Bellefonte Physician Services Inc: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- Bellefonte Physician Services Inc (EIN 35-2320780)
- Tax period
- 2015-09-01 to 2016-08-31
- Filed
- 2017-07-10
- IRS object ID
- 201711919349300851
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-07-10T09:44:13-05:00 | ReturnTs |
| Tax Period End | 2016-08-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352320780 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bellefonte Physician Services Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BELL | BusinessNameControlTxt |
| Phone | 6068334235 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 St Christopher Drive | AddressLine1Txt |
| City | Ashland | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Joe Buchheit | PersonNm |
| Person Title | CFO - BSKHS | PersonTitleTxt |
| Phone | 6068364002 | PhoneNum |
| Signature | 2017-07-10 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kevin Halter | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 St Christopher Drive | AddressLine1Txt |
| City | Ashland | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,608,115 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | bonsecours.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | Primary, urgent and specialty care | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 363 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $268,902 | PYContributionsGrantsAmt |
| CY Contributions Grants | $376,500 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,804,512 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,100,834 | CYProgramServiceRevenueAmt |
| PY Investment Income | $25 | PYInvestmentIncomeAmt |
| CY Investment Income | $641 | CYInvestmentIncomeAmt |
| PY Other Revenue | $209,362 | PYOtherRevenueAmt |
| CY Other Revenue | $130,140 | CYOtherRevenueAmt |
| PY Total Revenue | $27,282,801 | PYTotalRevenueAmt |
| CY Total Revenue | $27,608,115 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,700 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,967,602 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,767,067 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,544,110 | PYOtherExpensesAmt |
| CY Other Expenses | $13,031,111 | CYOtherExpensesAmt |
| PY Total Expenses | $42,511,712 | PYTotalExpensesAmt |
| CY Total Expenses | $43,799,878 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$15,228,911 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$16,191,763 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,916,973 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,357,581 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $76,993,153 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $92,637,283 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$71,076,180 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$87,279,702 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $39,863,242 | ExpenseAmt |
| Grant | $1,700 | GrantAmt |
| Revenue | $27,100,834 | RevenueAmt |
| Desc | Charity & Indigent Care - Bellefonte Physician Services (BPS) utilizes an affiliate model to provide residents of the tri-state with a variety of services, from primary care to pediatric, urgent and specialty care. A member of the Bon Secours Kentucky Health System, BPS continues to expand to meet the needs of community residents, especially those in charily and indigent need. The various practices that comprise BPS are strategically located throughout the region to bring the highest quality health care close to home with convenient locations. | Desc |
| Total Program Service Expenses | $39,863,242 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 60 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 363 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joe Buccheit | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6068333700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 St Christopher Dr | AddressLine1Txt |
| City | Ashland | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| John Darnell MD | |||||||||
| Board Member (Apr-Aug) | 0.50 | 49.50 | Yes (X) | $0 | $63,574 | $2,793 | |||
| Augustinus Lobach MD | |||||||||
| Board Member | 0.50 | 49.50 | Yes (X) | $0 | $269,183 | $14,239 | |||
| James Payne PhD | |||||||||
| Board Member | 0.50 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Samuel Ross MD | |||||||||
| Board Member | 0.50 | 49.50 | Yes (X) | $0 | $1,153,509 | $95,732 | |||
| Joe Buchheit | |||||||||
| CFO-BSKY | 10.00 | 40.00 | $0 | $338,797 | $24,261 | Yes (X) | |||
| Troy Connett | |||||||||
| Secretary | 0.50 | 49.50 | $65,666 | $0 | $12,004 | Yes (X) | |||
| Kevin Halter FACHE | |||||||||
| Chairman/CEO-BSKY | 10.00 | 40.00 | $0 | $620,478 | $57,080 | Yes (X) | |||
| Thomas Morris PhD | |||||||||
| President | 0.50 | 49.50 | $0 | $667,551 | $61,530 | Yes (X) | |||
| Tyler Walters | |||||||||
| Treasurer | 0.50 | 49.50 | $0 | $161,090 | $29,716 | Yes (X) | |||
| Charles Rhodes MD | |||||||||
| Cardiologist | 50.00 | 0.00 | $886,855 | $0 | $32,675 | Yes (X) | |||
| Richard Mailloux MD | |||||||||
| Gastroenterologist | 50.00 | 0.00 | $565,463 | $0 | $41,122 | Yes (X) | |||
| Diane Settles MD | |||||||||
| Internist | 50.00 | 0.00 | $555,938 | $0 | $38,519 | Yes (X) | |||
| Brian Defade MD | |||||||||
| Urologist | 50.00 | 0.00 | $456,262 | $0 | $22,528 | Yes (X) | |||
| Deborah Chadwick MD | |||||||||
| Surgeon | 50.00 | 0.00 | $456,100 | $0 | $35,947 | Yes (X) | |||
| John Wallenhorst PhD | |||||||||
| Former Board Officer | 0.00 | 50.00 | $0 | $454,099 | $31,025 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,986,284 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,728,281 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $499,171 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 49 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AthenaHealth Inc | |||||
| 311 Arsenal Court | Watertown | MA | 02472 | Billing Agent | $1,037,862 |
| Roland Benton PSC | |||||
| 413 Country Club Drive | Ashland | KY | 41101 | Contract Physician | $474,564 |
| Dirtbusters Janitorial Services | |||||
| 6433 Route 60 | Barboursville | WV | 25504 | Cleaning Services | $129,996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $376,500 | GovernmentGrantsAmt |
| Total Contributions | $376,500 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Rev. | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $27,100,834 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,100,834 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,100,834 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $193 | TotalRevenueColumnAmt |
| Exclusion | $193 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $448 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $448 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $448 | TotalRevenueColumnAmt |
| Exclusion | $448 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Retail Sales | 900099 | $71,809 | $71,809 |
| Nursing Services | 900099 | $35,305 | $35,305 |
| Medical Records | 900099 | $14,112 | $14,112 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,914 | TotalRevenueColumnAmt |
| Exclusion | $8,914 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $130,140 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,608,115 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,100,834 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $130,781 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700 | TotalAmt |
| Program Services | $1,700 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,228 | TotalAmt |
| Program Services | $68,605 | ProgramServicesAmt |
| Management And General | $7,623 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,601,927 | TotalAmt |
| Program Services | $23,041,734 | ProgramServicesAmt |
| Management And General | $2,560,193 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $807,580 | TotalAmt |
| Program Services | $726,822 | ProgramServicesAmt |
| Management And General | $80,758 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,557,439 | TotalAmt |
| Program Services | $2,301,695 | ProgramServicesAmt |
| Management And General | $255,744 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,723,893 | TotalAmt |
| Program Services | $1,551,504 | ProgramServicesAmt |
| Management And General | $172,389 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,833 | TotalAmt |
| Program Services | $121,350 | ProgramServicesAmt |
| Management And General | $13,483 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,615 | TotalAmt |
| Program Services | $749,615 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,662 | TotalAmt |
| Program Services | $10,496 | ProgramServicesAmt |
| Management And General | $1,166 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,695 | TotalAmt |
| Program Services | $452,425 | ProgramServicesAmt |
| Management And General | $50,270 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,829 | TotalAmt |
| Program Services | $71,846 | ProgramServicesAmt |
| Management And General | $7,983 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,010,086 | TotalAmt |
| Program Services | $2,709,077 | ProgramServicesAmt |
| Management And General | $301,009 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,571 | TotalAmt |
| Program Services | $113,914 | ProgramServicesAmt |
| Management And General | $12,657 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,790 | TotalAmt |
| Program Services | $26,811 | ProgramServicesAmt |
| Management And General | $2,979 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,821 | TotalAmt |
| Program Services | $135,821 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,643 | TotalAmt |
| Program Services | $599,979 | ProgramServicesAmt |
| Management And General | $66,664 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541,260 | TotalAmt |
| Program Services | $487,134 | ProgramServicesAmt |
| Management And General | $54,126 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $2,894,582 | $2,605,124 | $289,458 |
| Medical Supplies | $2,059,679 | $2,059,679 | |
| Bad Debt | $1,486,704 | $1,486,704 | |
| Physician Recruitment | $325,310 | $292,779 | $32,531 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,031 | TotalAmt |
| Program Services | $248,428 | ProgramServicesAmt |
| Management And General | $27,603 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,799,878 | TotalAmt |
| Program Services | $39,863,242 | ProgramServicesAmt |
| Management And General | $3,936,636 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,309 | BOYAmt |
| EOY | $5,940 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,382 | BOYAmt |
| EOY | $220,791 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,036,480 | BOYAmt |
| EOY | $1,764,960 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $799 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,904 | BOYAmt |
| EOY | $315,315 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,936,114 | BOYAmt |
| EOY | $1,596,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,173,356 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,045,118 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,307,700 | BOYAmt |
| EOY | $1,128,238 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,285 | BOYAmt |
| EOY | $326,189 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,916,973 | BOYAmt |
| EOY | $5,357,581 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,144,901 | BOYAmt |
| EOY | $914,381 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,848,252 | BOYAmt |
| EOY | $91,722,902 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,993,153 | BOYAmt |
| EOY | $92,637,283 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$71,076,180 | BOYAmt |
| EOY | -$87,279,702 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$71,076,180 | BOYAmt |
| EOY | -$87,279,702 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,916,973 | BOYAmt |
| EOY | $5,357,581 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$16,191,763 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$11,759 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $516,619 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $268,902 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $376,500 | CurrentTaxYearAmt |
| Total | $1,162,021 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,624,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,171,523 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,114,218 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,804,512 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,100,834 | CurrentTaxYearAmt |
| Total | $129,815,427 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,624,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,171,523 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,630,837 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,073,414 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,477,334 | CurrentTaxYearAmt |
| Total | $130,977,448 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $130,977,448 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $44 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $193 | CurrentTaxYearAmt |
| Total | $319 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $44 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $193 | CurrentTaxYearAmt |
| Total | $319 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,944 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $37,805 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $163,724 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $209,362 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,140 | CurrentTaxYearAmt |
| Total | $562,975 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,646,328 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,209,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,794,588 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,282,801 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,607,667 | CurrentTaxYearAmt |
| Total | $131,540,742 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99570 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99640 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Skin Care Products - 2011 Amount: $ 18,116. 2012 Amount: $ 31,606. 2013 Amount: $ 16,585. 2014 Amount: $ 54,180. 2015 Amount: $ 71,809. Purchase Discounts - 2011 Amount: $ 3,828. 2012 Amount: $ 6,199. EKG Reading Fees - 2013 Amount: $ 108,659. 2014 Amount: $ 113,201. Gift Shop - 2013 Amount: $ 21,537. All Other Revenue - 2013 Amount: $ 16,943. 2014 Amount: $ 41,981. 2015 Amount: $ 58,331. | ExplanationTxt |
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 D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,053 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,608 | DepreciationAmt |
| Book Value | $95,445 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $290,298 | OtherCostOrOtherBasisAmt |
| Depreciation | $171,896 | DepreciationAmt |
| Book Value | $118,402 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,643,575 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,809,590 | DepreciationAmt |
| Book Value | $833,985 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,430 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,024 | DepreciationAmt |
| Book Value | $80,406 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,128,238 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Affiliates | $307,966 |
| Misc A/R | $18,223 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $326,189 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $91,429,686 |
| Medicaid Settlement | $262,565 |
| Deferred Rent | $30,651 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $91,722,902 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. The System's taxable subsidiaries had approximately $89,895 and $84,748 of net operating loss carryforwards as of August 31, 2016 and 2015, respectively, which expire in varying periods through 2036 and are available to offset future taxable income. The System accounts for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to be in effect during the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Income tax liabilities are recorded for the impact of positions taken on income tax returns, which management believes are not more likely than not to be sustained on tax audit. Interest and penalties related to income taxes are accounted for as income tax expense. The System's deferred tax assets are fully reserved at August 31, 2016 and 2015 as the System considers it more likely than not that these amounts will not be recognized. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Augustinus Lobach MD | ||||||||||||||
| Board Member | $0 | $211,765 | $0 | $35,000 | $0 | $22,418 | $0 | $3,763 | $0 | $10,476 | $0 | $283,422 | $0 | $0 |
| Samuel Ross MD | ||||||||||||||
| Board Member | $0 | $611,251 | $0 | $423,522 | $0 | $118,736 | $0 | $75,234 | $0 | $20,498 | $0 | $1,249,241 | $0 | $47,512 |
| Joe Buchheit | ||||||||||||||
| CFO-BSKY | $0 | $239,994 | $0 | $57,425 | $0 | $41,378 | $0 | $4,533 | $0 | $19,728 | $0 | $363,058 | $0 | $0 |
| Kevin Halter FACHE | ||||||||||||||
| Chairman/CEO-BSKY | $0 | $335,998 | $0 | $238,589 | $0 | $45,891 | $0 | $28,778 | $0 | $28,302 | $0 | $677,558 | $0 | $3,006 |
| Thomas Morris PhD | ||||||||||||||
| President | $0 | $319,173 | $0 | $241,261 | $0 | $107,117 | $0 | $40,598 | $0 | $20,932 | $0 | $729,081 | $0 | $18,904 |
| Tyler Walters | ||||||||||||||
| Treasurer | $0 | $132,037 | $0 | $28,874 | $0 | $179 | $0 | $3,459 | $0 | $26,257 | $0 | $190,806 | $0 | $0 |
| Charles Rhodes MD | ||||||||||||||
| Cardiologist | $759,499 | $0 | $10,603 | $0 | $116,753 | $0 | $11,925 | $0 | $20,750 | $0 | $919,530 | $0 | $0 | $0 |
| Richard Mailloux MD | ||||||||||||||
| Gastroenterologist | $562,005 | $0 | $2,000 | $0 | $1,458 | $0 | $11,925 | $0 | $29,197 | $0 | $606,585 | $0 | $0 | $0 |
| Diane Settles MD | ||||||||||||||
| Internist | $535,312 | $0 | $10,093 | $0 | $10,533 | $0 | $8,866 | $0 | $29,653 | $0 | $594,457 | $0 | $0 | $0 |
| Brian Defade MD | ||||||||||||||
| Urologist | $432,235 | $0 | $23,541 | $0 | $486 | $0 | $11,925 | $0 | $10,603 | $0 | $478,790 | $0 | $0 | $0 |
| Deborah Chadwick MD | ||||||||||||||
| Surgeon | $355,499 | $0 | $100,015 | $0 | $586 | $0 | $7,950 | $0 | $27,997 | $0 | $492,047 | $0 | $0 | $0 |
| John Wallenhorst PhD | ||||||||||||||
| Former Board Officer | $0 | $318,576 | $0 | $72,652 | $0 | $62,871 | $0 | $20,380 | $0 | $10,645 | $0 | $485,124 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee |
| Part I, Line 4b | The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Samuel Ross, MD, $68,934; Thomas Morris, Ph.D., $24,711; Kevin Halter, FACHE, $3,669. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc is the sole member of Bon Secours Kentucky Health System, which in turn is the sole member of Bellefonte Physician Services, Inc. |
| Form 990, Part VI, Section A, line 7a | The governing body of Bellefonte Physician Services, Inc. is appointed by its Member, Bon Secours Kentucky Health System, Inc. and subject to approval by Bon Secours Health System, Inc. |
| Form 990, Part VI, Section A, line 7b | Certain authorities of Bellefonte Physician Services, Inc. are reserved to its member or to Bon Secours Health System, Inc. |
| Form 990, Part VI, Section B, line 11 | The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). |
| Form 990, Part VI, Section B, line 15b | The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. |
| Form 990, Part VI, Section C, line 19 | The filing organization provides any documents open to public inspection upon request. |
| Form 990, Part VII - Additional Disclosure: | Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Bon Secours Health System Inc | ||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org. - Management Services | MD | 501(c)(3) | Line 11c, III-FI | Bon Secours Inc | 0 |
| Our Lady of Bellefonte Hospital Inc | ||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 611356023 | Healthcare | KY | 501(c)(3) | Line 3 | Bon Secours Kentucky Health System | 0 |
| Our Lady of Bellefonte Hospital Foundation | ||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 611381952 | Grant Making Foundation | KY | 501(c)(3) | Line 7 | Bon Secours Kentucky Health System | 0 |
| Bon Secours Kentucky Health System | ||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 611356024 | Local System Parent Org. | KY | 501(c)(3) | Line 11c, III-FI | Bon Secours Health System Inc | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |