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Chesapeake Hospital Corporation: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
Chesapeake Hospital Corporation (EIN 23-7424835)
Tax period
2017-09-01 to 2018-08-31
Filed
2019-07-11
IRS object ID
201941929349300404
Schema version
2017v2.3
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)
Return2019-07-11T07:53:00-05:00ReturnTs
Tax Period End2018-08-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1695 Town Center DriveAddressLine1Txt
CityCosta MesaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92626ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237424835EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Chesapeake Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHESBusinessNameControlTxt
Phone8044358582PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris RoadAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonStephan QuiriconiPersonNm
Person TitleTreasurer, BSR-VP FinancePersonTitleTxt
Phone8044358582PhoneNum
Signature2019-07-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJohn W Sadoff JrPreparerPersonNm
PTINP00540589PTIN
Phone7144367100PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address168.250.63.1IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-07-11IPDt
IP Tm07:36:22IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCD71869BFC494223FABD92E93AB0669CE7B22062AtSubmissionCreationDeviceId
At Submission Filing Device IdF6D944725D87E8D67D75795748B251B00643F0ACAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Rappahannock General HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerChristopher AccashianPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris RoadAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,771,380GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.bonsecours.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionNot-for-profit Acute Care HospitalActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee354TotalEmployeeCnt
Total Volunteers110TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$839,433PYContributionsGrantsAmt
CY Contributions Grants$607,444CYContributionsGrantsAmt
PY Program Service Revenue$35,283,905PYProgramServiceRevenueAmt
CY Program Service Revenue$30,733,938CYProgramServiceRevenueAmt
PY Investment Income$17,456PYInvestmentIncomeAmt
CY Investment Income$74,347CYInvestmentIncomeAmt
PY Other Revenue$347,557PYOtherRevenueAmt
CY Other Revenue$355,651CYOtherRevenueAmt
PY Total Revenue$36,488,351PYTotalRevenueAmt
CY Total Revenue$31,771,380CYTotalRevenueAmt
PY Grants And Similar Paid$250PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,000,790PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,948,426CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$20,806,329PYOtherExpensesAmt
CY Other Expenses$16,943,600CYOtherExpensesAmt
PY Total Expenses$37,807,369PYTotalExpensesAmt
CY Total Expenses$33,892,026CYTotalExpensesAmt
PY Revenues Less Expenses-$1,319,018PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,120,646CYRevenuesLessExpensesAmt
Total Assets BOY$25,209,969TotalAssetsBOYAmt
Total Assets EOY$24,397,614TotalAssetsEOYAmt
Total Liabilities BOY$27,170,783TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,956,501TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,960,814NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$4,558,887NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe organization operates an acute care general hospital. The hospital has a community based Board of Directors, has an open medical staff, operates an emergency room providing care to all regardless of ability to pay, and provides non-emergency services to any with the ability to pay including Medicare and Medicaid covered individuals. The organization is dedicated to the provision of quality, compassionate care to all patients in the most cost effective manner. This will be accomplished through the most effective use of available resources and will reflect ethical decisions, including the effective management of pain, made jointly by the patients, the family, and health care professionals involved in its care.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$31,609,266ExpenseAmt
Revenue$30,762,642RevenueAmt
DescRappahannock General Hospital, which is the only provider of inpatient and outpatient acute care services within a five county area, provides medical care to patients without regard to their ability to pay. Please refer to the Community Benefit information on Schedule H.Desc
Total Program Service Expenses$31,609,266TotalProgramServiceExpensesAmt
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 Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
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 Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
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 Document38IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee354EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
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 CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Travis CrumBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5139525000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11701 Mercy Health PlaceAddressLine1Txt
CityCincinnatiCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45237ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Toni Ardabell
CEO-BSV6.0044.00Yes (X)Yes (X)$0$1,550,046$107,752
Jean Ann Bolling
Board Member (End 12/17)2.000.00Yes (X)$0$0$0
Jeffrey Brown MD
Board Member2.000.00Yes (X)$0$0$0
Stuart Bunting
Board Member (Beg 01/18)2.000.00Yes (X)$0$0$0
Janice Burnett
Board Member2.0048.00Yes (X)$0$1,343,437$143,169
Chandrashekar Challa
Board Member2.000.00Yes (X)$0$0$0
Elizabeth Crowther
Board Member2.000.00Yes (X)$0$0$0
John Daniel III MD
Board Member2.000.00Yes (X)$0$0$0
Thomas Gayner
Board Member (End 12/17)2.000.00Yes (X)$0$0$0
Chris Hairston-White
Board Member2.000.00Yes (X)$0$0$0
Morris Henderson D Min
Board Member (Beg 01/18)2.000.00Yes (X)$0$0$0
BHB Hubbard III
Board Member (End 05/18)2.000.00Yes (X)$0$0$0
Birdie Jamison
Board Member (Beg 01/18)2.000.00Yes (X)$0$0$0
Sr Rose Marie Jasinski CBS
Board Member (End 12/17)2.000.00Yes (X)$0$0$0
Joyce Lanier
Board Member (Beg 01/18)2.000.00Yes (X)$0$0$0
Sr Anne Marie Mack CBS
President3.5046.50Yes (X)Yes (X)$0$0$0
Linda Rigsby
Board Member2.000.50Yes (X)$0$0$0
Pamela Royal MD
Board Member2.000.00Yes (X)$0$0$0
Joseph Schilling
Board Member2.000.00Yes (X)$0$0$0
Sr Victoria Segura MD CBS
Board Member (Beg 01/18)2.0048.00Yes (X)$0$0$0
Shannon Sinclair
Board Member2.000.00Yes (X)$0$0$0
Nancy Thomas
Chairman2.000.00Yes (X)Yes (X)$0$0$0
Harry Turton Jr
Board Member (End 12/17)2.000.00Yes (X)$0$0$0
Deborah Ulmer PhD RN
Board Member2.000.00Yes (X)$0$0$0
Jane Watkins
Board Member2.000.00Yes (X)$0$0$0
BK Fulton
Board Member2.000.00Yes (X)$0$0$0
Allen Goolsby III
Secretary2.000.00Yes (X)$0$0$0
Stephan Quiriconi
Treasurer, BSR-VP Finance10.0040.00Yes (X)$0$460,619$16,253
Christopher Accashian
CEO-SFMC&CHC20.0030.00Yes (X)$0$454,835$42,988
Jim Godwin
VP HR8.0042.00$0$233,850$39,796Yes (X)
Ann Gumina
VP Patient Care Services50.000.00$156,953$0$2,263Yes (X)
Randall Scott
Psychiatrist50.000.00$245,739$0$36,891Yes (X)
William Stallings
Primary Care Physician50.000.00$233,442$0$33,422Yes (X)
James Bryant
Internist50.000.00$212,093$0$15,942Yes (X)
Maxine Luxton
Pharmacist/OM50.000.00$122,919$0$3,600Yes (X)
Paul Olson
Internist50.000.00$200,746$0$23,703Yes (X)
Mark Gordon
Former CEO - CHC0.0050.00$0$499,936$59,024Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,171,892TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,542,723TotReportableCompRltdOrgAmt
Total Other Compensation$524,803TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
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
Linde Health Care Staffing Inc
PO Box 915241DallasTX75391Physician Fee$1,542,198
Shiftwise
PO Box 70870St PaulMN551709705Agency Nursing$966,537
