2018-07-03T08:52:40-05:00 2017-08-31 990 2016-09-01 134290167 St Francis Physician Services Inc STFR 8642551000 One St Francis Drive Greenville SC 29601 Ronnie Hyatt CFO - BSSFHS 8642551000 2018-07-03 0 2016 2022-09-23 18:48:47Z Bon Secours Express Care Craig McCoy One St Francis Drive Greenville SC 29601 232436786 0 X bonsecours.com X 2004 SC Primary, urgent, and specialty care 12 4 1692 4 0 0 338570205 69241666 154632231 162198475 0 0 1269050 989202 494471486 232429343 48 372 0 0 155554802 171330121 0 0 0 57152684 61127785 212707534 232458278 281763952 -28935 36818909 40923811 25157211 29291048 11661698 11632763 X 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. St. Francis Physician Services, Inc. serves this mission as the vehicle for physician employment relationships in the Bon Secours St. Francis Health System, Inc. 0 0 211693047 372 162577600 St. Francis Physician Services (SFPS) operates as an affiliate model in the provision of services to the residents of Greenville, South Carolina and the surrounding communities including primary care, urgent care, and various specialities. A member of Bon Secours St Francis Health System, Inc., SFPS continues to expand to meet the needs of the community residents. The various practices that comprise SFPS are strategically located with the area to most effectively meet the needs of the community. 211693047 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 204 0 1 1692 1 0 0 0 0 0 0 0 0 0 0 X 12 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Ronnie Hyatt 8642551000 One St Francis Drive Greenville SC 29601 X Katherine Arbuckle Board Member 0.00 2.00 X 0 0 0 Thomas Baumgarten MD Board Member (Sep-Dec) 49.50 0.50 X 1926231 0 42397 Ahmad Boota Board Member (Jan-Aug) 50.00 0.00 X 430844 0 47360 Mark Grabarczyk MD Board Member 50.00 0.00 X 998354 0 42445 Edward Heidtman MD Board Member 50.00 0.00 X 408368 0 40769 Camilla Hertwig Board Member (Sep-Dec) 0.00 3.50 X 0 0 0 Laurence Hinsdale Board Member (Jan-Aug) 0.00 2.00 X 0 0 0 Fletcher Kirkland Jr Chairman 0.50 2.00 X X 0 0 0 Reed Mathias Board Member (Jan-Aug) 50.00 0.00 X 287135 0 21912 Craig McCoy CEO - BSSFHS 8.00 42.00 X X 0 602389 72041 Wayne McDonald MD Board Member 0.00 2.00 X 0 0 0 Thomas Morris PhD President 1.00 49.00 X X 0 464396 82259 Raana Naidu MD Board Member (Sep-Dec) 50.00 0.00 X 262318 0 22513 Anselmo Nunez MD CEO - SFPS 50.00 0.00 X X 0 654660 35813 James Wallace MD Board Member (Sep-Dec) 50.00 0.00 X 448978 0 45041 Karen Watson MD Board Member (Jan-Aug) 50.00 0.00 X 304477 0 26030 Lisa Browning Secretary (Jan-Mar) 40.00 0.00 X 38726 0 18105 Jennifer Dusso COO (Jan-Aug) 50.00 0.00 X 133967 0 10368 Wilbur Gay Treasurer/VP Finance 50.00 0.00 X 200498 0 36521 Irene Holcombe Secretary (Sep-Dec) 0.00 50.00 X 0 91689 16140 Ronnie Hyatt CFO - BSSFHS 8.00 42.00 X 0 492740 34364 Josephine Woods Secretary (Apr-Aug) 40.00 0.00 X 51441 0 11982 John Vann MD Orthopedic Surgeon 50.00 0.00 X 1656809 0 46665 Christie Mina Neurologist 50.00 0.00 X 1349880 0 36789 Christopher Van Pelt Orthopedic Surgeon 50.00 0.00 X 1346912 0 41971 James Jennings MD Orthopedic Surgeon 50.00 0.00 X 1301578 0 42652 Michael Bucci Neurologist 50.00 0.00 X 1293864 0 25815 Mark Nantz Former Officer 0.00 50.00 X 0 938016 130212 12440380 3243890 930164 253 1 1 0 Godshall & Godshall PO Box 1984 Greenville SC 29602 Contract Labor 1055194 Aramark CTS Inc 12483 Collections Ctr Dr Chicago IL 60693 Equip Maint Services 402326 Auxilio Inc PO Box 388 Palo Alto CA 94302 Professional Services 306304 Health Care Futures LP 300 Park Blvd Suite 200 Itasca IL 60143 Professional Services 300249 Nexsen Preut Adams Kleemeier PO Drawer 2426 Columbia SC 29202 Legal Services 253567 14 68865606 376060 69241666 Net Patient Svc Rev. 621110 162198475 162198475 162198475 13188 7443 5745 5745 5745 Clin. Trials/Research 900099 379125 379125 Employee Lease Agrmts 900099 297204 297204 Medical Directorships 900099 216570 216570 90558 90558 983457 232429343 162577600 0 610077 372 372 6049028 5444125 604903 137715862 123944276 13771586 4574769 4117292 457477 15114563 13603107 1511456 7875899 7088309 787590 686261 617635 68626 1622059 1622059 191212 172091 19121 2585329 2326796 258533 1593864 1434478 159386 14947657 13452891 1494766 218181 196363 21818 522757 470481 52276 201399 201399 2453703 2208333 245370 2097300 1887570 209730 Medical Supplies 16049055 16049055 Purchased Services 8924757 8032281 892476 Bad Debt 4651910 4651910 Medical Equip Rental 2281170 2281170 2101171 1891054 210117 232458278 211693047 20765231 0 54625 51975 12116120 12830012 71291 7062496 9044471 3438023 1549649 1489117 1888374 180927 16025260 16928052 36818909 40923811 12683097 11775034 12474114 17516014 25157211 29291048 X 11661698 11632763 11661698 11632763 36818909 40923811 -28935 0 X 0 1 X 1 0 X 1267436 338570205 69241666 409079307 142262334 141898266 144816860 154632231 162198475 745808166 142262334 141898266 146084296 493202436 231440141 1154887473 0 0 0 1154887473 244774 13188 257962 244774 13188 257962 100921 54105 1801172 1257813 983457 4197468 142363255 141952371 148130242 494460249 232436786 1159342903 0.99620 0.99650 0.00020 0.00020 X Schedule A, Part III, Line 12, Explanation of Other Income: Physician Consulting Fees - 2012 Amount: $ 15,500. Copies of Medical Records - 2012 Amount: $ 20,081. 2013 Amount: $ 19,534. Sales of Inventory - 2012 Amount: $ 59,171. 2013 Amount: $ 22,141. Purchased Services - 2012 Amount: $ 6,169. 2013 Amount: $ 12,430. Clinical Trials - 2014 Amount: $ 506,976. 2015 Amount: $ 427,837. 2016 Amount: $ 379,125. Medical Directorships - 2014 Amount: $ 384,475. 2015 Amount: $ 370,940. 2016 Amount: $ 216,570. Refunds - 2014 Amount: $ 347,619. Other Income - 2014 Amount: $ 562,102. 2015 Amount: $ 188,260. 2016 Amount: $ 90,558. Forgiveness of Debt - Employee Lease Agreements - 2015 Amount: $ 270,776. 2016 Amount: $ 297,204. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3438023 1549649 1888374 1888374 LT Non-Cash HPL/GL 13940671 Misc A/R 1869372 Due from Affiliates 1118009 16928052 HPL/GL Liability 13940671 Patient Credit Balances 2473377 Due to Affiliates 847027 Deferred Rent 254939 17516014 X Part X, Line 2: Schedule 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 BSHSI on September 1, 2007 did not have a material impact on BSHSI'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 Health System, 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, 2017 or 2016. 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, 2017 and 2016, the System has no uncertain tax positions. The System's taxable subsidiaries had approximately $106,393 and $89,895 of net operating loss carryforwards as of August 31, 2017 and 2016, 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, 2017 and 2016 as the System considers it more likely than not that these amounts will not be recognized. 0 1 0 0 0 0 0 0 0 Thomas Baumgarten MD Board Member (Sep-Dec) 720497 0 1199004 0 6730 0 15900 0 26497 0 1968628 0 0 0 Ahmad Boota Board Member (Jan-Aug) 423681 0 0 0 7163 0 15900 0 31460 0 478204 0 0 0 Mark Grabarczyk MD Board Member 701185 0 292581 0 4588 0 15900 0 26545 0 1040799 0 0 0 Edward Heidtman MD Board Member 272263 0 134518 0 1587 0 12252 0 28517 0 449137 0 0 0 Reed Mathias Board Member (Jan-Aug) 233239 0 52964 0 932 0 12543 0 9369 0 309047 0 0 0 Craig McCoy CEO - BSSFHS 0 456183 0 106067 0 40139 0 45400 0 26641 0 674430 0 0 Thomas Morris PhD President 0 336400 0 81600 0 46396 0 61346 0 20913 0 546655 0 21104 Raana Naidu MD Board Member (Sep-Dec) 209296 0 44241 0 8781 0 12715 0 9798 0 284831 0 0 0 Anselmo Nunez MD CEO - SFPS 0 468940 0 123726 0 61994 0 15900 0 19913 0 690473 0 0 James Wallace MD Board Member (Sep-Dec) 265588 0 175931 0 7459 0 15900 0 29141 0 494019 0 0 0 Karen Watson MD Board Member (Jan-Aug) 235266 0 67380 0 1831 0 10112 0 15918 0 330507 0 0 0 Wilbur Gay Treasurer/VP Finance 176150 0 24024 0 324 0 10920 0 25601 0 237019 0 0 0 Ronnie Hyatt CFO - BSSFHS 0 349926 0 81142 0 61672 0 15900 0 18464 0 527104 0 0 John Vann MD Orthopedic Surgeon 826152 0 819965 0 10692 0 15900 0 30765 0 1703474 0 0 0 Christie Mina Neurologist 639650 0 658305 0 51925 0 7950 0 28839 0 1386669 0 0 0 Christopher Van Pelt Orthopedic Surgeon 431302 0 907519 0 8091 0 15219 0 26752 0 1388883 0 0 0 James Jennings MD Orthopedic Surgeon 829209 0 461677 0 10692 0 15900 0 26752 0 1344230 0 0 0 Michael Bucci Neurologist 645320 0 592288 0 56256 0 15900 0 9915 0 1319679 0 0 0 Mark Nantz Former Officer 0 666960 0 155881 0 115175 0 103665 0 26547 0 1068228 0 67200 Part I, Line 3 Bon Secours Health System, 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 4b The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and 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: Thomas Morris, PhD, $22,519; Mark Nantz, $71,441. CCWH Properties More than 35% by BM, Edward Heidtman 258129 Lease 0 Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of St. Francis Physician Services, Inc. Form 990, Part VI, Section A, line 7a The governing body of is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of St. Francis Physician Services, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11b The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The 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 BSHSI 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 15b The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' 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 BSHSI 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 BSHSI 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 19 The filing organization provides any documents open to public inspection upon request. Form 990, Part VII - Additional Disclosure: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment. Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. Management Services MD 501(c)(3) Line 12c, III-FI Bon Secours Inc 0 St Francis Hospital Inc One St Francis Drive Greenville SC 29601 582504530 Health Care SC 501(c)(3) Line 3 Bon Secours St Francis Health System Inc 0 St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)(3) Line 7 St Francis Hospital Inc 0 Bon Secours St Francis Health System Inc One St Francis Drive Greenville SC 296013955 582504528 Local System Parent Org. SC 501(c)(3) Line 12c, III-FI Bon Secours Health System Inc 0 Upstate Surgery Center One St Francis Drive Greenville SC 29601 562186977 Ambulatory Surgery Center SC N/A 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0