ACENSION ST VINCENT SOUTH SIDE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ACENSION ST VINCENT SOUTH SIDE (EIN 46-1523194)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201701359349312785
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T18:04:38-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461523194 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Vincent's Medical Center-Clay County Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STVI | BusinessNameControlTxt |
| Phone | 9043087300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 Belfort Road 4020 | AddressLine1Txt |
| City | Jacksonville | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Pamela Hess | PersonNm |
| Person Title | CFO - Health System | PersonTitleTxt |
| Signature | 2017-05-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tom VanOsdol | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 Belfort Road | AddressLine1Txt |
| City | Jacksonville | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $86,043,224 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.jaxhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 596 | TotalEmployeeCnt |
| Total Volunteers | 271 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $6,937 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $73,404,563 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $85,117,193 | CYProgramServiceRevenueAmt |
| PY Investment Income | $316,242 | PYInvestmentIncomeAmt |
| CY Investment Income | -$43,946 | CYInvestmentIncomeAmt |
| PY Other Revenue | $375,992 | PYOtherRevenueAmt |
| CY Other Revenue | $894,308 | CYOtherRevenueAmt |
| PY Total Revenue | $74,096,797 | PYTotalRevenueAmt |
| CY Total Revenue | $85,974,492 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,667,668 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,936,324 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,481,373 | PYOtherExpensesAmt |
| CY Other Expenses | $41,939,447 | CYOtherExpensesAmt |
| PY Total Expenses | $68,149,041 | PYTotalExpensesAmt |
| CY Total Expenses | $70,875,771 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,947,756 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $15,098,721 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $120,698,985 | TotalAssetsBOYAmt |
| Total Assets EOY | $109,204,601 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,397,559 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,763,790 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $112,301,426 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $99,440,811 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $62,763,871 | ExpenseAmt |
| Revenue | $85,117,193 | RevenueAmt |
| Desc | St. Vincent's Healthcare has been part of Jacksonville for over 100 years. St. Vincent's Medical Center-Clay County is the newest hospital in the St. Vincent's umbrella and has been part of the system for just over two years. St. Vincent's Medical Center-Clay County provides care to all, but with special attention to the poor and vulnerable. Please refer to Schedule H for the Community Benefit Report. | Desc |
| Total Program Service Expenses | $62,763,871 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 65 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 596 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Maureen P Martin | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9043087300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 Belfort Road Suite 4020 | AddressLine1Txt |
| City | Jacksonville | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| DAVID G KULIK | ||||||||||
| VICE CHAIRMAN | 1.0 | 5.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| RICARDO MORALES JR | ||||||||||
| SECRETARY/TREASURER | 1.0 | 4.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SIDNEY S SIMMONS II | ||||||||||
| CHAIRMAN | 3.0 | 10.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| PAUL J CHAPPANO MD | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| CARLA HARRIS | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD JONES | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| SISTER JEAN D RHOADES | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| HELEN D ROWAN | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| VAN D ROYAL | ||||||||||
| MEMBER | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| KIMBERLY HODGKINSON | ||||||||||
| CFO (THRU 6.8.2016) | 3.0 | 51.0 | Yes (X) | $0 | $371,824 | $32,068 | ||||
| MICHAEL SCHATZLEIN MD | ||||||||||
| REGIONAL CEO | 5.0 | 59.5 | Yes (X) | $0 | $2,906,062 | $39,144 | ||||
| THOMAS J VANOSDOL | ||||||||||
| COO - MINISTRY MARKET JACKSONVILLE (STARTED 12/6/2015) | 3.0 | 57.0 | Yes (X) | $0 | $465,623 | $46,560 | ||||
| DONALD B CLAYPOOL | ||||||||||
| PRESIDENT - ACUTE CARE HOSPITALS | 40.0 | 6.0 | $325,449 | $0 | $31,722 | Yes (X) | ||||
| KAREN F DARNELL | ||||||||||
| VP/CHIEF AMBULATORY SERVICE OFFICER (THRU 3/27/15) | 10.0 | 41.0 | $0 | $138,819 | $16,238 | Yes (X) | ||||
| LORRAINE M KEITH | ||||||||||
| CNO | 0.0 | 40.0 | $0 | $262,193 | $13,492 | Yes (X) | ||||
| JANICE G LIPSKY | ||||||||||
| SR. VP HR/OD/CHRO (THRU 12/4/2015) | 3.0 | 49.0 | $0 | $272,949 | $35,171 | Yes (X) | ||||
| DENISE MCKROW | ||||||||||
| SVP - SUPPORT SERVICES (THRU 10/30/2015) | 3.0 | 51.0 | $0 | $197,861 | $29,012 | Yes (X) | ||||
| JOHN MEYER III | ||||||||||
| CSMO - MINISTRY MARKET JACKSONVILLE | 3.0 | 49.0 | $0 | $246,285 | $20,869 | Yes (X) | ||||
| JEFFREY MIDDLEBROOKS | ||||||||||
| GENERAL COUNSEL | 40.0 | 12.0 | $0 | $157,060 | $6,626 | Yes (X) | ||||
| DONNIE ROMINE JR | ||||||||||
| COO/ACUTE CARE HOSPITALS (THRU 10/30/2015) | 3.0 | 51.0 | $0 | $492,198 | $35,098 | Yes (X) | ||||
| MICHELLE ADAMOLEKUN | ||||||||||
| CHIEF HUMAN RESOURCES OFFICER REGIONAL VP | 3.0 | 23.0 | $0 | $249,594 | $14,528 | Yes (X) | ||||
| TERESA LOFTIS | ||||||||||
| VP MSN-CMIO MNSTRY MKT JAX | 3.0 | 49.0 | $0 | $172,010 | $27,443 | Yes (X) | ||||
| KENNETH ROTHFIELD | ||||||||||
| SYS VP/CHIEF MEDICAL OFFICER | 3.0 | 43.0 | $0 | $425,633 | $36,906 | Yes (X) | ||||
| RENE AUGUSTA GROSDIDIER | ||||||||||
| CNO - COO - CLAY | 40.0 | 0 | $131,817 | $0 | $8,305 | Yes (X) | ||||
| TRACY WILLIAMS | ||||||||||
| COO - ACUTE CARE HOSPITALS | 40.0 | 0 | $163,794 | $0 | $29,340 | Yes (X) | ||||
| JON DEBARDELEBEN | ||||||||||
| Assoc. General Counsel | 3.0 | 49.0 | $0 | $208,908 | $27,005 | Yes (X) | ||||
| William Mayher | ||||||||||
| SVP - Reg Dev & Corp Resp | 3.0 | 49.0 | $0 | $190,977 | $27,313 | Yes (X) | ||||
| JEANINE HUMPHREYS | ||||||||||
| PHARMACIST | 40.0 | 0 | $131,745 | $0 | $19,580 | Yes (X) | ||||
| ROSALYN SACAYANAN | ||||||||||
| RN - EMERGENCY SERVICES | 40.0 | 0 | $123,506 | $0 | $25,360 | Yes (X) | ||||
| ELIZABETH SANTIAGO | ||||||||||
| PHARMACIST | 40.0 | 0 | $134,346 | $0 | $12,386 | Yes (X) | ||||
| BRENDA MCGRATH | ||||||||||
| RN - EMERGENCY SERVICES | 40.0 | 0 | $135,707 | $0 | $12,161 | Yes (X) | ||||
| AMY TEDESCHI | ||||||||||
| COORDINATOR - CLINICAL PHARMACY | 40.0 | 0 | $111,650 | $0 | $23,945 | Yes (X) | ||||
| MOODY CHISHOLM | ||||||||||
| FORMER OFFICER (THRU 3/20/15) | 0.0 | 0.0 | $0 | $680,696 | $26,723 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,258,014 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,438,690 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $596,992 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| BRASFIELD & GORRIE LLC | ||||||
| 3021 7th AVE S | BIRMINGHAM | AL | 35233 | CONSTRUCTION Services | $3,493,683 | |
| GATE PRECAST COMPANY | ||||||
| 402 ZOO PKWY | JACKSONVILLE | FL | 32226 | ARCHITECTURAL PRECAST CONCRETE | $1,285,351 | |
| NORTH FLORIDA ANESTHESIA CONSULTANTS | ||||||
| 2165 HERSCHEL ST | JACKSONVILLE | FL | 32204 | ANESTHESIA | $676,937 | |
| ABM HEALTH INC | ||||||
| 2310 130th AVE NE | BELLEVUE | WA | 98005 | BUILDING MAINTENANCE & FACILITY | $573,045 | SUITE B200 |
| ANDRES AYUSO | ||||||
| PO Box 9479 | Fleming Island | FL | 32006 | Physician Services | $246,985 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $6,937 | RelatedOrganizationsAmt |
| Government Grants | $0 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $6,937 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 621990 | $46,708,655 | $46,708,655 |
| Medicare/Medicaid | 621990 | $38,408,478 | $38,408,478 |
| Intercompany Rev | $60 | $60 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $85,117,193 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,786 | TotalRevenueColumnAmt |
| Exclusion | $24,786 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,067 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,067 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,067 | TotalRevenueColumnAmt |
| Exclusion | $1,067 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $68,732 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$68,732 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$68,732 | TotalRevenueColumnAmt |
| Exclusion | -$68,732 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $52,096 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,096 | TotalRevenueColumnAmt |
| Exclusion | $52,096 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Cafeteria/Vending | Desc |
| Business | 722320 | BusinessCd |
| Total Revenue Column | $374,075 | TotalRevenueColumnAmt |
| Exclusion | $374,075 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $467,070 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $467,070 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $841,145 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,974,492 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $85,117,193 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $850,362 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,171 | TotalAmt |
| Program Services | $360,164 | ProgramServicesAmt |
| Management And General | $15,007 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,005,755 | TotalAmt |
| Program Services | $22,948,001 | ProgramServicesAmt |
| Management And General | $1,057,754 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $972,561 | TotalAmt |
| Program Services | $929,768 | ProgramServicesAmt |
| Management And General | $42,793 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,802,853 | TotalAmt |
| Program Services | $1,723,527 | ProgramServicesAmt |
| Management And General | $79,326 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,779,984 | TotalAmt |
| Program Services | $1,701,665 | ProgramServicesAmt |
| Management And General | $78,319 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,963 | TotalAmt |
| Program Services | $976,997 | ProgramServicesAmt |
| Management And General | $44,966 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,400 | TotalAmt |
| Management And General | $4,400 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,225,523 | TotalAmt |
| Program Services | $4,164,742 | ProgramServicesAmt |
| Management And General | $1,060,781 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,642 | TotalAmt |
| Program Services | $2,642 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,722 | TotalAmt |
| Program Services | $1,712 | ProgramServicesAmt |
| Management And General | $6,010 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,366 | TotalAmt |
| Program Services | $45,756 | ProgramServicesAmt |
| Management And General | $19,610 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $676,477 | TotalAmt |
| Program Services | $642,653 | ProgramServicesAmt |
| Management And General | $33,824 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,527 | TotalAmt |
| Program Services | $13,895 | ProgramServicesAmt |
| Management And General | $4,632 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,631 | TotalAmt |
| Program Services | $12,473 | ProgramServicesAmt |
| Management And General | $4,158 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$724,465 | TotalAmt |
| Program Services | -$702,731 | ProgramServicesAmt |
| Management And General | -$21,734 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,854,995 | TotalAmt |
| Program Services | $7,619,345 | ProgramServicesAmt |
| Management And General | $235,650 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,604 | TotalAmt |
| Program Services | $532,604 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $12,136,704 | $12,076,020 | $60,684 |
| Outside Purchased Srvs | $4,953,488 | $3,947,930 | $1,005,558 |
| Corporate Allocation | $1,541,808 | $749,319 | $792,489 |
| System Allocation | $6,276,566 | $3,050,411 | $3,226,155 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,328,496 | TotalAmt |
| Program Services | $1,966,978 | ProgramServicesAmt |
| Management And General | $361,518 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,875,771 | TotalAmt |
| Program Services | $62,763,871 | ProgramServicesAmt |
| Management And General | $8,111,900 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,200 | BOYAmt |
| EOY | $2,250 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,620,189 | BOYAmt |
| EOY | $11,494,534 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,091,095 | BOYAmt |
| EOY | $2,201,744 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,938 | BOYAmt |
| EOY | $137,365 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $111,495,755 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,480,834 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,390,903 | BOYAmt |
| EOY | $91,014,921 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,457,332 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $611,119 | BOYAmt |
| EOY | $528,984 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,902,541 | BOYAmt |
| EOY | $2,367,471 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,698,985 | BOYAmt |
| EOY | $109,204,601 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,858,594 | BOYAmt |
| EOY | $5,499,104 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,538,965 | BOYAmt |
| EOY | $4,264,686 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,397,559 | BOYAmt |
| EOY | $9,763,790 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,301,426 | BOYAmt |
| EOY | $97,983,479 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,457,332 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,301,426 | BOYAmt |
| EOY | $99,440,811 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,698,985 | BOYAmt |
| EOY | $109,204,601 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $15,098,721 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$395,919 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$27,563,417 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $850 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $850 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | St. Vincent's Medical Center-Clay County, Inc. had lobbying expenses related to the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. St. Vincent's Medical Center-Clay County, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | St. Vincent's Medical Center-Clay County, Inc. had lobbying expenses related to the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. St. Vincent's Medical Center-Clay County, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,969,851 | OtherCostOrOtherBasisAmt |
| Book Value | $6,969,851 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,532,675 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,163,392 | DepreciationAmt |
| Book Value | $64,369,283 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,158 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,845 | DepreciationAmt |
| Book Value | $28,313 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,208,020 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,196,643 | DepreciationAmt |
| Book Value | $12,011,377 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,745,051 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,108,954 | DepreciationAmt |
| Book Value | $7,636,097 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $91,014,921 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| Physician Guarantee Liability | $34,135 |
| INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE | $2,022,220 |
| SITF System Sponsored | $250,534 |
| Pension and Other Post Retirement Liabilities | $1,609,999 |
| AH Savings Plan | $258,256 |
| WC accrual and Sales tax | $36,805 |
| AH Deferred Comp Liability | $52,737 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,264,686 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE ("THE SYSTEM") (WHICH INCLUDES THE ACTIVITY OF ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC.): THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITION BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2016. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,896,527 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,896,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0268 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,845,966 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,141,437 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,704,529 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0382 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,742,493 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,141,437 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,601,056 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0649 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $949 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $236,246 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $236,246 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0033 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $237,195 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $237,195 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0033 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,979,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,141,437 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,838,251 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0683 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $88,500 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,024,982 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $706,444 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $33,267,041 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $30,332,671 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,934,370 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST VINCENT'S MEDICAL CENTER-CLAY COUNTY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 BELFORT ROAD SUITE 4020 | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.JAXHEALTH.COM | WebsiteAddressTxt |
| State License | 4515 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST VINCENT'S MEDICAL CENTER-CLAY COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.JAXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.JAXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.JAXHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAMS/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.JAXHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAMS/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - ST. VINCENT'S MEDICAL CENTER CLAY COUNTY. INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, WAS RECEIVED FROM 185 INDIVIDUALS THROUGH ELEVEN KEY INFORMANT INTERVIEWS, SEVENTEEN FOCUS GROUPS, AND FOUR TOWN HALL MEETINGS. INTERVIEWS INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; THE LOCAL PUBLIC HEALTH DEPARTMENT; AGENCIES WITH CURRENT DATA OR INFORMATION ABOUT THE HEALTH NEEDS OF THE COMMUNITY; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. DUVAL COUNTY DEPARTMENT OF HEALTH STAFF, WORKING UNDER SUBCONTRACT WITH VERITE, CONDUCTED AND SUMMARIZED RESULTS FROM THE KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - ST. VINCENT'S MEDICAL CENTER CLAY COUNTY. ST. VINCENT'S MEDICAL CENTER CLAY COUNTY COLLABORATED WITH OTHER HOSPITAL FACILITIES WITHIN THE ST. VINCENT'S HEALTHCARE SYSTEM, AND ALSO WITH THE OTHER HOSPITAL MEMBERS OF THE JACKSONVILLE METROPOLITAN COMMUNITY BENEFIT PARTNERSHIP. THE PARTNERSHIP IS COMPRISED OF LEADERS FROM BAPTIST HEALTH, BROOKS REHABILITATION, THE CLAY COUNTY HEALTH DEPARTMENT, THE DUVAL COUNTY HEALTH DEPARTMENT, MAYO CLINIC, THE NASSAU COUNTY HEALTH DEPARTMENT, THE PUTNAM COUNTY HEALTH DEPARTMENT, UF HEALTH JACKSONVILLE (THEN SHANDS JACKSONVILLE MEDICAL CENTER), ST. VINCENT'S HEALTHCARE, AND WOLFSON CHILDREN'S HOSPITAL. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - ST. VINCENT'S MEDICAL CENTER CLAY COUNTY. In 2014, hospital members of the Partnership initiated a second CHNA. Through this work, each hospital member developed and published a 2015 CHNA report. The CHNAs were conducted to identify priority health needs within each community served by each hospital, and to inform development of implementation strategies to address identified needs. The CHNAs also were conducted to respond to federal regulatory requirements. St. Vincent's HealthCare reviewed the results of the 2015 CHNA and utilized specific criteria for selection of the needs that are most compatible with our mission. Those included: available resources and competencies, the actual impact the hospital might have on designated needs, the value stakeholders placed upon the need and community support of the need. The prioritized needs selected are: - Access - increase medical access and quality of care for St. Vincent's Healthcare's Medicare eligible patients in Duval County through Alignment Healthcare. - Diabetes - Improve health outcomes for individuals diagnosed with Diabetes in Duval County through evidence-based activities. - Maternal and Child Health - Promote infant mortality for parents in Duval County with a safe sleep educational initiative featured at St. Vincent's Southside Family Birth Place. - Obesity/Nutrition/Lifestyle - Augment an evidenced based voluntary nutrition and fitness awareness program for youth 8-11 in Duval County Schools. St. Vincent's HealthCare is committed to our mission and to the community; however, no entity can address all of the health needs presented by the 2015 CHNA. The following are those we believe are either not supported by our mission or that resources are not currently available to adequately address. - Cancer - St. Vincent's HealthCare lacks resources in the ability to provide large-scale cancer services within the Northeast Florida areas but will continue to support local organizations that offer cancer services to the community. - Dental Care- Dental Care is currently not a medical service provided by St. Vincent's HealthCare. We will continue to seek additional opportunities to expand dental services to those most in need. - Health Disparities-St. Vincent's will continue to advocate for the poor and vulnerable through various means, especially those identified as having an increasing need; i.e., the elderly and an expanding Hispanic population. St. Vincent's HealthCare supports legislative and community efforts to expand Medicaid and other social programs aimed at improving the lives of those identified as poor, vulnerable or at-risk. We continue to partner with and support local organizations who serve these needs such as WeCare. - Mental Health-St. Vincent's lacks resources in the ability to provide effective Mental Health services within the Clay County area. We will continue to advocate for services to the poor and vulnerable through in-kind and financial donations to local organizations who offer these services to the community. - Transportation- Currently, St. Vincent's HealthCare lacks capacity to improve the overall public transportation system within the Northeast Florida area. We will continue to partner with local transportation authorities to advocate for the improvement of services, especially those most in need that rely on public transportation. No actions were taken during the tax year related to the entities most recently conducted CHNA given the CHNA was adopted at the end of the tax year. |
| Schedule H, Part V, Section B, Line 22 Facility , 1 | Facility , 1 - ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY. THE SELF-PAY DISCOUNT IS CALCULATED BASED UPON THE HIGHEST PAYING PAYER THAT REPRESENTS GREATER THAN 3% OF GROSS REVENUE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part II Community Information - Part II | Various metrics are reviewed when establishing community outreach programs, the following are examples of the data Clay County collects when determining regional and community needs: St. Vincent's Medical Center-Clay County, Inc. compares county population by race against the state, St. Vincent's Medical Center-Clay County, Inc. also compares population by race in each of the zip codes. The findings from the comparison indicate that of the approximately 1,400,000 persons in the region the significant racial breakdowns are 66% white, 22% African American, and 6% Hispanic. The percentage of non-English speaking populations in the 2000 census in the region was 0.1%. St. Vincent's Medical Center-Clay County, Inc. compares the Jacksonville Metropolitan Statistical Area (MSA) in average household income against the federal poverty percentage finding that in the five county area household incomes ranged from almost $66,000 in St. John's County to $46,000 in Baker County. The percentage of persons below the Federal Poverty Rate ranged from a low of 9.6% in St. John's County to a high of 18.8% in Baker County. The Florida average was 16%. Florida CHARTS tables which are provided by the Florida Department of Health, Office of Planning, Evaluation and Data Analysis are utilized to determine Behavioral Risk Factors (BRFSS) and Chronic disease prevalence in the region. By reviewing FL CHARTS, County Profiles and BRFSS data, along with internal volume and financial data, St. Vincent's Medical Center-Clay County, Inc. is able to determine areas of need and chronic disease prevalence in relation to behavioral risk factors. The analysis below is an example of the data often compiled from the resources mentioned above. Analysis of Baker County: Baker County demonstrates the least favorable situation with comparison to the other counties in the state with regards to the following diseases: CAD (deaths), stroke (deaths and hospitalizations), lung cancer (death and smoking rate), prostate cancer (death), skin cancer (death) and diabetes (death, hospitalization and percentage of adults with diabetes). This county has the least favorable situation in comparison to all counties on the following measures in the Behavioral Risk Factors (BRFSS) Data: percentage of adults who meet vigorous physical activity recommendations, percentage of adults who engage in no leisure-time physical activity, percentage of adults who eat at least 5 servings of fruits and vegetables a day, and the percentage of adults who are obese. Analysis of Clay County: Clay County demonstrates the least favorable situation in comparison to the other counties in the state with regards to the following diseases: Cancer Deaths (smoking), Chronic Lower Respiratory Disease (CLRD), Diabetes, Motor Vehicle Deaths, and HIV/AIDS. On the Behavioral Risk Factors (BRFSS) Data Duval has one measure in the least favorable situation which is the percentage of adults who meet moderate physical activity recommendations. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments. The best available data was used to calculate the amounts reported in the table. St. Vincent's Medical Center-Clay County, Inc. posts information about availability of charity care in its emergency room and admissions areas. Referrals for charity care are made by the financial specialist, patient accounting personnel, social work personnel, collection agency personnel, physicians and community members. All patients potentially eligible for charity care status are screened by the financial specialist/collection representatives for assistance through federal, state, county and other social service programs. The financial specialists/collection representatives work collaboratively with other health care members to explore alternative financial resources for the patients. The Charity Care Policy is available to patients upon request and provided the patient does not qualify for any funded program. Medicaid patients upon exhaustion of benefits will automatically qualify for charity care allowance as long as they remain eligible for Medicaid. Patients will be denied charity based on non-compliance with attempts to obtain insurance for eligibility coverage through other programs (i.e. Medicaid-eligible individuals who have failed to keep required appointments with their case worker). Patients should be screened prior to sending to Florida Department of Children and Family Services to determine if they qualify for Medicaid. Patients can be selected for presumptive charity care by using an electronic screening process. Patients may also be referred to St. Vincent's HealthCare's community outreach programs for continuing care. Information about the Charity Care Policy is included in the patient bills indicating financial assistance is available along with information about contacting the Hospital to seek assistance. We do not provide the "criteria" within the bills themselves. Any uninsured patient or patient requesting assistance is referred to a patient financial advocate to assist with resolving the bill with the Hospital. This process includes assisting the patient with filing an application for any government sponsored health care program. All patient financial services areas maintain a list of available translators for any non-English speaking patients. There are bi- lingual associates in the patient financial services department and are available as needed to assist with non-English speaking patients. All registration staff is trained and responsible for completing an initial financial assistance screening application that is used for assessing the patient's family financial situation. The financial assistance screening application is then forwarded to a patient financial advocate who will review and assist the patient with the process. The collection agencies used by St. Vincent' s HealthCare Inc. are required to follow St, Vincent's policies regarding patient notification about the availability of financial assistance. Those patients who indicate an inability to pay for their services are referred back to the hospital to apply for Charity Care. In addition to this process, open accounts are routinely screened using computer software tools for potential charity care qualified patients. Any patient with family income less that 200% of Federal Poverty Guidelines will qualify for 100% Charity Care write-off. |
| Schedule H, Part II Community Building Activities | St. Vincent's HealthCare has been part of Jacksonville for over 100 years. It has welcomed the sick and vulnerable to its doors throughout. In its Mission Statement, St. Vincent's proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis it employs in its Community Building Programs. It uses multiple tools to determine community need including data collection from the Health Planning council, Agency for Healthcare Administration, County Health Departments, The Florida Department of Health, live estimates via Thompson Reuters, inpatient and outpatient utilization rates and State Inpatient/Outpatient data allows St. Vincent's to participate in the following programs: Following our Mission, St. Vincent's supports a number of organizations working with poor and vulnerable youth. JP Hall Children's Charity awards annual scholarships for disadvantaged high school senior's to attend college. Each Christmas, JP Hall also gives hundreds of thousands of toys to impoverished children to spread joy and the spirit of giving. Seamark Ranch provides housing, counseling, and education for abused and neglected youth on a permanent basis. The Ranch also provides an extensive therapy program for children of various abused and traumatic backgrounds in individual and group settings. St. Vincent's supports a number of organizations focused on improving the health of the disadvantaged in Clay County. The Way Free Clinic provides free and charitable health care services to all of the underserved with a large Hispanic population. Challenge Enterprises provides resources and job opportunities for the physically and mentally disabled, maintaining their independence and dignity. Quigley House provides safe housing and counseling for abused women and children. St. Vincent's HealthCare also provides financial support and expertise for the Clay County Chamber of Commerce and Clay County Economic Development luncheon. The Chamber's objectives are to drive business in the region with emphasis on initiatives for the un/under employed in the area through their Career Academies and Youth Summer Initiatives. St. Vincent's supports preparation for all members of the community for entering and remaining in the workforce. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | St. Vincent's Medical Center-Clay County, Inc.'s bad debt allowance percentage is based on the weighted average of six twelve-to-seventeen month historical periods. The percentage is calculated monthly and analyzed for large variances |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | St. Vincent's Medical Center-Clay County, isolates bad debts for patients who have no insurance from the patient accounting records and calculates the cost of those services in a similar manner to how charity cost is calculated, using RCC's times the charges written off. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | From the consolidated audited financial statements of Ascension Health Alliance (which include the activity of St. Vincent's Medical Center-Clay County, Inc.): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The Organization does have a written debt collection policy and Charity Care Policy (financial assistance). Patients without insurance are interviewed face-to-face to determine if they qualify for any third party payers or governmental programs. Patient statements contain messages requesting the patients to contact the organization should they need assistance with their debt. Patients that do not request assistance or provide the information necessary to qualify for financial assistance will follow a routing collection methodology. |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC.: Line 16b URL: HTTP://WWW.JAXHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAMS/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC.: Line 16c URL: HTTP://WWW.JAXHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAMS/; |
| Schedule H, Part VI, Line 2 Needs assessment | St. Vincent's Medical Center Clay-County, Inc. uses multiple tools to determine community need. A copy is available for download on the company's website http://www.jaxhealth.com/about-us/community-health-needs-assessment/. Currently the following tools are used: data from the Health Planning Council, Agency for Healthcare Administration, County Health Departments, The Florida Department of Health, live estimates via Thomson Reuters, Inpatient and outpatient utilization rates, and state inpatient/outpatient discharge data (FHA). |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The parent organization St. Vincent's HealthCare (SVHC) website provides information and phone numbers to the HOPE program, to empower all patients who need access to health care enrollment or federal assistance programs. There is a special focus on engaging patients who are 200% at or below Federal Poverty Level. Financial counselors are available to decide whether a patient qualifies for charity care. Patients who do not have insurance are eligible for discounts on their bill when they agree to a payment plan; this service is also provided by the financial counselors. The website contains a wealth of information on services which St. Vincent's Medical Center-Clay County, Inc. provides to the less fortunate. It has an active Mobile Health Outreach Mission (MHOM). This mission provides free medical services to the residents of Northeast Florida, who are un-served and under-served. This mission mainly sees migrant/rural farm workers and their families and also poor inner city families in the following counties: Clay, Duval, Nassau, Putnam, St. John's and Volusia. A mobile health unit consists of a physician, nurse practitioner, emergency medical technician and social worker assist to assist in providing care. Examples of care provided to this population are: immunizations, health screenings, physicals, laboratory, diagnostic testing, dental care, case management, health education and dispensing of free medication. MHOM case management works with patients in need to gain access to services or specialist not provided by their mobile clinics. Patients are connected with appropriate resources for follow up care. Care Management manages the Good Samaritan Fund to help those less fortunate by providing support beyond the excellent medical care provided at St. Vincent's HealthCare. In Fiscal Year, 2016, over $48,000 in financial assistance was given to those in need. Many of St. Vincent's patients need financial assistance with prescription medications, funeral expenses and other critical needs. The Good Samaritan Fund pays for these items for patients who have no other assistance available to them. Volunteers are part of the assistance given to the people of that county. |
| Schedule H, Part VI, Line 4 Community information | St. Vincent's Medical Center-Clay County, Inc. looks at the community it serves in two ways. On a regional level, five counties fall into the overall planning region: Duval, Clay, Nassau, Baker, and St. John's. On a more narrow level, 75% of the primary service area is reviewed by zip code, which is comprised of approximately 90,000 inpatient cases. The zip codes on which St. Vincent's Medical Center-Clay County, Inc. focuses on are: 32003, 32006, 32030, 32043, 32050, 32058, 32065, 32067, 32068, 32073, 32079, 32091, 32140, 32234, 32656 and 32666. The facilities within the area are: Baptist Medical Center, an acute care not-for-profit facility in Jacksonville with 676 beds; Baptist Medical Center Beaches an acute care not-for-profit facility in Jacksonville Beach with 146 beds; Baptist Medical Center Nassau, an acute care not-for-profit facility in Fernandina Beach with 54 beds; Baptist Medical Center South, an acute care not-for-profit facility in Jacksonville with 225 beds; Ed Fraser Hospital, an acute care not- for-profit facility in Macclenny with 25 beds; Flagler Hospital, an acute care not- for-profit facility in St. Augustine with 302 beds; Kindred Hospital North Florida, an acute care for-profit facility in Green Cove Springs with 80 beds; Mayo Clinic Jacksonville, an academic not-for-profit facility in Jacksonville with 249 beds; Memorial Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 425 beds; Orange Park Medical Center an acute care for-profit facility in Orange Park with 297 beds; Riverpoint Behavioral Health, Jacksonville a psychiatric for-profit facility in Jacksonville with 93 beds; St. Vincent's Medical Center Riverside, an acute care not-for-profit facility in Jacksonville with 528 beds; Shands Jacksonville Medical Center, an acute care not-for-profit facility in Jacksonville with 695 beds; Specialty Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 107 beds; St. Vincent's Southside, an acute care not- for-profit facility in Jacksonville with 311 beds; Ten Broeck Jacksonville, Wekiva Springs an acute care for-profit facility in Jacksonville with 68 beds. |
| Schedule H, Part VI, Line 5 Promotion of community health | St. Vincent's Medical Center-Clay County, Inc. is the newest hospital in the St. Vincent's umbrella. Like its other St. Vincent's HealthCare siblings, St. Vincent's Medical Center-Clay County, Inc. welcomes the sick and vulnerable to its doors. In its Mission Statement, St. Vincent's HealthCare proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis St. Vincent's Medical Center- Clay County, Inc. uses in its community benefit programs. St. Vincent's Medical Center-Clay County, Inc. has a medical staff open to all qualified physicians in the Northeast Florida area. The majority of the dedicated members of the Board of Directors of parent organization, St. Vincent's HealthCare, are persons who live and work in the Jacksonville area and who by virtue of their continuous service to the community, are acutely aware of the social and health needs of the Northeast Florida region. These individuals along with the members of the medical staff are committed to the Mission Statement and its call to provide healthcare for all who come to its doors. The website, www.jaxhealth.com, is an encyclopedia with wellness tools for the community to gain information to live a healthier life style. Various seminars and educational opportunities, facilitated by health care providers and subject matter experts on different topics related to health, wellness, and aging and are open to the public, with a special emphasis to engage the elderly, to enhance their health care knowledge. The Clay County campus also allows various community groups to use the hospital, free of charge, as a central meeting location for the benefit of the community. The Good Samaritan Fund of St. Vincent's disbursed approximately $48,000 to patients in financial need. These services included medications, clothing, , funeral expenses and other critical needs.. |
| Schedule H, Part VI, Line 6 Affiliated health care system | St. Vincent's Medical Center, Inc. (the Medical Center) is a wholly owned subsidiary of St. Vincent's Health System, Inc. (SVHS), which is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central, and West Central Provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph, and the Sisters of St. Joseph of Carondelet (CSJ). The Medical Center, located in Jacksonville, Florida, is a nonprofit acute care hospital. The Medical Center provides inpatient, outpatient, and emergency care services for the residents of Northeast Florida and Southeast Georgia. Admitting physicians are primarily practitioners in the local area. The Medical Center is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. Mission: Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons who are poor and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS). ADDITIONAL AFFILIATES AND MEMBERS OF THE ST. VINCENT'S HEALTH SYSTEM INCLUDE: ST. LUKE'S-ST. VINCENT'S HEALTHCARE, ST. VINCENT'S HEALTHCARE, ST. VINCENT'S AMBULATORY CARE, INC., ST. VINCENT'S PHYSICIAN'S ENTERPRISE INC., CONSOLIDATED PHARMACY SERVICES, INC. AND ST. VINCENT'S FOUNDATION, INC. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | FL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MOODY CHISHOLM | ||||||||||||||
| FORMER OFFICER (THRU 3/20/15) | $0 | $144,240 | $0 | $0 | $0 | $536,455 | $0 | $3,231 | $0 | $23,492 | $0 | $707,419 | $0 | $0 |
| KIMBERLY HODGKINSON | ||||||||||||||
| CFO (THRU 6.8.2016) | $0 | $367,829 | $0 | $0 | $0 | $3,995 | $0 | $10,446 | $0 | $21,622 | $0 | $403,891 | $0 | $0 |
| MICHAEL SCHATZLEIN MD | ||||||||||||||
| REGIONAL CEO | $0 | $960,751 | $0 | $1,660,416 | $0 | $284,896 | $0 | $7,950 | $0 | $31,194 | $0 | $2,945,206 | $0 | $0 |
| THOMAS J VANOSDOL | ||||||||||||||
| COO - MINISTRY MARKET JACKSONVILLE (STARTED 12/6/2015) | $0 | $336,754 | $0 | $125,195 | $0 | $3,674 | $0 | $16,041 | $0 | $30,519 | $0 | $512,183 | $0 | $0 |
| DONALD B CLAYPOOL | ||||||||||||||
| PRESIDENT - ACUTE CARE HOSPITALS | $308,229 | $0 | $15,000 | $0 | $2,220 | $0 | $8,440 | $0 | $23,282 | $0 | $357,171 | $0 | $0 | $0 |
| KAREN F DARNELL | ||||||||||||||
| VP/CHIEF AMBULATORY SERVICE OFFICER (THRU 3/27/15) | $0 | $116,233 | $0 | $0 | $0 | $22,587 | $0 | $3,455 | $0 | $12,783 | $0 | $155,057 | $0 | $0 |
| LORRAINE M KEITH | ||||||||||||||
| CNO | $0 | $239,901 | $0 | $0 | $0 | $22,292 | $0 | $6,034 | $0 | $7,458 | $0 | $275,684 | $0 | $0 |
| JANICE G LIPSKY | ||||||||||||||
| SR. VP HR/OD/CHRO (THRU 12/4/2015) | $0 | $234,493 | $0 | $0 | $0 | $38,456 | $0 | $7,124 | $0 | $28,047 | $0 | $308,119 | $0 | $5,079 |
| DENISE MCKROW | ||||||||||||||
| SVP - SUPPORT SERVICES (THRU 10/30/2015) | $0 | $148,713 | $0 | $0 | $0 | $49,147 | $0 | $4,692 | $0 | $24,320 | $0 | $226,873 | $0 | $0 |
| JOHN MEYER III | ||||||||||||||
| CSMO - MINISTRY MARKET JACKSONVILLE | $0 | $244,961 | $0 | $0 | $0 | $1,323 | $0 | $2,068 | $0 | $18,801 | $0 | $267,154 | $0 | $0 |
| JEFFREY MIDDLEBROOKS | ||||||||||||||
| GENERAL COUNSEL | $0 | $109,960 | $0 | $11,240 | $0 | $35,859 | $0 | $4,544 | $0 | $2,082 | $0 | $163,686 | $0 | $0 |
| DONNIE ROMINE JR | ||||||||||||||
| COO/ACUTE CARE HOSPITALS (THRU 10/30/2015) | $0 | $430,630 | $0 | $0 | $0 | $61,568 | $0 | $10,153 | $0 | $24,945 | $0 | $527,296 | $0 | $0 |
| MICHELLE ADAMOLEKUN | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFICER REGIONAL VP | $0 | $186,433 | $0 | $34,617 | $0 | $28,545 | $0 | $11,086 | $0 | $3,443 | $0 | $264,122 | $0 | $0 |
| TERESA LOFTIS | ||||||||||||||
| VP MSN-CMIO MNSTRY MKT JAX | $0 | $170,818 | $0 | $0 | $0 | $1,191 | $0 | $4,983 | $0 | $22,460 | $0 | $199,452 | $0 | $0 |
| KENNETH ROTHFIELD | ||||||||||||||
| SYS VP/CHIEF MEDICAL OFFICER | $0 | $368,909 | $0 | $30,000 | $0 | $26,724 | $0 | $10,384 | $0 | $26,522 | $0 | $462,539 | $0 | $22,625 |
| TRACY WILLIAMS | ||||||||||||||
| COO - ACUTE CARE HOSPITALS | $163,599 | $0 | $0 | $0 | $195 | $0 | $5,186 | $0 | $24,154 | $0 | $193,134 | $0 | $0 | $0 |
| JON DEBARDELEBEN | ||||||||||||||
| Assoc. General Counsel | $0 | $208,571 | $0 | $0 | $0 | $337 | $0 | $6,148 | $0 | $20,857 | $0 | $235,913 | $0 | $0 |
| William Mayher | ||||||||||||||
| SVP - Reg Dev & Corp Resp | $0 | $189,478 | $0 | $0 | $0 | $1,499 | $0 | $5,625 | $0 | $21,688 | $0 | $218,290 | $0 | $0 |
| JEANINE HUMPHREYS | ||||||||||||||
| PHARMACIST | $131,323 | $0 | $0 | $0 | $422 | $0 | $4,060 | $0 | $15,520 | $0 | $151,325 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Ascension Health, a related organization of St. Vincent's Medical Center-Clay County, Inc. uses the following to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | THE FOLLOWING INDIVIDUALS RECEIVED SEVERENCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE CALENDAR YEAR 2015: MOODY CHISHOLM - $455,785 JANICE G LIPSKY - $9,769 DENISE MCKROW - $24,884 DONNIE ROMINE, JR - $56,808 MICHAEL ZWETSCHKENBAUM - $137,500 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990 Schedule J Part II Column B in the year paid. The following individual received a payout from Ascension Health's nonqualified retirement plan in the amount as noted: Janice G Lipsky- $5,079 Kenneth Rothfield - $22,625 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| NORTH FLORIDA ANESTHESIA CONSULTANTS (NFAC) | |||
| NFAC IS MORE THAN 35% OWNED BY A BOARD MEMBER OF SVMC-CLAY COUNTY, INC. | $676,937 | PROVIDE GOODS AND SERVICES TO ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC. | false |
| NORTH FLORIDA SURGEONS | |||
| THE PRESIDENT OF NORTH FLORIDA SURGEONS IS A BOARD MEMBER OF SVMC-CLAY COUNTY, INC. | $195,008 | PROVIDE HEALTHCARE SERVICES TO ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY INC. | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part IV, Line 20b Explanation of Financial Statements | The activity of St. Vincent's Medical Center Clay-County, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Vincent's Medical Center Clay-County, Inc. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Vincent's Medical Center Clay-County, Inc. |
| Form 990, Part VI, Line 15 COMPENATION | IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS, PERFORMED BY ST. VINCENT'S HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | St. Vincent's Medical Center-Clay County, Inc, has a single corporate member, St. Vincent's Health System, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | St. Vincent's Medical Center-Clay County, Inc. has a single corporate member, St. Vincent's Health System, Inc., who has the ability to elect members to the governing body of St. Vincent's Medical Center-Clay County, Inc. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to St. Vincent's Medical Center-Clay County, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent's Health System, Inc. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Officers, directors or trustees, and key employees are required to complete a Conflict of Interest Attestation Statement at the time of hiring or when their service begins. Annually, the Corporate Responsibility Officer sends the Conflict of Interest Policy and Attestation Statement to all officers directors or trustees and key employees for completion and return within two weeks. Three separate mailings are sent out with two week deadlines to receive a maximum response. The responses from the returned Attestation Statement are organized in a spreadsheet and are carefully reviewed by the Corporate Responsibility Officer, the Chief Legal Officer, and the Chief Executive Officer. A full report is presented to the Audit Committee and any potential conflicts of interest are handled by the committee in an appropriate manner. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization will provide any documents open to public inspection upon request. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | - Total Revenue: 467070, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 467070; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Transfers to/from Affiliates - -26114164; Deferred Pension Cost Adjustement - -1449253; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 631455998 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | NA | false |
| ASCENSION HEALTH | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | ASCENSION HEALTH ALLIANCE | false |
| ST VINCENT'S HEALTH SYSTEM INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 593650609 | PARENT ENTITY | FL | 501(c)(3 | Type II | ASCENSION HEALTH | false |
| ST VINCENT'S MEDICAL CENTER INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 590624449 | HOSPITAL | FL | 501(c)(3 | 3 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST LUKE'S-ST VINCENT'S HEALTHCARE INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 260479484 | HOSPITAL | FL | 501(c)(3 | 3 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST VINCENT'S AMBULATORY CARE INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 592292041 | PHYSICIAN PRACTICE | FL | 501(c)(3 | 9 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST VINCENT'S FOUNDATION INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 592219923 | FUND RAISING | FL | 501(c)(3 | 7 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CONSOLIDATED PHARMACY SERVICES INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593398033 | RETAIL PHARMACY & PATIENT TRANSPORT | FL | NA | C Corporation | Yes (true) |
| ADVANCED PATIENT TRANSPORTATION INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593381444 | TRANSPORT SERVICES | FL | NA | C Corporation | false |
| SETON PHARMACY INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593001427 | RETAIL PHARMACY | FL | NA | C Corporation | false |
| FAMILY MEDICINE CENTER CONDOMINIUM ASSOCIATION INC | |||||||||
| 1 SHIRCLIFF WAY | JACKSONVILLE | FL | 32204 | 261983355 | CONDOMINIUM ASSOCIATION | FL | NA | C Corporation | false |
| St Vincent's Strategic Ventures Inc | |||||||||
| 4205 Belfort Road Suite 4030 | Jacksonville | FL | 33213 | 593133073 | LEASING | FL | NA | C Corporation | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST VINCENT'S HEALTH SYSTEM INC | ||
| M | $3,860,317 | FMV |
| CONSOLIDATED PHARMACY SERVICES | ||
| R | $84,715 | FMV |
| ST VINCENT'S HEALTH SYSTEM INC | ||
| R | $106,694,541 | FMV |
| ST VINCENT'S AMBULATORY CARE | ||
| R | $385,556 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| R | $28,954,087 | FMV |
| ST VINCENT'S ACCOUNTABLE CARE | ||
| R | $68,535 | FMV |
| ST LUKE'S-ST VINCENT'S MEDICAL CENTER | ||
| S | $1,464,146 | FMV |
| ST VINCENT'S FOUNDATION INC | ||
| S | $3,311,953 | FMV |
| ST LUKES-ST VINCENT'S HEALTHCARE INC | ||
| K | $140,032 | fmv |