VA Anesthesia & Perioperative
760 McGuire Place 1st FloorNewport NewsVA23601Anesthesia & Perioperative$800,004
Aramark CTS Inc
12483 Collections Center DriveChicagoIL60693Biomedical Equipment Maintenance$532,683
Emergency Medical Associates
20010 Century Boulevard Suite 200GermantownMD20874Physician Fee$492,298
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
Related Organizations$600,944RelatedOrganizationsAmt
Government Grants$6,500GovernmentGrantsAmt
Total Contributions$607,444TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet Patient Service ReDesc
Business622110BusinessCd
Total Revenue Column$30,733,938TotalRevenueColumnAmt
Related Or Exempt Func Income$30,733,938RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$30,733,938TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,370TotalRevenueColumnAmt
Exclusion$2,370ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$67,398RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$67,398RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,398TotalRevenueColumnAmt
Exclusion$67,398ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$71,977OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$71,977OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$71,977TotalRevenueColumnAmt
Exclusion$71,977ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria and Vending900099$220,044$220,044
Medical Director Fees900099$28,704$28,704
Gift Shop900099$12,735$12,735

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,770TotalRevenueColumnAmt
Exclusion$26,770ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$288,253OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,771,380TotalRevenueColumnAmt
Related Or Exempt Func Income$30,762,642RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$401,294ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$159,216TotalAmt
Program Services$143,294ProgramServicesAmt
Management And General$15,922ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,291,254TotalAmt
Program Services$11,962,129ProgramServicesAmt
Management And General$1,329,125ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$342,993TotalAmt
Program Services$308,694ProgramServicesAmt
Management And General$34,299ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,028,649TotalAmt
Program Services$1,825,784ProgramServicesAmt
Management And General$202,865ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,126,314TotalAmt
Program Services$1,013,683ProgramServicesAmt
Management And General$112,631ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$97,825TotalAmt
Management And General$97,825ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,348TotalAmt
Management And General$23,348ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,760TotalAmt
Program Services$1,584ProgramServicesAmt
Management And General$176ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,737,326TotalAmt
Program Services$5,585,242ProgramServicesAmt
Management And General$152,084ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,913TotalAmt
Program Services$3,522ProgramServicesAmt
Management And General$391ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$384,098TotalAmt
Program Services$345,688ProgramServicesAmt
Management And General$38,410ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$97,493TotalAmt
Program Services$87,744ProgramServicesAmt
Management And General$9,749ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$876,142TotalAmt
Program Services$788,528ProgramServicesAmt
Management And General$87,614ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$67,744TotalAmt
Program Services$60,970ProgramServicesAmt
Management And General$6,774ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,053TotalAmt
Program Services$3,648ProgramServicesAmt
Management And General$405ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$921,972TotalAmt
Program Services$921,972ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,261,779TotalAmt
Program Services$1,135,601ProgramServicesAmt
Management And General$126,178ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$219,593TotalAmt
Program Services$197,634ProgramServicesAmt
Management And General$21,959ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$6,152,230$6,152,230
Bad Debt Expense$739,396$739,396
Rental - Medical Equip.$124,871$124,871
Repairs$94,532$85,079$9,453

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$135,525TotalAmt
Program Services$121,973ProgramServicesAmt
Management And General$13,552ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,892,026TotalAmt
Program Services$31,609,266ProgramServicesAmt
Management And General$2,282,760ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$909BOYAmt
EOY$1,059EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$182,095BOYAmt
EOY$182,402EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,407,765BOYAmt
EOY$4,416,783EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$979,919BOYAmt
EOY$915,677EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$405,263BOYAmt
EOY$258,629EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,131,278LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,985,840LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,448,269BOYAmt
EOY$15,145,438EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$17,109BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,768,640BOYAmt
EOY$3,477,626EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,209,969BOYAmt
EOY$24,397,614EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,659,622BOYAmt
EOY$1,460,219EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,511,161BOYAmt
EOY$27,496,282EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,170,783BOYAmt
EOY$28,956,501EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$2,142,936BOYAmt
EOY-$4,741,009EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$182,122BOYAmt
EOY$182,122EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,960,814BOYAmt
EOY-$4,558,887EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,209,969BOYAmt
EOY$24,397,614EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,120,646ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$477,427OtherChangesInNetAssetsAmt
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 RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

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$1,760OtherActivitiesAmt
Total Lobbying Expenditures$1,760TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,672,060OtherCostOrOtherBasisAmt
Book Value$1,672,060BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,284,497OtherCostOrOtherBasisAmt
Depreciation$1,425,065DepreciationAmt
Book Value$8,859,432BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,693,026OtherCostOrOtherBasisAmt
Depreciation$2,501,937DepreciationAmt
Book Value$4,191,089BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$481,695OtherCostOrOtherBasisAmt
Depreciation$58,838DepreciationAmt
Book Value$422,857BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,145,438TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Medicare Settlement$1,748,361
LT Non-Cash Inv - HPL/GL$1,539,265
Organizational Costs$190,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,477,626TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Due to Affiliates$25,464,197
HPL/GL Liability$1,539,265
Medicare Settlement$304,736
Patient Credit Balances$177,050
Unclaimed Property Accrual$11,034
FieldValueIRS element (for citing)
Total Liability$27,496,282TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationSchedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by Bon Secours Mercy Health, Inc. on September 1, 2007 did not have a material impact on BSMH's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Mercy Health, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The System accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. Their related income is exempt from federal income tax under Section 501(A). The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of August 31, 2018 or 2017. Accounting for uncertainty in income taxes, ASC Topic 740-10 prescribes a comprehensive model for how an organization should measure, recognize, present, and disclose in its financial statements uncertain tax positions that an organization has taken or expects to take on a tax return. The System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The System believes it is no longer subject to income tax examinations for years prior to 2013. As of August 31, 2018 and 2017, the System has no uncertain tax positions. The System's taxable subsidiaries had approximately $97,815 and $106,393 of net operating loss carryforwards as of August 31, 2018 and 2017, respectively, which expire in varying periods through 2037 and are available to offset future taxable income. The System accounts for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to be in effect during the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Interest and penalties related to income taxes are accounted for as income tax expense. The System's deferred tax assets are fully reserved at August 31, 2018 and 2017 as the System considers it more likely than not that these amounts will not be recognized. On December 22, 2017, the President signed into law H.R. 1, originally known as the Tax Cuts and Jobs Act. The Act significantly revises the U.S. corporate income tax by, lowering the statutory corporate tax rate from 35% to 21% and eliminating certain deductions. The new law also includes several provisions that result in substantial changes to the tax treatment of tax-exempt organizations and their donors. The System has reviewed these provisions and the potential impact and concluded the enactment of H.R. 1 will not have a material effect on the operations of the organization.ExplanationTxt

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
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
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$742,194TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$742,194NetCommunityBenefitExpnsAmt
Total Expense0.02240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,591,435TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,348,738DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,242,697NetCommunityBenefitExpnsAmt
Total Expense0.03750TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,333,629TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,348,738DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,984,891NetCommunityBenefitExpnsAmt
Total Expense0.05990TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served3835PersonsServedCnt
Total Community Benefit Expns$57,383TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,383NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$300TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$300NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served3835PersonsServedCnt
Total Community Benefit Expns$57,683TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,683NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served3835PersonsServedCnt
Total Community Benefit Expns$3,391,312TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,348,738DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,042,574NetCommunityBenefitExpnsAmt
Total Expense0.06160TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$739,396BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$19,071,222ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$18,091,445CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$979,777MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
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 Line1Chesapeake Hospital CorporationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris DriveAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd
FieldValueIRS element (for citing)
Website Addressbonsecours.comWebsiteAddressTxt
State LicenseH1885StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Chesapeake Hospital CorpBusinessNameLine1Txt
FieldValueIRS element (for citing)
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
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Section COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Section CStrategyWebsiteURLTxt
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 Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.fa.bonsecours.com/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.fa.bonsecours.com/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.fa.bonsecours.com/FAPSummaryOnWebsiteURLTxt
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
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Chesapeake Hospital CorpPart V, Section B, Line 5: 2016 (FY2017) CHNA: Community SurveyAn electronic survey using Survey Monkey was developed and administered to 215 community members and partners of whom 184 completed the full survey. Individuals were invited to participate based on their ability to represent: underserved, low-income and minority population needs; needs of chronically ill patients; and awareness of healthcare needs in their respective communities. Participants were asked to share their viewpoints on: Important health concerns in the community; Significant service gaps in the community; Ideas for addressing concerns and service gaps.To gauge the importance of various health concerns, respondents were asked to "Choose the top 5 priorities you think should be addressed in your community" from a list of 34 health concerns. Respondents were then asked to rate their overall health, the health of the community, and the quality of life of the community. Other questions included reviewing lists of services typically important to addressing health concerns and how strong the community was in providing those services. Respondents were then asked to indicate services that needed to be strengthened in terms of availability, access, and quality. Open-ended response items were provided for participants to indicate additional service gaps in the community and ideas for addressing concerns and service gaps. Community ConversationsTwo Community Conversations were held as part of the CHNA process in which 22 individuals participated from all of the core jurisdictions of Lancaster, Middlesex, and Northumberland. Overall, the racial and geographical diversity of the participants represented a healthy mix of the region's residents. The purpose of the conversation was to elicit feedback from community members about publicly available health data describing health conditions in the services area, and to review the online survey results to further explore findings. Attendees were asked to 1) rank the health issues identified in the Community Survey according to the issues that impact them and the people close to them the most and 2) rank the issues needing to be addressed to improve the overall health of the region from a community view.Priority Needs Bon Secours Rappahannock General Hospital convened a CHNA Advisory Board to support the process by engaging community members and providing feedback on the findings. The CHNA Advisory Board included individuals with special knowledge of public health and underserved populations and included the following: Director of the Three Rivers Health Department, Executive Director of the Northern Neck Free Clinic, Mayor of Kilmarnock, Executive Director of the Middle Peninsula Northern Neck Community Services Board, Board Member from Peninsula EMS Council, and President and CEO of Bay Aging.A group conversation was facilitated by Becky Clay Christensen and included a review of all qualitative and quantitative data gathered from the Community Survey, Community Conversations, and publicly available secondary health data. Advisory Board members were asked to categorize issues as high or low need in the community using a Strategy Grid. They were also asked to determine the feasibility of the community's ability to make an impact on the issues.
Chesapeake Hospital CorpPart V, Section B, Line 11: The Implementation Plan focuses on 3 broad areas including Access to Care for the Uninsured, Health Education, and Behavioral Health. Goals and objectives were created for each area and were based on Healthy People 2020 objectives, Virginia's Plan for Well-Being 2016-2020 goals, and other evidence-based sources.The overarching goal for Access to Care for the Uninsured is to improve access to comprehensive, quality health care services. This has been achieved in part by recruiting primary care physicians and mid-level providers to the service area. We are also coordinating strategies with the Northern Neck Free Clinic, current primary care providers, and Lively and Hartfield Medical Centers to identify resources for the provision of care and to enhance service coverage.The goal in addressing Health Education is to increase the quality, availability, and effectiveness of educational and community-based programs designed to prevent disease and injury, improve health, and enhance quality of life. We provide health education on Diabetes, Hypertension, and the Continuum of Care as well as provide our Senior University to promote health and wellness among older adults. Additional partners in this work include the Northern Neck YMCA and Lancaster, Northumberland, and Middlesex School systems.The goal for Behavioral Health is to increase access to behavioral health services to improve mental health of the community. This has been achieved by conducting support groups around the topics of Women's Cancer, Grief Counseling, Alzheimer's Care Givers, and Stroke. We are also working closely with the Northern Neck Community Service Board and primary care providers to promote bridges between behavioral health and primary care.Needs Not AddressedAdditional areas of need identified in the community survey include: Jobs with fair wages, Adult and Childhood Obesity, Alcohol and Drug Use, Transportation, and Diabetes. While these needs will not be directly addressed, we recognize that activities in Access to Care for the Uninsured, Health Education, and Behavioral Health will also impact these areas of need. Additionally, the following resources are available in the community and are addressing these needs: Three Rivers Health Department, Northern Neck Family YMCA, Northern Neck Free Health Clinic, American Cancer Society, Bay Aging, American Heart Association, Middle Peninsula/Northern Neck Community Services Board, Bay Transit, Virginia Women's Center, Eastern Virginia Care Transition Partnerships, Lancaster County High School, Northumberland High School, and Middlesex High School.
Chesapeake Hospital CorpPart V, Section B, Line 16j: Information regarding the FAP is available on our websites, brochures are available at time of registration. We have on-site Financial Counselors who assist patients. We also have eligibility vendors who work with the patients and our statements indicate we have an FAP. We also provided local clinics in each market brochures regarding our FA program.
Form 990, Schedule H, Part V, Section B, Line 7a:https://bonsecours.com/richmond/community-commitment/community-health-needs-assessment
Form 990, Schedule H, Part V, Section B, Line 10a:https://bonsecours.com/richmond/community-commitment/community-health-needs-assessment
Form 990, Schedule H, Part V, Section B, Line 7b:www.behealthyrva.org; https://bonsecours.com/richmond/community-commitment/community-health-needs-assessment
Form 990, Schedule H, Part V, Section B, Line 14:Charges for patients who are eligible for financial assistance shall be limited to no more than amounts generally billed ("AGB") for such services. These charges are based on the average allowed amounts from Medicare and commercial payers for emergency and other medically necessary care. The allowed amounts include both the amount the insurer will pay and the amount, if any, the individual is personally responsible for paying. The AGB is calculated using a look back method.
Form 990, Schedule H, Part V, Section B, Line 3i:Rappahannock General Hospital (RGH) was acquired by Bon Secours Mercy Health on December 31, 2014. A Community Health Needs Assessment was conducted for RGH in FY2016 (tax year 2015). In order to align the tax years of the two organizations, a second CHNA was prepared for RGH in FY2017 (tax year 2016). The FY2017 CHNA document provides updated publicly available health data. Community input was obtained from an online survey conducted between September 2015 and February 2016 and two community conversations conducted in November 2015. The initiatives contained in the FY2016 Implementation Plan will continue to be advanced under the FY2017 CHNA Implementation Plan. This approach was approved by the CHNA Advisory Board on March 24, 2017. CHNAs for Bon Secours Mercy Health hospitals, including Rappahannock General Hospital will be conducted again in tax year 2018 during FY2019 and will include a description of the impact of any actions taken to address the significant health needs identified in the prior CHNA.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - RGH Bridges OutpatientBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1113 DMV DriveAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd
FieldValueIRS element (for citing)
FacilityPhysician PracticeFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:Annually, Bon Secours Richmond Health System (BSRHS) publishes a report for the community on the community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is available to the public each year on or around January 24, commemorating Founding Day of the Sisters of Bon Secours. This report is available online at https://bonsecours.com/richmond/about-us.
Part I, Line 7:Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges captured in the patient accounting system and general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.
Part I, Ln 7 Col(f):Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $739,396.
Part II, Community Building Activities:Rappahannock General Hospital works with community partners to improve community health in targeted neighborhoods by identifying and prioritizing community needs.
Part III, Line 2:Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.
Part III, Line 3:The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.
Part III, Line 4:Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on page 10 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for uncollectible accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 37-38 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS.
Part III, Line 8:Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publicly insured patients where reimbursement is less than cost of providing the service.
Part III, Line 9b:The hospital has a written policy that describes collection practices applying to patients who qualify for financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is approved, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exists for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of eight months from the date of the application. This eligibility is identified by hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of the eight months, the patient is responsible for reapplying for FAP eligibility.
Part VI, Line 2:The 2016 CHNA was conducted during Fiscal Year 2017 by the Community Health Services team in order to prepare documents by the end of the fiscal year. It was determined that existing quantitative data, augmented by a community survey, and community conversations would be used to identify and prioritize health indicators. All identified needs were reported to the Community Advisory Board to prioritize based on need and feasibility. An executive summary and report was then presented to system leadership from Mission. Findings were then presented to the Executive Management Team for further review and comment. Finally, a presentation was made to the Bon Secours Richmond Health System Board for final approval prior to being made available to the public.Quantitative DataData was gathered and compiled via publicly available data sources such as County Health Rankings, the Census Bureau, and the Virginia Department of Health. The data presented in the CHNA reflects how the area served by Bon Secours Rappahannock General Hospital compares to Virginia overall and/or the nation. Health issues and conditions were either identified by the community during qualitative community conversations or are issues which deviated from the state or national findings.Community Input Input from community members was included in assessing health care needs as described in Part V, Line 5.
Part VI, Line 3:The Patient Financial Assistance program is communicated to patients verbally upon scheduling, registration, visible postings of the program are in common areas throughout the hospital, along with brochures and the program is detailed on our Bon Secours Mercy Health website. In addition, patient billing statements and letters inform patients regarding our financial assistance program. Bon Secours Mercy Health proactively screens patients to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Mercy Health Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Bon Secours Mercy Health is also dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours Mercy Health employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial assistance process. Based on market need, our financial assistance policy and application is translated into multiple languages and placed on our Bon Secours Mercy Health website for patients to access.
Part VI, Line 4:Rappahannock General Hospital was founded in 1977. The hospital is located in the eastern central section of Lancaster County. The Bon Secours Mercy Health Health System, a faith based, not-for-profit healthcare system acquired Rappahannock General Hospital in 2014. For purposes of the CHNA, RGH defines the three counties of Lancaster, Middlesex and Northumberland as the community it serves as many secondary data sources are county specific and enable comparison to data for the state of Virginia and the United States. Approximately 35,000 residents reside in Lancaster, Northumberland, and Middlesex Counties. For the purpose of this CHNA, the residents of these three counties will represent the primary service area for Rappahannock General Hospital. The population is relatively evenly distributed among the three counties. The actual population served by the hospital is closer to 40,000. Approximately 88% of RGH's patient population resides in one of these 3 counties.The RGH community is predominantly White (73%), with a large African American population (24%). Compared to Virginia as a whole, RGH has a larger percentage of African Americans but has less ethnic diversity, due to a lower percentage of Hispanics, Asians, and Native Americans.The RGH community is comprised of approximately 20% more older adults (65+) than Virginia and the nation, and a comparatively lower percentage of children (age <18). Middlesex has a greater percentage of adults (19-64) residing in the community and fewer older adults (65+) compared to Lancaster and Northumberland.The median household incomes for Lancaster, Middlesex and Northumberland are lower than the Virginia state average of $65,015 and the national average of $53,889. While Middlesex has lower rates of unemployment than Virginia, the median household income is lower than Virginia and consistent with Lancaster and Northumberland. The median household incomes for the three RGH counties are as follows: Lancaster County; $50,374, Middlesex County; $54,654 and Northumberland County; $51,885.Compared to Virginia, the percentage of uninsured adults is higher in Lancaster and Northumberland. The percentage of uninsured children is higher in all three counties, with the highest percentage of uninsured residing in Northumberland County (20% of adults and 11% of children).
Part VI, Line 5:Rappahannock General Hospital provides numerous services to the community including health fairs, free health screenings and education on cholesterol, blood pressure and glucose. Cancer screenings are available as well as support groups for cancer patients and their families. The Rappahannock General Hospital Emergency Department offers CPR training, heart saver courses and pediatric basic life support. Free sports physicals are provided to area secondary students.
Part VI, Line 6:Bon Secours Mercy Health, Inc., a Maryland nonprofit, nonstock membership corporation (BSMH), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSMH, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSMH aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of Bon Secours Mercy Health, Inc. (BSMH), this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSMH Vision. BSMH's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2016-2018). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents - Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that the struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression.- Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSMH and the SQP (Strategic Quality Plan).
Part VI, Line 7, Reports Filed With StatesVA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
Toni Ardabell
CEO-BSV$0$677,035$0$130,351$0$742,660$0$105,750$0$2,002$0$1,657,798$0$196,397
Janice Burnett
Board Member$0$667,595$0$240,070$0$435,772$0$129,000$0$14,169$0$1,486,606$0$92,090
Stephan Quiriconi
Treasurer, BSR-VP Finance$0$349,584$0$69,669$0$41,366$0$5,300$0$10,953$0$476,872$0$0
Christopher Accashian
CEO-SFMC&CHC$0$334,407$0$81,213$0$39,215$0$15,650$0$27,338$0$497,823$0$0
Jim Godwin
VP HR$0$199,313$0$13,959$0$20,578$0$18,746$0$21,050$0$273,646$0$0
Ann Gumina
VP Patient Care Services$146,818$0$9,382$0$753$0$1,851$0$412$0$159,216$0$0$0
Randall Scott
Psychiatrist$244,681$0$0$0$1,058$0$7,356$0$29,535$0$282,630$0$0$0
William Stallings
Primary Care Physician$201,861$0$31,341$0$240$0$4,347$0$29,075$0$266,864$0$0$0
James Bryant
Internist$194,883$0$0$0$17,210$0$5,954$0$9,988$0$228,035$0$0$0
Paul Olson
Internist$180,178$0$4,538$0$16,030$0$4,153$0$19,550$0$224,449$0$0$0
Mark Gordon
Former CEO - CHC$0$400,916$0$46,079$0$52,941$0$32,182$0$26,842$0$558,960$0$9,636

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Bon Secours Mercy Health, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Line 4bThe filing organization participates in a BSMH sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Toni Ardabell, $381,880; Janice Burnett, $106,552; Mark Gordon, $11,367; James Godwin, $0; Stephan Quiriconi, $0; Christopher Accashian, $0.
Part I, Line 7The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. Within these established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Bon Secours Mercy Health, Inc. is the sole member of Bon Secours Richmond LLC. Bon Secours Richmond LLC holds the majority interest in Bon Secours - Richmond Health System, which in turn is the sole member of the filing organization.
Form 990, Part VI, Section A, line 7aThe governing body of the filing organization is appointed by its member Bon Secours - Richmond Health System and subject to approval by Bon Secours Mercy Health, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of the filing organization are reserved to its member or to Bon Secours Mercy Health, Inc.
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared by BSMH's tax department and reviewed by management. Upon review, the Form 990 is then forwarded to the local system's independent Audit and Compliance Committee for review and approval. Once the Form 990 is reviewed by all applicable parties a copy of the final version is provided to all members of the governing body prior to filing.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSMH CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15bThe compensation committee of the board of Bon Secours Mercy Health, Inc. (BSMH) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSMH. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS's rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSMH board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSMH compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization makes all documents available to the general public upon request.
Form 990, Part VII - Additional Disclosure:The governing bodies of the following entities are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer): - Bon Secours St. Mary's Hospital - Bon Secours St. Francis Medical Center - Bon Secours Memorial Regional Medical Center - Richmond Community Hospital - Chesapeake Hospital Corporation - Chesapeake Medical Group The entities listed above and the parent organization to these entities, Bon Secours Richmond Health System, Inc. (RHS), established a mirror board. The action aligned the board members and board officers of RHS and the listed entities. Hours reported on Form 990, Part VII represents total hours worked per week. These hours may include time spent as an employee of the organization and any hours spent serving as a volunteer board member. Any compensation paid to these individuals is payment for their employment with the filing organization or related organization. Volunteers are not paid for their time. Sr. Anne Marie Mack, Sr. Rose Marie Jasinski, and Sr Victoria Segura do not receive payroll distributions as they have taken vows of poverty.
Form 990, Part IX, line 11gPurchased Services - Intercompany: Program service expenses 585. Management and general expenses 65. Fundraising expenses 0. Total expenses 650. Physician Fees: Program service expenses 3,274,527. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,274,527. Billing and Collections: Program service expenses 164,726. Management and general expenses 18,303. Fundraising expenses 0. Total expenses 183,029. Other Purchased Services: Program service expenses 870,819. Management and general expenses 96,758. Fundraising expenses 0. Total expenses 967,577. Maintenance and Service Agreements: Program service expenses 225,660. Management and general expenses 25,072. Fundraising expenses 0. Total expenses 250,732. Consulting: Program service expenses 106,970. Management and general expenses 11,886. Fundraising expenses 0. Total expenses 118,856. Contracted Nursing and Ancillary Tech Staff: Program service expenses 941,955. Management and general expenses 0. Fundraising expenses 0. Total expenses 941,955.
Form 990, Part XI, line 9:Intercompany Transfers Relating to Debt -477,427.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (50 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Bon Secours Mercy Health Inc
1701 Mercy Health PlaceCincinnatiOH45237521301088Healthcare system parentOH501(c)(3)Line 12c, III-FIBon Secours Inc0
Bon Secours New York Health System Inc
2975 Independence AvenueBronxNY10463912135196Local System Parent Org.NY501(c)(3)Line 12a, IBon Secours Mercy Health Inc0
Bon Secours Kentucky Health System Inc
St Christopher DrAshlandKY41101611356024Local System Parent Org.KY501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
Bon Secours Baltimore Health Corporation
2000 West Baltimore StreetBaltimoreMD21223800728893Local System Parent Org.MD501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
Bon Secours St Francis Health System Inc
1 St Francis DriveGreenvilleSC29601582504528Local System Parent Org.SC501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
Bon Secours Hampton Roads Health System
7007 Harbour View BlvdPortsmouthVA23435521538513Local System Parent Org.VA501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
Bon Secours Richmond Health System
8580 Magellan ParkwayRichmondVA23227521988421Local System Parent Org.VA501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
Bon Secours Baltimore Health System Foundation Inc
26 North Fulton AvenueBaltimoreMD21223383843816Grant Making FoundationMD501(c)(3)Line 12c, III-FIBon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health0
The Bon Secours of Maryland Foundation Inc
26 North Fulton AvenueBaltimoreMD21223521732800Grant Making FoundationMD501(c)(3)Line 12c, III-FIBon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health0
Mary Immaculate Foundation
7007 Harbour View BlvdSuffolkVA23435311644734FundraisingVA501(c)(3)Line 12c, III-FIMary Immaculate Hospital0
Bon Secours DePaul Health Foundation
7007 Harbour View BlvdSuffolkVA23435541843876FundraisingVA501(c)(3)Line 7Bon Secours DePaul Medical Center0
Bon Secours Maryview Foundation
7007 Harbour View BlvdSuffolkVA23435521694731FundraisingVA501(c)(3)Line 7Bon Secours Hampton Roads Health System0
Our Lady of Bellefonte Hospital Inc
1000 St Christopher DrAshlandKY41101611356023Health CareKY501(c)(3)Line 3Bon Secours Kentucky Health System0
Bon Secours Hospital Baltimore Inc
2000 West Baltimore StreetBaltimoreMD21223520591555Health CareMD501(c)(3)Line 3Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health0
St Francis Hospital Inc
One St Francis DriveGreenvilleSC29601582504530Health CareSC501(c)(3)Line 3Bon Secours St Francis Health System Inc0
Mary Immaculate Hospital Inc
7007 Harbour View BlvdSuffolkVA23435540548200Health CareVA501(c)(3)Line 3Bon Secours Mercy Health Inc0
Bon Secours - DePaul Medical Center Inc
7007 Harbour View BlvdSuffolkVA23435541820093Health CareVA501(c)(3)Line 3Bon Secours Hampton Roads Health System0
Maryview Hospital
7007 Harbour View BlvdPortsmouthVA23707540506463Health CareVA501(c)(3)Line 3Bon Secours Hampton Roads Health System0
Bon Secours - Memorial Regional Medical Center Inc
8580 Magellan ParkwayRichmondVA23227541744931Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Bon Secours - St Mary's Hospital of Richmond Inc
8580 Magellan ParkwayRichmondVA23227540793767Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Bon Secours - Richmond Community Hospital
8580 Magellan ParkwayRichmondVA23227540647482Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Bon Secours - St Francis Medical Center Inc
8580 Magellan ParkwayRichmondVA23227311716973Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Bon Secours Kentucky Health System Foundation Inc
St Christopher DrAshlandKY41101611381952Grant Making FoundationKY501(c)(3)Line 7Bon Secours Kentucky Health System0
Bon Secours Baltimore Development Inc
26 North Fulton AvenueBaltimoreMD21223760785344Community HousingMD501(c)(3)Line 7Unity Properties Inc0
Unity Properties Inc
26 North Fulton AvenueBaltimoreMD21223521857768Low Income HousingMD501(c)(3)Line 7Bon Secours of Maryland Foundation0
Bon Secours - St Francis Health System Foundation Inc
One St Francis DriveGreenvilleSC29601260012031Grant Making FoundationSC501(c)(3)Line 7St Francis Hospital Inc0
Bon Secours Richmond Health Care Foundation
8580 Magellan ParkwayRichmondVA23227541201346Grant Making FoundationVA501(c)(3)Line 7Bon Secours Richmond LLC0
Bon Secours St Petersburg Home Care Services Inc
10300 Fourth Street NorthSt PetersburgFL33716134334363Home Care ServicesFL501(c)(3)Line 10Maria Manor Nursing Care Center0
Bon Secours - Maria Manor Nursing Care Center Inc
10300 Fourth Street NorthSt PetersburgFL33716650061820Nursing HomeFL501(c)(3)Line 10Bon Secours Mercy Health Inc0
Bellefonte Physician Services Inc
St Christopher DrAshlandKY41101352320780Physician PracticesKY501(c)(3)Line 10Bon Secours Kentucky Health System0
Bon Secours Housing Inc
26 North Fulton AvenueBaltimoreMD21223521442707Low Income HousingMD501(c)(3)Line 10Bon Secours of Maryland Foundation0
Bon Secours Housing II Inc
26 North Fulton AvenueBaltimoreMD21223521543174Low Income HousingMD501(c)(3)Line 10Bon Secours of Maryland Foundation0
Schervier Housing Development Fund Corporation
2975 Independence AvenueBronxNY10463133098867HousingNY501(c)(3)Line 10Bon Secours NY Health System0
St Francis Physician Services Inc
One St Francis DriveGreenvilleSC29601134290167Physician ServicesSC501(c)(3)Line 10St Francis Health System Inc0
Mary Immaculate Nursing Center Inc
7007 Harbour View BlvdSuffolkVA23435541516476Nursing Care CenterVA501(c)(3)Line 10Mary Immaculate Hospital0
Bon Secours - Maryview Nursing Care Center
7007 Harbour View BlvdSuffolkVA23435521578169Nursing Care CenterVA501(c)(3)Line 10Bon Secours Hampton Roads Health System0
Bayley Properties
7007 Harbour View BlvdSuffolkVA23435541424748Title Holding CompanyVA501(c)(2)Bon Secours DePaul Medical Center0
Laburnum Properties
8580 Magellan ParkwayRichmondVA23227521260700Title Holding CompanyVA501(c)(2)Bon Secours Richmond Health System0
Bon Secours Health System Foundation Inc
8990 Old Annapolis RoadColumbiaMD21045474765376FundraisingMD501(c)(3)Line 7Bon Secours Mercy Health Inc0
IVNA Health Services
5008 Monument AvenueRichmondVA23230541479847Home Care ServicesVA501(c)(3)Line 10Bon Secours Home Care LLC0
Rappahanock General Hospital Foundation
101 Harris RoadKilmarnockVA22482541210450Supporting OrganizationVA501(c)(3)Line 7Bon Secours Richmond Health System0
Chesapeake Medical Group
101 Harris RoadKilmarnockVA22482541857174Healthcare ServicesVA501(c)(3)Line 10Bon Secours Richmond Health System0
Chesapeake Hospital Corporation
101 Harris RoadKilmarnockVA22482237424835Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Bon Secours New Jersey Health System Inc
1505 Marriottsville RoadMarriottsvilleMD27104222754781Local System Parent Org.NJ501(c)(3)Line 12c, III-FIBon Secours Mercy Health Inc0
St Mary Hospital Inc
308 WillowHobokenNJ07030221487324Health CareNJ501(c)(3)Line 3Bon Secours New Jersey Health System Inc0
Mercy Health Services
1505 Marriottsville RoadMarriottsvilleMD27104251585441Local System Parent Org.PA501(c)(3)Bon Secours Mercy Health Inc0
Pennsylvania Health Choice Plan
1505 Marriottsville RoadMarriottsvilleMD27104Health CarePA501(c)(3)Mercy Health Services0
Liberty Medical Center
1505 Marriottsville RoadMarriottsvilleMD27104521466304Health CareMD501(c)(3)Line 3Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health0
Bon Secours - Stuart Circle Hospital Inc
8580 Magellan ParkwayRichmondVA23227541740128Health CareVA501(c)(3)Line 3Bon Secours Richmond Health System0
Post Office Plaza Owners Association Inc
1703 Laurel StreetColumbiaSC29201Health CareSC501(c)(3)Bon Secours St Francis Health System Inc0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Bon Secours Place at St Petersburg LLP
10300 Fourth Street NorthSt PetersburgFL33716593589729Assisted Living/Senior CareFLN/A
Bon Secours Apartments LP
1800 West Baltimore StBaltimoreMD21223521952505Low Income HousingMDN/A
Bon Secours Apartments II LP
1800 West Baltimore StBaltimoreMD21223522063512Low Income HousingMDN/A
Liberty Senior Housing LP
1800 West Baltimore StBaltimoreMD21223522134447Low Income HousingMDN/A
Bon Secours Apartments III LP
1800 West Baltimore StBaltimoreMD21223522134444Low Income HousingMDN/A
Bon Secours Smallwood Summit LP
26 North Fulton AveBaltimoreMD21223522280175Low Income HousingMDN/A
Bon Secours Chesapeake Apartments LP
26 North Fulton AveBaltimoreMD21223200107034Low Income HousingMDN/A
Bon Secours Shiloh LP
26 North Fulton AveBaltimoreMD21223203965243Low Income HousingMDN/A
Bon Secours New Shiloh II Limited Partnership
26 North Fulton AveBaltimoreMD21223820655142Low Income HousingMDN/A
Bon Secours Wayland LP
26 North Fulton AveBaltimoreMD21223270468688Low Income HousingMDN/A
Bon Secours Gibbons Apartments LP
26 North Fulton AveBaltimoreMD21223472322323Low Income HousingMDN/A
Upstate Surgery Center LLC
One St Francis DriveGreenvilleSC29601562186977Ambulatory Surgery CenterSCN/A
Province Place of DePaul LLC
6403 Granby StreetNorfolkVA23505541950880Assisted Living FacilitiesVAN/A
Province Place of Maryview LLC
One Bon Secours WayPortsmouthVA23703541842697Assisted LivingVAN/A
Broad64 Imaging LLC
8580 Magellan ParkwayRichmondVA23227205886018Imaging ServicesVAN/A
Richmond Radiation Oncology Center I LLC
8580 Magellan ParkwayRichmondVA23227208444551Radiation Oncology ServicesVAN/A
RI LP
8580 Magellan ParkwayRichmondVA23227541708835Imaging ServicesVAN/A
Bon Secours Benet House LP
26 North Fulton AveBaltimoreMD21223364765400Low Income HousingMDN/A
Bon Secours Benet House LLC
26 North Fulton AveBaltimoreMD21223463055312Low Income HousingMDN/A
Southeastern Health PartnersLLC
One St Francis DriveGreenvilleSC29601813264385Coordinated CareSCN/A
Harbour View MOB 2 LLC
5818 Harbour View Blvd Suite A1SuffolkVA23435822484997Real EstateVAN/A
Memorial Ambulatory Surgery Center LLC
8580 Magellan ParkwayRichmondVA23227593813233Ambulatory Surgery CenterVAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Bon Secours-Florida Integrated Services Inc
10300 Fourth Street NorthSt PetersburgFL33716650779777Holding Company/Assisted LivingFLN/AC0
Professional Health Care Management Services Inc
150 Kingsley LaneNorfolkVA23505541241031AdministrativeVAN/AC0
Bon Secours - Tidewater Diversified Inc
160 Kingsley LaneNorfolkVA23505541431826PharmacyVAN/AC0
OSF Inc
2 Bernadine DriveNewport NewsVA23602541369919RentalVAN/AC0
Unity Housing Inc
26 North Fulton AvenueBaltimoreMD21223521952507Low Income HousingMDN/AC0
Bon Secours Wayland LLC
26 North Fulton AvenueBaltimoreMD21223270468561Low Income HousingMDN/AC0
Bon Secours New Shiloh II LLC
26 North Fulton AvenueBaltimoreMD21223820631206Low Income HousingMDN/AC0
Bon Secours New York Housing Development Fund Corporation
2975 Independence AvenueBronxNY10463472224316Low Income HousingNYN/AC0
Maryview Building Corporation
3636 High StreetPortsmouthVA23707541306612AdministrativeVAN/AC0
Bon Secours-Virginia Healthsource Inc
8580 Magellan ParkwayRichmondVA23227541417686Ambulatory Healthcare ServicesVAN/AC0
Chesterfield Community Healthcare Center Inc
8580 Magellan ParkwayRichmondVA23227541812738Ambulatory Healthcare ServicesVAN/AC0
Richmond Radiation Oncology Center Inc
8580 Magellan ParkwayRichmondVA23227541570244Ambulatory Healthcare ServicesVAN/AC0
RHS Management Corp
8580 Magellan ParkwayRichmondVA23227541313425Independent Living FacilityVAN/AC0
Richmond MRI Inc
8580 Magellan ParkwayRichmondVA23227541568452Medical ServicesVAN/AC0
Good Help Connections LLC
8990 Old Annapolis RoadColumbiaMD21045472345223IT ConsultingMDN/AC0
Optimum Health Network Inc
One St Francis DriveGreenvilleSC29601570973524Healthcare ServicesSCN/AC0
Bon Secours Assurance Company Ltd
980152147Offshore Captive ManagementN/AC0PO Box 69CJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd