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KENMORE MERCY HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
KENMORE MERCY HOSPITAL (EIN 16-0762843)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-01
IRS object ID
201943059349301889
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-01T16:24:28-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN160762843EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kenmore Mercy HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKENMBusinessNameControlTxt
Phone7168282974PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Catholic Health 144 Genesee StAddressLine1Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid P MacholzPersonNm
Person TitleTreasurer CHS MS BoardPersonTitleTxt
Phone7168282974PhoneNum
Signature2019-11-01SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address204.68.186.4IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-01IPDt
IP Tm16:24:23IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id924F5484B370A9FF257601B07D0C5CFB195EBBD3AtSubmissionCreationDeviceId
At Submission Filing Device Id06E798C64FE9B4A74D95EF11437255C02E87A9E2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMark SullivanPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1144 Genesee Street AdministrationAddressLine1Txt
Address Line26th FloorAddressLine2Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$181,560,612GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.chsbuffalo.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1957FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionThe Mission of Kenmore Mercy Hospital, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Kenmore Mercy Hospital continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2018 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/communityActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee1516TotalEmployeeCnt
Total Volunteers978TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$43,951NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,317,416PYContributionsGrantsAmt
CY Contributions Grants$276,746CYContributionsGrantsAmt
PY Program Service Revenue$169,349,854PYProgramServiceRevenueAmt
CY Program Service Revenue$181,936,350CYProgramServiceRevenueAmt
PY Investment Income$2,134,755PYInvestmentIncomeAmt
CY Investment Income-$602,536CYInvestmentIncomeAmt
PY Other Revenue$1,449,936PYOtherRevenueAmt
CY Other Revenue-$49,948CYOtherRevenueAmt
PY Total Revenue$174,251,961PYTotalRevenueAmt
CY Total Revenue$181,560,612CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$75,311,615PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$78,095,911CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$94,107,292PYOtherExpensesAmt
CY Other Expenses$96,145,975CYOtherExpensesAmt
PY Total Expenses$169,418,907PYTotalExpensesAmt
CY Total Expenses$174,241,886CYTotalExpensesAmt
PY Revenues Less Expenses$4,833,054PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$7,318,726CYRevenuesLessExpensesAmt
Total Assets BOY$160,498,161TotalAssetsBOYAmt
Total Assets EOY$167,922,912TotalAssetsEOYAmt
Total Liabilities BOY$121,554,491TotalLiabilitiesBOYAmt
Total Liabilities EOY$119,575,211TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$38,943,670NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$48,347,701NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe Mission of Kenmore Mercy Hospital, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Kenmore Mercy Hospital continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2018 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/communityMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$83,723,073ExpenseAmt
Revenue$103,291,586RevenueAmt
DescInpatient Routine/Surgery Visits: Acute Care Patient Days = 31,343Medical Rehab Patient Days = 4,953Skilled Nursing Patient Days = 53,267IP Surgeries = 3,483Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$60,920,490ExpenseAmt
Revenue$75,159,377RevenueAmt
DescOutpatient Routine/Surgery Services:Emergency Visits (Net of Admits) = 31,251Referred Ambulatory Visits = 60,438Operating Room = 2,760G.I. Laboratory = 1,551Interventional Radiology = 1,203Transfusion/Infusion = 43Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,825,087ExpenseAmt
Revenue$3,485,391RevenueAmt
DescClinic/Primary Care Services:Primary Care Visits = 16,872Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$147,468,650TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document122IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1516EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1David P Macholz VP FinanceCorp Controller CHSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7168282974PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1144 Genesee StreetAddressLine1Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Joseph McDonald
President and CEO, CHS0.0055.00Yes (X)Yes (X)$0$1,217,317$29,530
Mark Sullivan
President and CEO, CHS0.0055.00Yes (X)Yes (X)$0$1,126,042$93,913
James Millard
President and CEO, Kenmore Mercy55.000.00Yes (X)Yes (X)$316,719$0-$50,019
Walter Ludwig
President and CEO, Kenmore Mercy55.000.00Yes (X)Yes (X)$296,019$0$49,141
David Macholz
Treasurer0.0055.00Yes (X)Yes (X)$0$286,087$33,427
Gary Tucker
Director0.0055.00Yes (X)$0$379,138$49,345
Joyce Markiewicz
Director0.0055.00Yes (X)$0$425,967$78,638
Martin Boryszak
Director0.0055.00Yes (X)$0$371,258$27,945
Brian Beitz
Director0.008.00Yes (X)$0$0$0
Lynn Catalano
Director0.004.00Yes (X)$0$0$0
John Davanzo
Director0.004.00Yes (X)$0$0$0
Georgiana Ford Esq
Director0.004.00Yes (X)$0$0$0
Dr Donald J Largo Jr
Director0.0055.00Yes (X)$0$93,606$0
Mary Turkiewiecz MD
Director0.004.00Yes (X)$0$0$0
Katherine Vanderhorst
Director0.004.00Yes (X)$0$0$0
Monsignor Robert E Zapfel
Director0.004.00Yes (X)$0$0$0
Charles J Urlaub
Director0.0055.00Yes (X)$0$461,578$45,568
James A Dunlop Jr
Executive VP / COO0.0055.00Yes (X)$0$774,324$18,105
Dr Brian D'Arcy
Senior VP, Medical Affairs0.0055.00Yes (X)$0$559,472$43,350
Dr Michael Galang
Sr. VP, Chief Information Officer0.0055.00$0$533,930$33,302Yes (X)
Nancy Sheehan
SVP Legal Service, General Counsel0.0055.00$0$393,915$46,854Yes (X)
Dr James Fitzpatrick
Physician55.000.00$350,392$0$37,676Yes (X)
Dr Michael Edbauer
Chief Clincal Officer0.0028.00$0$508,629$18,325Yes (X)
Maria Foti
Sr. VP, Strategic Planning0.0055.00$0$391,140$46,311Yes (X)
Michael Moley
Sr.VP, Human Resources0.0055.00$0$604,916$42,703Yes (X)
Dr Thomas Brewer
Physician55.000.00$294,903$0$23,442Yes (X)
Dr Michael Gough
Physician55.000.00$317,855$0$30,451Yes (X)
Dr Erik Diringer
Physician55.000.00$300,726$0$4,086Yes (X)
Cheryl Hayes
Director of Nursing55.000.00$191,399$0$19,153Yes (X)
Dr Nadia Polataiko
Physician55.000.00$217,892$0-$25,376Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,285,905TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,127,319TotReportableCompRltdOrgAmt
Total Other Compensation$695,870TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K55IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Trimedx LLC
5451 Lakeview Pkwy S DriveIndianapolisIN46268Clinical Engineering Services$1,138,909
Telco Construction Inc
500 Buffalo RdEast AuroraNY14052Construction Services$869,272
Buffalo Niagara Hospitalists
2950 Elmwood Ave/Med Staff OfficeKenmoreNY14217Physician Services$860,905
AMN Healthcare Inc
2735 Collection Center DriveChicagoIL60693Healthcare Services$729,731
Picone Construction Corporation
10995 Main StreetClarenceNY14031Construction Services$654,176
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K27CntrctRcvdGreaterThan100KCnt
All Other Contributions$276,746AllOtherContributionsAmt
Total Contributions$276,746TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenu900099$129,502,941$129,502,941
Medicare/Medicaid900099$52,433,409$52,433,409
FieldValueIRS element (for citing)
Total Program Service Revenue$181,936,350TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$602,536TotalRevenueColumnAmt
Related Or Exempt Func Income$170,010RelatedOrExemptFuncIncomeAmt
Exclusion-$772,546ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$484,056RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$484,056RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$484,056TotalRevenueColumnAmt
Exclusion$484,056ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Shared Service900099$484,610$484,610
DSRIP Revenue900099$262,278$262,278
Net Periodic Pension900099-$1,658,947-$512,947-$1,146,000

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$378,055TotalRevenueColumnAmt
Exclusion$378,055ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total-$534,004OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$181,560,612TotalRevenueColumnAmt
Related Or Exempt Func Income$182,078,023RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$794,157ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$61,462,765TotalAmt
Program Services$54,937,405ProgramServicesAmt
Management And General$6,525,360ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,161,402TotalAmt
Program Services$1,931,931ProgramServicesAmt
Management And General$229,471ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,095,057TotalAmt
Program Services$9,023,288ProgramServicesAmt
Management And General$1,071,769ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,376,687TotalAmt
Program Services$3,912,024ProgramServicesAmt
Management And General$464,663ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$78,565TotalAmt
Program Services$260ProgramServicesAmt
Management And General$78,305ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,442,577TotalAmt
Program Services$3,460,146ProgramServicesAmt
Management And General$982,431ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$94,241TotalAmt
Program Services$830ProgramServicesAmt
Management And General$93,411ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,041,808TotalAmt
Program Services$1,311,536ProgramServicesAmt
Management And General$2,730,272ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$86,249TotalAmt
Program Services$3,389ProgramServicesAmt
Management And General$82,860ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,797,387TotalAmt
Program Services$1,348,040ProgramServicesAmt
Management And General$449,347ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,223TotalAmt
Program Services$2,034ProgramServicesAmt
Management And General$5,189ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,707TotalAmt
Program Services$3,829ProgramServicesAmt
Management And General$9,878ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,054,701TotalAmt
Program Services$1,551,724ProgramServicesAmt
Management And General$502,977ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,652,184TotalAmt
Program Services$5,922,479ProgramServicesAmt
Management And General$1,729,705ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,714,665TotalAmt
Program Services$1,461,889ProgramServicesAmt
Management And General$252,776ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$38,132,776$38,368,689-$235,913
Dues & Shared Services$25,395,361$18,792,567$6,602,794
Purchased Services & Ot$9,012,962$4,193,821$4,819,141
Other Supplies Non Medi$1,621,569$1,242,769$378,800

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$174,241,886TotalAmt
Program Services$147,468,650ProgramServicesAmt
Management And General$26,773,236ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,432BOYAmt
EOY$2,432EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$37,154,095BOYAmt
EOY$48,498,699EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,941,430BOYAmt
EOY$18,050,959EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,825,104BOYAmt
EOY$2,503,261EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$430,940BOYAmt
EOY$571,006EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$137,219,609LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$81,701,044LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$57,010,374BOYAmt
EOY$55,518,565EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$23,182,873BOYAmt
EOY$22,008,441EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,950,913BOYAmt
EOY$20,769,549EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$160,498,161BOYAmt
EOY$167,922,912EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$20,825,418BOYAmt
EOY$21,573,820EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,757,479BOYAmt
EOY$21,117,315EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$12,263,457BOYAmt
EOY$12,146,642EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$65,708,137BOYAmt
EOY$64,737,434EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,554,491BOYAmt
EOY$119,575,211EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$38,794,934BOYAmt
EOY$48,171,148EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$148,736BOYAmt
EOY$176,553EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,943,670BOYAmt
EOY$48,347,701EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$160,498,161BOYAmt
EOY$167,922,912EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$7,318,726ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$2,085,305OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$8,928OtherActivitiesAmt
Total Lobbying Expenditures$8,928TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationOther lobbying activities: Lobbying expenses of $8,928 represent the total of dues paid to national and state associations that is specifically allocable to lobbying. Kenmore Mercy Hospital does not participate in or intervene in (including the publishing or distributing of statement) any political campaign on behalf of (or opposition to) any candidate.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$235,852InvestmentCostOrOtherBasisAmt
Book Value$235,852BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$61,705,510InvestmentCostOrOtherBasisAmt
Depreciation$37,482,260DepreciationAmt
Book Value$24,223,250BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$21,240,304InvestmentCostOrOtherBasisAmt
Depreciation$5,966,492DepreciationAmt
Book Value$15,273,812BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$52,336,465InvestmentCostOrOtherBasisAmt
Depreciation$37,498,533DepreciationAmt
Book Value$14,837,932BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,701,478InvestmentCostOrOtherBasisAmt
Depreciation$753,759DepreciationAmt
Book Value$947,719BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$55,518,565TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescAscension Investment ManagementDesc
Book Value$22,008,441BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$22,008,441TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Insurance Recoveries$14,172,136
Interest in Net Assets of KMH Foundation, Inc.$3,227,108
Due from Affilates$1,536,005
Other Receivables$1,829,007
Interest in Net Assets of CCD Foundation, Inc.$5,293
FieldValueIRS element (for citing)
Total Book Value Other Assets$20,769,549TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Pension Obligation$31,096,359
Long-Term Portion Of Insurance Liabilities$22,109,548
Due to Affiliates$12,209,776
Asset Retirement Obligation$197,275
Debt Issuance Costs-$875,524
FieldValueIRS element (for citing)
Total Liability$64,737,434TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$181,531,415TotalRevEtcAuditedFinclStmtAmt
Other Revenue$232,063OtherRevenueAmt
Revenue Not Reported$232,063RevenueNotReportedAmt
Revenue Subtotal$181,299,352RevenueSubtotalAmt
Other Revenues Not Included$261,260OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$261,260RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$181,560,612TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$174,137,612TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$475,340OtherExpensesIncludedAmt
Expenses Not Reported$475,340ExpensesNotReportedAmt
Expenses Subtotal$173,662,272ExpensesSubtotalAmt
Other Expenses Not Included$579,614OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$579,614ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$174,241,886TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part XI, Line 2d - Other Adjustments:Kenmore Mercy Foundation Activity 232063.
Part XI, Line 4b - Other Adjustments:Contributions from Kenmore Mercy Foundation to Kenmore 261260.
Part XII, Line 2d - Other Adjustments:Kenmore Mercy Foundation Expenses (net of eliminations) 475340.
Part XII, Line 4b - Other Adjustments:KMH Homes Expense 579614.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,593,547TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$39,293DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,554,254NetCommunityBenefitExpnsAmt
Total Expense0.00890TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,605,887TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,837,268DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,768,619NetCommunityBenefitExpnsAmt
Total Expense0.05610TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,199,434TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,876,561DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,322,873NetCommunityBenefitExpnsAmt
Total Expense0.06500TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$866,648TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$866,648NetCommunityBenefitExpnsAmt
Total Expense0.00500TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,820,478TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,820,478NetCommunityBenefitExpnsAmt
Total Expense0.01040TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,633,035TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,933,309DirectOffsettingRevenueAmt
Net Community Benefit Expns$699,726NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$315,104TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$315,104NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$575,745TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$575,745NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,211,010TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,933,309DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,277,701NetCommunityBenefitExpnsAmt
Total Expense0.02450TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$45,410,444TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$29,809,870DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,600,574NetCommunityBenefitExpnsAmt
Total Expense0.08950TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,571TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,571NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$92,883TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$92,883NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,582TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,582NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$126,036TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$126,036NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$30,103,809ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$29,821,811CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$281,998MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kenmore Mercy HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12950 Elmwood AveAddressLine1Txt
CityKenmoreCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14217ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.chsbuffalo.orgWebsiteAddressTxt
State License1404000HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherAmbulatory Surgery - Multi SpecialtyOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Kenmore Mercy HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLPart V line 7a page 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLPart V, line 10a page 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.chsbuffalo.org/billing-insurance/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.chsbuffalo.org/sites/default/files/files/billing/catholic-healtFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.chsbuffalo.org/sites/default/files/files/billing/catholic-healtFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
None MadeYes (X)NoneMadeInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section A:Audiology O/PCT Scanner Clinic Part Time ServicesClinical Laboratory Services Coronary Care Dental O/P Emergency Department Health Fairs O/P Intensive Care Medical Social Services Medical/Surgical Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Pediatric O/P Pharmaceutical Service Physical Medical Rehabilitation Physical Medicine and Rehabilitation O/PPrimary Medical Care O/P Radiology - Diagnostic Renal Dialysis - Acute Respiratory Care Therapy - Occupational O/P Therapy - Physical O/P Therapy - Speech Language Pathology
Kenmore Mercy HospitalPart V, Section B, Line 5: Kenmore Mercy Hospital, as part of Catholic Health utilized a variety of sources to develop the health needs assessment to ensure the inclusion of persons who represent the broad interest of the community and have special expertise in, or knowledge of, public health issues and concerns: * Disseminating and promoting the completion of a fifty-seven question survey developed by the Erie County Department of Health to the community at large including Catholic Health's own staff. * Two focus groups including representation from a broad range of health care and social service organizations in Erie County * Western New York Community Health Needs Assessment (December 2014) jointly sponsored by the two Performing Provider Systems in the region linked the Delivery System Reform Incentive Program (DSRIP). * 50 patient interviews (verbal survey) targeting individuals utilizing services at Catholic Health clinics operating within federally designated Health Professional Shortage Areas (HPSA)Focus group participants: Catholic Charities Brylin Hospitals Erie County DOH P2 Collaborative of WNY City of Buffalo community Physician representation Erie County Department of Health Community Meeting Participants Catholic Health American Cancer Society Cazenovia Recovery Systems Friends of Night People Buffalo Fire Department Northwest Community Center Mid Erie Counseling and Treatment Center American Heart Association Meals on Wheels Evergreen Services Pride Center of Western New York United WayFor more information about our CHNA, go to https://www.chsbuffalo.org/mission/social-responsibility-community-benefit
Kenmore Mercy HospitalPart V, Section B, Line 6b: Kenmore Mercy Hospital was conducted with Mercy Hospital and Sisters Hospital and Mount St. Mary's Hospital as well as the Erie County Department of Health.
Kenmore Mercy HospitalPart V, Section B, Line 11: Through the needs assessment, numerous areas were identified as important and clearly impact the health of the community. Catholic Health identified the "significant" needs as the New York State Department of Health Prevention Agenda priorities. Within the "priorities", Catholic Health will address numerous health needs as described in the publicly available CHNA report. One priority area was prioritized lower and not addressed in the implementation plan: Promote a Healthy and Safe Environment. Contributing to this lower priority was lack of available funds and potential for less impact upon the community. Although, should opportunity arise, with resources available to effectively address this need, Catholic Health will reconsider for incorporation in the future.Other needs were identified as part of the Community Health Needs Assessments conducted by Erie County Department of Health, the local DSRIP PPS organizations, and Catholic Health. However, a number of those needs were not incorporated into CH's individual 2016-2018 Community Health Implementation Plans for each of its acute care operations for one or more of the following reasons: * Was not deemed as impactful on the overall health of the community as compare to other identified need * Is being targeted or addressed by other entities within the community * Requires resources that CH does not currently have available without compromising other important initiatives. But, should community circumstances change or additional resources become available, CH will consider incorporating other initiatives into its plan.Among those additional needs not addressed in the 2016-2018 CHIP are: * Need for greater integration of primary care and behavioral health services (being addressed by local PPS organizations via NYS DSRIP *) * Need to address childhood obesity through improved nutrition especially in urban "food deserts and increased exercise programming for children * Continued need to improve access to smoking cessation programs (Roswell Park Cancer Institute leading efforts of local PPS organizations as part of the NYS DSRIP program) * Need to improve educational services to parents in urban areas with regard to asthma management and dangers of lead poisoning * Slowing the rate of HIV infection especially within minority communities (NYS Prep program with local support from Evergreen)The 2016 Erie County Community Health Needs Assessment began by first re-evaluating the needs prioritized in the previous cycle (2013) and the impact of the projects corresponding to those needs that were selected for implementation. Catholic Health's understanding of the communities it serves was then updated by soliciting new input from the public and several community organizations as outlined in the Process and Methods section of this report. This assessment represents a collaborative effort across Catholic Health's facilities as well as with external organizations to identify the health needs of the community and to develop a strategy for addressing them. The systematic process used helped identify significant health needs across Catholic Health's Erie County service area including vulnerable and under-represented populations. Part V, line 7a page 8 https://www.chsbuffalo.org/mission/social-responsibility-community-benefitPart V, line 10a, page 8 https://www.chsbuffalo.org/mission/social-responsibility-community-benefit
Kenmore Mercy HospitalPart V, Section B, Line 16j: Includes information in both English and Spanish on all signage and brochures for financial assistance.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Ken-Ton Family Care
300 Two Mile Creek RoadTonawandaNY14150Extension Clinic: Medical Services - Primary Care
2 - McAuley Residence
1503 Military RoadKenmoreNY14217Long Term Care: Clinical Laboratory Service/Radiology - Diagnostic

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:Kenmore Mercy Hospital Community Benefit Report is contained in the annual report prepared by the Catholic Health System.
Part I, Line 7:Costing is a full step down methodology of cost from non-revenue producing departments to revenue producing departments', with assignment of cost to individual charge items based on volume and charge amount. All patient accounts are cost with the same methodology regardless of patient type (inpatient, outpatient, emergency room, etc.) or insurance coverage (Medicare, Medicaid, private insurance, uninsured, etc.).
Part II, Community Building Activities:Kenmore Mercy Hospital participated in Community Building activities including Community support of $12,571 Environmental improvements of $92,883 and Coalition building of $20,582.
Part III, Line 2:Kenmore Mercy Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue.
Part III, Line 3:Kenmore Mercy Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue.
Part III, Line 4:Kenmore Mercy Hospital does not have a footnote that describes bad debt in the financial statements.
Part III, Line 8:Kenmore Mercy Hospital does not treat Medicare shortfall as a community benefit, as serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations. The existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories.
Part III, Line 9b:The hospital's collection policies contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance. The hospital has implemented billing and collection practices for patient payment obligations that are fair, consistent, and compliant with state and federal regulations and no extraordinary collection practices are followed.
Part VI, Line 2:In addition to its CHNA, Kenmore Mercy Hospital as part of Catholic Health utilizes multiple methods to assess the health care needs of the communities it serves, including:* Evaluations administered by Kenmore Mercy Hospital in coordination with the Catholic Health Community Education Department after each class, workshop, or program it sponsors seeking input on other programs or topics of interest participants would like to see. Based on this feedback, program planners meet with leadership to develop programs or workshops that match community interest/need;* Input from physician community during doctor to doctor education programs. Based on this feedback, program planners meet with leadership to develop physician continuing education programs that address gaps in care or other pressing community health needs. * Patient, resident and caregiver satisfaction surveys conducted in our hospitals, health centers, and nursing homes and among our home care patients, help alert us to health care needs among our patient population; * Physician and leadership participation in community boards, coalitions and forums to define the health needs of patient populations and seek community solutions; * Surveys conducted among high risk, high need Medicaid populations through our collaborative Health Home Program help alert us to the needs of individuals with developmental disabilities and behavioral health issues; * Participation in NYS Delivery System Reform Incentive Program (DSRIP) with Community Partners of WNY initiatives that look at transforming the care of the Medicaid population; * Information management obtains from administrative data and payer mix to assist in evaluating the health needs and trends of the community; and* Input from Catholic Health Board including Board Committee (e.g. Mission Integration Committee).
Part VI, Line 3:Catholic Health's Kenmore Mercy Hospital informs and educates patients and persons who may be billed for medical services about their eligibility for assistance under federal, state, or local government programs or our own Healthcare Assistance Program (HAP) in a variety of ways. For example, Kenmore Mercy Hospital, like our other Catholic Health facilities, has posters and brochures available, which include eligibility and contact information for the Patient Financial Services Team. This information is available in admissions areas, emergency rooms, primary care and outpatient rehabilitation centers, the Administrative and Regional Training Center (ARTC) and other areas throughout Catholic Health where eligible patients and family members are likely to be present. This information is also on the website https://www.chsbuffalo.org/billing-insurance/financial-assistanceand includes general information, our policy and application and is translated in Spanish and Arabic. In addition, information on financial assistance is included on our website.Kenmore Mercy Hospital also provides information about financial assistance and Healthcare Assistance program (HAP) contact information to patients as part of the intake process and during or within 90 days of their discharge from the hospital via patient statements or outreach. To further assist patients, all patient bills include the following language: "If you need financial assistance: Catholic Health offers a healthcare assistance program to help those in need. For more details please visit www.chsbuffalo.org/financial assistance, or call our Patient Financial Services Team at (716) 601-3600". For free, confidential assistance in applying for financial assistance, patients can also call our Patient Financial Services team at 716-601-3600. A counselor will work with them to see if they qualify for free or low-cost insurance or other financial assistance. For patients who do not have insurance and need care at a Catholic Health hospital, a registration clerk can put the patient in touch with one of our Certified Application Counselors. Interpreting services are also available for patients who do not speak English. We offer case management services, and our Certified Application Counselors who discuss with patients the availability of various government benefits, such as Medicaid or other state and federal programs, and assist patients and families with eligibility and applications when necessary.
Part VI, Line 4:Catholic Health is a not-for-profit integrated healthcare delivery system that operates four acute care operations in Erie County and one in Niagara County. For all intents and purposes, the primary service area for Catholic Health's Erie County based acute care operations is Erie County. In fact, Erie County residents account for 79% of all inpatient volume.Kenmore Mercy Hospital is located in Erie County, which consists of a mix of urban, suburban and rural populations, with about one-third of the population residing in the City of Buffalo. Buffalo is New York State's second largest city, surrounded by a ring of older suburbs. Beyond the first ring suburbs are newer suburban communities and established rural communities. The current population of Erie County is over nine hundred thousand.Erie County is less racially and ethnically diverse than New York State or the rest of the country, and the Non-White populations are concentrated in and immediately around the City of Buffalo. All of the 11 zip codes in Erie County that have a Non-White population of 50% or more are in Buffalo.
Part VI, Line 5:One of the fundamental reasons for the creation of Catholic Health was to ensure the continued viability of faith-based health care to meet the needs of residents in Erie County and the surrounding communities. The Mission statement of Kenmore Mercy Hospital, as part of Catholic Health - We are called to reveal the healing love of Jesus to those in need further articulates why we exist. Integral to this effort is caring for the needs of those who are poor and disadvantaged. The services provided by Kenmore Mercy Hospital are in response to identified community needs, and reflect the Hospitals's emphasis on caring for the underserved. The Hospital collaborates with other charitable organizations and social service agencies (i.e. Catholic Charities, Spectrum Human Services, Evergreen Health Services, Erie County Department of Health, etc.), to maximize its ability to provide needed services to the residents of our region.The governing Board of Directors of Kenmore Mercy Hospital is comprised of community representatives from universities, legal communities, and business leaders. Religious orders are represented, as well as active and retired medical staff members. The Kenmore Mercy Hospital medical staff is considered an "open" medical staff, as any physician can apply for privileges. Each application is reviewed by a vigorous credentialing verification process. The hospitals have robust health professional education programs. Mercy Hospital and Sisters Hospital are physician teaching facilities. All sites participate in teaching programs for other allied health professionals. Our six emergency departments are open to all people regardless of their ability to pay. Our primary care centers are strategically located in areas deemed economically disadvantaged or where other medical services are lacking. Each year, Kenmore Mercy Hospital, as part of Catholic Health touches tens of thousands of area residents through its community health education programs, health screenings, clinical and support services, and community service activities. Most of these program are free to encourage participation by people from all walks of life.Catholic Health will continue to meet community needs by providing charity care to the uninsured and underinsured, traditional Medicaid services, and community benefit programs, including collaborative community health improvement initiatives, health professional education programs, volunteering and community service activities, and cash and in-kind contributions to community organizations that serve the poor and disadvantaged.In 2018, the Catholic Health System provided more than $126 million in charity care and community benefit activities to help make our community a healthier place, especially for the poor and underserved. These activities included: * Spearheading Project Homeless Connect An outreach initiative to link homeless individuals and families with medical and other support services; * Supporting charitable and educational organizations, like the Global Health Ministry, United Way, Harvest House, St. Luke's Mission of Mercy, The CRIB Maternity Group Home in Niagara Falls, MY (part of Family & Children Services of Niagara), Care and Share Food Pantry, and the Project Connect Niagara that help the poor and vulnerable in our community; * Hosting numerous health education and screening programs to help people learn their health risks and take steps to improve their health; * Offering a Healthcare Assistance Program to ensure that people without insurance or financial means get the care they need; * Providing health and wellness information in places of worship through our Faith Community Nursing program; * Helping refugees access quality medical care through our Primary Care and School Based Health Centers, including the Mercy Comprehensive Care Center in Buffalo's Old First Ward; * Providing free care and services to those in need, like our "Cribs for Kids" program, which helps families provide a safe sleeping environment for their newborns; * Supporting children and families in need through our Reach Out and Read Program; Backpack Program for Kids; and Bridget Closet (clothes for the needy); * Sponsoring programs at the Mercy Comprehensive Care Center, which serve the local community, including refugees from Burma, Somalia, the Middle East, and Nepal ; * Providing services through our Social Work Department, which link patients with necessary services including: ESL (English as a Second Language), job opportunities, substance abuse treatment, health care navigators, senior services, insurance information, parenting assistance and more; and * Supporting nationally recognized "green" initiatives to remain good stewards of our natural resources and protect the environment.Additional initiatives that the hospital participates in as part of CHS provide benefit to the community including: Advanced Directive / MOLST education, Community Health Fairs , Footprints on the Heart(perinatal bereavement) , McGowan Grant for Health Care Tabling Events , Marian Building & Springville, OB/GYN Clinics, Medicaid Enrollment Assistance, Neonatal Abstinence Syndrome Program in Mercy, NICU Cuddler Program, Open Access Scheduling, Osteoporosis Screening, Prenatal-perinatal Network of WNY, Quest Fit Testing, Refugee Programs, Transitional contact to Catholic Charities from Primary Care Sites, and Transportation Assistance. One of the innovative ways Catholic Health is leading the transformation of healthcare is by supporting other organizations whose work has a direct impact on community health. For the third year, Catholic Health has allocated a portion of its net income ($139,000) for Community Benefit Grants to support programs that serve the poor and disadvantaged and address unmet health needs in our community. Recipients of the 2018 Community Benefit Grants include: * Durham's Central City Baby Caf - $7,000 * The Canopy of Neighbors Programming to Address Social Isolation - $12,000 * Buffalo Go Green Healthy Community Fruits & Vegetables Rx Program (FVRx) - $16,920 * RAHAMA: Trauma-informed domestic violence program for Muslim, Immigrant and Refugee Women - $20,000 * Buffalo United Charter School Moral Focus: Focus on Building Up Our Future - $13,000 * Urban Christian Ministries: Brothers With A Purpose - $18,100 * Catholic Health Neighborhood Legal Services: Medical-Legal Partnership - $25,000 * Ransom House - $19,780
Part VI, Line 7, Reports Filed With StatesNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joseph McDonald
President and CEO, CHS$0$124,093$0$191,491$0$901,733$0$8,633$0$20,897$0$1,246,847$0$191,491
Mark Sullivan
President and CEO, CHS$0$695,527$0$156,198$0$274,317$0$65,865$0$28,048$0$1,219,955$0$156,198
James Millard
President and CEO, Kenmore Mercy$8,001$0$0$0$308,718$0-$68,320$0$18,301$0$266,700$0$0$0
Walter Ludwig
President and CEO, Kenmore Mercy$277,875$0$0$0$18,144$0$22,756$0$26,385$0$345,160$0$0$0
David Macholz
Treasurer$0$229,943$0$47,229$0$8,915$0$5,658$0$27,769$0$319,514$0$0
Gary Tucker
Director$0$270,048$0$72,907$0$36,183$0$22,058$0$27,287$0$428,483$0$72,907
Joyce Markiewicz
Director$0$407,828$0$0$0$18,139$0$58,453$0$20,185$0$504,605$0$0
Martin Boryszak
Director$0$354,592$0$0$0$16,666$0$2,824$0$25,121$0$399,203$0$0
Charles J Urlaub
Director$0$423,637$0$0$0$37,941$0$26,189$0$19,379$0$507,146$0$0
James A Dunlop Jr
Executive VP / COO$0$547,002$0$140,504$0$86,818$0-$8,500$0$26,605$0$792,429$0$140,504
Dr Brian D'Arcy
Senior VP, Medical Affairs$0$515,961$0$0$0$43,511$0$16,137$0$27,213$0$602,822$0$0
Dr Michael Galang
Sr. VP, Chief Information Officer$0$413,567$0$102,217$0$18,146$0$23,361$0$9,941$0$567,232$0$102,217
Nancy Sheehan
SVP Legal Service, General Counsel$0$374,956$0$25$0$18,934$0$26,085$0$20,769$0$440,769$0$0
Dr James Fitzpatrick
Physician$346,054$0$0$0$4,338$0$18,417$0$19,259$0$388,068$0$0$0
Dr Michael Edbauer
Chief Clincal Officer$0$173,522$0$117,972$0$217,135$0$10,293$0$8,032$0$526,954$0$321,406
Maria Foti
Sr. VP, Strategic Planning$0$299,755$0$74,394$0$16,991$0$36,561$0$9,750$0$437,451$0$74,394
Michael Moley
Sr.VP, Human Resources$0$354,293$0$96,820$0$153,803$0$23,426$0$19,277$0$647,619$0$96,820
Dr Thomas Brewer
Physician$276,099$0$0$0$18,804$0$5,971$0$17,471$0$318,345$0$0$0
Dr Michael Gough
Physician$299,062$0$0$0$18,793$0$5,646$0$24,805$0$348,306$0$0$0
Dr Erik Diringer
Physician$282,125$0$0$0$18,601$0$3,771$0$315$0$304,812$0$0$0
Cheryl Hayes
Director of Nursing$190,285$0$0$0$1,114$0$18,489$0$664$0$210,552$0$0$0
Dr Nadia Polataiko
Physician$217,191$0$0$0$701$0-$43,243$0$17,867$0$192,516$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4aFormAndLineReferenceDesc
ExplanationChange of Control Payments were made to: Joseph McDonald: $618,613 Jim Millard: $305,963 Certain portions of the incentive compensation paid in 2018 are a result of the targets that were achieved in previous years. Deferred compensation reported in 2018 includes both qualified deferred pension compensation, as well as deferred compensation and employer contribution for 403b for certain associates for the amounts that are able to be estimated in 2018. Actual W-2 compensation paid to the executive is as per Schedule J Part II B.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Dormitory Authority of the State of New York
A14600029364983Q5T22006-11-29$16,730,000See Part VI000
Dormitory Authority of the State of New York
B146000293649906J622012-07-12$14,235,000See Part VI000
Buffalo and Erie County Industrial Land Development Corporation
C222413596SeePartVI2015-04-30$3,515,000See Part VI000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmt
A$16,730,000$657,688$99,008$15,973,3041998Yes (1)0Yes (1)Yes (1)
B$14,235,000$563,473$12,430,146201300Yes (1)Yes (1)$954,691$286,690
C$3,898,409$114,244$3,527,536201400Yes (1)Yes (1)$256,629

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdIndEngage Bond Counsel ContractsEngageBondCounselContractsInd
A0Yes (1)000.000400.0004000Yes (1)
B00000.000000.0000000Yes (1)
C0Yes (1)Yes (1)00.033900.0339000Yes (1)Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueInd
JP Morgan Chase NA
AYes (1)Yes (1)Yes (1)15.5000000000000Yes (1)00Yes (1)
(no name)
BYes (1)0000Yes (1)
(no name)
C00000Yes (1)000

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART 1 A (F)To refund the New York State Medical Care Facilities Finance Agency FHA - Insured mortgage Project Revenue Bonds, 1995 Series B, which were applied to finance the construction of a three floor patient tower and to refinance outstanding indebtedness.
PART 1 B (F)To finance the cost of construction, reconstruction, and equipping certain improvements to Kenmore's existing approximately 347,661 square foot hospital facility located at 2950 Elmwood Avenue, Kenmore, NY,including a new two-story addition that includes approximately 19,000 square feet on the first floor to house Kenmore's Emergency Department
PART IV 4 (E)The interest rate swap through JP Morgan Chase associated with the 2006 series were unwound and terminated on 11/26/14.
PART IC (C)CUSIP #: The 2015 Bond Series were issued under numerous CUSIP #s with varying maturity dates. The associated CUSIP #s are as follows: 11943KBH4, 11943KBJ0, 11943KBK7, 11943KBL5, 11943KBM3, 11943KBN1, 11943KBP6, 11943KBQ4, 11943KBR2, 11943KBS0, 11943KBT8, 11943KBU5, 11943KBV3, 11943KBW1, 11943KBX9, 11943KBY7
PART 1C (F)Description of Purpose: To finance the costs associated with the Operating Room Expansion project at Kenmore Mercy Hospital.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Susan Urlaub
Wife of Mercy CEO, C.J. Urlaub$93,874Corporate Nurse educator0
Kathleen Zapfel
Sister-in-law of BOD, Msgr. Robert Zapfel$63,506HR Employee of CHS0
Scott Markiewicz
Son of Key Employee, Joyce Markiewicz$52,480Supervisor, Father Baker Manor0
Julie Sullivan
Daughter of Chief Executive Officer$54,655HR employee, CHS0
Jacob Tucker
Son of Director, Gary Tucker$5,403Imaging associate, MSMH0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6CHS has two members: Trinity Health, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws.
Form 990, Part VI, Section A, line 7aAccording to the CHS Bylaws, each member is equally allowed to appoint one representative and one alternative representative to serve on the Corporate Member Council and to serve as a voting director on the Catholic Health System Board of Directors.
Form 990, Part VI, Section A, line 7bYes, the corporate members do have reserve powers
Form 990, Part VI, Section B, line 11bYes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities that file a 990. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6. Schedule J: Compensation Information 7. Schedule L: Transactions with Interested Persons 8. Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information
Form 990, Part VI, Section B, line 12cAll officers, directors, and key employees complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner.
Form 990, Part VI, Section B, line 15CHS, in determining the compensation for the CEO, utilizes a process of review and approval, governed by the Board of Directors that includes an outside nationally recognized independent compensation consultant experienced in compensation and benefit matters for non-profit healthcare organizations, and comparability data. In 2018, the Catholic Health System utilized a Compensation Committee of the corporation Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives.
Form 990, Part VI, Section C, line 19We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws.
Form 990, Part XI, line 9:Minimum Pension Liability Adjustment 1614820. Equity Transfer from Affiliates 604197. Change in Temporarily Restricted Interest in Related Foundations 33110. Change in Unrestricted Interest in KMH Foundation, Inc. -473223. Interest Rate Swap Adjustment 306401.
EXPLANATION OF RETURNKMH Homes files their own separate 990 return.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Catholic Health System Inc
144 Genesee StreetBuffaloNY14203222565278Health Care Delivery SystemNY501C 3Schedule A Line 10N/A0
Mercy Hospital of Buffalo
565 Abbott RoadBuffaloNY14220160756336Acute Care HospitalNY501C 3Schedule A Line 30Catholic Health System Inc
Sisters of Charity Hospital
2157 Main StreetBuffaloNY14214160743187Acute Care HospitalNY501C 3Schedule A Line 30Catholic Health System Inc
Nazareth Home of the Franciscan Sisters
291 North StreetBuffaloNY14201160813142Skilled Nursing FacilityNY501C 3Schedule A Line 100Catholic Health System Inc
St Elizabeth Home of the Aged
5539 BroadwayLancasterNY14086160743154Adult HomeNY501C 3Schedule A Line 100Catholic Health System Inc
St Francis Home of Williamsville
147 Reist StWilliamsvilleNY14221160743153Skilled Nursing FacilityNY501C 3Schedule A Line 100Catholic Health System Inc
St Francis of Buffalo Inc
34 Benwood AveBuffaloNY14214161523535Skilled Nursing FacilityNY501C 3Schedule A Line 100Catholic Health System Inc
St Vincent Manor
319 Washington AvenueDunkirkNY14048160743167Adult HomeNY501C 3Schedule A Line 100Catholic Health System Inc
WNY Catholic Long Term Care Inc
6400 Powers RoadOrchard ParkNY14127161434368Skilled Nursing FacilityNY501C 3Schedule A Line 100Catholic Health System Inc
Niagara Homemaker Services (Mercy Home Care)
144 Genesee StreetBuffaloNY14203161317960Home Care ProviderNY501C 3Schedule A Line 100Catholic Health System Inc
McAuley Seton Home Care
144 Genesee StreetBuffaloNY14203161310062Home Care ProviderNY501C 3Schedule A Line 100Catholic Health System Inc
Catholic Health System Infusion Pharmacy Inc
6350 Transic RoadDepewNY14043200198518Home Care Infusion ServicesNY501C 3Schedule A Line 100Catholic Health System Inc
CHS Program of All-Inclusive Care of the Elderly Inc
55 Melroy AvenueLackawannaNY14218261252884All-inclusive Care for the ElderlyNY501C 3Schedule A Line 30Catholic Health System Inc
Trinity Medical WNY PC
2625 Harlem RdCheektowagaNY14225272576645Primary Care ProviderNY501C 3Schedule A Line 120Catholic Health System Inc
Kenmore Mercy Hospital Foundation
2950 Elmwood AvenueKenmoreNY14217161162971FoundationNY501C 3Schedule A Line 70Kenmore Mercy Hospital
KMH Homes Inc
144 Genesee StreetBuffaloNY14203161387890Real Estate Holding CompanyNY501C 3Schedule A Line 100Catholic Health System Inc
Mount St Mary's Hospital of Niagara Falls
5300 Military RoadLewistonNY14092161523353Acute Care HospitalNY501C 3Schedule A Line 30Catholic Health System Inc
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd