KENMORE MERCY HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- KENMORE MERCY HOSPITAL (EIN 16-0762843)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-01
- IRS object ID
- 201803059349301690
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-01T14:45:14-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160762843 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kenmore Mercy Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KENM | BusinessNameControlTxt |
| Phone | 7168282974 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Catholic Health 144 Genesee St | AddressLine1Txt |
| City | Buffalo | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David P Macholz | PersonNm |
| Person Title | VP Finance/Corp Controller CHS | PersonTitleTxt |
| Phone | 7168282974 | PhoneNum |
| Signature | 2018-11-01 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 204.68.186.4 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-01 | IPDt |
| IP Tm | 14:44:12 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0E4C15207DC127BDB52450F77D4060F40C3F1AE4 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 943C2B779621AE68CF3E0BED5C235FDF89DF7949 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Joseph D McDonald | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 Genesee Street Administration | AddressLine1Txt |
| Address Line2 | 6th Floor | AddressLine2Txt |
| City | Buffalo | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $174,251,961 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.chsbuffalo.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | The Catholic Health System (CHS) Mission is to provide quality healthcare services in an acute care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2017 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1469 | TotalEmployeeCnt |
| Total Volunteers | 252 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $451,232 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,317,416 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $167,826,918 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $169,349,854 | CYProgramServiceRevenueAmt |
| PY Investment Income | $593,014 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,134,755 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,915,946 | PYOtherRevenueAmt |
| CY Other Revenue | $1,449,936 | CYOtherRevenueAmt |
| PY Total Revenue | $170,784,110 | PYTotalRevenueAmt |
| CY Total Revenue | $174,251,961 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $74,178,242 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $75,311,615 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $94,979,940 | PYOtherExpensesAmt |
| CY Other Expenses | $94,107,292 | CYOtherExpensesAmt |
| PY Total Expenses | $169,158,182 | PYTotalExpensesAmt |
| CY Total Expenses | $169,418,907 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,625,928 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,833,054 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $163,744,212 | TotalAssetsBOYAmt |
| Total Assets EOY | $160,498,161 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $121,936,198 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $121,554,491 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $41,808,014 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,943,670 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The Catholic Health System (CHS) Mission is to provide quality healthcare services in an acute care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2017 Community Service Plan can be found at www.chsbuffalo.org. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $80,803,673 | ExpenseAmt |
| Revenue | $95,452,598 | RevenueAmt |
| Desc | Inpatient services provided 3,495 Inpatient Surgery visits. Inpatient services provided 30,262 acute care patient days and 4,829 medical rehab service days. The Skilled Nursing Facility provided 52,374 days of care. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $58,752,184 | ExpenseAmt |
| Revenue | $69,403,387 | RevenueAmt |
| Desc | Outpatient services prodvided 2,870 Outpatient Surgery visits, 1,859 G.I. visits,1,429 Interventional Radiology visits, and 75 Transfusion/ Infusion visits. Outpatient services also provided 31,385 Emergency Department visits net of admissions and 62,625 Referred Ambulatory visits. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,804,204 | ExpenseAmt |
| Revenue | $4,493,869 | RevenueAmt |
| Desc | Primary Care Centers and Clinics provided 19,345 visits. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $143,360,061 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 112 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1469 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David MacholzCorporate Controller Catholic Health System | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7168282974 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 Genesee Street | AddressLine1Txt |
| City | Buffalo | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Mark Sullivan | |||||||||
| Executive VP / COO | 0.00 | 55.00 | Yes (X) | Yes (X) | $0 | $892,421 | $161,256 | ||
| James Millard | |||||||||
| President and CEO, Kenmore Mercy | 55.00 | 0.00 | Yes (X) | Yes (X) | $322,914 | $0 | $231,028 | ||
| David Macholz | |||||||||
| Treasurer | 0.00 | 55.00 | Yes (X) | Yes (X) | $0 | $265,735 | $51,732 | ||
| Charles J Urlaub | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $446,938 | $47,606 | |||
| Gary Tucker | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $323,253 | $70,511 | |||
| Joyce Markiewicz | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $372,553 | $82,696 | |||
| Martin Boryszak | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $326,086 | $20,914 | |||
| Brian Beitz | |||||||||
| Director | 0.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| Lynn Catalano | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| John Davanzo | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Georgiana Ford Esq | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Dr Mark Jajkowski | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $24,250 | $0 | |||
| Raquel Martin DO | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Mary Turkiewiecz MD | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Katherine Vanderhorst | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Monsignor Robert E Zapfel | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Joseph McDonald | |||||||||
| President and CEO, CHS | 0.00 | 55.00 | Yes (X) | $0 | $1,321,419 | $187,715 | |||
| James A Dunlop Jr | |||||||||
| Executive VP / CFO | 0.00 | 55.00 | Yes (X) | $0 | $795,936 | $278,895 | |||
| Dr Brian D'Arcy | |||||||||
| Senior VP, Medical Affairs | 0.00 | 55.00 | Yes (X) | $0 | $729,372 | $51,159 | |||
| Walter Ludwig | |||||||||
| Chief Operating Officer | 55.00 | 0.00 | Yes (X) | $214,060 | $0 | $45,167 | |||
| Michael Moley | |||||||||
| Sr.VP, Human Resources | 0.00 | 55.00 | $0 | $657,728 | $135,613 | Yes (X) | |||
| Dr Michael Galang | |||||||||
| Sr. VP, Chief Information Officer | 0.00 | 55.00 | $0 | $546,797 | $73,371 | Yes (X) | |||
| Nancy Sheehan | |||||||||
| SVP Legal Service, General Counsel | 0.00 | 55.00 | $0 | $488,411 | $51,193 | Yes (X) | |||
| Dr James Fitzpatrick | |||||||||
| Physician | 55.00 | 0.00 | $342,358 | $0 | $42,277 | Yes (X) | |||
| Dr Michael Edbauer | |||||||||
| Chief Clincal Officer | 0.00 | 28.00 | $0 | $429,423 | $78,470 | Yes (X) | |||
| Maria Foti | |||||||||
| Sr. VP, Strategic Planning | 0.00 | 55.00 | $0 | $392,400 | $91,557 | Yes (X) | |||
| Thomas Brewer MD | |||||||||
| Physician | 55.00 | 0.00 | $328,102 | $0 | $30,652 | Yes (X) | |||
| Michael Gough MD | |||||||||
| Physician | 55.00 | 0.00 | $321,207 | $0 | $34,850 | Yes (X) | |||
| Dr Erik Diringer | |||||||||
| Physician | 55.00 | 0.00 | $291,903 | $0 | $10,263 | Yes (X) | |||
| Cheryl Hayes | |||||||||
| Director of Nursing | 55.00 | 0.00 | $187,842 | $0 | $21,699 | Yes (X) | |||
| Dr Edward Stehlik | |||||||||
| Physician | 55.00 | 0.00 | $199,886 | $0 | $211 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,208,272 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,012,722 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,798,835 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Genesys Orthopedic Systems LLC | |||||
| 1250 S Capital of Texas Highway Bl | Austin | TX | 78746 | Healthcare Service | $2,418,246 |
| Buffalo Niagara Hospitalists | |||||
| 2950 Elmwood Ave/Med Staff Office | Buffalo | NY | 14217 | Physician Service | $828,123 |
| Picone Construction Corporation | |||||
| 10995 Main Street | Clarence | NY | 14031 | Construction Service | $626,200 |
| AMN Healthcare Inc | |||||
| 22735 Collection Center Drive | Chicago | IL | 60693 | Healthcare Service | $622,677 |
| IR Mueller Corp | |||||
| 789 Colvin Blvd | Buffalo | NY | 14217 | Security Service NY | $620,804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 30 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,317,416 | AllOtherContributionsAmt |
| Total Contributions | $1,317,416 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenu | 900099 | $120,509,975 | $120,509,975 |
| Medicare/Medicaid | 900099 | $48,839,879 | $48,839,879 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $169,349,854 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,134,755 | TotalRevenueColumnAmt |
| Exclusion | $2,134,755 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $577,843 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $577,843 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $577,843 | TotalRevenueColumnAmt |
| Exclusion | $577,843 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Shared Service | 900099 | $388,810 | $388,810 | |
| Cafeteria | 900099 | $267,497 | $267,497 | |
| CHS Non-Operating Rev | 900099 | $138,437 | $138,437 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,349 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,076 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $74,273 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $872,093 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $174,251,961 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $169,880,177 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,054,368 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,835,826 | TotalAmt |
| Program Services | $51,987,722 | ProgramServicesAmt |
| Management And General | $6,848,104 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,261,234 | TotalAmt |
| Program Services | $2,881,648 | ProgramServicesAmt |
| Management And General | $379,586 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,992,791 | TotalAmt |
| Program Services | $7,946,090 | ProgramServicesAmt |
| Management And General | $1,046,701 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,221,764 | TotalAmt |
| Program Services | $3,730,378 | ProgramServicesAmt |
| Management And General | $491,386 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,729 | TotalAmt |
| Management And General | $241,729 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,833 | TotalAmt |
| Program Services | $135,833 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,118,066 | TotalAmt |
| Program Services | $3,311,979 | ProgramServicesAmt |
| Management And General | $806,087 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,437 | TotalAmt |
| Program Services | $1,482 | ProgramServicesAmt |
| Management And General | $97,955 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,954,201 | TotalAmt |
| Program Services | $1,353,471 | ProgramServicesAmt |
| Management And General | $2,600,730 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,219 | TotalAmt |
| Program Services | $3,582 | ProgramServicesAmt |
| Management And General | $85,637 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,967,548 | TotalAmt |
| Program Services | $1,475,661 | ProgramServicesAmt |
| Management And General | $491,887 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,961 | TotalAmt |
| Program Services | $6,700 | ProgramServicesAmt |
| Management And General | $1,261 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,722 | TotalAmt |
| Program Services | $6,920 | ProgramServicesAmt |
| Management And General | $23,802 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,640,353 | TotalAmt |
| Program Services | $1,314,344 | ProgramServicesAmt |
| Management And General | $326,009 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,426,883 | TotalAmt |
| Program Services | $5,770,130 | ProgramServicesAmt |
| Management And General | $1,656,753 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,051,834 | TotalAmt |
| Program Services | $1,747,496 | ProgramServicesAmt |
| Management And General | $304,338 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $36,800,389 | $37,020,191 | -$219,802 |
| Dues & Shared Services | $26,086,834 | $19,304,257 | $6,782,577 |
| Purchase Services & Oth | $8,034,985 | $4,230,865 | $3,804,120 |
| Other Supplies - Non Me | $1,421,298 | $1,131,312 | $289,986 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,418,907 | TotalAmt |
| Program Services | $143,360,061 | ProgramServicesAmt |
| Management And General | $26,058,846 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,932 | BOYAmt |
| EOY | $2,432 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,260,746 | BOYAmt |
| EOY | $37,154,095 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,169,347 | BOYAmt |
| EOY | $20,941,430 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,814,417 | BOYAmt |
| EOY | $2,825,104 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $766,231 | BOYAmt |
| EOY | $430,940 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $131,102,290 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $74,091,916 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,841,233 | BOYAmt |
| EOY | $57,010,374 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,169,452 | BOYAmt |
| EOY | $23,182,873 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,720,854 | BOYAmt |
| EOY | $18,950,913 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,744,212 | BOYAmt |
| EOY | $160,498,161 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,025,467 | BOYAmt |
| EOY | $20,825,418 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,272,431 | BOYAmt |
| EOY | $22,757,479 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,895,941 | BOYAmt |
| EOY | $12,263,457 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,742,359 | BOYAmt |
| EOY | $65,708,137 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,936,198 | BOYAmt |
| EOY | $121,554,491 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,742,986 | BOYAmt |
| EOY | $38,794,934 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,028 | BOYAmt |
| EOY | $148,736 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,808,014 | BOYAmt |
| EOY | $38,943,670 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,744,212 | BOYAmt |
| EOY | $160,498,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,833,054 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$7,697,398 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $10,967 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,967 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Other lobbying activities: Lobbying expenses of $10,967 represent the total of dues paid to national and state associations that is specifically allocable to lobbying. Kenmore Mercy Hospital does not participate in or intervene in (including the publishing or distributing of statement) any political campaign on behalf of (or opposition to) any candidate. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $235,852 | InvestmentCostOrOtherBasisAmt |
| Book Value | $235,852 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $61,674,657 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $35,820,711 | DepreciationAmt |
| Book Value | $25,853,946 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $18,432,890 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $4,850,640 | DepreciationAmt |
| Book Value | $13,582,250 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $48,854,455 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $32,740,879 | DepreciationAmt |
| Book Value | $16,113,576 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,904,436 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $679,686 | DepreciationAmt |
| Book Value | $1,224,750 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $57,010,374 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Ascension Investment Management | Desc |
| Book Value | $23,182,873 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $23,182,873 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Insurance Recoveries | $13,154,664 |
| Interest in Net Assets of KMH Foundation | $3,579,625 |
| Dues from Affilates | $1,523,762 |
| Other Receivables | $689,853 |
| Interest in Net Assets of CCD Foundation | $3,009 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $18,950,913 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Obligation | $32,614,667 |
| LT Gen Liab/ Workers Comp IBNR | $20,663,775 |
| Dues to Affiliates | $13,170,351 |
| Asset Retirement Obligation | $181,131 |
| LT Portion of Disposable | $127,553 |
| Debt Issuance Costs | -$1,049,340 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $65,708,137 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $173,889,499 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $954,954 | OtherRevenueAmt |
| Revenue Not Reported | $954,954 | RevenueNotReportedAmt |
| Revenue Subtotal | $172,934,545 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,317,416 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,317,416 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $174,251,961 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $169,469,121 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $459,557 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $459,557 | ExpensesNotReportedAmt |
| Expenses Subtotal | $169,009,564 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $409,343 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $409,343 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $169,418,907 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Kenmore Mercy Foundation Activity - $954,954 954954. |
| Part XI, Line 4b - Other Adjustments: | Contributions from Kenmore Mercy Foundation to Kenmore - $1,317,416 1317416. |
| Part XII, Line 2d - Other Adjustments: | Kenmore Mercy Foundation Expenses (net of eliminations) - $459,557 459557. |
| Part XII, Line 4b - Other Adjustments: | KMH Homes Expenses - $409,343 409343. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,469,808 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,551 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,421,257 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,657,664 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,581,665 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,075,999 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05950 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,127,472 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,630,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,497,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $795,369 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $795,369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,408,370 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,408,370 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,224,739 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,736,248 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,488,491 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $248,690 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $248,690 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $654,240 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $654,240 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,331,408 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,736,248 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,595,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02720 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,458,880 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,366,464 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,092,416 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09510 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,048 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,048 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $93,789 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $93,789 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,772 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,772 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $110,609 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $110,609 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,674,000 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $567,320 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,953,602 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,101,867 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,148,265 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kenmore Mercy Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2950 Elmwood Ave | AddressLine1Txt |
| City | Kenmore | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14217 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.chsbuffalo.org | WebsiteAddressTxt |
| State License | 1404000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Ambulatory Surgery - Multi Specialty | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kenmore Mercy Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.chsbuffalo.org/mission/social-responsibility-community-benefit | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.chsbuffalo.org/mission/social-responsibility-community-benefit | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://chsbuffalo.org/billing/finance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://chsbuffalo.org/billing/finance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://chsbuffalo.org/billing/finance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section A: | Audiology O/P Clinic Part Time Services Clinical Laboratory Services Coronary Care CT Scanner Dental O/P Emergency Department Health Fairs O/P Intensive Care Medical Social Services Medical/Surgical Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Pediatric O/P Pharmaceutical Service Physical Medical Rehabilitation Physical Medicine and Rehabilitation O/P Primary Medical Care O/P Radiology - Diagnostic Renal Dialysis - Acute Respiratory Care Therapy - Occupational O/P Therapy - Physical O/P Therapy - Speech Language Pathology |
| Kenmore Mercy Hospital | Part V, Section B, Line 5: Catholic Health utilized a variety of sources to develop the health needs assessment to ensure the inclusion of persons who represent the broad interest of the community and have special expertise in, or knowledge of, public health issues and concerns:* Disseminating and promoting the completion of a fifty-seven question survey developed by the Erie County Department of Health to the community at large including Catholic Health's own staff. * Two focus groups including representation from a broad range of health care and social service organizations in Erie County * Western New York Community Health Needs Assessment (December 2014) jointly sponsored by the two Performing Provider Systems in the region linked the Delivery System Reform Incentive Program (DSRIP). * 50 patient interviews (verbal survey) targeting individuals utilizing services at Catholic Health clinics operating within federally designated Health Professional Shortage Areas (HPSA)Focus group participants: Catholic Charities Brylin Hospitals Erie County DOH P2 Collaborative of WNY City of Buffalo community Physician representation Erie County Department of Health Community Meeting Participants Catholic Health American Cancer Society Cazenovia Recovery Systems Friends of Night People Buffalo Fire Department Northwest Community Center Mid Erie Counseling and Treatment Center American Heart Association Meals on Wheels Evergreen Services Pride Center of Western New York United WayFor more information about our CHNA, go to https://www.chsbuffalo.org/mission/social-responsibility-community-benefit |
| Kenmore Mercy Hospital | Part V, Section B, Line 6b: Kenmore Mercy Hospital was conducted with Mercy Hospital and Sisters Hospital and Mount St. Mary's Hospital as well as the Erie County Department of Health. |
| Kenmore Mercy Hospital | Part V, Section B, Line 11: Through the needs assessment, numerous areas were identified as important and clearly impact the health of the community. Catholic Health identified the "significant" needs as the New York State Department of Health Prevention Agenda priorities. Within the "priorities", Catholic Health will address numerous health needs as described in the publicly available CHNA report. One priority area was prioritized lower and not addressed in the implementation plan: Promote a Healthy and Safe Environment. Contributing to this lower priority was lack of available funds and potential for less impact upon the community. Although, should opportunity arise, with resources available to effectively address this need, Catholic Health will reconsider for incorporation in the future.Other needs were identified as part of the Community Health Needs Assessments conducted by Erie County Department of Health, the local DSRIP PPS organizations, and Catholic Health. However, a number of those needs were not incorporated into CH's individual 2016-2018 Community Health Implementation Plans for each of its acute care operations for one or more of the following reasons: *Was not deemed as impactful on the overall health of the community as compare to other identified need*Is being targeted or addressed by other entities within the community*Requires resources that CH does not currently have available without compromising other important initiatives. But, should community circumstances change or additional resources become available, CH will consider incorporating other initiatives into its plan.Among those additional needs not addressed in the 2016-2018 CHIP are:*Need for greater integration of primary care and behavioral health services (being addressed by local PPS organizations via NYS DSRIP *)*Need to address childhood obesity through improved nutrition especially in urban "food deserts and increased exercise programming for children*Continued need to improve access to smoking cessation programs (Roswell Park Cancer Institute leading efforts of local PPS organizations as part of the NYS DSRIP program)*Need to improve educational services to parents in urban areas with regard to asthmamanagement and dangers of lead poisoning*Slowing the rate of HIV infection especially within minority communities (NYS Prepprogram with local support from Evergreen)The 2016 Erie County Community Health Needs Assessment began by first re-evaluating the needs prioritized in the previous cycle (2013) and the impact of the projects corresponding to those needs that were selected for implementation. Catholic Health's understanding of the communities it serves was then updated by soliciting new input from the public and several community organizations as outlined in the Process and Methods section of this report. This assessment represents a collaborative effort across Catholic Health's facilities as well as with external organizations to identify the health needs of the community and to develop a strategy for addressing them. The systematic process used helped identify significant health needs across Catholic Health's Erie County service area including vulnerable and under-represented populations. |
| Kenmore Mercy Hospital | Part V, Section B, Line 16j: Includes information in both English and Spanish on all signage and brochures for financial assistance. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Ken-Ton Family Care | ||||
| 300 Two Mile Creek Road | Tonawanda | NY | 14150 | Extension Clinic:Pediatric O/P, Prenatal O/P, Primary Medical Care O/P |
| 2 - McAuley Residence | ||||
| 1503 Military Road | Kenmore | NY | 14217 | Long Term Care: Radiology-Diagnostic, Clinical Laboratory Service |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | Kenmore Mercy Hospital Community Benefit Report is contained in the annual report prepared by the Catholic Health System. |
| Part I, Line 7: | Costing is a full step down methodology of cost from non-revenue producing departments to revenue producing departments', with assignment of cost to individual charge items based on volume and charge amount. All patient accounts are cost with the same methodology regardless of patient type (inpatient, outpatient, emergency room, etc.) or insurance coverage (Medicare, Medicaid, private insurance, uninsured, etc.). |
| Part II, Community Building Activities: | Kenmore Mercy Hospital participated in Community Building activities including Community support of $9,048 Environmental improvements of $93,789 and Coalition building of $7,772. |
| Part III, Line 2: | The amount in Part III line 2 is the actual bad debt expenses of $3,674,000. The amount in Part III line 3 is the estimate of bad debt from uninsured balance which is developed as follows: as policy is to write accounts to bad debt 120 days after discharge, the discharge date period of 10/1/2016 to 9/30/2017 was used to determine the population of uninsured accounts. The balance of these accounts was determined and the RCC was applied to develop the estimate in H Part III Line 3. |
| Part III, Line 3: | As our determination of eligibility for the Healthcare Assistance Program (HAP) (Charity Care) is based solely on the presentation for care without insurance, which is now for each account, and use of a sophisticated estimator (PARO) of each guarantor's ability to pay an estimate of "the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy if sufficient information had been available to make a determination of their eligibility" is not relevant. The organization's financial statements do not include a footnote that describes bad debt expense, but the financial statements account for bad debt expenses in the statement of operations as actual expenses written off and an estimate of future write-offs less any recoveries. |
| Part III, Line 4: | The hospital does not have a footnote that describes bad debt in the financial statements. |
| Part III, Line 8: | Kenmore Mercy Hospital does not treat Medicare shortfall as a community benefit, as serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations. The existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories. |
| Part III, Line 9b: | The hospital's collection policies contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance. The hospital has implemented billing and collection practices for patient payment obligations that are fair, consistent, and compliant with state and federal regulations and no extraordinary collection practices are followed. |
| Part VI, Line 2: | In addition to its CHNA, Catholic Health utilizes multiple methods to assess the health care needs of the communities it serves, including:* Evaluations administered by the Catholic Health Community Education Department after each class, workshop, or program it sponsors seeking input on other programs or topics of interest participants would like to see. Based on this feedback, program planners meet with leadership to develop programs or workshops that match community interest/need;* Input from physician community during doctor to doctor education programs. Based on this feedback, program planners meet with leadership to develop physician continuing education programs that address gaps in care or other pressing community health needs. * Patient, resident and caregiver satisfaction surveys conducted in our hospitals, health centers, nursing homes and among our home care patients, help alert us to health care needs among our patient population; * Physician and leadership participation in community boards, coalitions and forums to define the health needs of patient populations and seek community solutions; * Surveys conducted among high risk, high need Medicaid populations through our collaborative Health Home Program help alert us to the needs of individuals with developmental disabilities and behavioral health issues; * Participation in NYS Delivery System Reform Incentive Program (DSRIP) with Community Partners of WNY initiatives that look at transforming the care of the Medicaid population; * Information management obtains from administrative data and payer mix to assist in evaluating the health needs and trends of the community; and* Input from Catholic Health Board including Board Committee (e.g. Mission Integration Committee). |
| Part VI, Line 3: | Catholic Health's Mercy Hospital, Sisters Hospital, Kenmore Mercy and Mount St. Mary's Hospital inform and educate patients and persons who may be billed for medical services about their eligibility for assistance under federal, state, or local government programs or our own Healthcare Assistance Program (HAP) in a variety of ways. For example, Kenmore Mercy Hospital, like our other facilities, has posters and brochures available, which include eligibility and contact information for the Patient Financial Services Team. This information is available in admissions areas, emergency rooms, primary care and outpatient rehabilitation centers, the Revenue Management Center (RMC) and other areas throughout Catholic Health where eligible patients and family members are likely to be present. This information is also on the website CHSBuffalo.org and includes general information, our policy and application and is translated in Spanish and Arabic.Catholic Health also provides information about financial assistance and HAP contact information to patients as part of the intake process and during or within 90 days of their discharge from the hospital. To further assist patients, all patient bills include the following language: "The Catholic Health System has a Healthcare Assistance Program to assist those in need of financial assistance for qualified patients. If you would like to obtain additional information on the Healthcare Assistance Program, or in applying for health insurance through the NYS Department of Health, please call our Patient Financial Services Team at (716) 601-3600. Thank you." For free, confidential assistance in applying for financial aid, patients can also call our Patient Financial Services team at 716-601-3600. A counselor will work with them to see if they qualify for free or low-cost insurance or other financial assistance. For patients who do not have insurance and need care at a Catholic Health hospital, a registration clerk will also assist them in applying for assistance at the time of registration. Interpreting services are also available for patients who do not speak English. We offer case management services, and we have Certified Application Counselors who discuss with patients the availability of various government benefits, such as Medicaid or other state and federal programs, and assist patients and families with eligibility and applications when necessary. |
| Part VI, Line 4: | Catholic Health is a not-for-profit integrated healthcare delivery system that operates four acute care operations in Erie County and one in Niagara County. For all intents and purposes, the primary service area for Catholic Health's Erie County based acute care operations is Erie County. In fact, Erie County residents account for 87% of all inpatient volume, 85% of ambulatory surgery cases and 95% of emergency room visits.Erie County consists of a mix of urban, suburban and rural populations, with about one-third of the population residing in the City of Buffalo. Buffalo is New York State's second largest city, surrounded by a ring of older suburbs. Beyond the first ring suburbs are newer suburban communities and established rural communities. The current population of Erie County is over nine hundred thousand. Erie County is less racially and ethnically diverse than New York State or the rest of the country, and the Non-White populations are concentrated in and immediately around the City of Buffalo. All of the 11 zip codes in Erie County that have a Non-White population of 50% or more are in Buffalo. |
| Part VI, Line 5: | One of the fundamental reasons for the creation of Catholic Health was to ensure the continued viability of faith-based health care to meet the needs of residents in Erie County and the surrounding communities. Our Mission Statement - We are called to reveal the healing love of Jesus to those in need - further articulates why we exist. Integral to this effort is caring for the needs of those who are poor and disadvantaged. The services provided by Catholic Health are in response to identified community needs, and reflect the System's emphasis on caring for the underserved. Catholic Health collaborates with other charitable organizations and social service agencies (i.e. Catholic Charities, Spectrum Human Services, Evergreen Health Services, Erie County Department of Health, etc.), to maximize its ability to provide needed services to the residents of our region.The governing Board of Directors of Kenmore Mercy Hospital is comprised of community representatives from universities, legal communities, and business leaders. Religious orders are represented, as well as active and retired medical staff members. The Kenmore Mercy Hospital medical staff is considered an "open" medical staff, as any physician can apply for privileges. Each application is reviewed by a vigorous credentialing verification process. The hospitals have robust health professional education programs. Mercy Hospital and Sisters Hospital are physician teaching facilities. All sites participate in teaching programs for other allied health professionals. Our six emergency departments are open to all people regardless of their ability to pay. Our primary care centers are strategically located in areas deemed economically disadvantaged or where other medical services are lacking. Each year, Catholic Health touches tens of thousands of area residents through its community health education programs, health screenings, clinical and support services, and community service activities. Most of these program are free to encourage participation by people from all walks of life. Catholic Health will continue to meet community needs by providing charity care to the uninsured and underinsured, traditional Medicaid services, and community benefit programs, including collaborative community health improvement initiatives, health professional education programs, volunteering and community service activities, and cash and in-kind contributions to community organizations that serve the poor and disadvantaged. In 2017, the Catholic Health System provided more than $129 million in charity care and community benefit activities to help make our community a healthier place, especially for the poor and underserved. These activities included: " Spearheading Project Homeless Connect - An outreach initiative to link homeless individuals and families with medical and other support services;"Supporting charitable and educational organizations, like the St. Vincent DePaul, United Way, Catholic Charities, Gerard Place, Care and Share Food Pantry, Casey House, Project Connect Niagara and the Health Science Charter School that help the poor and vulnerable in our community;"Hosting numerous health education and screening programs to help people learn their health risks and take steps to improve their health; " Offering a Healthcare Assistance Program to ensure that people without insurance or financial means get the care they need; " Providing health and wellness information in places of worship through our Faith Community Nursing program; " Helping refugees access quality medical care through our Primary Care and School Based Health Centers, including the Mercy Comprehensive Care Center in Buffalo's Old First Ward; " Providing free care and services to those in need, like our "Cribs for Kids" program, which helps families provide a safe sleeping environment for their newborns; " Supporting children and families in need through our Reach Out and Read Program; Backpack Program for Kids; and Bridget Closet (clothes for the needy);" Sponsoring programs at the Mercy Comprehensive Care Center, which serve the local community, including refugees from Burma, Somalia, the Middle East, and Nepal ; " Providing services through our Social Work Department, which link patients with necessary services including: ESL (English as a Second Language), job opportunities, substance abuse treatment, health care navigators, senior services, insurance information, parenting assistance and more; and "Supporting nationally recognized "green" initiatives to remain good stewards of our natural resources and protect the environment.Additional initiatives that CHS participates in that provide benefit to the community include: Advanced Directive / MOLST education, Community Health Fairs , Footprints on the Heart(perinatal bereavement) , McGowan Grant for Health Care Tabling Events , Marian Building & Springville, OB/GYN Clinics, Medicaid Enrollment Assistance, Neonatal Abstinence Syndrome Program in Mercy, NICU Cuddler Program, Open Access Scheduling, Osteoporosis Screening, Prenatal-perinatal Network of WNY, Quest Fit Testing, Refugee Programs, Transitional contact to Catholic Charities from Primary Care Sites, and Transportation Assistance. One of the innovative ways Catholic Health is leading the transformation of healthcare is by supporting other organizations whose work has a direct impact on community health. For the second year, Catholic Health has allocated a portion of its net income ($137,700) for Community Benefit Grants to support programs that serve the poor and disadvantaged and address unmet health needs in our community. Recipients of the 2017 Community Benefit Grants include: *Pride Center of WNY, Inc. - Field Education on Health Disparities of LGBTQ People - $20,000*Durham's Central City Baby Caf - $20,000*RAHAMA: Trauma-informed domestic violence program for Muslims, immigrants, and refugee women - $20,000*Erie-Niagara Health Justice Alliance Planning Project (Medical-Legal Partnership) - $25,000*UB Partnership: Reduce Healthcare Disparities in Vulnerable Populations Through "Trauma Informed" Care Practices - $20,000*Sisters Hospital Chemical Dependency Treatment Services: Screening brief intervention and referral treatment (SBIRT) access in primary care with mental, emotional and behavioral (MEB) disorder screening - $10,000*Food Bank of WNY: School Backpack Program at West Hertel Academy - $17,700*Heart Love and Soul Soup Kitchen: Diabetes Self-Management and Support - $5,000 |
| Part VI, Line 7, Reports Filed With States | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark Sullivan | ||||||||||||||
| Executive VP / COO | $0 | $589,554 | $0 | $181,701 | $0 | $121,166 | $0 | $134,653 | $0 | $26,603 | $0 | $1,053,677 | $0 | $181,701 |
| James Millard | ||||||||||||||
| President and CEO, Kenmore Mercy | $305,290 | $0 | $0 | $0 | $17,624 | $0 | $206,285 | $0 | $24,743 | $0 | $553,942 | $0 | $0 | $0 |
| David Macholz | ||||||||||||||
| Treasurer | $0 | $222,439 | $0 | $34,402 | $0 | $8,894 | $0 | $25,118 | $0 | $26,614 | $0 | $317,467 | $0 | $0 |
| Charles J Urlaub | ||||||||||||||
| Director | $0 | $409,653 | $0 | $0 | $0 | $37,285 | $0 | $27,553 | $0 | $20,053 | $0 | $494,544 | $0 | $0 |
| Gary Tucker | ||||||||||||||
| Director | $0 | $262,727 | $0 | $0 | $0 | $60,526 | $0 | $45,307 | $0 | $25,204 | $0 | $393,764 | $0 | $0 |
| Joyce Markiewicz | ||||||||||||||
| Director | $0 | $354,692 | $0 | $0 | $0 | $17,861 | $0 | $63,393 | $0 | $19,303 | $0 | $455,249 | $0 | $0 |
| Martin Boryszak | ||||||||||||||
| Director | $0 | $313,904 | $0 | $0 | $0 | $12,182 | $0 | $12,092 | $0 | $8,822 | $0 | $347,000 | $0 | $0 |
| Joseph McDonald | ||||||||||||||
| President and CEO, CHS | $0 | $748,297 | $0 | $229,770 | $0 | $343,352 | $0 | $158,886 | $0 | $28,829 | $0 | $1,509,134 | $0 | $229,770 |
| James A Dunlop Jr | ||||||||||||||
| Executive VP / CFO | $0 | $528,833 | $0 | $163,443 | $0 | $103,660 | $0 | $253,453 | $0 | $25,442 | $0 | $1,074,831 | $0 | $163,443 |
| Dr Brian D'Arcy | ||||||||||||||
| Senior VP, Medical Affairs | $0 | $504,377 | $0 | $163,178 | $0 | $61,817 | $0 | $25,101 | $0 | $26,058 | $0 | $780,531 | $0 | $155,534 |
| Walter Ludwig | ||||||||||||||
| Chief Operating Officer | $201,226 | $0 | $2,000 | $0 | $10,834 | $0 | $20,589 | $0 | $24,578 | $0 | $259,227 | $0 | $0 | $0 |
| Michael Moley | ||||||||||||||
| Sr.VP, Human Resources | $0 | $388,982 | $0 | $112,624 | $0 | $156,122 | $0 | $114,645 | $0 | $20,968 | $0 | $793,341 | $0 | $112,624 |
| Dr Michael Galang | ||||||||||||||
| Sr. VP, Chief Information Officer | $0 | $406,244 | $0 | $122,651 | $0 | $17,902 | $0 | $63,847 | $0 | $9,524 | $0 | $620,168 | $0 | $122,651 |
| Nancy Sheehan | ||||||||||||||
| SVP Legal Service, General Counsel | $0 | $361,936 | $0 | $108,547 | $0 | $17,928 | $0 | $30,315 | $0 | $20,878 | $0 | $539,604 | $0 | $108,547 |
| Dr James Fitzpatrick | ||||||||||||||
| Physician | $338,533 | $0 | $0 | $0 | $3,825 | $0 | $23,411 | $0 | $18,866 | $0 | $384,635 | $0 | $0 | $0 |
| Dr Michael Edbauer | ||||||||||||||
| Chief Clincal Officer | $0 | $300,713 | $0 | $106,281 | $0 | $22,429 | $0 | $65,257 | $0 | $13,213 | $0 | $507,893 | $0 | $92,418 |
| Maria Foti | ||||||||||||||
| Sr. VP, Strategic Planning | $0 | $288,899 | $0 | $86,539 | $0 | $16,962 | $0 | $80,592 | $0 | $10,965 | $0 | $483,957 | $0 | $86,539 |
| Thomas Brewer MD | ||||||||||||||
| Physician | $309,765 | $0 | $0 | $0 | $18,337 | $0 | $13,965 | $0 | $16,687 | $0 | $358,754 | $0 | $0 | $0 |
| Michael Gough MD | ||||||||||||||
| Physician | $302,944 | $0 | $0 | $0 | $18,263 | $0 | $11,187 | $0 | $23,663 | $0 | $356,057 | $0 | $0 | $0 |
| Dr Erik Diringer | ||||||||||||||
| Physician | $273,665 | $0 | $0 | $0 | $18,238 | $0 | $9,952 | $0 | $311 | $0 | $302,166 | $0 | $0 | $0 |
| Cheryl Hayes | ||||||||||||||
| Director of Nursing | $183,341 | $0 | $2,000 | $0 | $2,501 | $0 | $21,045 | $0 | $654 | $0 | $209,541 | $0 | $0 | $0 |
| Dr Edward Stehlik | ||||||||||||||
| Physician | $179,829 | $0 | $0 | $0 | $20,057 | $0 | $0 | $0 | $211 | $0 | $200,097 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | One Officer and one highest paid employee received a tax indemnification and gross-up payment for reimbursement of withholding taxes in conjunction with certain taxable benefits paid on behalf of employee. |
| Part I, Line 4b | Certain Officers and Key employees participated in a supplemental nonqualified retirement plan. The intention is to provide additional retirement compensation to address any gaps in the compensation limit. Pension Gap SERP Joseph McDonald $26,000.00 $101,863.00 Mark Sullivan $19,500.00 Dr. Brian D'Arcy $9,800.00 Certain portions of the incentive compensation paid in 2017 are a result of the targets that were achieved in previous years. Deferred compensation reported in 2017 includes both qualified deferred pension compensation and employer contribution for 403b for certain Sisters of Charity Hospital associates, as well as deferred compensation for the amounts that are able to be estimated in 2017. Actual W-2 compensation paid to the executive is as per Schedule J Part II B. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Dormitory Authority of the State of New York | ||||||||
| A | 146000293 | 64983Q5T2 | 2006-11-29 | $16,730,000 | See Part VI | 0 | 0 | 0 |
| Dormitory Authority of the State of New York | ||||||||
| B | 146000293 | 649906J62 | 2012-07-12 | $14,235,000 | See Part VI | 0 | 0 | 0 |
| Buffalo and Erie County Industrial Land Development Corporation | ||||||||
| C | 222413596 | SeePartVI | 2015-04-30 | $3,515,000 | See Part VI | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $16,730,000 | $657,688 | $99,008 | $15,973,304 | 1998 | Yes (1) | 0 | Yes (1) | Yes (1) | ||||
| B | $14,235,000 | $563,473 | $12,430,146 | 2013 | 0 | 0 | 0 | Yes (1) | $954,691 | $286,690 | |||
| C | $3,898,409 | $114,244 | $3,158,244 | 2014 | 0 | 0 | 0 | Yes (1) | $256,629 | $369,292 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.00040 | 0.00040 | 0 | 0 | Yes (1) | |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) | |
| C | 0 | Yes (1) | Yes (1) | 0 | 0.03390 | 0.03390 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JP Morgan ChaseNA | ||||||||||||
| A | Yes (1) | Yes (1) | Yes (1) | 15.500000000000 | 0 | Yes (1) | 0 | 0 | Yes (1) | |||
| (no name) | ||||||||||||
| B | 0 | 0 | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | |||
| (no name) | ||||||||||||
| C | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) | ||||||
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART 1 A (F) | To refund the New York State Medical Care Facilities Finance Agency FHA - Insured mortgage Project Revenue Bonds, 1995 Series B, which were applied to finance the construction of a three floor patient tower and to refinance outstanding indebtedness. |
| PART 1 B (F) | To finance the cost of construction, reconstruction, and equipping certain improvements to Kenmore's existing approximately 347,661 square foot hospital facility located at 2950 Elmwood Avenue, Kenmore, NY,including a new two-story addition that includes approximately 19,000 square feet on the first floor to house Kenmore's Emergency Department. |
| PART IV 4 (E) | The interest rate swap through JP Morgan Chase associated with the 2006 series were unwound and terminated on 11/26/14. |
| PART IC (C) | The 2015 Bond Series were issued under numerous CUSIP #s with varying maturity dates. The associated CUSIP #s are as follows: 11943KBH4, 11943KBJ0, 11943KBK7, 11943KBL5, 11943KBM3, 11943KBN1, 11943KBP6, 11943KBQ4, 11943KBR2, 11943KBS0, 11943KBT8, 11943KBU5, 11943KBV3, 11943KBW1, 11943KBX9, 11943KBY7. |
| PART 1C (F) | To finance the costs associated with the Operating Room Expansion project at Kenmore Mercy Hospital. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Susan Urlaub | |||
| Wife of Mercy CEO, C.J. Urlaun | $90,121 | Corporate Nurse Educator | 0 |
| Kathleen Zapfel | |||
| Sister-in-law of BOD, Msgr. Robert Zapfel | $68,944 | HR Employee of CHS | 0 |
| Scott Markiewicz | |||
| Son of Key Employee, Joyce Markiewicz | $48,434 | Supervisor, Father Baker Manor | 0 |
| Julie Sullivan | |||
| Daughter of Chief Operating Officer | $33,395 | HR Employee of CHS | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | CHS has two members: Trinity Health, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws. |
| Form 990, Part VI, Section A, line 7a | According to the CHS Bylaws, each member is equally allowed to appoint one representative and one alternative representative to serve on the Corporate Member Council and to serve as a voting director on the Catholic Health System Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Yes, the corporate members do have reserve powers |
| Form 990, Part VI, Section B, line 11b | Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities that file a 990. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4.Schedule H: Hospitals 5.Schedule K: Supplemental information on Tax Exempt Bonds 6.Schedule J: Compensation Information 7.Schedule L: Transactions with Interested Persons 8.Schedule R: Related Organizations and Unrelated Partnerships 9.Process for which remaining Core Form was completed, utilizing audited financial information |
| Form 990, Part VI, Section B, line 12c | All associates on the Merit program; all Physicians and Non Physician Practitioners as well as Physician groups who are independent contractors or employees of CHS; and all board members must complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner. |
| Form 990, Part VI, Section B, line 15 | CHS, in determining the compensation for the CEO, utilizes a process of review and approval, governed by the Board of Directors that includes an outside nationally recognized independent compensation consultant experienced in compensation and benefit matters for non-profit healthcare organizations, and comparability data. In 2017, the Catholic Health System utilized a Compensation Committee of the Board of Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives. |
| Form 990, Part VI, Section C, line 19 | We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws. |
| Form 990, Part XI, line 9: | Minimum Pension Liability Adjustment -998591. Equity Transfer to Affiliates -6202967. Change in Temporarily Restricted Interest in KMH/CCD Foundations 83708. Other KMH Homes and Supply Chain Suspense 8212. Change in Unrestricted Interest in KMH Foundation -769575. Interest Rate Swap Adjustment 181815. |
| EXPLANATION OF RETURN | KMH Homes files their own separate 990 return. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Catholic Health System Inc | |||||||||||
| 144 Genesee Street | Buffalo | NY | 14203 | 222565278 | Health Care Delivery System | NY | 501C 3 | Schedule A Line 10 | N/A | 0 | |
| Mercy Hospital of Buffalo | |||||||||||
| 565 Abbott Road | Buffalo | NY | 14220 | 160756336 | Acute Care Hospital | NY | 501C 3 | Schedule A Line 3 | 0 | Catholic Health System Inc | |
| Sisters of Charity Hospital | |||||||||||
| 2157 Main Street | Buffalo | NY | 14214 | 160743187 | Acute Care Hospital | NY | 501C 3 | Schedule A Line 3 | 0 | Catholic Health System Inc | |
| Nazareth Home of the Franciscan Sisters | |||||||||||
| 291 North Street | Buffalo | NY | 14201 | 160813142 | Skilled Nursing Facility | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| St Elizabeth Home of the Aged | |||||||||||
| 5539 Broadway | Lancaster | NY | 14086 | 160743154 | Adult Home | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| St Francis Home of Williamsville | |||||||||||
| 147 Reist St | Williamsville | NY | 14221 | 160743153 | Skilled Nursing Facility | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| St Francis of Buffalo Inc | |||||||||||
| 34 Benwood Ave | Buffalo | NY | 14214 | 161523535 | Skilled Nursing Facility | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| St Vincent Manor | |||||||||||
| 319 Washington Avenue | Dunkirk | NY | 14048 | 160743167 | Adult Home | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| WNY Catholic Long Term Care Inc | |||||||||||
| 6400 Powers Road | Orchard Park | NY | 14127 | 161434368 | Skilled Nursing Facility | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| Niagara Homemaker Services (Mercy Home Care) | |||||||||||
| 144 Genesee Street | Buffalo | NY | 14203 | 161317960 | Home Care Provider | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| McAuley Seton Home Care | |||||||||||
| 144 Genesee Street | Buffalo | NY | 14203 | 161310062 | Home Care Provider | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| Catholic Health System Infusion Pharmacy Inc | |||||||||||
| 6350 Transic Road | Depew | NY | 14043 | 200198518 | Home Care Infusion Services | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| CHS Program of All-Inclusive Care of the Elderly Inc | |||||||||||
| 55 Melroy Avenue | Lackawanna | NY | 14218 | 261252884 | All-inclusive Care for the Elderly | NY | 501C 3 | Schedule A Line 3 | 0 | Catholic Health System Inc | |
| Trinity Medical WNY PC | |||||||||||
| 2625 Harlem Rd | Cheektowaga | NY | 14225 | 272576645 | Primary Care Provider | NY | 501C 3 | Schedule A Line 12 | 0 | Catholic Health System Inc | |
| Kenmore Mercy Hospital Foundation | |||||||||||
| 2950 Elmwood Avenue | Kenmore | NY | 14217 | 161162971 | Foundation | NY | 501C 3 | Schedule A Line 7 | 0 | Kenmore Mercy Hospital | |
| KMH Homes Inc | |||||||||||
| 144 Genesee Street | Buffalo | NY | 14203 | 161387890 | Real Estate Holding Company | NY | 501C 3 | Schedule A Line 10 | 0 | Catholic Health System Inc | |
| Mount St Mary's Hospital of Niagara Falls | |||||||||||
| 5300 Military Road | Lewiston | NY | 14092 | 161523353 | Acute Care Hospital | NY | 501C 3 | Schedule A Line 3 | 0 | Catholic Health System Inc | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |