 35b

36 Secti on 501(c)(3) organizations . Did the organization make any transfers to an exempt non-charitablerelated organization? If "Yes," complete ScheduleR,PartV, line 2 36

37 Did the organization conduct more than 5% of its activities through an entity that is not a related organizationand that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R,Part VI 37

38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and19?Note.All Form 990 filers are required to complete Schedule O 38

/

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N

/Form 9 9 0 (20


5/34


Statem ents Regardin g Other IRS Fil ings and Tax Com pli ance

Check if Schedule O contains a response to any question in this Part V

1a

b

c

2a

3a

b

4a

5a

b

c

6a

10

11a

b

12ab

13

a

c14a

b

Yes N

1a

1b

2a

Enter the number reported in Box 3 of Form 1096. Enter-0 -if not applicable . . . .

Enter the number of Forms W-2G included in line1a. Enter -0- if not applicable . . . .

Did the organization comply with backup withholding rules for reportable payments to vendors and

reportable gaming (gambling) winnings to prize winners?

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax

Statements, filed for the calendar year ending with or within the year covered by this returnIf at least one is reported on line 2a, did the organization file all required federal employment tax returns? .

Note.If the sum of lines 1a and 2a is greater than 250, you may be required to e-file(see instructions) . .

Did the organization have unrelated business gross income of $1,000 or more during the year? . . . .

If "Yes," has it filed a Form 990-T for this year?If "No," provide an explanation in Schedule OAt any time during the calendar year, did the organization have an interest in, or a signature or other authorityover, a financial account in a foreign country (such as a bank account, securities account, or other financialaccount)?

If "Yes," enter the name of the foreign country: See instructions for filing requirements for Form TD F90-22.1,Report of Foreign Bank and Financiaf Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? .

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If "Yes" to line 5a or 5b, did the organization file Form 8886-T?

Does the organization have annual gross receipts that are normally greater than $100,000, and did theorganization solicit any contributions that were not tax deductible?

If "Yes," did the organization include with every solicitation an express statement that such contributions or

gifts were not tax deductible?

Organizations th at may receive deduct ible contributi ons under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goodsand services provided to the payor?

If "Yes," did the organization notify the donor of the value of the goods or services provided?Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it wasrequired to file Form 8282?

If "Yes," indicate the number of Forms 8282 filed during the year | 7d |

51

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? .

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?If the organization received a contribution ofcars,boats, airplanes, or othervehicles,did the organization fileaForm 1098-C?

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting

organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring

organization, have excess business holdings at any time during the year?

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?

Did the organization make a distribution to a donor, donor advisor, or related person?

Section501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on PartVIII,line 12 10a

Gross receipts, included on Form 990, PartVIII,line 12, for public use of club facilities .

Section 501(c)(12) organizations.Enter:

Gross income from members or shareholders

Gross income from other sources (Do not net amounts due or paid to other sourcesagainst amounts due or received from them.)

Section 4947(a)(1) non-exempt charitable trusts.Is the organization filing Form 990 in lieu of Form 1041?If "Yes," enter the amount of tax-exempt interest received or accrued during the year. . 112b|

Section 501 (c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?

Note.See the instructions for additional information the organization must report on Schedule O.Enter the amount of reserves the organization is required to maintain by the states in which

10b

11a

11b

the organization is licensed to issue qualified health plans

Enter the amount of reserves on hand

Did the organization receive any payments for indoor tanning services during the tax year?

13b

13c

1c

2b

3a

3b

4a

5a

5b

5c

6a

6b

7a

7b

7c

7e

7f

7g7h

9a

9b

12a

13a

If "Yes," has it filed a Form 720 to report these payments? If "No,"provide an explanation in Schedule O14a

14bForm9 90(20


6/34


Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "N

response to line8a,8b, or 10b below, describe the circumstances, processes, or changes in Schedule 0. See instructions

' Check if Schedule O contains a response to any question in this Part VI [

Section A. Governing Body and Management

1a 1a

1b

4

5

6

7a

Enter the number of voting members of the governing body at the end of the tax year. .

If there are material differences in voting rights among members of the governing body, orif the governing body delegated broad authority to an executive committee or similarcommittee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independentDid any officer, director, trustee, or key employee have a family relationship or a business relationship withany other officer, director, trustee, or key employee?

Did the organization delegate control over management duties customarily performed by or under the directsupervision of officers, directors, or trustees, or key employees to a management company or other person?

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

Did the organization become aware during the year of a significant diversion of the organization's assets? .

Did the organization have members or stockholders?Did the organization have members, stockholders, or other persons who had the power to elect or appointone or more members of the governing body? . . . . . . . .

Are any governance decisions of the organization reserved to (or subject to approval by) members,stockholders, or persons other than the governing body? . . .

Did the organization contemporaneously document the meetings held or written actions undertaken duringthe year by the following:

The governing body?

Each committee with authority to act on behalf of the governing body?Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached atthe organization's mailing address? If"Yes,"provide the names and addresses in Schedule O. . . .

7a

7b

8a

8b

Yes

/

/

/

No

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

10a

b

11a

b

12a

b

c

13

14

15

Did the organization have local chapters, branches, or affiliates?If "Yes," did the organization have written policies and procedures governing the activities of such chapters,

affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form9

Describe in Schedule O the process, if any, used by the organization to review this Form 990.

Did the organization have a written confl ict of interest policy?If "No,"go to line 13Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes,"describe in Schedule O how this was done

Did the organization have a written whistleblower policy'?

Did the organization have a written document retention and destruction policy?Did the process for determining compensation of the following persons include a review and approval byindependent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization's CEO, Executive Director, or top management official

16a

Other officers or key employees of the organizationIf "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangementwith a taxable entity during the year?

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate itsparticipation in joint venture arrangements under applicable federal tax law, and take steps to safeguard theorganization's exempt status with respect to such arrangements?

10a

10b

11a

12a

12b

12c

13

14

15a

15b

16a

16b

Yes

/

/

/

/

//

//

Section C. Disclosure

1718-

19

20

List the states with which a copy of this Form 990 is required to be filed OHSection 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s onavailable for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website E) Upon requestDescribe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policand financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the

organization: Deaconess Hospital, c/o Jennifer Simon, Accounting Manager,311Straight St, Cinti.,OH 45219 513-559-2100

Form990(20


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Form 990 (2011) Pag

| 2 ? 5 E H Compensat i on of Of f icers, Directors, Trustees, Key Employees, Highest Compens ated Employees, an

Independent Contractors

Check if Schedule O contains a response to any quest ion in this Part VII

Section A. Officers, Directors , Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within t

organization's tax year.

List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount

compensation. Enter -0- in columns (D), (E), and (F) if no compensation waspaid.

List all of the organization'scurrent

key employees, if any See instructions for defini tion of "key employee." List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employewho received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from torganization and any related organizations.

List all of the organization's former officers, key employees, and highest compensated employees who received more th$100,000 of reportable compensation from the organization and any related organizations.

List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of torganization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highecompensated employees; and former such persons.

D Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A)

Name and Title

(B)

Averageflours perweek

(describehours forrelated

organizationsin Schedule

O)

(C)

Position(do not check more than one

box, unless person is both anofficer and a director/trustee)

(D)

Reportablecompensationfromthe

organization(W-2/1099-MISC)

(E)

Reportablecompensation fromrelated

organizations(W-2/1099-MISC)

(F)

Estimatedamount ofother

compensationfrom the

organizationand related

organizations

(B)

Averageflours perweek

(describehours forrelated

organizationsin Schedule

O)

R5"*tro a

o SL

cW

CD

CD ii it ij

-no3CD

(D)

Reportablecompensationfromthe


(E)

Reportablecompensation fromrelated

organizations(W-2/1099-MISC)

(F)

Estimatedamount ofother

compensationfrom the

organizationand related

organizations

(1) E. Anthony Woods

Chairman/CEO 25 / / 0 1,872,000 330,9

(2) William Bahl

Board Member 0 / 0 0

(3) *..J. McPhieBoard Member 0 / 0 0

(4) Rodger Reed

Board Member 0 / 0 0

(5) Lee Scroggms

0 / 0 0Board Member 0 / 0 0

(6) William Zimmer

0 / 0 0Board Member 0 / 0 0

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14) t

Form99 0 (2


8/34

Form 990 (2011) Pag

I J H S y j r i Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees(continued)

(A)

Name and title

(B)

Average

hours per

week

(describe

hours for

related

organizations

in Schedule

O)

(C)

Position

(do not check more than one

box, unless person is both an

officer and a director/trustee)

(D)

Reportablecompensation

fromthe


(E)

Reportablecompensation from

relatedorganizations

(W-2/1099-MISC)

(F)

Estimatedamount of

(B)

Average

hours per

week

(describe

hours for

related

organizations

in Schedule

O)

ca a.Q- cEJSL

" ?wCDCD

Z3CO

c5

GO

CD

CD

3oCD

1

1!]

"no

iCD

(D)

Reportablecompensation

fromthe


(E)

Reportablecompensation from

relatedorganizations

(W-2/1099-MISC)compensation

from theorganizationand related

organizations

(15)

(16)

(17)

(18)

(19)

(20)

(21)

(22)

(23)

(24)

(25)

1b Sub-total

0 1,872,000 330,9

c Total fro m continuation sheets to Part VII, Section A

0 0 d Total (add lines 1b and 1c)

0 1,872,000 330,9

Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization 1

Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1a?If "Yes," complete Schedule J for such individual

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from theorganization and related organizations greater than $150,000? If "Yes," complete Schedule J for suchindividual . . .

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individualfor services rendered to the organization?If "Yes," complete Schedule J for such person

J_

5

Yes

/

N

/

/

Section B. Independent Contractors

1 Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization. Report compensation for the calendar year ending with or within the organization's taxyear.

(A)Name and business address

(B)Description of services

(C)Compensation

Health Strategy Partners Consulting 139,4

2 Total number of independent contractors (including but not limited to those listed above) whoreceived more than $100,000 of compensation from the organization 1

- .

Form 99 0 (2


9/34

Form 990 (2011) Pag

SETTpin Statement of Revenue

pin(A)

Total revenue(B)

Related orexemptfunctionrevenue

(C)Unrelatedbusinessrevenue

n (D )

Revenueexcluded from tax

under sections512, 513,or 514

in in 1a

b

c

d

ef

g

h

Federa ted cam pai gns . . .

Membership dues . . . .

Fundr aising eve nts . . . .

Related organi zation s . . .

Government grants (contributions)

All other contributions, gifts, grants,

and similar amounts not included above

1a 0

0

E =

(3

1a

b

c

d

ef

g

h








1b 0

0

E =

(3

1a

b

c

d

ef

g

h








1c 0

0

E =

(3

1a

b

c

d

ef

g

h








1d 0

0

E

1a

b

c

d

ef

g

h








1e 0

0

.2*2

1a

b

c

d

ef

g

h







and similar amounts not included above 1f 0

05 "o

1a

b

c

d

ef

g

h

Noncash contributions included in lines la-lf $ 0

0o CO ra

1a

b

c

d

ef

g

h Tota l . Add lines 1a-1f . . . . 0

3

2a

b

c

d

e

f

g

Management Services

Affiliated Rental Income

Patient Services

Business Code

481,027 481,027a>>

2a

b

c

d

e

f

g

Management Services


Patient Services

561000 481,027 481,027a>

cc

2a

b

c

d

e

f

g

Management Services


Patient Services

531390 192,204 192,204u

'e

2a

b

c

d

e

f

g

Management Services


Patient Services 621990 517,113 517,113u

'e

2a

b

c

d

e

f

g

Management Services


Patient Services

0

E

2a

b

c

d

e

f

g

Management Services


Patient Services

0

2a

b

c

d

e

f

g

All other program service revenue . 02D_

2a

b

c

d

e

f

g Tota l . Add lines 2a-2f . . . . 1,190,344

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Investment incomeand other similar amo including dividends, interest,unts) 9,261,629 9,261,63

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Investment incomeand other similar amo 9,261,629 9,261,63

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Income from investment of tax-exempt bond proceeds

Royal ti es

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Income from investment of tax-exempt bond proceeds

Royal ti es 0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .

Less: rental expenses

Rental income or (loss)

Net rental income or

Gross amount from sales of

assets otherthaninventory

Less: cost or other basis

and sales expenses .

Gai n or (loss) . .

(i) Real (n) Personal

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

0 0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

loss) 0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

(i) Securities (u) Other

7,541,340

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

71,078,137

7,541,340

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . .

63,536,797

7,541,340-

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross rents . .








Gai n or (loss) . . 7,541,3407,541,340

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Net gain or (loss) . 7,541,340 7,541,3

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

7,541,340

0)3C0)>

CC

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross income from fundraising

events (not including $ o

of contributions reported on line 1c).

See Part IV, line 18 a

Less: direc t expe nses . . . . b

0

0o

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross income from fundraising

events (not including $ o

of contributions reported on line 1c).


Less: direc t expe nses . . . . b 0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Net income or (loss) from fundraising e ve nt s 0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross income from gaming activities.


Less: direct expen ses . . . . b

0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross income from gaming activities.


Less: direct expen ses . . . . b 0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Net income or (loss) from gaming acti v it ies . . 0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross sales of inventory, lessreturns and allo wance s . . . a

Less: cost of goo ds sold . . . b

0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c

Gross sales of inventory, lessreturns and allo wance s . . . a

Less: cost of goo ds sold . . . b 0

0

3

4

5

6a

b

c

d

7a

b

cd

8a

b

9a

b

c

10a

b

c Net income or (loss) from sales of invejn to ry . . 0

Miscellaneous Revenue Business Code

167 16711a

b

c

d

e12

Other receip ts 561000 167 16711a

b

c

d

e12

Other receipts

0

11a

b

c

d

e12

Other receipts

0

11a

b

c

d

e12

All other revenue 0

11a

b

c

d

e12

Tota l . Add lines 11a-

Total revenue. See ir

11d . . . . . . . . 167

11a

b

c

d

e12

Tota l . Add lines 11a-

Total revenue. See ir istru ction s 17,993,480 1,190,511 0 16,802,9

Form990(20


10/34


Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must completeallcolumns.Allother organizations must complete column (Arequiredtocomplete columns(B), (C),and(D).

Check i f Schedule O contains a response to any question in th is Part IX . .

Do not include amounts reported on lines 6b, 7b,

8b, 9b, and 10b of Part VIII.

(A)Total expenses

(B)Program service

expenses

(C)Management andgeneral expenses

(D)Fundraisingexpenses

1 Grants and other assistance to governments and

organizations in the United States. See Part IV, line 21 0

2 Grants and other assistan ce to individuals inthe United States. See Part IV, line 22 . . . 0

3 Grants and other assistance to governments,

organizations, and individuals outside the

United States. See Part IV, lines 15 and 16 . . 0

4 Ben ef it s p ai d t o o r f or m em be rs . . . . 0

5 Compen sation of current officers, directors,

trustees, and key employee s 482,993 0 482,993

6 Compensation not included above, to disqualified

persons (as defined under section 4958(f)(1)) and

persons described in section 4958(c)(3)(B) . . 0

7 Other salaries and wage s 0

8 Pension plan accruals and contributions (include

section401(k) and 403(b) employer contributions)0

9 Other empl oyee benefit s 65,493 49,261 16,232

10 Payroll taxes 0

11 Fees for services (non-e mployees) :

a Management 0

b Legal 5,566 5,566

c Accounting 161,632 161,632

d Lobbying 0

e Professional fundraising services. See Part IV, line 17 0 t & ^

f Investmen t man agem ent fees 61.096 61,096

g Other 1,217,951 953,407 264544

12 Advertising and promo tion 11,657 11,657

13 Office expe nses 114,676 104,240 10,436

14 Information techno logy 015 Royalties 0

16 Occupancy 202,823 184,863 17,960

17 Travel 46,938 0 46,938

18 Payments of travel or entertainment expenses

for any federal, state, or local public officials 0

19 Conferences, conventio ns, and meetings 3,190 0 3,190

20 Interest 0

21 Payme nts to affiliates 0

22 Depreciation, deplet ion, and amortization 188,696 173,659 15,037

23 Insurance 329,977 50,175 279,802

24 Other expenses. Itemize expenses not covered

above. (List miscellaneous expenses in line 24e. If

line 24e amount exceeds 10% of line 25, column(A) amount, list line 24e expenses on Schedule O.) .

a Trustee Agenc y Fees 1,293,086 1,293,086

b Alloca ted Salaries/Wages & Taxes 550,910 360,799 190,111

c Manage ment Fees 22,822 22,822

d Bad Debt 2,328 2,328

e All other expe nses 0

25 Tota l func tion al expenses. Add lines1through 24e 4,761,834 3,255,736 1,506,098

26 Joi nt cos ts. Complete this line only if theorganization reported in column (B) joint costsfrom a combined educational campaign andfundraising solicitation. Check here D iffol lowing SOP 98-2 (ASC 958-720) . . . .

Form99 0(20


11/34


12-Ti9:m Balance Sheet12(A)

Beginning of year(B)

End of year

1 Cashnon-interest-bearing 1,264,778 1 1,256,0

2 Savings and temporary cash investments

3 Pledges and grants receivable, net

4 Accounts receivable, net

403,030 2 323,02 Savings and temporary cash investments


4 Accounts receivable, net

0 3

2 Savings and temporary cash investments


4 Accounts receivable, net 0 4 7,9

5 Receivables from current and former officers, directors, trustees, keyemployees, and highest compensated employees. Complete Part II ofSchedule L 5

6 Receivables from other disqual ified persons (as defined under section4958(f)(1)), persons described in section 4958(c)(3)(B), and contributingemployers and sponsoring organizations of section 501(c)(9) voluntaryemployees' beneficiary organizations (see instructions)

7 Notes and loans receivable, net

5

2


7 Notes and loans receivable, net

6

I


7 Notes and loans receivable, net 142,573 7 172.0

% 8 Inventories for sale or use 8

9 Prepaid expenses and deferred charges 1,585 9 610a Land, buildings, and equipment: cost or

other basis. Complete Part VI of Schedule D

b Less: accumulated depreciat ion . . . .

10a 4,783,326

3,478,316 10c

!, 10a Land, buildings, and equipment: cost orother basis. Complete Part VI of Schedule D

b Less: accumulated depreciat ion . . . . 10b 1,340,222 3,478,316 10c 3,443,1

11 Investmentspublicly traded securities . . 330,489,347 11 332,020,7

,.12 Investmentsother securities. See Part IV, line 11 . . . .13 Investmentsprogram-related. See Part IV, line 11 . . . .

14 Intangible assets

15 Other assets. See Part IV, line 11

16 Total assets.Add lines1through 15 (must equal line 34) . .

8,753,28412

8,452,9,.12 Investmentsother securities. See Part IV, line 11 . . . .13 Investmentsprogram-related. See Part IV, line 11 . . . .




0 13,.12 Investmentsother securities. See Part IV, line 11 . . . .13 Investmentsprogram-related. See Part IV, line 11 . . . .




0 14





30,593,910 15 29,816,5




16 Total assets.Add lines1through 15 (must equal line 34) . . 375,126,823 16 375,493,1

17 Accounts payable and accrued expenses

18 Grants payable

19 Deferred revenue

1,746,627 17 853,017 Accounts payable and accrued expenses

18 Grants payable

19 Deferred revenue

18

17 Accounts payable and accrued expenses

18 Grants payable

19 Deferred revenue 19

20 Tax-exempt bond liabilities 20

21 Escrow or custodial account liabil ity. Complete Part IV of Schedule D .

22 Payables to current and former officers, directors, trustees, keyemployees, highest compensated employees, and disqualified persons.Complete Part II of Schedule L

21

121 Escrow or custodial account liabil ity. Complete Part IV of Schedule D .

22 Payables to current and former officers, directors, trustees, keyemployees, highest compensated employees, and disqualified persons.Complete Part II of Schedule L 22

(Q

23 Secured mortgages and notes payable to unrelated third parties . .24 Unsecured notes and loans payable to unrelated third parties . . .

25 Other liabilities (including federal income tax, payables to related thirdparties, and other liabilities not included on lines 17-24). Complete Part Xof Schedule D

22

- i 23 Secured mortgages and notes payable to unrelated third parties . .24 Unsecured notes and loans payable to unrelated third parties . . .


22,105,005 23 23,705,023 Secured mortgages and notes payable to unrelated third parties . .24 Unsecured notes and loans payable to unrelated third parties . . .


0 2423 Secured mortgages and notes payable to unrelated third parties . .24 Unsecured notes and loans payable to unrelated third parties . . .


0

25

26 Total liabiliti es.Add lines 17 through 25

0

25

26 Total liabiliti es.Add lines 17 through 25 23,851,632 26 24,558,0

1Organizations that follow SFAS 117, check here and completelines 27 through 29, and lines 33 and 34.

27 Unrestricted net assets 351,275,191 27 350,935,0

g28 Temporarily restricted net assets 28

g 29 Permanently restricted net assets 29

1o

J2

Organizations that do not fo llow SFAS 117, clcomp lete lines 30 through 34.

30 Capital stock or trust principal, or current funds31 Paid-in or capital surplus, orland,building, or ec

leek here and

30

1

Organizations that do not fo llow SFAS 117, clcomp lete lines 30 through 34.

30 Capital stock or trust principal, or current funds31 Paid-in or capital surplus, orland,building, or ecjuipment fund . . . 31< 32 Retained earnings, endowment, accumulated income, or other funds .

33 Total net assets or fund balances

32

232 Retained earnings, endowment, accumulated income, or other funds .

33 Total net assets or fund balances 351,275,191 33 350,935,0234 Total liabilities and net assets/ fund balances 375,126,823 34 375,493,1

Form990 (2


12/34


Reconcil iat ion of Net Assets

Check if Schedule O contains a response to any question in this Part XI

1

2

3

4

5

6

Total revenue (must equal PartVIII,column (A), line 12) 1 17,993,4

Total expenses (must equal Part IX, column (A), line 25) 2 4,761,8

Revenue less expenses. Subtract line 2 from line 1 3 13,231,6

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)). . . 4 351,275,1

Other changes in net assets or fund balances (explain in Schedule 0) 5 -13,571,7

Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33,column (B)) 6 350,935,06 350,935,0

I2 2 S ED T F inancia l Statements and Repor t ing

Check if Schedule O contains a response to any question in this Part XII

1 Accounting method used to prepare the Form 990: Cash 0 Accrual OtherIf the organization changed its method of accounting from a prior year or checked "Other," explain in

Schedule O.

2a Were the organization's financial statements compiled or reviewed by an independent accountant? . . .b Were the organization's financial statements audited by an independent accountant?c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight

of the audit, review, or compilation of its financial statements and selection of an independent accountant?If the organization changed either its oversight process or selection process during the tax year, explain in

Schedule O.d If "Yes" to line 2a or 2b, check a box below to indicate whether the financial statements for the year wereissued on a separate basis, consolidated basis, orboth:

Separate basis 0 Consol idated basis D Both consolidated and separate basis3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in

the Single Audit Act and OMB Circular A-133?

b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo therequired audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits

2a

2b

2c

3a

3b

Yes N

/

/

/

/

Form 9 9 0 (2


13/34

SCHEDULE A(Form 990 or 990-EZ)

Department of the TreasuryInternal Revenue Service

Public Charity Status and Public SupportComplete if the organization is a section 501(c)(3) organization or a section

4947(a)(1) nonexempt charitable trust

Attach to Form 990 or Form 990-EZ. See separate instructions.

OMBNo 1545-0047

'OH

Name of the organization

Deaconess Associations, Inc.

Open to Public

InspectionEmployer identification number

31-1209377

Reason for Public Charit y Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines1through 11 ,check only one box.)

1 D A church, convention of churches, or association of churches described in sec tio n 170(b)(1)(A)(i).

2 D A school described in sect ion 170(b)(1)(A)(ii). (Attach Schedule E.)

3 D A hospital or a cooperative hospital service organization described in sec tion 170(b)(1)(A)(iii).4 D A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the

hospital's name, city, and state:

5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in sec tio n 170(b)(1)(A)(v). An organization that normally receives a substantial part of its support from a governmental unit or from the general pub

described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in sec tion 170(b)(1)(A)(vi). (Complete Part II.)

D An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and groreceipts from activities related to its exempt functionssubject to certain exceptions, and (2) no more than 33V3% of isupport from gross investment income and unrelated business taxable income (less section 511 tax) from businesseacquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

D An organization organized and operated exclusively to test for public safety. See sec tion 509(a)(4).

IZI An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out thpurposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See sectio509(a)(3). Check the box that describes the type of supporting organization and complete lines11e through 11h.

a Type I b Type II c 0 Type lll-Functionally integrated d Type Ill-Other

e 0 By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disquali fied personother than foundation managers and other than one or more publicly supported organizations described in section 509(a)(or section 509(a)(2).If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supportingorganization, check this box

Since August 17, 2006, has the organization accepted any gift or contribution from any of thefollowing persons?

(j) A person who directly or indirectly controls, either alone or together with persons descr ibed in (ii) and(iii) below, the governing body of the supported organization?

(ii) A family member of a person descr ibed in (i) above?

(iii)A 35% controlled entity of a person described in (i) or (n) above?Provide the following information about the supported organization(s).

10

11

f

g

Yes No

ng(i) /

11g() /

11g(iifl /

(i) Name of supportedorganization

(ii) EIN (iii)Type of organization(described on lines 1-9above or IRC section(see instructions))

(iv) Is the organizationin col (i) listed in yourgoverning document?

(v)Did you notifythe organization in

col (i) of yoursupport?

(vi) Is theorganization in col(i) organized in the

US?

(vii)Amount ofsupport

(ii) EIN (iii)Type of organization(described on lines 1-9above or IRC section(see instructions))

Yes No Yes No Yes No

i\ DeaconessHealthcare Services 31-1365388 3 / / / 52,05

ia\ Deaconess LongTerm Care 31-1391195 11b / /

IQ\ Deaconess Hospitalof Ci nt i. OH 31-0537109 11b / / / 2,241,75

in\ Deaconess HealthAss oc. Fund 31-1209378 11b / / / 368,47

(E)

Total

For Paperwork Reduction Act Notice, see the Instructions forForm 990 or 990-EZ.

Cat No 11285F Schedule A (Form 990 or 990-EZ) 20


14/34

Version A, cycle

Schedule A (Form 990 or 990-EZ) 2011 Pag

Supp ort Sc hedu le fo r Organ izati ons Descri bed in Secti on s 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under

Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)Section A. Public Support

Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d)2010 (e) 2011 (f) Total1 Gifts, grants, contributions, and

membership fees received. (Do notinclude any "unusual grants.") . . .

2 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

3 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

4 Total.Add lines1through 3 . . . .

5 The portion of total contributions byeach person (other than agovernmental unit or publiclysupported organization) included online 1 that exceeds 2% of the amountshown on line 11 ,column (f) . . . .

6 Public support. Subtract line 5 from line 4.Section B. Total Support

Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d)2010 (e) 2011 (f) Total7 Amounts from line 4

8 Gross income from interest, dividends,payments received on securities loans,rents, royalties and income from similarsources

9 Net income from unrelated businessactivities, whether or not the businessis regularly carried on

10 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part IV.)

11 Total support.Add lines 7 through 1012 Gross receipts from related activit ies, etc . (see instructu3ns) . . . 1213 First five years. If the Form 990 is for the organization's first, second,third, fourth, or fifth tax year as a section 501(c)(3)

organization, check this box andstop here Section C. Computat ion of Public Support Percentage

14

15

16a

17a

14

15

18

Public support percentage for2011(line 6, column (f) divided by line 11 ,column (f)) . . . .Public support percentage from 2010 Schedule A, Part II, line 14331/3%supporttest 2011.If the organization did not check the box on line 13, and line 14 is 33V3% or more, check thisbox andstop here.The organization qualifies as a publicly supported organization

331/3% support test2010. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more,check this box andstop here.The organization qualifies as a publicly supported organization

10%-facts-and-circumstances test2011.If the organization did not check a box on line 13, 16a, or 16b, and line 14 is

10%or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.Explain inPart IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supportedorganization

10%-facts-and-circumstances test2010.If the organization did not check a box on line 13, 16a, 16b, or 17a, and line15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publiclysupported organization

Private foundation.If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and seeinstructions

Schedule A (Form 990 or 990-EZ) 2


15/34


Support Schedule for Organizations Described in Sectio n 509(a)(2)(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II.If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in) (a) 2007 (b)2008 (c) 2009 (d)2010 (e) 2011 (f) Total1 Gifts, grants, contributions, and membership fees

received.(Donot include any "unusual grants.')2 Gross receipts from admissions, merchandise

sold or services performed, or facilities

furnished in any activity that is related to theorganization's tax-exempt purpose . . .3 Gross receipts from activities that are not an

unrelated trade or business under section 513

4 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

5 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

6 Total.Add lines1through 5 . . . .7a Amounts included on lines 1, 2, and 3

received from disqualified persons

b Amounts included on lines 2 and 3received from other than disqualifiedpersons that exceed the greater of $5,000or1 %of the amount on line 13 for the year

c Add lines 7a and 7b8., Public support (Subtract line 7c from

line 6.) i , - "" v

Section B. Total Support

Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d)2010 (e) 2011 (f) Total

9 Amounts from line 6

10a Gross income from interest, dividends,payments received on securities loans, rents,royalties and income from similar sources .

b Unrelated business taxable income (lesssection 511 taxes) from businessesacquired after June 30,1975 . . . .

c Add lines 10a and 10b

11 Net income from unrelated businessactivities not included in line 10b, whetheror not the business is regularly carried on

12 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part IV.)

13 Total support. (Add lines 9, 10c, 11,and 12.)

14 First five years. If the Form 990 is for the organization's first, second, third, fourth,

organization, check this box andstop here

or fifth tax year as a section 501(c)(3)

Section C. Computation of Public Support Percentage15

16

Public support percentage for 2011 (line 8, column (f) divided by line 13, column (f))

Public support percentage from 2010 Schedule A, Part III, line 15

15

16

Section D. Computat ion of Investment Income Percentage

17

18

19a

17

18

Investment income percentage for2011 (line 10c, column (f) divided by line 13, column (f)) . .Investment income percentage from2010Schedule A, Part III, line 1733V3%support tests2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line17 is not more than 331/3%, check this box andstop here.The organization qualifies as a publicly supported organization

b 331/3% support tests2010.If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, andline 18 is not more than 331/3%, check this box andstophere. The organization qualifies as a publicly supported organization

20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions



16/34


Q S 3 Q Supplemental Information.Complete this part to provide the explanations required by Part II, line 10;Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (Seeinstructions).



17/34

SCHEDULE DSupplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,Part IV, line 6, 7,8,9,10,11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.

Attach to Form 990. See separate instructions.

OMBNo 1545-0047

(Form 990) Supplemental Financial StatementsComplete if the organization answered "Yes," to Form 990,

Part IV, line 6, 7,8,9,10,11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.Attach to Form 990. See separate instructions.

I11Department of the TreasuryInternal Revenue Service

Supplemental Financial StatementsComplete if the organization answered "Yes," to Form 990,

Part IV, line 6, 7,8,9,10,11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.Attach to Form 990. See separate instructions.

Open to PublicInspection


Deaconess Associations, Inc.

Employer identification number

31-1209377

Organizat ions Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the

organization answered "Yes" to Form 990, Part IV, line 6.(a) Donor advised funds (b) Funds and other accounts

1 Total number at end of year

2 Aggregate contributions to (during year) .

3 Aggregate grants from (during year) . .

4 Aggregate value at end of year . . . .5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised

funds are the organization's property, subject to the organization's exclusive legal control? p j Yes N

6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be usedonly for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purposeconferring impermissible private benefit? f j Yes N

Conservat ion Easements.Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use(e.g.,recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure Preservation of open spaceComplete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservationeasement on the last day of the tax year.

Held at the End of the Tax Ye

2a

2b

2c

2d

4

5

Total number of conservation easements

Total acreage restricted by conservation easements

Number of conservation easements on a certified historic structure included in (a) . . . .Number of conservation easements included in (c) acquired after 8/17/06, and not on ahistoric structure listed in the National Register

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during thtax year

Number of states where property subject to conservation easement is located

Does the organization have a written policy regarding the periodic monitoring, inspection, handling ofviolations, and enforcement of the conservation easements it holds? Yes D N

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year

$8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)

(i) and section 170(h)(4)(B)(ii)? D Yes D N

9 In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, andbalance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes theorganization's accounting for conservation easements

I 2 Q D D Organizat ions Maintain ing Col lect ions of Ar t , H istor ical Treasures, or Other Simi lar Assets.

Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance shworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance public service, provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

b If the organization elected, as permit ted under SFAS 116 (ASC 958), to report in its revenue statement and balance shworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance public service, provide the following amounts relating to these items:

(i) Revenues included in Form 990, PartVIII,line1 $

(ii) Assets included in Form 990, Part X $2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide t

following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

a Revenues included in Form 990, PartVIII,line1 $

b Assets included in Form 990, Part X $

For Paperwork Reduction Act Noti ce, see the Instructions for Form 990. Cat No 52283D ScheduleD(Form990)2


18/34

Schedule D (Form 990) 2011 Pag

Organizat ions Maintaining Collect ions of Art, Histor ical Treasures, or Other Similar Assets (continued3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of

collection items (check all that apply):

a Public exhibition d Loan or exchange programs

b Scholarly research e Other

c Preservation for future generations

* Provide a description of the organization's collections and explain how they further the organization's exempt purpose in P

XIV.

5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similarassets to be sold to raise funds rather than to be maintained as part of the organization's collection? . . r j Yes N

Escrow and Custodia l Ar rangements. Comp lete if the organization answered "Ye s" to Form 990, Part IV

line 9, or reported an amount on Form 990, Part X, line 21.Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets notincluded on Form 990, Part X? r j Yes NIf "Yes," explain the arrangement in Part XIV and complete the following table:

1a

b

c

d

e

f

2a

b

1abc

de

f

92

abc

3a

1c1d

1e

Beginning balance

Additions during the year

Distributions during the year

Ending balance . . . .

Did the organization include an amount on Form 990, Part X, line 21? Yes 0 N

If "Yes," explain the arrangement in Part XIV.

1f

Amount

PM Endow ment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years bac

Beginning of year balance . . .

ContributionsNet investment earnings, gains, andlosses

Grants or scholarships . . . .Other expenditures for facilities andprograms

Administrative expenses . . . .

End of year balance

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment %Permanent endowment %

Temporarily restricted endowment %

The percentages in lines 2a, 2b, and 2c should equal 100%Are there endowment funds not in the possession of the organization that are held and administered for theorganization by:

(i) unrelated organizations

(ii) related organizations

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R?Describe in Part XIV the intended uses of the organization's endowment funds.

Yes N

3a(i)

3a(ii)

3b

uiaavtu Land , Buildi ngs, and Equipm ent. See Form 990, Part X, line 10.

Description of property (a) Cost or other basis(investment)

(b) Cost or other basis(other)

(c) Accumulateddepreciation

(d) Book value

1a Land 691,795 0 691,7b Buildings 0 3,188,837 694,449 2,494,3

c Leasehold improvements . . . . 0 0 0

d Equipment 0 902,694 645773 256,9

e Other

Total.Add lines 1a through 1e.(Column (d) must equal Form 990, PartX,column (B),line 10(c).} . . . . 3,443,10

Schedul e D (Form 990) 2


19/34


WJttAHm InvestmentsOther Secur i t ies.See Form 990, Part X, line 12.

(a) Description of security or category(including name of security)

(b)Book value (c) Method of valuationCost or end-of-year market value

(1) Financial derivatives

(2) Closely-held equity interests

(3) Other(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(I)

Total.(Column(b)must equalForm 990,PartX, col.(B) line 12.)

Ig iTgVi l l l Investments Program Related. See Form 990, Part X, line 13.

(a) Descnption of investment type (b) Book value (c) Method of valuationCost or end-of-year market value

(D(2)

(3)(4)

(5)

(6)

(7)

(8)

(9)

(10)

Total.(Column(b)must equalForm990, PartX,col (B)line13)

Other Assets.See Form 990, Part X, line 15.(a) Description (b) Book value

(1) Due Fro m Aff il i ates 29.816,5

(2)

(3)(4)

(5)

(6)

( 7 ) -

(8)

(9)

(10)

Total.(Column (b) must eaual Form 990, Part X, col. (B) line 15.)

Other Liabil i t ies.See Form 990, Part X, line 25.1 . (a) Descnption of liabilit y (b) Book value

(1) Federal income taxes 0

(2)

(3)(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

Total.(Column(b)must equal Form990,PartX,col (B)line25.) 0

2.FIN 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports theorganization's liability for uncertain tax positions under FIN 48 (ASC 740).

Schedule D (Form 990) 20


20/34


Reconciliation of Change in Net Assets from Form 990 to Audited Financial Statements

1 Total revenue (Form 990, PartVIII,column (A), line 12)

2' Total expenses (Form 990, Part IX, column (A), line 25)

3 Excess or (deficit) for the year. Subtract line 2 from line 1

4 Net unrealized gains (losses) on investments

5 Donated services and use of facili ties

6 Investment expenses

7 Prior period adjustments

8 Other (Describe in Part XIV.)9 Total adjustments (net). Add lines 4 through 8 . . . . . .10 Excess or (deficit) for the year per audited financial statements. Combine lines 3 and 9

Part XII10

17,993,48

4,761,83

13,231,64

13,231,64

Reconcil iat io n of Revenue per Audited Financial Statemen ts With Revenue per Return

3

4

Total revenue, gains, and other support per audited financial statements

Amounts included on line1but not on Form 990, PartVIII,line 12:

Net unrealized gains on investments

Donated services and use of facilities

Recoveries of prior year grants

Other (Describe in Part XIV.)

Add lines 2a through 2d . . . .

Subtract line 2e from line 1 . . . .

Amounts included on Form 990, PartVIII,line 12, but not on line1:

Investment expenses not included on Form 990, PartVIII,line 7b . .Other (Describe in Part XIV.)

Add lines4aand4b

2a

2b

2c

2d

4a4bab

c5 Total revenue. Add lines 3 and 4c.(This must equal Form 990, Part I, line 12.)

1

2e

4c

17,993,4

17,993,8

Reconcil iat ion of Expenses per Audited Financial Statements With Expenses per Return

1

2

3

4

Total expenses and losses per audited financial statements . .

Amounts included on line1but not on Form 990, Part IX, line 25:

Donated services and use of facilities

Prior year adjustments

Other losses


Add lines 2a through 2d

Subtract line 2e from line 1

Amounts included on Form 990, Part IX, line 25, but not on line 1:Investment expenses not included on Form 990, PartVIII,line 7b


Add lines 4a and 4b

2a

2b

2c

2d

4a

4b

5 Total expenses. Add lines 3 and 4c.(This must equal Form 990, Part I, line 18.)

2e

4c

4,761,8

4,761,8

Supplementa l In format ion

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b;Part V, line 4; Part X, line 2; PartXI,line 8; Part XII, lines 2d and 4b; and PartXIII,lines 2d and 4b. Also complete this part to provideanv additional information.

Schedule D (Form 990) 2


21/34

Schedule D (Form 990) 2011 Page

Supplemental Information (continued)

Schedul e D (Form 990) 20


22/34

SCHEDULE J Compensation InformationFor certain Officers, Directors, Trustees, Key Employees, and Highest

Compensated Employees Complete if the organization answered "Yes" to Form 990,

Part IV, line 23. Attach to Form 990. See separate instructions.

OMB No 1545-0047

(Form 90)Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and HighestCompensated Employees

Complete if the organization answered "Yes" to Form 990,Part IV, line 23.

Attach to Form 990. See separate instructions.

2011Department of the TreasuryInternal Revenue Service

Compensation InformationFor certain Officers, Directors, Trustees, Key Employees, and Highest

Compensated Employees Complete if the organization answered "Yes" to Form 990,

Part IV, line 23. Attach to Form 990. See separate instructions.

Open to PublicInspection


DEACONESS ASSOCIATIONS, INC.

Employer identification number

31-1209377

Quest ions Regarding Compensat ion

1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form990,PartVII,Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax indemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g.,maid, chauffeur, chef)

b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding paymentor reimbursement or provision of all of the expenses described above? If "No," complete Part III toexplain

2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a?

3 Indicate which, if any, of the following the filing organization used to establish the compensation of theorganization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a

related organization to establish compensation of the CEO/Executive Director Explain in Part III.

0 Compensation committee Written employment contract

0 Independent compensation consultant 0 Compensation survey or study

Form 990 of other organizations 0 Approval by the board or compensation committee

4 ' During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filingorganization or a related organization:

a Receive a severance payment or change-of-control payment?

b Participate in, or receive payment from, a supplemental nonqualified retirement plan?

c Participate in, or receive payment from, an equity-based compensation arrangement?

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only section 501(c)(3) and 501(c)(4)organizations must complete lines 5-9.5 For persons listed in Fo

deaconess associations 2011 irs 990

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