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Our Lady of Bellefonte Hospital Inc: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
Our Lady of Bellefonte Hospital Inc (EIN 61-1356023)
Tax period
2016-09-01 to 2017-08-31
Filed
2018-07-09
IRS object ID
201821909349301152
Schema version
2016v3.0
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)
Return2018-07-09T13:13:27-05:00ReturnTs
Tax Period End2017-08-31TaxPeriodEndDt

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 Line1191 Peachtree St Suite 2000AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP303031749ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN611356023EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Our Lady of Bellefonte Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlOURLBusinessNameControlTxt
Phone6068333333PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKevin HalterPersonNm
Person TitleChief Executive OfficerPersonTitleTxt
Phone6068333600PhoneNum
Signature2018-07-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJohn W Sadoff JrPreparerPersonNm
PTINP00540589PTIN
Phone4042201500PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKevin HalterPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$174,034,835GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addressbonsecours.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionAcute Care HospitalActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee1355TotalEmployeeCnt
Total Volunteers61TotalVolunteersCnt
Total Gross UBI$6,486,245TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$168,856NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$367,860PYContributionsGrantsAmt
CY Contributions Grants$382,574CYContributionsGrantsAmt
PY Program Service Revenue$170,895,730PYProgramServiceRevenueAmt
CY Program Service Revenue$169,298,843CYProgramServiceRevenueAmt
PY Investment Income$640,865PYInvestmentIncomeAmt
CY Investment Income$483,753CYInvestmentIncomeAmt
PY Other Revenue$3,123,969PYOtherRevenueAmt
CY Other Revenue$3,869,665CYOtherRevenueAmt
PY Total Revenue$175,028,424PYTotalRevenueAmt
CY Total Revenue$174,034,835CYTotalRevenueAmt
PY Grants And Similar Paid$601,770PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$582,381CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$63,103,862PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$70,958,001CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$100,665,935PYOtherExpensesAmt
CY Other Expenses$103,988,754CYOtherExpensesAmt
PY Total Expenses$164,371,567PYTotalExpensesAmt
CY Total Expenses$175,529,136CYTotalExpensesAmt
PY Revenues Less Expenses$10,656,857PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,494,301CYRevenuesLessExpensesAmt
Total Assets BOY$153,602,571TotalAssetsBOYAmt
Total Assets EOY$153,618,023TotalAssetsEOYAmt
Total Liabilities BOY$88,441,278TotalLiabilitiesBOYAmt
Total Liabilities EOY$87,483,269TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$65,161,293NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$66,134,754NetAssetsOrFundBalancesEOYAmt
MissionThe 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$162,621,305ExpenseAmt
Grant$582,381GrantAmt
Revenue$164,019,680RevenueAmt
DescTo bring compassion to healthcare and to be good help to those in need by providing healthcare services. Please see community benefit disclosures in Sch H.Desc
Total Program Service Expenses$162,621,305TotalProgramServiceExpensesAmt
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 Assets0ReportOtherAssetsInd
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 OrganizationsYes (1)GrantsToOrganizationsInd
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 MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document121IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1355EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
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 FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Aaron AkersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6068334136PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Carol Allen
Board Member2.000.00Yes (X)$0$0$0
Gregory Bausch PhD
Board Member2.000.00Yes (X)$0$0$0
Lori Cooksey
Board Member2.000.00Yes (X)$0$0$0
Mary Flath PhD
Board Member2.000.00Yes (X)$0$0$0
Geoff Griffith
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Kevin Halter FACHE
CEO - BSKY37.0013.00Yes (X)$0$452,561$56,406Yes (X)
Kevin Howard
Board Member (Jan-Aug)50.000.00Yes (X)$183,046$0$17,424
Daniel Huffman
Board Member2.000.00Yes (X)$0$0$0
Gregory Jackson
Chairman3.000.00Yes (X)$0$0$0Yes (X)
Connie Johnson
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Larry Jones
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
James Martin Jr MD
Board Member2.000.00Yes (X)$2,003$0$0
Andrea Mazzoccoli PhD
Board Member2.0048.00Yes (X)$0$585,415$83,331
Jason McCloud OD
Board Member2.000.00Yes (X)$0$0$0
Stephen McGinnis Esq
Board Member2.000.00Yes (X)$0$0$0
Thomas Morris PhD
President3.5046.50Yes (X)$0$464,396$82,259Yes (X)
James Payne PhD
Board Member2.000.00Yes (X)$0$0$0
Pam Phillips
Board Member2.0048.00Yes (X)$0$228,445$27,431
Laura Timberlake
Board Member2.000.00Yes (X)$0$0$0
Emily Watson
Board Member2.000.00Yes (X)$0$0$0
William Willan PhD
Board Member2.000.00Yes (X)$0$0$0
Joe Buchheit
Treasurer/CFO-BSKY37.0013.00$307,585$0$22,742Yes (X)
Rodney Hieneman
Secretary50.000.00$164,861$0$32,718Yes (X)
John Darnell
CMO50.000.00$285,348$0$17,880Yes (X)
Michele Friday MD
Cardiologist49.500.50$857,498$0$33,705Yes (X)
Yogendra Prasad MD
Cardiologist50.000.00$608,458$0$32,814Yes (X)
Kurt Jaenicke MD
Obstetrician50.000.00$586,008$0$24,742Yes (X)
Phillip Lackey MD
Plastic Surgeon50.000.00$396,559$0$31,318Yes (X)
Jason Ford MD
Pediatrician50.000.00$340,861$0$29,694Yes (X)
John Wallenhorst
Former Board Officer0.0050.00$0$454,099$35,488Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,732,227TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,184,916TotReportableCompRltdOrgAmt
Total Other Compensation$527,952TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K45IndivRcvdGreaterThan100KCnt
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
Morrison MGT Specialists
PO Box 102289AtlantaGA303682289Food Services$3,009,005
Ashland Anesthesia PSC
PO Box 29AshlandKY411050029Anesthesia Services$2,806,769
Aramark CTS Inc
12483 Collections CTR DrChicagoIL60693Equipment Maintenance$2,454,825
Aramark
24863 Network PlaceChicagoIL606731248Housekeeping/Laundry$2,008,321
Jackson & Coker Locum Tenens
3000 Old Alabama Road Suite 119-608AlpharettaGA30022Jobs Services$1,867,211
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K35CntrctRcvdGreaterThan100KCnt
Related Organizations$316,640RelatedOrganizationsAmt
Government Grants$65,934GovernmentGrantsAmt
Total Contributions$382,574TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service Rev.Desc
Business622110BusinessCd
Total Revenue Column$169,298,843TotalRevenueColumnAmt
Related Or Exempt Func Income$163,685,699RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$5,613,144UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$169,298,843TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$226,555TotalRevenueColumnAmt
Exclusion$226,555ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$634,363RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$634,363RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$634,363TotalRevenueColumnAmt
Exclusion$634,363ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$236,963SecuritiesAmt
Other$20,235OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$236,963SecuritiesAmt
Other$20,235OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$257,198TotalRevenueColumnAmt
Exclusion$257,198ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Retail Pharmacy Rev.446110$2,546,793$873,101$1,673,692
Comm. Health & Fitness713940$333,981$333,981
Medical Records900099$157,695$157,695

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$196,833TotalRevenueColumnAmt
Exclusion$196,833ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,235,302OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$174,034,835TotalRevenueColumnAmt
Related Or Exempt Func Income$164,019,680RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$6,486,245UnrelatedBusinessRevenueAmt
Exclusion$3,146,336ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$578,381TotalAmt
Program Services$578,381ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$4,000TotalAmt
Program Services$4,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,096,547TotalAmt
Program Services$986,893ProgramServicesAmt
Management And General$109,654ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$50,983,628TotalAmt
Program Services$45,885,265ProgramServicesAmt
Management And General$5,098,363ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,635,991TotalAmt
Program Services$5,972,392ProgramServicesAmt
Management And General$663,599ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,257,681TotalAmt
Program Services$7,431,913ProgramServicesAmt
Management And General$825,768ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,984,154TotalAmt
Program Services$3,585,739ProgramServicesAmt
Management And General$398,415ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$213,873TotalAmt
Program Services$192,486ProgramServicesAmt
Management And General$21,387ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,404TotalAmt
Program Services$21,064ProgramServicesAmt
Management And General$2,340ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$13,750TotalAmt
Program Services$12,375ProgramServicesAmt
Management And General$1,375ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,147,022TotalAmt
Program Services$10,147,022ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$432,176TotalAmt
Program Services$388,958ProgramServicesAmt
Management And General$43,218ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,743,452TotalAmt
Program Services$1,569,107ProgramServicesAmt
Management And General$174,345ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$469,110TotalAmt
Program Services$422,199ProgramServicesAmt
Management And General$46,911ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,338,520TotalAmt
Program Services$5,704,668ProgramServicesAmt
Management And General$633,852ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$373,189TotalAmt
Program Services$335,870ProgramServicesAmt
Management And General$37,319ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$41,268TotalAmt
Program Services$37,141ProgramServicesAmt
Management And General$4,127ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,112,234TotalAmt
Program Services$2,112,234ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,709,656TotalAmt
Program Services$7,838,690ProgramServicesAmt
Management And General$870,966ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$692,436TotalAmt
Program Services$623,192ProgramServicesAmt
Management And General$69,244ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$28,794,413$28,794,413
Purchased Services$15,986,064$14,387,458$1,598,606
Corporate Mgmt Dues$14,775,379$13,297,841$1,477,538
Unrelated Business Inco$455,982$455,982

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$12,666,826TotalAmt
Program Services$12,292,004ProgramServicesAmt
Management And General$374,822ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$175,529,136TotalAmt
Program Services$162,621,305ProgramServicesAmt
Management And General$12,907,831ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$824BOYAmt
EOY$824EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$63,982,185BOYAmt
EOY$59,570,773EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,667,834BOYAmt
EOY$19,909,181EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$751,291BOYAmt
EOY$1,644,278EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,093,040BOYAmt
EOY$4,150,922EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,537,028BOYAmt
EOY$1,645,273EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$143,278,698LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$95,413,496LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$45,022,308BOYAmt
EOY$47,865,202EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,733,063BOYAmt
EOY$10,609,579EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$419,692BOYAmt
EOY$436,396EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$252,734BOYAmt
EOY$243,053EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,142,572BOYAmt
EOY$7,542,542EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$153,602,571BOYAmt
EOY$153,618,023EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,343,620BOYAmt
EOY$16,216,566EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,451,748BOYAmt
EOY$4,499,531EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$70,645,910BOYAmt
EOY$66,767,172EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$88,441,278BOYAmt
EOY$87,483,269EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$65,160,733BOYAmt
EOY$66,134,194EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$560BOYAmt
EOY$560EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$65,161,293BOYAmt
EOY$66,134,754EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$153,602,571BOYAmt
EOY$153,618,023EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,494,301ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$551,684NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,916,078OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$13,750OtherActivitiesAmt
Total Lobbying Expenditures$13,750TotalLobbyingExpendituresAmt
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$4,509,318OtherCostOrOtherBasisAmt
Book Value$4,509,318BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,825,441OtherCostOrOtherBasisAmt
Depreciation$33,028,444DepreciationAmt
Book Value$25,796,997BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,563,271OtherCostOrOtherBasisAmt
Depreciation$2,545,740DepreciationAmt
Book Value$17,531BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,620,470OtherCostOrOtherBasisAmt
Depreciation$56,975,044DepreciationAmt
Book Value$15,645,426BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,760,198OtherCostOrOtherBasisAmt
Depreciation$2,864,268DepreciationAmt
Book Value$1,895,930BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$47,865,202TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
LT Liab - Pension Liability$58,922,558
HPL/GL Liability$5,786,497
Medicare/Medicaid Settlements$1,047,769
Due to Affiliates$686,725
Reserves from Medicare$254,334
Unapplied Credit$41,178
Unclaimed Prop Accrual$28,111
FieldValueIRS element (for citing)
Total Liability$66,767,172TotalLiabilityAmt
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 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.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$1,443,181TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$445,930DirectOffsettingRevenueAmt
Net Community Benefit Expns$997,251NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,126,387TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,657,329DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,469,058NetCommunityBenefitExpnsAmt
Total Expense0.08660TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$40,569,568TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,103,259DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,466,309NetCommunityBenefitExpnsAmt
Total Expense0.09260TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served30514PersonsServedCnt
Total Community Benefit Expns$764,228TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$764,228NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served313PersonsServedCnt
Total Community Benefit Expns$381,340TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$224,167DirectOffsettingRevenueAmt
Net Community Benefit Expns$157,173NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$340,447TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$340,447NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served5317PersonsServedCnt
Total Community Benefit Expns$75,937TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$75,937NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served36144PersonsServedCnt
Total Community Benefit Expns$1,561,952TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$224,167DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,337,785NetCommunityBenefitExpnsAmt
Total Expense0.00800TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served36144PersonsServedCnt
Total Community Benefit Expns$42,131,520TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,327,426DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,804,094NetCommunityBenefitExpnsAmt
Total Expense0.10060TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Persons Served1920PersonsServedCnt
Total Community Benefit Expns$3,481TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,481NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Persons Served126PersonsServedCnt
Total Community Benefit Expns$1,068TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,068NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Persons Served295PersonsServedCnt
Total Community Benefit Expns$3,867TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,867NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Persons Served1155PersonsServedCnt
Total Community Benefit Expns$3,196TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,196NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Persons Served5573PersonsServedCnt
Total Community Benefit Expns$57,043TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,043NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Persons Served9571PersonsServedCnt
Total Community Benefit Expns$49,895TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$49,895NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Persons Served1435PersonsServedCnt
Total Community Benefit Expns$7,871TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,871NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Persons Served20075PersonsServedCnt
Total Community Benefit Expns$126,421TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$126,421NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$8,424,472BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$42,201,682ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$43,255,756CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,054,074MedicareSurplusOrShortfallAmt

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 Line1Our Lady of Bellefonte Hospital IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://bonsecours.com/kentuckyWebsiteAddressTxt
State License100154StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Our Lady of Bellefonte Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
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 (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Our Lady of Bellefonte Hospital, Inc.Part V, Section B, Line 5: In preparing the OLBH CHNA, the hospital collaborated with community service organizations to provide feedback on the questions we included in the survey. Local health dept's, police and fire dept's, school districts, community based service organizations, local businesses, representatives from faith communities along with residents and organizations. Interviews were conducted with individuals with special knowledge and expertise in public health, along with representatives of individuals that are medically underserved and battling chronic diseases. Interviews were conducted with the following individuals: Chris Crum, Director of Greenup Co. Health Dept., Maria Hardy, Director Boyd Co. Health Dept., Laura Brown, Director Ironton OH Health Dept. , Debbie Fisher Director Lawrence Co. Ohio Health Dept., Kelli Prater, Director Boyd Co. Head Start, Mary Crowley, NEKCC Free clinic, Debbie Sivis, Director at Shelter of Hope, Alfreda Moore, Director Ashland Community Kitchen, Debbie Blevins, Director of Helping Hands of Greenup KY, Ann Perkins, Director of Safe Harbor, Trish Hall Director of CARES, Eve Greene Nurse at Greenup Co. Health Dept.
Our Lady of Bellefonte Hospital, Inc.Part V, Section B, Line 6a: King's Daughters Medical Center
Our Lady of Bellefonte Hospital, Inc.Part V, Section B, Line 7d: The CHNA is available to the public in the following locations: Hospital and coalition Web sites, printed copies were made available at the hospital in various departments including the emergency department, administration, marketing and mission departments.
Our Lady of Bellefonte Hospital, Inc.Part V, Section B, Line 11: The CHNA identified significant needs in several areas. Through collaboration with Healthy Choices/Healthy Communities coalition the following 4 areas are being addressed through team committees or sub-groups.1) Obesity- Festival of Fitness: A community event aimed to bring awareness to opportunities in the local area to increase individual and family fitness in daily lives. Several coalition agencies have funded walking tracks and trails in several local communities. This initiative aims to provide facilities in remote and rural areas. BSKY has increased financial support for school and community gardens, and funded two community bicycle safety programs, and assists with funding for three local farmers markets, support for safe routes to schools and continue work on policy changes through schools to support active recess and healthy eating in child care centers. Initiatives are in place to support completion of streets in several communities.2) Access to Care: Supports a van ministry program to transport patients to physician appointments and treatments. Sponsors community events to bring awareness to colon cancer through an event at the mall in collaboration with the American Cancer Society. We provide free screenings in the community for Blood Pressure, Blood sugar, A1C, Hemoglobin and Cholesterol.3) Substance abuse: Assists with a program in local schools- "2 good for drugs program" is currently in 4 local school systems in collaboration with Pathways, working on 24-7 smoke free policy in schools, and supports a program in the schools called "truth or consequences" in collaboration with UK extension office and law enforcement.4) Poverty/Socioeconomic challenges: This workgroup is working with the United Way to implement a 2-1-1 system for referrals to social service agencies. The group is working on a job fair to assist the homeless and most vulnerable to find employment which would assist them to move out of poverty.
Our Lady of Bellefonte Hospital, Inc.Part 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 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. Because both Maryland law and Federal tax law limit the amounts that may be charged to patients, an FAP eligible individual or an uninsured individual will not be charged more than the lesser of the AGB or the regulated charge set by the Maryland Health Services Cost Review Commission for emergency or other medically necessary care.
Form 990, Schedule H, Part V, Section B, Line 7a:https://bonsecours.com/kentucky/community-commitment/community-health-needs-assessment
FieldValueIRS element (for citing)
Facility14FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Med Plaza Pharmacy
700 St Christopher DriveAshlandKY41101Pharmacy
2 - Same Day Surgery Center
1101 St Christopher DriveAshlandKY41101Surgery Center
3 - Bellefonte Behavioral Health
1000 St Christopher DriveAshlandKY41101Behavioral Health
4 - Bellefonte Home Health Care Agency
700 St Christopher Drive Suite 105AshlandKY41101Home Health
5 - Ironton MRI
1015 East Ring RoadIrontonOH45638Imaging Center
6 - Ashland Imaging
1816 Carter AveAshlandKY41101Imaging Center
7 - Ashland Lab
1816 Carter AveAshlandKY41101Lab Services
8 - Bellefonte Center
1000 Ashland DriveAshlandKY41101Women's Health, Pre-testing, Various physician offices
9 - Ashland Infusion Center
2930 Carter AveAshlandKY41101Infusion Therapy
10 - Wheelersburg PT
8985 Ohio River RoadWheelersburgOH45638Physical Therapy
11 - OLBH Pediatric Rehabilitation Clinic
1100 St Christopher DriveAshlandKY41101Pediatric Rehab
12 - Bellefonte Sleep Lab
118 St Christopher DriveAshlandKY41101Sleep Lab
13 - Vitality Center
1100 St Christopher DriveAshlandKY41101Cardio/Vascular Rehab
14 - Bellefonte Home Health Care Agency - Ohi
109 N 3rd StIrontonOH45638Home Health

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:Annually, Bon Secours Kentucky Health System, through its Foundation, publishes a report for the community, explaining the various 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 March 15.This report is available online at https://www.olbhfoundation.org/annual-report.
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.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. 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, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
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: $8,424,472.
Part II, Community Building Activities:The service area addressed in the recent CHNA covered 4 counties in 2 states; Boyd, Greenup, Carter in KY and Lawrence Co in Ohio. located in 2 states, Ky and OH. Our community building activites include School and community gardens, walking trails, farmers markets, after school and summer camps for low income students living in public housing in the Ironton Ohio community. The trails and gardens located in the Greenup county community of Argillite KY continue to be utilized and provide opportunities for education on how to grow fresh vegetables and provides a venue for the community and the school students and personal to walk in a safe atmospher in a rural community this project is aimed to to help fight obesity. BSKY continues to use First Book market place to purchase books to distribute free to students in the low income communities of Ashland, Greenup, Argillite, KY and Ironton, OH. Support of 94 student backpacks and weekend snack sack programs provides supplies and food to students most at risk of going hungry during the weekend and without needed school supplies when school resumes form the summer break. These programs are essential and continues to assist the high risk students in our service area. Healthy Community Services conducted 94 health fairs, providing approximately 7,650 health screenings in 2017 for chronic conditions such as heart disease, diabetes, osteoporosis, anemia, glaucoma, and peripheral vascular disease. All participants in our health fairs received personal health counseling and those with abnormal results 1,719 received educational materials and the offer of assistance in finding a medical home or care provider if they had none. Additionally Healthy Community services conducted 8 community CPR classes in 2017 resulting in 46 individuals being certified in adult, infant and child CPR. We offered 2 safe sitter classes and certified 13 young people as safe sitters. We offered bicycle safety camp with 75 children and their families in attendance. We currently have faith ministry or faith community nurse partnerships with 58 local churches. We have 4 churches offering exercise classes with 50 participants. We provided Flu shots at 16 locations providing 205 immunizations. . Our Healthy Community Services Van Ministry provided free non-emergency medical transportation for outpatient services on the OLBH campus and to patients who had appointments with campus or BPS-affiliated physicians. We operate four vans --two of which is equipped with a wheelchair lift we provided 358 wheelchair transports. In an area which has very limited public transportation, our van ministry provides an option for our patients who need treatment but have no means of affordable non-emergency medical transportation. Our van ministry provided over 3,907 round trips and traveled over 94,192 miles. We served over 493 individuals in transporting most of these individuals multiple times. Our Meals on Wheels programs serve 200 home-bound seniors in 10 communities for an average of 3,600 meals delivered each month. We provide approximately $32,000 in free or reduced price meals each year.
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 38-39 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.In addition to the costs reported above, the organization incurred additional costs relating to Medicare support that are not includable in the Medicare Cost Report in the amount of: $388,339.
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:Our Lady of Bellefonte Hospital (OLBH) uses multiple approaches to assess the health needs of the communities it serves. We have a community based Board of Directors that provides the hospital with guidance and input on services needed in the local community through contacts with local business and government leaders. Community health screening data is gathered through the year and analyzed for use in planning. Community need assessments are updated using a variety of informational sources including Kentucky Health Information for state-based performance data, Kentucky Hospital Association information for market and geographic data bases, third party data bases, US Census Bureau data and Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to Our Lady of Bellefonte Hospital. We have also developed regional alignment plans using this data and tying it to our underserved areas to plan for future growth in the communities we serve by providing more access points for patients in our service areas. The CHNA survey was open to the public through a web based survey and available in hard copies. We worked with local health departments, participated in health needs assessments, had conversations with local residents, health professionals, public forums, community meetings and coalitions. All these groups contributed to the assessment of the community's health care needs.
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 website. In addition, patient billing statements and letters inform patients regarding our financial assistance program. Bon Secours proactively screens patients to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours 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 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 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 are translated into multiple languages and placed on our Bon Secours website for patients to access.
Part VI, Line 4:Our Lady of Bellefonte Hospital and related entities serve a region of approximately 400,000 people in northeastern Kentucky, southern Ohio, and western West Virginia. The service areas include six counties in northern Kentucky (Greenup, Boyd, Lawrence, Carter, and Elliott) which comprises of the FIVCO Area Development District as well as Lewis County, two counties in southern Ohio (Lawrence, and Scioto) and Wayne and Cabell counties in western West Virginia. Due to our growing aging population, services for our community residents aged 55 and older are needed, particularly women's health, orthopedics, diabetes, cardiopulmonary services, cancer, drug rehab and wound care. According to the 2017 County Health rankings data, the counties in OLBH primary service area rank among the highest in the state at risk for poor health outcomes and poor health factors. Consistent with the state and national trends, five chronic diseases account for most of the spending on health care: diabetes, heart disease, hypertension, asthma and depression. Prescription drug abuse and addiction is a growing problem in the area, as is illegal drug use including heroine, methamphetamine and marijuana. Access to quality preventative care and disease management education is critical in minimizing future hospitalizations. Health insurance coverage is also a factor in determining whether patients will seek preventative care or wait for symptoms to become more severe, thus requiring more extensive treatments, including hospitalization. The area's growing drug addiction problems puts these individuals more at risk for depression, suicides and kidney failure. The area's population of drug abuse by all ages is growing at a relatively fast pace and will necessitate planning of and access to health care services unique to this population. There are few exceptions to our local community versus state averages with regard to health impacts. Our service area has higher overall cancer rates in lung cancer than the state average. Other cancers that are prevalent in our primary and secondary service areas are breast, colon, bladder, prostate and lymphoma.
Part VI, Line 5:The organization has an open medical staff with privileges available to all qualified physicians in the area. Bon Secours Kentucky Health System is governed by a board of directors whose composition is representative of the community it serves. OLBH has been instrumental in developing and collaborating with other local agencies on programs to meet the needs of uninsured and low income families. OLBH also supports van ministry that provides free non-emergency medical transportation for outpatient services at our campus, primary care centers and other service areas. Our staff organizes and chairs the Greenup County Interagency Council. We have partnerships with 54 churches to conduct health ministry and/or faith community nursing programs.Healthy Choices Healthy Communities coalition: This coalition is tackling obesity, substance abuse, poverty, and access to care issues in our communities. OLBH Green Team: The OLBH Green Team has implemented recycling programs (plastic, aluminum, electronics, printer cartridges and toners, cardboard, batteries, etc.) that offer the opportunity for our community residents to be better stewards of our earth and live in a healthier environment. In 2016, the team took on the project of adding rain barrels to a walking trail on our campus that provides an opportunity for employees and community residents to walk, garden (adopt-a-flower-bed program) or just enjoy nature. The team also operates a clothing closet, has regular clean-up days for our campus and participates in Cell Phones for Soldiers by donating old cell phones to provide talk time for American military personnel around the world. We also have an E-recycling drop off site for the community and recycling for Christmas lights.
Part VI, Line 6:Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), 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 BSHSI, 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 BSHSI 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 Health System, Inc. (BSHSI), 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 BSHSI Vision. BSHSI'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 BSHSI and the SQP (Strategic Quality Plan).
Part VI, Line 7, Reports Filed With StatesKY

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Kentucky Health System Foundation IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Recipient EIN611381952RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$576,581CashGrantAmt
Purpose Of GrantGeneral and Administrative SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. Grant administration is maintained within the Foundation arm and received by the hospital as reimbursement for spend.ExplanationTxt

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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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
Kevin Halter FACHE
CEO - BSKY$0$358,895$0$41,539$0$52,127$0$29,714$0$26,692$0$508,967$0$8,326
Kevin Howard
Board Member (Jan-Aug)$175,025$0$7,866$0$155$0$0$0$17,424$0$200,470$0$0$0
Andrea Mazzoccoli PhD
Board Member$0$407,244$0$97,555$0$80,616$0$62,355$0$20,976$0$668,746$0$36,954
Thomas Morris PhD
President$0$336,400$0$81,600$0$46,396$0$61,346$0$20,913$0$546,655$0$21,104
Pam Phillips
Board Member$0$160,241$0$38,357$0$29,847$0$17,282$0$10,149$0$255,876$0$0
Joe Buchheit
Treasurer/CFO-BSKY$236,843$0$28,648$0$42,094$0$4,681$0$18,061$0$330,327$0$0$0
Rodney Hieneman
Secretary$153,807$0$10,742$0$312$0$4,738$0$27,980$0$197,579$0$0$0
John Darnell
CMO$250,884$0$32,819$0$1,645$0$6,090$0$11,790$0$303,228$0$0$0
Michele Friday MD
Cardiologist$683,773$0$172,144$0$1,581$0$4,745$0$28,960$0$891,203$0$0$0
Yogendra Prasad MD
Cardiologist$440,517$0$166,809$0$1,132$0$4,622$0$28,192$0$641,272$0$0$0
Kurt Jaenicke MD
Obstetrician$342,733$0$240,891$0$2,384$0$4,829$0$19,913$0$610,750$0$0$0
Phillip Lackey MD
Plastic Surgeon$395,060$0$500$0$999$0$4,617$0$26,701$0$427,877$0$0$0
Jason Ford MD
Pediatrician$142,649$0$198,080$0$132$0$4,652$0$25,042$0$370,555$0$0$0
John Wallenhorst
Former Board Officer$0$300,576$0$72,652$0$80,871$0$24,843$0$10,645$0$489,587$0$24,034

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Bon 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 4bThe filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to 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: Kevin Halter, FACHE, $ 9,610; Andrea Mazzoccoli, $37,070; Thomas Morris, PhD, $ 22,519; John Wallenhorst, PhD, $34,685.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Judy Houston
Sibling of BM, James Payne$84,438Employment0
Teresa Baron
Sibling of BM, James Payne$56,960Employment0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Kentucky Health System, Inc. which in turn is the sole member of Our Lady of Bellefonte Hospital, Inc.
Form 990, Part VI, Section A, line 7aThe governing body of Our Lady of Bellefonte Hospital, Inc. is appointed by its Member, Bon Secours Kentucky Health System, Inc. and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Our Lady of Bellefonte Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc.
Form 990, Part VI, Section B, line 11bThe 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 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 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 15bThe 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 BSHSI. 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 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 19Our Lady of Bellefonte Hospital, Inc. 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 and do not receive additional compensation for their board responsibilities.
Form 990, Part XI, line 9:Minimum Pension Liability 3,382,757. Transfer to BSHSI for Swaps & Debt -1,170,982. Miscellaneous Changes in Net Assets -295,697.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Eastern Kentucky Quality Alliance LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
EIN822832840EIN
Primary ActivitiesClinically Integrated NetworkPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Our Lady of Bellefonte Hospital IncBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)Line 12c, III-FIBon Secours Inc0
Bellefonte Physician Services Inc
1000 St Christopher DriveAshlandKY41101352320780Physician PracticesKY501(c)(3)Line 10Bon Secours Kentucky Health System Inc0
Bon Secours Kentucky Health System Foundation Inc
1000 St Christopher DriveAshlandKY41101611381952Grant Making FoundationKY501(c)(3)Line 7Bon Secours Kentucky Health System Inc0
Bon Secours Kentucky Health System Inc
1000 St Christopher DriveAshlandKY41101611356024Local System Parent Org.KY501(c)(3)Line 12c, III-FIBon Secours Health System Inc0
Our Lady of Bellefonte Hospital Auxiliary
1000 St Christopher DriveAshlandKY41101610488859Fundraising for Our Lady of Bellefonte HospitalKY501(c)(3)0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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 Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd