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Mary Immaculate Hospital: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
Mary Immaculate Hospital (EIN 54-0548200)
Tax period
2016-09-01 to 2017-08-31
Filed
2018-07-03
IRS object ID
201841849349300104
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)
Return2018-07-03T06:33:58-05:00ReturnTs
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 Street Suite 2000AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP303031749ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540548200EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMARYBusinessNameControlTxt
Phone7578866000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDarlene StephensonPersonNm
Person TitleChief Executive OfficerPersonTitleTxt
Phone7578866000PhoneNum
Signature2018-07-03SignatureDt
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

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDarlene StephensonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$180,821,434GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addressbonsecours.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionAcute Care HospitalActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee1065TotalEmployeeCnt
Total Volunteers136TotalVolunteersCnt
Total Gross UBI$101,568TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$34,287NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$835,837PYContributionsGrantsAmt
CY Contributions Grants$555,093CYContributionsGrantsAmt
PY Program Service Revenue$181,714,333PYProgramServiceRevenueAmt
CY Program Service Revenue$176,111,949CYProgramServiceRevenueAmt
PY Investment Income$892,900PYInvestmentIncomeAmt
CY Investment Income$2,000,678CYInvestmentIncomeAmt
PY Other Revenue$2,443,033PYOtherRevenueAmt
CY Other Revenue$2,115,360CYOtherRevenueAmt
PY Total Revenue$185,886,103PYTotalRevenueAmt
CY Total Revenue$180,783,080CYTotalRevenueAmt
PY Grants And Similar Paid$74,710PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$17,250CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,965,533PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,889,564CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$114,659,640PYOtherExpensesAmt
CY Other Expenses$110,362,954CYOtherExpensesAmt
PY Total Expenses$169,699,883PYTotalExpensesAmt
CY Total Expenses$165,269,768CYTotalExpensesAmt
PY Revenues Less Expenses$16,186,220PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$15,513,312CYRevenuesLessExpensesAmt
Total Assets BOY$242,150,281TotalAssetsBOYAmt
Total Assets EOY$258,942,792TotalAssetsEOYAmt
Total Liabilities BOY$20,619,993TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,519,918TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$221,530,288NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$237,422,874NetAssetsOrFundBalancesEOYAmt
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$155,074,307ExpenseAmt
Grant$17,250GrantAmt
Revenue$177,788,355RevenueAmt
DescMary Immaculate Hospital provides medical care to patients without regard to their ability to pay. Among the major services provided to the residents of Hampton Roads, three major areas of focus are orthopedics, general surgery and women's health. In addition, Mary Immaculate provides support for community services. Please see Schedule H for additional information regarding programs, community benefit programs and Charity Care.Desc
Total Program Service Expenses$155,074,307TotalProgramServiceExpensesAmt
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 EndowmentsYes (1)TempOrPermanentEndowmentsInd
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 ActivitiesYes (1)FundraisingActivitiesInd
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 Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document84IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1065EmployeeCnt
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 ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7572152709PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd Suite 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Susan Anthony
Board Member2.000.00Yes (X)$0$0$0
James Bento
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Robert Bray
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Bruce Britton MD
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Brother Arthur Caliman
President - BSHR/DMC/MMC/MNCC3.5046.50Yes (X)$0$0$0
Arthur Collins
Chairman (Jan-Aug)3.000.00Yes (X)$0$0$0Yes (X)
Sister Elaine Davia
Board Member2.0048.00Yes (X)$0$0$0
Timothy Davis
Board Member2.0048.00Yes (X)$0$953,293$35,876
Debra Deihl
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Charlette Fairchild PhD
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Gabriel Franco
Board Member2.000.00Yes (X)$0$0$0
Rev Ivan Harris
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Deborah Jones
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Dr Vincent Joseph
Board Member2.000.00Yes (X)$0$0$0
Michael Kerner
Secretary/CEO-BSHR14.0036.00Yes (X)$0$842,080$126,937Yes (X)
Sister Sandra Lyons
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Sister Shaun Malone
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Shelley Mishoe
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Helena Mock
Secretary (Sep-Dec)2.000.00Yes (X)$0$0$0Yes (X)
Jeffrey Morrison DO
Board Member (Sep-Dec)2.000.00Yes (X)$0$20,750$0
Sister David Niski
President - MIH/SFNC3.500.00Yes (X)$0$0$0Yes (X)
William Pile
Chair (Sep-Dec)/BM (Jan-Aug)3.000.00Yes (X)$0$0$0Yes (X)
Cynthia Romero MD
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Rodrigo Romulo MD
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Stephanie Short
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Douglas Ziegenfuss PhD
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Charmaine Rochester PhD
Treasurer/VP Finance (Sep-Apr)15.0035.00$0$275,200$16,870Yes (X)
Darlene Stephenson
CEO - MIH47.502.50$0$322,337$34,367Yes (X)
Michael Dooley
Int VP Fin(Apr-Aug)/Treas (Jul-Aug)12.0038.00$0$0$0Yes (X)
Jeffrey Doucette
VP Patient Care Services (Sep-Dec)50.000.00$0$244,395$42,687Yes (X)
Vickie Humphries
VP of Human Resources15.0035.00$0$228,779$24,073Yes (X)
James McNamara
VP of Ortho7.0043.00$0$272,959$21,760Yes (X)
Terri Spence
VP & Regional CIO15.0035.00$0$253,014$32,322Yes (X)
Anthony Terracina MD
General Surgeon50.000.00$1,086,584$0$42,210Yes (X)
Jason Andre MD
Vascular Surgeon50.000.00$209,811$179,515$35,093Yes (X)
Edward Pak
Internist50.000.00$371,729$0$10,600Yes (X)
Thomas Hoffmier MD
Cardiologist50.000.00$283,922$0$30,186Yes (X)
Michael Mangano
Pharmacist50.000.00$169,439$0$26,436Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,121,485TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,592,322TotReportableCompRltdOrgAmt
Total Other Compensation$479,417TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K40IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
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
Tidewater Physicians Multispecialty Grou
860 Omni Blvd Suite 401Newport NewsVA23606Physician Services$2,788,304
Morrison Management Specialists Inc
PO Box 102289AtlantaGA303682289Dietary Services$2,730,993
Aramark CTS Inc
12483 Collections Ctr DrChicagoIL60693Biomedical Engineering$2,566,510
WM Jordan Co Inc
PO Box 1337Newport NewsVA236010337Construction$1,709,399
Anesthesia Assoc of Hampton
110 Three Point CtYorktownVA23692Physician Services$1,403,875
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Fundraising$36,461FundraisingAmt
Related Organizations$302,896RelatedOrganizationsAmt
Government Grants$8,978GovernmentGrantsAmt
All Other Contributions$206,758AllOtherContributionsAmt
Total Contributions$555,093TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service Rev.Desc
Business622110BusinessCd
Total Revenue Column$176,111,949TotalRevenueColumnAmt
Related Or Exempt Func Income$176,010,381RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$101,568UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$176,111,949TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,076,598TotalRevenueColumnAmt
Exclusion$1,076,598ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$34,151RealAmt
Personal$1,820PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$2,765RealAmt
Personal$2,163PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$31,386RealAmt
Personal-$343PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,043TotalRevenueColumnAmt
Exclusion$31,043ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$789,594SecuritiesAmt
Other$134,486OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

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

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$789,594SecuritiesAmt
Other$134,486OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$924,080TotalRevenueColumnAmt
Exclusion$924,080ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$13,309FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$36,461ContriRptFundraisingEventAmt
Fundraising Direct Expenses$33,426FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,117TotalRevenueColumnAmt
Exclusion-$20,117ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Joint Venture Income900099$1,004,560$1,004,560
Outpatient Pharmacy446110$542,787$542,787
Physical Therapy Svcs900099$230,627$230,627

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$326,460TotalRevenueColumnAmt
Exclusion$326,460ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,104,434OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$180,783,080TotalRevenueColumnAmt
Related Or Exempt Func Income$177,788,355RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$101,568UnrelatedBusinessRevenueAmt
Exclusion$2,338,064ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$17,250TotalAmt
Program Services$17,250ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$43,338,954TotalAmt
Program Services$39,005,059ProgramServicesAmt
Management And General$4,333,895ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,882,998TotalAmt
Program Services$1,694,698ProgramServicesAmt
Management And General$188,300ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,908,562TotalAmt
Program Services$5,317,706ProgramServicesAmt
Management And General$590,856ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,759,050TotalAmt
Program Services$3,383,145ProgramServicesAmt
Management And General$375,905ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$186,706TotalAmt
Program Services$168,035ProgramServicesAmt
Management And General$18,671ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$29,661TotalAmt
Program Services$26,695ProgramServicesAmt
Management And General$2,966ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,883,730TotalAmt
Program Services$8,883,730ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$5,267TotalAmt
Program Services$4,740ProgramServicesAmt
Management And General$527ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,894,987TotalAmt
Program Services$1,705,488ProgramServicesAmt
Management And General$189,499ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$174,156TotalAmt
Program Services$156,740ProgramServicesAmt
Management And General$17,416ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,912,480TotalAmt
Program Services$2,621,232ProgramServicesAmt
Management And General$291,248ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$83,516TotalAmt
Program Services$75,164ProgramServicesAmt
Management And General$8,352ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$20,851TotalAmt
Program Services$18,766ProgramServicesAmt
Management And General$2,085ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,604,838TotalAmt
Program Services$1,604,838ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,935,823TotalAmt
Program Services$6,242,241ProgramServicesAmt
Management And General$693,582ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$800,549TotalAmt
Program Services$720,494ProgramServicesAmt
Management And General$80,055ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$42,915,417$42,915,417
Purchased Services$30,579,909$27,521,918$3,057,991
Bad Debt Expense$9,893,936$9,893,936
BSHSI Allocation$2,612,652$2,351,387$261,265

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$828,476TotalAmt
Program Services$745,628ProgramServicesAmt
Management And General$82,848ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$165,269,768TotalAmt
Program Services$155,074,307ProgramServicesAmt
Management And General$10,195,461ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,205BOYAmt
EOY$3,206EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$138,467,253BOYAmt
EOY$155,855,703EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$119,067BOYAmt
EOY$87,955EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,774,088BOYAmt
EOY$16,697,675EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$50,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,784,652BOYAmt
EOY$3,760,210EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$855,946BOYAmt
EOY$877,098EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$106,114,265LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$71,072,370LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$35,078,863BOYAmt
EOY$35,041,895EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$33,757,493BOYAmt
EOY$36,740,915EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$77,030BOYAmt
EOY$74,079EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,232,684BOYAmt
EOY$9,754,056EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$242,150,281BOYAmt
EOY$258,942,792EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,585,815BOYAmt
EOY$11,217,812EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,122,358BOYAmt
EOY$1,090,972EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,911,820BOYAmt
EOY$9,211,134EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,619,993BOYAmt
EOY$21,519,918EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$220,408,597BOYAmt
EOY$236,455,666EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,062,772BOYAmt
EOY$913,358EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,919BOYAmt
EOY$53,850EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$221,530,288BOYAmt
EOY$237,422,874EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$242,150,281BOYAmt
EOY$258,942,792EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$15,513,312ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,876,400NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,497,126OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

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 LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$15,635DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$14,026OtherActivitiesAmt
Total Lobbying Expenditures$29,661TotalLobbyingExpendituresAmt
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. The filing organization also conducted advocacy relating to education of legislative body regarding hospital and healthcare reform and how it impacts communities. The lobbying expense related to this activity is included on Line 1g.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$58,919BeginningYearBalanceAmt
Contributions-$140ContributionsAmt
Investment Earnings Or Losses-$4,929InvestmentEarningsOrLossesAmt
End Year Balance$53,850EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,357BeginningYearBalanceAmt
Contributions$451ContributionsAmt
Investment Earnings Or Losses$2,111InvestmentEarningsOrLossesAmt
End Year Balance$58,919EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,700BeginningYearBalanceAmt
Investment Earnings Or Losses-$3,024InvestmentEarningsOrLossesAmt
Other Expenditures$318OtherExpendituresAmt
Administrative Expenses$1AdministrativeExpensesAmt
End Year Balance$56,357EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,878BeginningYearBalanceAmt
Investment Earnings Or Losses$4,213InvestmentEarningsOrLossesAmt
Other Expenditures$1,391OtherExpendituresAmt
End Year Balance$59,700EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$44,871BeginningYearBalanceAmt
Contributions$521ContributionsAmt
Investment Earnings Or Losses$11,749InvestmentEarningsOrLossesAmt
Grants Or Scholarships$263GrantsOrScholarshipsAmt
End Year Balance$56,878EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,352,921OtherCostOrOtherBasisAmt
Book Value$3,352,921BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$723,312InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$40,614,077OtherCostOrOtherBasisAmt
Depreciation$21,830,412DepreciationAmt
Book Value$19,506,977BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$390,703OtherCostOrOtherBasisAmt
Depreciation$385,189DepreciationAmt
Book Value$5,514BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$32,485InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$59,621,460OtherCostOrOtherBasisAmt
Depreciation$47,614,518DepreciationAmt
Book Value$12,039,427BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$348,295InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,031,012OtherCostOrOtherBasisAmt
Depreciation$1,242,251DepreciationAmt
Book Value$137,056BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$35,041,895TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
HPL/GL Liability$4,322,273
Fin 47 LT Asbestos Liab$1,841,373
Due to Affiliates$1,486,554
Patient Credit Balances$1,183,350
Medicare/Medicaid Liabilities$235,069
Deferred Rent$118,611
Other Misc Liabilities$23,904
FieldValueIRS element (for citing)
Total Liability$9,211,134TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Earnings are used to assist the needy.
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.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GolfEvent1Nm
Gross Receipts Event1$39,431GrossReceiptsEvent1Amt
Charitable Contri Event1$31,834CharitableContriEvent1Amt
Gross Revenue Event1$7,597GrossRevenueEvent1Amt
Rent Facility Costs Event1$22,857RentFacilityCostsEvent1Amt
Event2Holiday BrunchEvent2Nm
Gross Receipts Event2$10,339GrossReceiptsEvent2Amt
Charitable Contri Event2$4,627CharitableContriEvent2Amt
Gross Revenue Event2$5,712GrossRevenueEvent2Amt
Rent Facility Costs Event2$10,257RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$312OtherDirectExpensesEvent2Amt
Gross Receipts Total$49,770GrossReceiptsTotalAmt
Charitable Contributions Tot$36,461CharitableContributionsTotAmt
Gross Revenue Total Events$13,309GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$33,114RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$312OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$33,426DirectExpenseSummaryEventsAmt
Net Income Summary-$20,117NetIncomeSummaryAmt

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 BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,653,532TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$175,312DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,478,220NetCommunityBenefitExpnsAmt
Total Expense0.02240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,031,311TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,579,355DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,451,956NetCommunityBenefitExpnsAmt
Total Expense0.02220TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,684,843TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,754,667DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,930,176NetCommunityBenefitExpnsAmt
Total Expense0.04460TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs35ActivitiesOrProgramsCnt
Persons Served17887PersonsServedCnt
Total Community Benefit Expns$1,152,917TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,115DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,150,802NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served497PersonsServedCnt
Total Community Benefit Expns$225,267TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$225,267NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served7995PersonsServedCnt
Total Community Benefit Expns$293,764TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$293,764NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs47ActivitiesOrProgramsCnt
Persons Served26379PersonsServedCnt
Total Community Benefit Expns$1,671,948TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,115DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,669,833NetCommunityBenefitExpnsAmt
Total Expense0.01070TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs47ActivitiesOrProgramsCnt
Persons Served26379PersonsServedCnt
Total Community Benefit Expns$19,356,791TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,756,782DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,600,009NetCommunityBenefitExpnsAmt
Total Expense0.05530TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served37PersonsServedCnt
Total Community Benefit Expns$370TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$370NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$3,922TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,922NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served2088PersonsServedCnt
Total Community Benefit Expns$13,882TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,882NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served2125PersonsServedCnt
Total Community Benefit Expns$18,174TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,174NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$9,893,936BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$39,767,383ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$45,465,294CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$5,697,911MedicareSurplusOrShortfallAmt

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 Line1Mary Immaculate HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12 Bernardine DrAddressLine1Txt
CityNewport NewsCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23602ZIPCd
FieldValueIRS element (for citing)
Website Addressbonsecours.comWebsiteAddressTxt
State LicenseH1873StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
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 URLwww.fa.bonsecours.comFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.fa.bonsecours.comFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.fa.bonsecours.comFAPSummaryOnWebsiteURLTxt
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 (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Mary Immaculate HospitalPart V, Section B, Line 5: Mary Immaculate Hospital (MIH) contracted with ToXcel to conduct an electronic survey of key stakeholders to determine the top healthcare needs of the community. MIH developed a list of key stakeholders who were asked to provide their viewpoints on important healthcare concerns in the community, significant gaps in the community, and ideas for addressing health concerns and service gaps. Stakeholders included individuals who have special knowledge and expertise in public health, as well as the deans of area colleges and universities with medical degree programs. In addition, MIH surveyed representatives of medically underserved, minority populations, and those with chronic conditions. MIH also conducted community forums to gather additional input from residents. Upon receipt of all information, MIH convened a community advisory board made up of 36 representatives from 40 organizations focused on community health, including Sentara and Riverside health systems and the Peninsula Health Department to review the list of key needs and gaps identified to prioritize the needs and make recommendations to MIH leadership.
Mary Immaculate HospitalPart V, Section B, Line 7d: The MIH CHNA was posted on the Bon Secours Hampton Roads website (https://bonsecours.com/hampton-roads), as well as distributed to community advisory board members. In addition, copies of the CHNA are located in the emergency departments at MIH and Administration Office.
Mary Immaculate HospitalPart V, Section B, Line 11: Through development of an implementation plan from the CHNA, Mary Immaculate Hospital (MIH) identified the health priorities in the related service areas. MIH has an open medical staff with privileges available to all qualified physicians. The MIH emergency department provides service 24 hours/day, 7 days/week to ensure access for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located.MIH strives to reduce barriers to accessing behavioral health services to improve the mental health of the community. Nearly 120 patients were referred to the Peninsula CSB by the MIH ED and Life Coaches. Bereavement and grief counseling is a significant need in the service area and MIH has been able to provide many services to meet the need of the community. The Bereavement Center and Family Focus are addressing bereavement issues in English and Spanish to provide additional support to Hispanic families in Newport News. Collaboration with Jim's Local Market continues to provide community space for grief education and support in the community. Nearly 400 families are involved with the Kidz'N'Grief support group and Mikey's Camp had 140 participants. The partnership between Kidz'N'Grief and the Mason School of Business at the College of William & Mary was enhanced through a variety of fundraising and awareness events. Children of Incarcerated Parents (CHIPs) Program served 14 7-12 year olds in its inaugural year. Collaboration with community partners continues to address the opioid epidemic.MIH offers health services via the Care-A-Van (CAV). The CAV is a free mobile medical service that provides general medical care to uninsured adults and children in Newport News, as well as Norfolk, Portsmouth, and Suffolk. Services provided include urgent and primary care (including examination, diagnosis, lab, pharmacy, and follow-up), immunizations for school, pregnancy tests, blood pressure measurement, health education, referrals for specialty care, opportunity to enroll eligible children in children's health insurance. While the CAV primarily serves adults, some sites provide care and referral services for children aged 12 and older. Community partners include free clinics, local health agencies, physicians, and numerous faith-based organizations which collaborate with CAV staff. Over 900 patient visits were rendered by the CAV in Newport News and over $4,000 in lab services were provided at no cost to the patient. Eight patients were referred to area CSBs for follow-up.MIH offers support to qualified patients though the Life Coach Program. The Life Coach Program connects patients with no insurance, little resources, or no personal doctor with primary care resources to minimize their trips to the emergency room. These coaches work closely with the emergency department staff and care managers to find medical homes for patients who regularly use emergency rooms for non-emergency issues. Life Coaches help patients overcome social barriers to care, make follow up appointments, and obtain medications. MIH Life Coaches had 1,213 patient contacts, of which 120 were referred to areas CSBs for follow-up.Prevention and treatment of obesity with an emphasis on diabetes and nutrition was identified as one of the top health concerns in the MIH service area. MIH offers free Community Education programs open to the public throughout Hampton Roads on health topics such as heart disease, diabetes, bone and joint conditions, women's health and other chronic diseases. Monthly nutrition program held at Jim's Local Market reached 88 participants. Nutrition education programs were held with the Hampton Police Department student and trainees. A community health and safety fair was held at Jim's Local Market and provided nutrition advice and resources to approximately 40 participants. 175 glucose screens were provided through seven community events. The total attendance of those events was over 1,200. The Heart Health Academy was held and attended by 141 students. In partnership with other area health systems and organizations, MIH is addressing the issue of healthy lifestyles through the Peninsula Community Health Collaborative.MIH partners with several organizations to address the needs of the homeless. MIH was an active participant at the first Newport News Project Homeless Connect. Over 100 homeless clients were seen. Collaborating with LINK of Hampton Roads has led to a partnership with St. Francis Nursing Center to provide hospice beds to homeless patients if the need arises. MIH also has many staff volunteers that support LINK of Hampton Roads' winter shelter initiative PORT. Crime and community violence were identified as a community need. Although they are not addressed in the MMC Implementation Plan, human trafficking and gun control/violence are two of the Bon Secours Health System advocacy resolutions. MIH is very involved in the human trafficking effort.Although Bon Secours Mary Immaculate Hospital recognizes the importance of all the needs identified by the community including education, jobs with fair wages, community violence, transportation services, dental health, alcohol/drugs, and housing resources are limited within the organization to prioritize these specific needs. There are other providers and organizations addressing these needs with specialized programs and services. BSMIH is prepared to collaborate or assist with these efforts beyond the current set of services we provide.
Mary Immaculate HospitalPart 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/hampton-roads/community-commitment/community-health-needs-assessment
FieldValueIRS element (for citing)
Facility9FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - In-Motion Boo Williams Sportsplex
5 Armistead Pointe ParkwayHamptonVA23666Physical Therapy
2 - PT Outpatient Rehab
2 Bernardine DrNewport NewsVA23602Physical Therapy
3 - Mary Immaculate Phys Therapy Victory
101-A Long Green BlvdYorktownVA23693Physical Therapy
4 - Mary Immaculate Phys Therapy Denbigh
14703 Warwick Blvd Suite BNewport NewsVA23608Physical Therapy
5 - Bon Secours Surgical Specialists
12720 McManus Blvd Ste 311Newport NewsVA23602Physician Practice
6 - Bon Secours Occumed
14703 Warwick Blvd Suite ANewport NewsVA23608Occupational Medicine
7 - Bon Secours Vein and Vascular-MIH
12720 McManus Blvd Suite 303Newport NewsVA23602Physician Practice
8 - Bon Secours Palliative Medicine
12720 McManus Blvd Suite 301Newport NewsVA23602Physician Practice
9 - Bon Secours Pulmonary Specialists
12720 McManus Blvd Ste 303Newport NewsVA23602Physician Practice

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:Annually, Bon Secours Hampton Roads Health System (BSHRHS) 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 January 24, commemorating Foundation Day of the Sisters of Bon Secours. This report is available online at https://bonsecours.com/hampton-roads.
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: $9,893,936.
Part II, Community Building Activities:Bon Secours Mary Immaculate Hospital provided staff and resources in support of the Healthy Community Initiative of Bon Secours Health System, and advocated for local and state policies that would improve health across its communities. MIH has partnered with LINK of Hampton Roads to address socioeconomic and health disparities among the homeless population throughout the service area. Bon Secours Hampton Roads has partnered with the Peninsula Health Department, Sentara Healthcare, and Riverside Health System to form the Peninsula Community Health Collaborative to address issues affecting the health of the community. Bon Secours Hampton Roads also partnered with the Southeast Virginia United Way, Sentara Healthcare, and Virginia Department of Health to develop the Greater Hampton Roads Connects website, a community dashboard that aggregates data for use in the CHNA and CHA processes. MIH donated staff time and resources in support of these efforts.
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 "accountsreceivable" on page 10 in the attached BSHSI consolidated auditedfinancial statements ("AFS"). "Allowance for uncollectible accounts" isdiscussed in the second paragraph in Footnote "(10) Net Patient ServiceRevenue" 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 non-reimbursable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and non-reimbursable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publicly insured patients where reimbursement is less than cost of providing the service.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: $439,260.
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:In partnership with Bon Secours Virginia Health System, Mary Immaculate Hospital uses multiple approaches to assess the health needs of the communities it serves. Health care needs of the community are assessed and updated using a variety of informational sources including Virginia Health Information for state-based performance data, and Claritas and Sg2 for market and geographic data. The Sg2 strategic planning tools are used to retrieve demographic information and trends for the primary and secondary service areas pertaining to Maryview Medical Center. National Research Corporation (NRC), and other strategic market intelligence are also utilized.
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:As of 2017, Hampton Roads is a very diverse community within an MSA of over 1.7 million people residing in 16 cities and counties, stretching from northeastern North Carolina to Williamsburg. The area is characterized by racial diversity, a significant military population and a growing elderly population.The primary service area population served by Mary Immaculate Hospital (MIH), encompasses Newport News, Hampton, Williamsburg, and York County. The largest populations for the MIH service area are white (59.1%), Black or African American (29.3%), and small percentages of other groups. The median income for the MIH service area is $59,346. The City of Newport News has the highest rate of children living in poverty (26.0%) compared to Virginia (15.0%). York County has 7% of children living in poverty. The percentage of children living in single parent households (39.8%) is higher compared to Virginia (30%) and 38.8% of students are eligible for free lunch.The most prevalent chronic conditions among adults in the service area include high blood pressure (30.7%), asthma (15%), diabetes (10.4%), and smoking (17%). The leading causes of mortality in the MIH service area per 100,000 are heart disease (168.5), cerebrovascular disease (43.1) cancer (172.2), chronic lower respiratory diseases (35.8), diabetes (24.8), kidney disease (17.9) and septicemia (13.0). The infant mortality rate (per 1,000 live births) in the MIH service area is 12.4% compared to 6.2% in Virginia.
Part VI, Line 5:Bon Secours Hampton Roads has an open medical staff with privileges available to all qualified physicians. Emergency departments at the three hospitals provide service 24 hours/day, 7days/week to ensure access for emergency care for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located.
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 teh 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 StatesVA

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 Line1Literacy For LifeBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 8795AddressLine1Txt
CityWilliamsburgCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23185ZIPCd
FieldValueIRS element (for citing)
Recipient EIN541085026RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$17,250CashGrantAmt
Purpose Of GrantHEAL ProgramPurposeOfGrantTxt
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.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 (13 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
Timothy Davis
Board Member$0$648,505$0$151,613$0$153,175$0$15,900$0$19,976$0$989,169$0$0
Michael Kerner
Secretary/CEO-BSHR$0$555,514$0$156,883$0$129,683$0$106,277$0$20,660$0$969,017$0$73,667
Charmaine Rochester PhD
Treasurer/VP Finance (Sep-Apr)$0$205,465$0$30,621$0$39,114$0$12,879$0$3,991$0$292,070$0$0
Darlene Stephenson
CEO - MIH$0$227,405$0$54,452$0$40,480$0$14,917$0$19,450$0$356,704$0$0
Jeffrey Doucette
VP Patient Care Services (Sep-Dec)$0$193,710$0$44,700$0$5,985$0$12,258$0$30,429$0$287,082$0$0
Vickie Humphries
VP of Human Resources$0$159,662$0$24,632$0$44,485$0$14,231$0$9,842$0$252,852$0$0
James McNamara
VP of Ortho$0$237,568$0$34,415$0$976$0$12,205$0$9,555$0$294,719$0$0
Terri Spence
VP & Regional CIO$0$221,664$0$30,442$0$908$0$22,171$0$10,151$0$285,336$0$0
Anthony Terracina MD
General Surgeon$485,661$0$599,747$0$1,176$0$13,250$0$28,960$0$1,128,794$0$0$0
Jason Andre MD
Vascular Surgeon$208,876$178,714$754$646$181$155$3,233$2,767$15,679$13,414$228,723$195,696$0$0
Edward Pak
Internist$348,567$0$22,755$0$407$0$10,600$0$0$0$382,329$0$0$0
Thomas Hoffmier MD
Cardiologist$240,991$0$38,542$0$4,389$0$10,600$0$19,586$0$314,108$0$0$0
Michael Mangano
Pharmacist$168,809$0$150$0$480$0$8,122$0$18,314$0$195,875$0$0$0

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 is 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: Michael Kerner, $82,150.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 4On January 1, 2017, the bylaws of (i) Bon Secours Hampton Roads Health System, Inc., Bon Secours-DePaul Medical Center, Inc., Maryview Hospital, and Bon Secours-Maryview Nursing Care Center (collectively the "Hampton Roads Entities"); and (ii) Mary Immaculate Hospital, Incorporated and Mary Immaculate Nursing Center, Inc. (collectively, the "Mary Immaculate Entities") were amended and restated in their entirety to implement a single mirror board structure for the Hampton Roads and Mary Immaculate Entities, as well as to otherwise bring the documents up to date with current templates. No changes in corporate or sponsorship structure occurred as a result of the bylaws revisions. Additionally, on December 28, 2016, the articles of Mary Immaculate Hospital, Incorporated were amended to ensure that the board appointment provisions mirrored the new bylaws provisions.
Form 990, Part VI, Section A, line 6The General Minister and General Council of the Bernardine Sisters of the Third order of St. Francis and Bon Secours Health System, Inc. are the members of Mary Immaculate Hospital.
Form 990, Part VI, Section A, line 7aThe governing body of Mary Immaculate Hospital is appointed by both members, with Bon Secours Health System, Inc. having the majority vote.
Form 990, Part VI, Section A, line 7bCertain authorities of Mary Immaculate Hospital are reserved to its members.
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' 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 19The filing organization makes all documents available to the general public 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. The governing bodies of the hospitals of Bon Secours Hampton Roads Health System, including DePaul Medical Center, Maryview Hospital, Mary Immaculate Hospital, Bon Secours Maryview Nursing Care Center, and Mary Immaculate Nursing Center are comprised of the same board members and board officers (Chairman, Secretary and Treasurer), with the exception of President. These governing bodies are referred to as the Hampton Roads Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for the applicable entities. Br. Art Caliman and Sr. Elaine Davia do not receive payroll distributions as they have taken a vow of poverty.
Form 990, Part XI, line 9:BSHSI Principal Debt & Swaps -1,494,175. Writedown of Goodwill - Sale of BSNY -2,951.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Mary Immaculate Hospital Auxiliary
7007 Harbourview BlvdSuffolkVA23435546040266AuxiliaryVA501(c)(3)Line 10N/A0
Mary Immaculate Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435311644734FundraisingVA501(c)(3)Line 12c, III-FIYes (1)Mary Immaculate Hospital
Mary Immaculate Nursing Center
7007 Harbour View Blvd Suite 108SuffolkVA23435541516476Nursing Care CenterVA501(c)(3)Line 10Yes (1)Mary Immaculate Hospital
Bon Secours Health System Inc
8990 Old Annapolis RoadColumbiaMD21045521301088Parent Org. - Mgmt. ServicesMD501(c)(3)Line 12c, III-FI0Bon Secours Inc

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1OSF IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12 Bernadine DriveAddressLine1Txt
CityNewport NewsCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23602ZIPCd
FieldValueIRS element (for citing)
EIN541369919EIN
Primary ActivitiesRentalPrimaryActivitiesTxt
Legal Domicile StateVALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$740,436ShareOfTotalIncomeAmt
Share Of EOY Assets$1,008,921ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd