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MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS (EIN 16-1523353)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201743179349302604
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-13T10:17:58-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN161523353EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mount St Mary's HospitalBusinessNameLine1Txt
Business Name Line2of Niagara FallsBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlMOUNBusinessNameControlTxt
Phone7168282974PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1144 Genesee StAddressLine1Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid P MacholzPersonNm
Person TitleCHS VP Finance,Corp.ControllerPersonTitleTxt
Phone7168282974PhoneNum
Signature2017-11-13SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address204.68.186.4IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-13IPDt
IP Tm10:16:50IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7A6C0E4E833B5736639BD5417150D578DD5EAFB4AtSubmissionCreationDeviceId
At Submission Filing Device IdA1FF77BEB3708404F77A91D7B895CEDA7937CD66AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJoseph D McDonaldPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1144 Genesee StreetAddressLine1Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$100,400,696GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.chsbuffalo.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1907FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionThe 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 2016 Community Service Plan can be found at www.chsbuffalo.org.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee895TotalEmployeeCnt
Total Volunteers240TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$1,432,628CYContributionsGrantsAmt
PY Program Service Revenue$92,209,017PYProgramServiceRevenueAmt
CY Program Service Revenue$96,226,820CYProgramServiceRevenueAmt
PY Investment Income$32,150PYInvestmentIncomeAmt
CY Investment Income$12,598CYInvestmentIncomeAmt
PY Other Revenue$1,437,648PYOtherRevenueAmt
CY Other Revenue$2,728,650CYOtherRevenueAmt
PY Total Revenue$93,678,815PYTotalRevenueAmt
CY Total Revenue$100,400,696CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$59,044,765PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$64,487,690CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$35,757,873PYOtherExpensesAmt
CY Other Expenses$34,411,086CYOtherExpensesAmt
PY Total Expenses$94,802,638PYTotalExpensesAmt
CY Total Expenses$98,898,776CYTotalExpensesAmt
PY Revenues Less Expenses-$1,123,823PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,501,920CYRevenuesLessExpensesAmt
Total Assets BOY$47,446,166TotalAssetsBOYAmt
Total Assets EOY$50,025,734TotalAssetsEOYAmt
Total Liabilities BOY$20,119,146TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,846,503TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$27,327,020NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,179,231NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe 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 2016 Community Service Plan can be found at www.chsbuffalo.org.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$53,482,727ExpenseAmt
Revenue$60,082,531RevenueAmt
DescInpatient Routine/Surgery Visits:Acute Care Patient Days = 19,775Newborn Patient Days = 933Inpatient Surgeries = 2,126Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$17,720,322ExpenseAmt
Revenue$19,907,022RevenueAmt
DescOutpatient Routine/Surgery Services:Emergency Visits (Net of Admits) = 18,403Referred Ambulatory Visists = 81,560Operating Room = 3,385G.I. Laboratory = 2,159Interventional Radiology = 423Transfusion = 186Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$14,453,674ExpenseAmt
Revenue$16,237,267RevenueAmt
DescClinic/Primary Care Services:Clinic Visits = 35,948Primary Care Visits = 32,890Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$85,656,723TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document82IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee895EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDavid P Macholz Controller CatholPersonNm
Phone7168282974PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1144 Genesee StAddressLine1Txt
CityBuffaloCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mark Sullivan
Executive VP/COO0.0055.00Yes (X)Yes (X)$0$868,844$298,589
Gary Tucker
Pres. & CEO, Mount St. Mar55.000.00Yes (X)Yes (X)$327,138$0$71,712
David Macholz
Treasurer0.0055.00Yes (X)Yes (X)$0$268,947$35,004
Peter Bergmann
Director0.0055.00Yes (X)$0$436,915$35,599
Joyce Markiewicz
Director0.0055.00Yes (X)$0$356,171$48,930
James Millard
Director0.0055.00Yes (X)$0$315,450$151,407
Charles Urlaub
Director/Officer0.0055.00Yes (X)Yes (X)$0$435,436$39,771
Martin Boryszak
Director0.0055.00Yes (X)$0$201,548$5,587
Lynn Catalano
Director0.002.00Yes (X)$0$0$0
John Davanzo
Director0.002.00Yes (X)$0$0$0
Georgiana Ford Esq
Director0.002.00Yes (X)$0$0$0
Mark Jajkowski
Director0.0055.00Yes (X)$0$98,000$0
Raquel Martin DO
Director0.002.00Yes (X)$0$0$0
Mary Turkiewiecz MD
Director0.002.00Yes (X)$0$0$0
Katherine Vanderhorst
Director0.002.00Yes (X)$0$0$0
Monsignor Robert E Zapfel
Director0.002.00Yes (X)$0$0$0
Brian Beitz
Director0.004.00Yes (X)$0$0$0
Dr Michael Galang
Sr. VP, Chief Information0.0055.00Yes (X)$0$476,331$191,735
Joseph McDonald
President and CEO, CHS0.0055.00Yes (X)$0$1,392,009$382,381
James A Dunlop Jr
Executive VP, Finance/CFO0.0055.00Yes (X)$0$739,625$344,451
Dr Brian D'Arcy
Senior VP, Medical Affairs0.0055.00Yes (X)$0$697,837$204,522
Dr Michael Edbauer
Chief Clinical Officer0.0028.00$0$187,804$153,258Yes (X)
Maria Foti
Sr. VP, Strategic Planning0.0055.00$0$347,897$151,644Yes (X)
Michael Moley
Sr. VP, Human Resources0.0055.00$0$639,095$207,439Yes (X)
Nancy Sheehan
SVP Legal Service, General Counsel0.0055.00$0$431,398$147,216Yes (X)
Dr Samuel Sirianni
Physician55.00$369,689$0$43,620Yes (X)
Dr Roger W Rogers
Physician55.00$463,765$0$33,868Yes (X)
Dr Benjamin G Rueda
Physician55.00$508,003$0$47,963Yes (X)
Dr Arif S Syed
Physician55.00$510,371$0$38,387Yes (X)
Dr Parag Parikh
Physician55.00$356,457$0$30,934Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,535,423TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,893,307TotReportableCompRltdOrgAmt
Total Other Compensation$2,664,017TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K59IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Trimedx LLC
5451 Lakeview Pkwy S DriveIndianapolisIN46268Clinical Engineering Services$1,294,818
Precision Health Care Services
1160 Southwest 21st AvenueBoca RotonFL33486Healthcare Services$897,965
Exigence Hospitalist Medical
1 John James Audubon PkwyBuffaloNY14228Physician Services$710,560
Atlas Healthcare Linen
414 WTaylor StSyracuseNY13202Linen Services$591,076
Morrison Management Specialist
400 Northridge Road Suite 600Sandy SpringsGA30350Nutrition Services$491,913
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K32CntrctRcvdGreaterThan100KCnt
All Other Contributions$1,432,628AllOtherContributionsAmt
Total Contributions$1,432,628TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
All Other Payers621990$63,726,101$63,726,101
Medicare621990$19,017,372$19,017,372
Medicaid621990$13,483,347$13,483,347
FieldValueIRS element (for citing)
Total Program Service Revenue$96,226,820TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,598TotalRevenueColumnAmt
Exclusion$12,598ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$69,629RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$69,629RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$69,629TotalRevenueColumnAmt
Exclusion$69,629ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Meaningful Use621990$795,003$795,003
340B Pharmacy621990$482,926$482,926
Cafeteria722210$364,424$364,424

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,016,668TotalRevenueColumnAmt
Related Or Exempt Func Income$193,551RelatedOrExemptFuncIncomeAmt
Exclusion$823,117ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,659,021OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,400,696TotalRevenueColumnAmt
Related Or Exempt Func Income$97,698,300RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,269,768ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$50,046,523TotalAmt
Program Services$43,918,109ProgramServicesAmt
Management And General$6,128,414ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,895,340TotalAmt
Program Services$1,686,853ProgramServicesAmt
Management And General$208,487ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$12,355,870TotalAmt
Program Services$10,806,045ProgramServicesAmt
Management And General$1,549,825ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$189,957TotalAmt
Program Services$169,062ProgramServicesAmt
Management And General$20,895ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$54,513TotalAmt
Management And General$54,513ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$7,308TotalAmt
Management And General$7,308ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,182,137TotalAmt
Program Services$2,516,393ProgramServicesAmt
Management And General$665,744ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$104,733TotalAmt
Management And General$104,733ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,213,624TotalAmt
Program Services$2,252,881ProgramServicesAmt
Management And General$1,960,743ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$141,816TotalAmt
Program Services$34,522ProgramServicesAmt
Management And General$107,294ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,401,384TotalAmt
Program Services$1,051,038ProgramServicesAmt
Management And General$350,346ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,306TotalAmt
Program Services$20,668ProgramServicesAmt
Management And General$10,638ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$61,000TotalAmt
Program Services$53,042ProgramServicesAmt
Management And General$7,958ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$11,919TotalAmt
Program Services$10,922ProgramServicesAmt
Management And General$997ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,167,507TotalAmt
Program Services$2,902,468ProgramServicesAmt
Management And General$265,039ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$578,858TotalAmt
Program Services$522,265ProgramServicesAmt
Management And General$56,593ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$12,275,872$12,150,819$125,053
Purchased Services$5,623,675$5,011,575$612,100
Dues and Shared Service$3,275,482$2,354,454$921,028
Other Supplies Non-Medi$279,952$195,607$84,345

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$98,898,776TotalAmt
Program Services$85,656,723ProgramServicesAmt
Management And General$13,242,053ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,003,131BOYAmt
EOY$6,067,089EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,790,533BOYAmt
EOY$10,592,651EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,070,267BOYAmt
EOY$296,864EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,765,902BOYAmt
EOY$1,668,296EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$565,563BOYAmt
EOY$345,156EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$61,917,994LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$37,918,204LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$24,680,688BOYAmt
EOY$23,999,790EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,570,082BOYAmt
EOY$7,055,888EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$47,446,166BOYAmt
EOY$50,025,734EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,972,611BOYAmt
EOY$10,129,282EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$372,539BOYAmt
EOY$190,106EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,773,996BOYAmt
EOY$12,527,115EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,119,146BOYAmt
EOY$22,846,503EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,030,833BOYAmt
EOY$24,429,162EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,249,249BOYAmt
EOY$2,702,286EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$46,938BOYAmt
EOY$47,783EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,327,020BOYAmt
EOY$27,179,231EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$47,446,166BOYAmt
EOY$50,025,734EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,501,920ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1,649,709OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,308OtherActivitiesAmt
Total Lobbying Expenditures$7,308TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationLobbying expenses represent the portion of dues paid to national and state associations that is specifically allocable to lobbying. Mount St. Mary's Hospital of Niagara Falls 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 for public office.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,227,100OtherCostOrOtherBasisAmt
Book Value$1,227,100BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,802,186OtherCostOrOtherBasisAmt
Depreciation$17,892,596DepreciationAmt
Book Value$12,909,590BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,221,523OtherCostOrOtherBasisAmt
Depreciation$20,698,659DepreciationAmt
Book Value$8,522,864BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$667,185OtherCostOrOtherBasisAmt
Depreciation-$673,051DepreciationAmt
Book Value$1,340,236BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,999,790TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Due From Affiliates$275,553
Interest in Net Assets of Mount St. Mary's Hospital Foundation$5,960,995
Insurance Recoveries$819,340
FieldValueIRS element (for citing)
Total Book Value Other Assets$7,055,888TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
Due to Affiliates$1,077,332
Long-Term Portion of Insurance Liabilities$2,665,445
Pension Obligation$763,821
Asset Retirement Obligation$380,355
Long-Term Portion of EIB Bank$343,876
Contingent Liability$7,242,452
Long-Term Portion of Disposables$53,834
FieldValueIRS element (for citing)
Total Liability$12,527,115TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$100,357,032TotalRevEtcAuditedFinclStmtAmt
Other Revenue$1,304,882OtherRevenueAmt
Revenue Not Reported$1,304,882RevenueNotReportedAmt
Revenue Subtotal$99,052,150RevenueSubtotalAmt
Other Revenues Not Included$1,348,546OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,348,546RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$100,400,696TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$99,892,734TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$993,958OtherExpensesIncludedAmt
Expenses Not Reported$993,958ExpensesNotReportedAmt
Expenses Subtotal$98,898,776ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$98,898,776TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part XI, Line 2d - Other Adjustments:Childcare Revenue - 605,522 Foundation Revenue - 699,360
Part XI, Line 4b - Other Adjustments:Foundation Contributions - 1,318,546 Grant Income - 30,000
Part XII, Line 2d - Other Adjustments:Childcare Expenses - 629,220 Foundation Expenses (net of eliminations) - 364,738

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$725,650TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$26,393DirectOffsettingRevenueAmt
Net Community Benefit Expns$699,257NetCommunityBenefitExpnsAmt
Total Expense0.00710TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,908,846TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,410,917DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,497,929NetCommunityBenefitExpnsAmt
Total Expense0.06570TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,634,496TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,437,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,197,186NetCommunityBenefitExpnsAmt
Total Expense0.07280TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$750,997TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$750,997NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$951,404TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$951,404NetCommunityBenefitExpnsAmt
Total Expense0.00960TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,853,935TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,259,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,594,306NetCommunityBenefitExpnsAmt
Total Expense0.01610TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$123,297TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$123,297NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$384,165TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$384,165NetCommunityBenefitExpnsAmt
Total Expense0.00390TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,063,798TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,259,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,804,169NetCommunityBenefitExpnsAmt
Total Expense0.03840TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,698,294TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,696,939DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,001,355NetCommunityBenefitExpnsAmt
Total Expense0.11120TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,352TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,352NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,009TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,009NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$80,388TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$80,388NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,301TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,301NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,662TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,662NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,034TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,034NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$129,746TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$129,746NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$2,556,472BadDebtExpenseAmt
Bad Debt Expense Attributable$551,015BadDebtExpenseAttributableAmt
Reimbursed By Medicare$19,154,870ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,486,973CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$2,667,897MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mount St Mary's Hospital of Niagara FallsBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15300 Military RdAddressLine1Txt
CityLewistonCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14092ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.chsbuffalo.orgWebsiteAddressTxt
State License3121001HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherAmbulatory Surgery - Multi SpecialityOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mount St Mary's Hospital of Niagara FalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYYes (1)TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://chsbuffalo.org/CommunityOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.chsbuffalo.org/CommunityStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://chsbuffalo.org/billing/financeFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://chsbuffalo.org/billing/financeFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://chsbuffalo.org/billing/financeFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
None MadeYes (X)NoneMadeInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section A:CT Scanner Chemical Dependence - IP Rehabilitation O/P Chemical Dependence - Withdrawal O/P Clinic Part Time Services Clinical Laboratory ServiceCoronary Care Emergency Department Health Fairs O/P Intensive Care Lithotripsy Magnetic Resonance Imaging Maternity Medical Services - Primary Care Medical Social Services Medical/Surgical Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Pediatric O/PPharmaceutical Service Radiology - Diagnostic Renal Dialysis - Acute Therapy - Occupational O/P Therapy - Physical O/P Therapy - Speech Language Pathology
Mount St. Mary's Hospital of Niagara FallsPart V, Section B, Line 5: To identify and prioritize the MSMH community' s health needs, this Community Health Needs Assessment (CHNA) considered multiple data sources, including written surveys, interviews, focus groups, demographic data, health status indicators, and disease prevalence data. MSMH compiled the data from these sources to arrive at potential priority health needs in the community. MSMH convened meetings with MSMH staff and external healthcare experts (including the Niagara County Department of Health) to share the survey results, discuss the potential priority health needs and to elicit considerations regarding secondary health needs. Collaboration included involvement from other local area local area hospitals, Niagara Falls Memorial, DeGraff Memorial, and Eastern Niagara. A countywide questionnaire was sent in addition to individual surveys sent to community organizations, local health officials and others of varying socioeconomic backgrounds:- Written Survey targeting local community organizations and non-profits that are active in the primary service area - Written Survey targeting local block clubs and church groups active in the primary service area- Focus Group at the Mount St. Mary's Neighborhood Health Center, located in the part of the service area with the lowest per capita income and underserved in a variety of ways- Focus Group at Mount St. Mary's Hospital involving associates- Input from Focus Groups conducted throughout Niagara County by Niagara County DOH- Written Request for input from physicians at Mount St. Mary's- Written Survey conducted by Niagara County Department of Health that was countywide, but also with the ability to gather input from our primary service area.These included members of the Creating a Healthier Niagara Falls Collaborative and Healthy Behaviors Work Group:- Family and Children's Services of Niagara- Niagara County Office of the Aging- American Diabetes Association- Niagara County Department of Mental Health- Buffalo-Niagara YMCA- Planned Parenthood of Niagara- Native American Community Services- Isaiah 61 Project- Roswell Park Cancer Institute/Niagara Falls City Council- Niagara Falls School District/Niagara Falls City CouncilOther groups included:- Mom's Net- Family and Children's Services of Niagara- Heart, Love & Soul Food Pantry- Project Connect Niagara
Mount St. Mary's Hospital of Niagara FallsPart V, Section B, Line 6b: Catholic Health System, P2 Collaborative, Niagara County Department of Health and New York State Department of Health
Mount St. Mary's Hospital of Niagara FallsPart V, Section B, Line 2: Effective July 1, 2015, Catholic Health and Ascension completed a transaction to transfer ownership/sponsorship of Mount St. Mary's from Ascension to Catholic Health. Ascension was the sponsor of Mount St. Mary's from 2000 to July 1, 2015.
Mount St. Mary's Hospital of Niagara FallsPart V, Section B, Line 11: The 2016 Niagara County Community Health Needs Assessment began by bringing together the participants from the 2013 process. This included the Niagara County Department of Health, and representatives of the four hospitals in Niagara County: Mount St. Mary's, Niagara Falls Memorial, DeGraff Memorial, and Eastern Niagara. The process was coordinated by the P2 Collaborative of Western New York.Initial meetings focused on evaluating activities from the 2013 CHNA's and the County Health Department's Community Service Plan priorities. Despite posting our 2013-16 report on our website and providing notice in the media, we did not receive any written input on the report. Subsequent sessions were devoted to developing a countywide questionnaire to survey residents and initiatives to gather as much relevant data as possible from surveys, interviews, and focus groups.As part of this coordinated initiative, Mount St. Mary's worked to develop an updated three-year(2016-2018) Community Health Improvement Plan/Implementation Strategy (CHIP/IS) to continue the collaboration in our community to improve patient care, preventive services, overall health, and quality of life. Our input process covered many segments of the community including individual surveys, community organizations, local health officials and others of varying socioeconomic backgrounds. Through the needs assessment, numerous areas were identified as important and clearly impact the health of the community. Mount St. Mary's identified the "significant" needs as related to the New York State Department of Health Prevention Agenda priorities. Within the "priorities," Mount St. Mary's will address numerous health needs as described in the publicly available CHNA report.Two priorities not specifically addressed in the implementation plan: Neighborhood Safety and Food/Water Safety. We did not address in our plan because of a lack of expertise and resources to effectively address each of the issues.
Mount St. Mary's Hospital of Niagara FallsPart V, Section B, Line 16j: Includes information in both English and Spanish on all signage and brochures for financial assistance.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Mount St Mary's Hospital Rehab Svc
1 Columba DriveNiagara FallsNY14305Licensed, Extension Clinic: Therapy-Occupational O/P, Therapy-Physical O/P
2 - Mount St Mary's Diagnostic Imaging Svc
7300 Porter RoadNiagara FallsNY12414Licensed, Extension Clinic: Medical Services-Primary Care
3 - Mount St Mary's Ear Nose and Throat Sv
6941 Elaine DriveNiagara FallsNY14304Licensed, Extension Clinic: Primary Medical Care O/P
4 - Mount St Mary's Orthopedic Services and
5320 Military RoadLewistonNY14092Licensed, Extension Clinic: Orthopedic Services General,Vascular & Cardiotho
5 - Mount St Mary's Primary Care
1302 Main StreetNiagara FallsNY14301Extension Clinic: Medical Services O/P, Primary Medical Care O/P, Radiology
6 - Mount St Mary's Neighborhood Health Ctr
3101 Ninth StreetNiagara FallsNY14305Licensed, Extension Clinic: Medical Social Services O/P, Nutritional O/P
7 - Mount St Mary's Campus Medical Arts Bld
5290 Military Road Suite 8LewistonNY14092Extension Clinic: Primary Care
8 - Witmer Park Medical Center
One Colomba Drive Suite 8Niagara FallsNY14304Extension Clinic: Primary Care

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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:Community Building Activities for Mount St. Mary's Hospital included Economic Development of $7,352 Community Support of $26,009, Environmental Improvements of $80,388, Leadership development of $13,301, Community health improvement of $1,662, and Workforce development of $1,034.
Part III, Line 2:The amount in Part III line 2 is the actual bad debt expenses of $2,556,472. 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 10/1/2015 to 9/30/2016 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. 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:Mount St. Mary's 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:As part of Catholic Health, Mount St. Mary's benefits from information received from evaluations administered by the Catholic Health Community Education Department after each class, workshop, or program it sponsors; from input from the physician community during doctor to doctor education programs; from physician and leadership participation in community boards, coalitions and forums to define the health needs of patient populations and seek community solutions; from participation in regional planning initiatives that look at the needs of the broader community; and input from Catholic Health Board including Board Committee (e.g. Mission Integration Committee). Examples of other sources of input include input from leadership of Family and Children's Services of Niagara, the Heart, Love and Soul Food Pantry, Stella Niagara Education Center, Catholic Academy of Niagara Falls, March of Dimes, Healthy Moms/Healthy Babies, among others. In each of the organizations listed, a member of the Mount St. Mary's leadership team serves on their board of directors or key committee with consistent dialogue about our services.
Part VI, Line 3:Catholic Health's Mount St. Mary's Hospital informs 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, Mount St. Mary's Hospital, like our other facilities, has posters and brochures available, which include eligibility and contact information for the Financial Clearance staff. 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. 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, please call (716) 601-3600. Thank you." For free, confidential assistance in applying for financial aid, patients can also call our Financial Clearance department 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. Additionally, as part of our case management services, we 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. There is also information about our financial assistance program in our patient handbooks and posted on the Catholic Health System website.
Part VI, Line 4:Mount St. Mary's Primary Service Area includes the City of Niagara Falls (Zip Codes 14301, 14302, 14303, 14304 and 14305), a city of about 49,000 where 60% of the population is on some form of public assistance. The towns of Lewiston (14092, 14107, 14109, and 14132), Niagara (portions of 14304 and 14305), Wheatfield (portions of 14305 and 14120), Grand Island {14072) and Porter (14174) are more suburban and rural areas with slightly higher income levels. Secondary Service Area includes the towns of Wilson (14172) a small agricultural community and Lockport (14094) a nearby city with similar characteristics to Niagara Falls. In general, the primary service area is described as Western Niagara County.
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 Mount St. Mary's 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 Mount St. Mary's 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 hospital has a robust health professional education programs and participates in teaching programs for other allied health professionals. Our emergency department is 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 programs 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 2016, the Catholic Health System provided more than $115 million in charity care and community benefit activities (including $11 million from Mount St. Mary's) 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 Buffalo City Mission, Friends of Night People, 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.In 2016, CHS initiated an ongoing program to provide grants to organizations for Community Benefit projects. $120,154 in total was provided to the following organizations:- Expansion of Food Back pack program at West Hertel School on Buffalo, New York- Healthy Weight management at CHS Primary Care centers in Niagara County- HPV Protection for Adolescents in Niagara County- Medical Mission supplies- Donor Human Milk Depots- Trauma and Trauma Informed Care Training- Safe Start for Newborns- Partnership with Enterprise Charter School and Willie Hutch Jones After School program to enrich critical thinking, creativity and to transfer concepts across contexts in STEM disciplines- Health Science Charter School Community Wellness ProjectAs part of Catholic Health, Mount St. Mary's is supportive of the initiatives above. In addition, other ways the Hospital furthers its exempt purpose by promoting the health of the community include free health screenings (Lipid Panel each February as part of Heart Month and PSA in June as part of a Father's Day promotion) and health fairs as described further in our community benefit report in Schedule 0. The organization extends medical staff privileges to all qualified physicians in its community for many of its departments. The organization applies funding to improvements in patient care, such as the expanded cardiology services Women's Center for Breast Health, and its Center for Women, which provides services at both the main hospital and the Neighborhood Health Center facility in an underserved section of the City of Niagara Falls. Other substantive community benefit initiatives supported by Mount St. Mary's Hospital include: Advanced Directive / MOLST education, Baby and Me Program, Caring Smiles Dental Program, Community Health Fairs, Medicaid Enrollment Assistance, P2 Collaborative for Adult Mental Health and Substance Abuse Screening, Tower Grant for Pediatric Care Coordination, and Transportation Assistance.
Part VI, Line 7, Reports Filed With StatesNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
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
Gary Tucker
Pres. & CEO, Mount St. Mar$259,019$0$48,355$0$19,764$0$46,832$0$24,880$0$398,850$0$0$0
David Macholz
Treasurer$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
Joyce Markiewicz
Director$0$338,634$0$0$0$17,537$0$31,113$0$17,817$0$405,101$0$0
James Millard
Director$0$297,882$0$0$0$17,568$0$127,811$0$23,596$0$466,857$0$0
Charles Urlaub
Director/Officer$0$397,617$0$0$0$37,819$0$20,655$0$19,116$0$475,207$0$0
Martin Boryszak
Director$0$201,401$0$0$0$147$0$4,887$0$700$0$207,135$0$0
Dr Michael Galang
Sr. VP, Chief Information$0$353,459$0$105,025$0$17,847$0$182,634$0$9,101$0$668,066$0$34,658
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 A 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
Dr Brian D'Arcy
Senior VP, Medical Affairs$0$490,055$0$151,739$0$56,043$0$179,848$0$24,674$0$902,359$0$50,074
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
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
SVP Legal Service, General Counsel$0$324,583$0$89,242$0$17,573$0$129,403$0$17,813$0$578,614$0$29,450
Dr Samuel Sirianni
Physician$335,988$0$30,579$0$3,122$0$15,730$0$27,890$0$413,309$0$0$0
Dr Roger W Rogers
Physician$457,823$0$5,212$0$730$0$11,186$0$22,682$0$497,633$0$0$0
Dr Benjamin G Rueda
Physician$501,866$0$3,960$0$2,177$0$18,493$0$29,470$0$555,966$0$0$0
Dr Arif S Syed
Physician$477,198$0$32,575$0$598$0$11,562$0$26,825$0$548,758$0$0$0
Dr Parag Parikh
Physician$356,089$0$0$0$368$0$4,136$0$26,798$0$387,391$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4bFormAndLineReferenceDesc
ExplanationCertain 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 Joseph McDonald $26,000.00 Mark Sullivan $19,500.00 Dr. Brian D'Arcy $9,800.00 Peter Bergmann $7,334.00 SERP Joseph McDonald $97,946.00 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.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Susan Urlaub
Wife of Mercy CEO, C.J. Urlaub$86,475Corporate Nurse educator0
Kathleen Zapfel
Sister-in-law of BOD, Msgr. Robert Zapfel$70,649HR Employee of CHS0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6CHS 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 7aAccording to the CHS Bylaws, each member is equally allowed to appoint one representative and one alternate 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 7bYes, the corporate members do have reserve powers.
Form 990, Part VI, Section B, line 11bYes, an electronic copy of the Form 990 was provided to the CHS Board 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 12cAll 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 15CHS, 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 19We 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:Pension Liability Adjustment -377822. Transfer From Affiliate -1084545. Change in Interest in Foundation -185785. Other -1557.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Catholic Health System Inc
144 Genesee StreetBuffaloNY14203222565278Health Care Delivery SystemNY501(c)(3)Line 100
Mercy Hospital of Buffalo
565 Abbott RoadBuffaloNY14220160756336Acute Care HospitalNY501(c)(3)Line 30Catholic Health System Inc
Sisters Of Charity Hospital
2157 Main StreetBuffaloNY14214160743187Acute Care HospitalNY501(c)(3)Line 30Catholic Health System Inc
Kenmore Mercy Hospital
2950 Elmwood AvenueKenmoreNY14217160762843Acute Care HospitalNY501(c)(3)Line 30Catholic Health System Inc
Nazareth Home of Franciscan Sisters
291 North StreetBuffaloNY14201160813142Skilled Nursing FacilityNY501(c)(3)Line 100Catholic Health System Inc
St Elizabeth Home for the Aged
5539 BroadwayLancasterNY14086160743154Adult HomeNY501(c)(3)Line 100Catholic Health System Inc
St Francis Home of Williamsville
147 Reist StWilliamsvilleNY14221160743153Skilled Nursing FacilityNY501(c)(3)Line 100Catholic Health System Inc
St Francis of Buffalo Inc
34 Benwood AveBuffaloNY14214161523535Skilled Nursing FacilityNY501(c)(3)Line 100Catholic Health System Inc
St Vincent Manor
319 Washington AvenueDunkirkNY14048160743167Adult HomeNY501(c)(3)Line 100Catholic Health System Inc
WNY Catholic Long Term Care Inc
6400 Powers RdOrchard ParkNY14127161434368Skilled Nursing FacilityNY501(c)(3)Line 100Catholic Health System Inc
Niagara Homemaker Services (Mercy Home Care)
144 Genesee StreetBuffaloNY14203161317960Home Care ProviderNY501(c)(3)Line 100Catholic Health System Inc
McAuley Seton Home Care
144 Genesee StreetBuffaloNY14203161310062Home Care ProviderNY501(c)(3)Line 100Catholic Health System Inc
Catholic Health System Infusion Pharmacy Inc
6350 Transit RoadDepewNY14043200198518Home Care Infusion ServicesNY501(c)(3)Line 100Catholic Health System Inc
OLV Renaissance Corporation
144 Genesee StreetBuffaloNY14203200167745Real Estate Holding CompanyNY501(c)(3)Line 100Catholic Health System Inc
CHS Program of All-Inclusive Care for the Elderly Inc
55 Melroy AvenueLackawannaNY14218261252884All-inclusive Care for the ElderlyNY501(c)(3)Line 30Catholic Health System Inc
Trinity Medical WNY PC
2625 Harlem RdCheektowagaNY14225272576645Primary Care ProviderNY501(c)(3)Line 12a, I0Catholic Health System Inc
KMH Homes Inc
144 Genesee StreetBuffaloNY14203161387890Real Estate Holding CompanyNY501(c)(3)Line 100Catholic Health System Inc
Mount St Mary's Hospital Foundation Inc
5300 Military RoadLewistonNY14092161360884FoundationNY501(c)(3)Line 70Mount St Mary's Hospital of Niagara Falls
Mount St Mary's Hospital Child Care Center
5310 Military RoadLewistonNY14092161523352Child CareNY501(c)(3)Line 100Catholic Health System Inc
Board of Associates of Mount St Mary's Hospital Inc
5300 Military RoadLewistonNY14092161582926Fund RaisingNY501(c)(3)Line 12a, I0Mount St Mary's Hospital of Niagara Falls
The St Francis Guild of Mount St Mary's Hospital of Niagara Falls Inc
5300 Military RoadLewistonNY14092510217790Fund RaisingNY501(c)(3)Line 12a, I0Mount St Mary's Hospital of Niagara Falls
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd