CATHOLIC HEALTH SYSTEM INFUSION PHARMACY INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CATHOLIC HEALTH SYSTEM INFUSION PHARMACY INC (EIN 20-0198518)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-13
- IRS object ID
- 201733179349300248
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-13T09:27:29-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200198518 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Catholic Health System Infusion Pharmacy | BusinessNameLine1Txt |
| Business Name Line2 | Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CATH | BusinessNameControlTxt |
| 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 |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David P Macholz | PersonNm |
| Person Title | VP Finance CHS Corp Controller | PersonTitleTxt |
| Phone | 7168282974 | PhoneNum |
| Signature | 2017-11-13 | 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 | 2017-11-13 | IPDt |
| IP Tm | 09:26:20 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B771E52E22EB51C577E255A282798A21CA53CB4A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B771E52E22EB51C577E255A282798A21CA53CB4A | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | 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 | AddressLine1Txt |
| City | Buffalo | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,890,147 | 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 | 2003 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | The Catholic Health System (CHS) Mission is to provide quality healthcare services in a home 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 2016 Community Service Plan can be found at www.chsbuffalo.org. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 34 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,505,257 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,873,678 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,697 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,469 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,518,954 | PYTotalRevenueAmt |
| CY Total Revenue | $10,890,147 | 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 | $3,062,177 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,619,425 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,357,479 | PYOtherExpensesAmt |
| CY Other Expenses | $7,119,300 | CYOtherExpensesAmt |
| PY Total Expenses | $10,419,656 | PYTotalExpensesAmt |
| CY Total Expenses | $9,738,725 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $99,298 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,151,422 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,864,184 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,150,671 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,027,829 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,137,207 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,836,355 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,013,464 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The Catholic Health System (CHS) Mission is to provide quality healthcare services in a home 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 2016 Community Service Plan can be found at www.chsbuffalo.org. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,458,075 | ExpenseAmt |
| Revenue | $10,890,147 | RevenueAmt |
| Desc | Catholic Health system Infusion Pharmacy provides home health infusion care and supportive services to individuals throughout Western New York as well as pharmaceutical needs to Catholic Health System long term care facilities. Committed to a common mission, Western New York's Catholic Health providers continue the healing mission of Jesus. Seeking to improve the health of individuals and communities, we provide high quality service that is holistic, compassionate, and respectful of human dignity. Central to this endeavor is the service of persons who are poor and disadvantaged. For more detailed information, the 2016 Catholic Health Community Service report can be found at www.chsbuffalo.org. | Desc |
| Total Program Service Expenses | $8,458,075 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 34 | 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 |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David P Macholz | PersonNm |
| 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 (30 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 | $868,844 | $298,589 | ||
| Joyce Markiewicz | |||||||||
| President and CEO, Home and Community Based Care | 0.00 | 55.00 | Yes (X) | Yes (X) | $0 | $356,171 | $48,930 | ||
| David Macholz | |||||||||
| Treasuer | 0.00 | 55.00 | Yes (X) | Yes (X) | $0 | $268,947 | $35,004 | ||
| Brian Beitz | |||||||||
| Chairman | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Peter Bergmann | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $436,915 | $35,599 | |||
| Marty Boryszak | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $201,548 | $5,587 | |||
| Lynn Catalano | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| John Davanzo | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Georgiana Ford Esq | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark Jajkowski | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $98,000 | $0 | |||
| Raquel Martin DO | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| James Millard | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $315,450 | $151,407 | |||
| Gary Tucker | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $327,138 | $71,712 | |||
| Mary Turkiewiecz MD | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Charles Urlaub | |||||||||
| Director | 0.00 | 55.00 | Yes (X) | $0 | $435,436 | $39,771 | |||
| Katherine Vanderhorst | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Monsignor Robert E Zapfel | |||||||||
| Director | 0.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Joseph McDonald | |||||||||
| President and CEO, CHS | 0.00 | 55.00 | Yes (X) | $0 | $1,392,009 | $382,381 | |||
| James Dunlop Jr | |||||||||
| Executive VP, Finance/CFO | 0.00 | 55.00 | Yes (X) | $0 | $739,625 | $344,451 | |||
| Thomas Gleason | |||||||||
| COO, Home and Community Based Care | 0.00 | 55.00 | Yes (X) | $0 | $164,516 | $28,581 | |||
| Dr Michael Edbauer | |||||||||
| Chief Clinical Officer | 0.00 | 28.00 | $0 | $187,804 | $153,258 | Yes (X) | |||
| Maria Foti | |||||||||
| Sr. VP, Strategic Planning | 0.00 | 55.00 | $0 | $347,897 | $151,644 | Yes (X) | |||
| Dr Michael Galang | |||||||||
| Sr. VP, Chief Information Officer | 0.00 | 55.00 | $0 | $476,331 | $191,735 | Yes (X) | |||
| Michael Moley | |||||||||
| Sr. VP, Human Resources | 0.00 | 55.00 | $0 | $639,095 | $207,439 | Yes (X) | |||
| Nancy Sheehan | |||||||||
| Sr. VP, Legal Services | 0.00 | 55.00 | $0 | $431,398 | $147,216 | Yes (X) | |||
| Paul Bembenista | |||||||||
| Pharmacist | 55.00 | 0.00 | $140,992 | $0 | $81,014 | Yes (X) | |||
| Mark Czaplicki | |||||||||
| Manager Pharmacy Operations | 55.00 | 0.00 | $104,469 | $0 | $7,424 | Yes (X) | |||
| Lisa Dwyer | |||||||||
| Pharmacist | 55.00 | 0.00 | $107,069 | $0 | $4,809 | Yes (X) | |||
| Edward Dybala | |||||||||
| Pharmacist | 55.00 | 0.00 | $140,668 | $0 | $9,968 | Yes (X) | |||
| Joan Twarog | |||||||||
| Pharmacist | 55.00 | 0.00 | $117,228 | $0 | $12,570 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $610,426 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,687,124 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,409,089 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Medical Specialties Dist | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1549 Hunter Road | AddressLine1Txt |
| City | Hanover Park | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60133 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Healthcare Services | ServicesDesc |
| Compensation | $430,963 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOME CARE INFUSION SERVIES | 621610 | $6,700,028 | $6,700,028 |
| ORAL PHARMACY SERVICES | 621610 | $4,173,650 | $4,173,650 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,873,678 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,469 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,469 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,890,147 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,890,147 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,339,843 | TotalAmt |
| Program Services | $1,520,898 | ProgramServicesAmt |
| Management And General | $818,945 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,704 | TotalAmt |
| Program Services | $55,708 | ProgramServicesAmt |
| Management And General | $29,996 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,267 | TotalAmt |
| Program Services | $37,224 | ProgramServicesAmt |
| Management And General | $20,043 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,611 | TotalAmt |
| Program Services | $88,797 | ProgramServicesAmt |
| Management And General | $47,814 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,825 | TotalAmt |
| Management And General | $53,825 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,330,400 | TotalAmt |
| Program Services | $6,241,734 | ProgramServicesAmt |
| Management And General | $88,666 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,297 | TotalAmt |
| Program Services | $133,297 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,839 | TotalAmt |
| Program Services | $54,330 | ProgramServicesAmt |
| Management And General | $7,509 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,361 | TotalAmt |
| Management And General | $8,361 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,017 | TotalAmt |
| Management And General | $5,017 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,512 | TotalAmt |
| Program Services | $27,821 | ProgramServicesAmt |
| Management And General | $9,691 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,289 | TotalAmt |
| Management And General | $8,289 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt | $295,754 | $295,754 | |
| Outside Services | $137,189 | $137,189 | |
| Dues and Subscriptions | $22,003 | $22,003 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,814 | TotalAmt |
| Program Services | $2,512 | ProgramServicesAmt |
| Management And General | $23,302 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,738,725 | TotalAmt |
| Program Services | $8,458,075 | ProgramServicesAmt |
| Management And General | $1,280,650 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,302,421 | BOYAmt |
| EOY | $1,695,343 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,323,195 | BOYAmt |
| EOY | $1,402,684 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,759 | BOYAmt |
| EOY | $669,555 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,151 | BOYAmt |
| EOY | $707,992 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $274,044 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $181,899 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,841 | BOYAmt |
| EOY | $92,145 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,000 | BOYAmt |
| EOY | $140,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $533,817 | BOYAmt |
| EOY | $442,952 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,864,184 | BOYAmt |
| EOY | $5,150,671 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,875,055 | BOYAmt |
| EOY | $1,120,343 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,774 | BOYAmt |
| EOY | $16,864 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,027,829 | BOYAmt |
| EOY | $1,137,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,836,355 | BOYAmt |
| EOY | $4,013,464 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,836,355 | BOYAmt |
| EOY | $4,013,464 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,864,184 | BOYAmt |
| EOY | $5,150,671 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,151,422 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $25,687 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,847,221 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,173,440 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,431,317 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,505,257 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,873,678 | CurrentTaxYearAmt |
| Total | $48,830,913 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,847,221 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,173,440 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,431,317 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,505,257 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,873,678 | CurrentTaxYearAmt |
| Total | $48,830,913 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $48,830,913 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,059 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,469 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,417 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,697 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,469 | CurrentTaxYearAmt |
| Total | $41,111 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,059 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,469 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,417 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,697 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,469 | CurrentTaxYearAmt |
| Total | $41,111 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,849,280 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,175,909 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,437,734 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,518,954 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,890,147 | CurrentTaxYearAmt |
| Total | $48,872,024 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99920 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99940 | PublicSupportPY509Pct |
| Investment Income CY | 0.00080 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00060 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $274,044 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $181,899 | DepreciationAmt |
| Book Value | $92,145 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $92,145 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT IN JOINT VENTURE | $426,088 |
| WORKERS COMP RECOVERY | $14,558 |
| MEDICAL MALPRACTICE RECOVERY | $2,306 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $442,952 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED WORKERS COMP IBNR | $14,558 |
| ACCRUED MEDICAL MALPRACTICE IBNR | $2,306 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,864 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $10,890,147 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,890,147 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,890,147 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,738,725 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,738,725 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,738,725 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (18 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 | $573,434 | $0 | $176,409 | $0 | $119,001 | $0 | $273,307 | $0 | $25,282 | $0 | $1,167,433 | $0 | $58,215 |
| Joyce Markiewicz | ||||||||||||||
| President and CEO, Home and Communit | $0 | $338,634 | $0 | $0 | $0 | $17,537 | $0 | $31,113 | $0 | $17,817 | $0 | $405,101 | $0 | $0 |
| David Macholz | ||||||||||||||
| Treasuer | $0 | $260,167 | $0 | $0 | $0 | $8,780 | $0 | $9,691 | $0 | $25,313 | $0 | $303,951 | $0 | $0 |
| Peter Bergmann | ||||||||||||||
| Director | $0 | $408,137 | $0 | $0 | $0 | $28,778 | $0 | $12,153 | $0 | $23,446 | $0 | $472,514 | $0 | $0 |
| Marty Boryszak | ||||||||||||||
| Director | $0 | $201,401 | $0 | $0 | $0 | $147 | $0 | $4,887 | $0 | $700 | $0 | $207,135 | $0 | $0 |
| James Millard | ||||||||||||||
| Director | $0 | $297,882 | $0 | $0 | $0 | $17,568 | $0 | $127,811 | $0 | $23,596 | $0 | $466,857 | $0 | $0 |
| Gary Tucker | ||||||||||||||
| Director | $0 | $259,019 | $0 | $48,355 | $0 | $19,764 | $0 | $46,832 | $0 | $24,880 | $0 | $398,850 | $0 | $0 |
| Charles Urlaub | ||||||||||||||
| Director | $0 | $397,617 | $0 | $0 | $0 | $37,819 | $0 | $20,655 | $0 | $19,116 | $0 | $475,207 | $0 | $0 |
| Joseph McDonald | ||||||||||||||
| President and CEO, CHS | $0 | $756,655 | $0 | $306,361 | $0 | $328,993 | $0 | $355,355 | $0 | $27,026 | $0 | $1,774,390 | $0 | $101,099 |
| James Dunlop Jr | ||||||||||||||
| Executive VP, Finance/CFO | $0 | $510,950 | $0 | $157,684 | $0 | $70,991 | $0 | $320,331 | $0 | $24,120 | $0 | $1,084,076 | $0 | $52,036 |
| Thomas Gleason | ||||||||||||||
| COO, Home and Community Based Care | $0 | $164,430 | $0 | $0 | $0 | $86 | $0 | $5,611 | $0 | $22,970 | $0 | $193,097 | $0 | $0 |
| Dr Michael Edbauer | ||||||||||||||
| Chief Clinical Officer | $0 | $94,214 | $0 | $83,957 | $0 | $9,633 | $0 | $140,631 | $0 | $12,627 | $0 | $341,062 | $0 | $29,185 |
| Maria Foti | ||||||||||||||
| Sr. VP, Strategic Planning | $0 | $259,490 | $0 | $71,592 | $0 | $16,815 | $0 | $141,148 | $0 | $10,496 | $0 | $499,541 | $0 | $23,625 |
| Dr Michael Galang | ||||||||||||||
| Sr. VP, Chief Information Officer | $0 | $353,459 | $0 | $105,025 | $0 | $17,847 | $0 | $182,634 | $0 | $9,101 | $0 | $668,066 | $0 | $34,658 |
| Michael Moley | ||||||||||||||
| Sr. VP, Human Resources | $0 | $377,753 | $0 | $108,014 | $0 | $153,328 | $0 | $187,632 | $0 | $19,807 | $0 | $846,534 | $0 | $35,645 |
| Nancy Sheehan | ||||||||||||||
| Sr. VP, Legal Services | $0 | $324,583 | $0 | $89,242 | $0 | $17,573 | $0 | $129,403 | $0 | $17,813 | $0 | $578,614 | $0 | $29,450 |
| Paul Bembenista | ||||||||||||||
| Pharmacist | $135,855 | $0 | $0 | $0 | $5,137 | $0 | $64,148 | $0 | $16,866 | $0 | $222,006 | $0 | $0 | $0 |
| Edward Dybala | ||||||||||||||
| Pharmacist | $136,086 | $0 | $0 | $0 | $4,582 | $0 | $9,814 | $0 | $154 | $0 | $150,636 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. Joseph McDonald $26,000.00, SERP $97,946.00 Mark Sullivan $19,500.00 Peter Bergmann $7,334.00 |
| PART II B | Certain portions of the incentive compensation paid in 2016 are a result of the targets that were achieved in previous years. Deferred compensation reported in 2016 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 2016. Actual W-2 compensation paid to the executive is as per Schedule J Part II B. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|
| Susan Urlab | ||
| Wife of Mercy CEO, CJ Urlaub | $86,475 | 0 |
| Kathleen Zapfel | ||
| Sister-in-law of BOD, Msgr. Robert Zapfel | $70,649 | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 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 2016, 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 25,687. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM INC | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 222565278 | HEALTH CARE DELIVERY SYSTEM | NY | 501 C 3 | SCHEDULE A LINE 10 | 0 | |
| MERCY HOSPITAL OF BUFFALO | ||||||||||
| 565 ABBOTT ROAD | BUFFALO | NY | 14220 | 160756336 | ACUTE CARE HOSPITAL | NY | 501 C 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 | 501 C 3 | SCHEDULE A LINE 3 | 0 | CATHOLIC HEALTH SYSTEM INC |
| KENMORE MERCY HOSPITAL | ||||||||||
| 2950 ELMWOOD AVENUE | KENMORE | NY | 14217 | 160762843 | ACUTE CARE HOSPITAL | NY | 501 C 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 | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| ST ELIZABETH HOME FOR THE AGED | ||||||||||
| 5539 BROADWAY | LANCASTER | NY | 14086 | 160743154 | ADULT HOME | NY | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| ST FRANCIS HOME IN WILLIAMSVILLE | ||||||||||
| 147 REIST STREET | WILLAMSVILLE | NY | 14221 | 160743153 | SKILLED NURSING FACILITY | NY | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| ST FRANCIS OF BUFFALO | ||||||||||
| 34 BENWOOD AVENUE | BUFFALO | NY | 14214 | 161523535 | SKILLED NURSING FACILITY | NY | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| ST VINCENT MANOR | ||||||||||
| 319 WASHINGTON STREET | DUNKIRK | NY | 14048 | 160743167 | ADULT HOME | NY | 501 C 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 | 501 C 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 | 501 C 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 | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| CHS CONTINUING CARE FOUNDATION | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 200947831 | FOUNDATION | NY | 501 C 3 | SCHEDULE A LINE 7 | 0 | CATHOLIC HEALTH SYSTEM INC |
| OLV RENAISSANCE CORPORATION | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 200167745 | REAL ESTATE HOLDING COMPANY | NY | 501 C 3 | SCHEDULE A LINE 10 | 0 | CATHOLIC HEALTH SYSTEM INC |
| CHS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY INC | ||||||||||
| 55 MELROY AVENUE | LACKAWANNA | NY | 14218 | 261252884 | ALL-INCLUSIVE CARE FOR THE ELDERLY | NY | 501 C 3 | SCHEDULE A LINE 3 | 0 | CATHOLIC HEALTH SYSTEM INC |
| TRINITY MEDICAL WNY PC | ||||||||||
| 2625 HARLEM ROAD | CHEEKTOWAGA | NY | 14225 | 272576645 | PRIMARY CARE PROVIDER | NY | 501 C 3 | SCHEDULE A LINE 12 | 0 | CATHOLIC HEALTH SYSTEM INC |
| KMH HOMES INC | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 161387890 | REAL ESTATE HOLDING COMPANY | NY | 501 C 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 | 501 C 3 | SCHEDULE A LINE 3 | 0 | CATHOLIC HEALTH SYSTEM INC |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Catholic Health Home Respiratory | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 Maryland Way Suite 400 | AddressLine1Txt |
| City | Brentwood | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 370245018 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Home Care Respiratory Services | PrimaryActivitiesTxt |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |