ST MARYS HEALTHCARE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HEALTHCARE (EIN 14-1347719)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-09
- IRS object ID
- 201721299349301837
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-09T16:00:20-05:00 | 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 | 141347719 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 5188421900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1Txt |
| City | Amsterdam | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 120101054 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Rick Henze | PersonNm |
| Person Title | VP of Finance & CFO | PersonTitleTxt |
| Signature | 2017-05-09 | 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 | Victor Giulianelli | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1Txt |
| City | Amsterdam | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 120101054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $169,230,476 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.smha.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1903 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | To serve all persons with compassion and excellence, especially those who are vulnerable. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1882 | TotalEmployeeCnt |
| Total Volunteers | 200 | TotalVolunteersCnt |
| Total Gross UBI | $994,203 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$119,926 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,702,769 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,749,772 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $145,738,566 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $157,346,043 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,506,354 | PYInvestmentIncomeAmt |
| CY Investment Income | $402,935 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,110,628 | PYOtherRevenueAmt |
| CY Other Revenue | $1,510,408 | CYOtherRevenueAmt |
| PY Total Revenue | $154,058,317 | PYTotalRevenueAmt |
| CY Total Revenue | $169,009,158 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $106,803 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $56,359 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $94,171,981 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $101,890,274 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $57,371,618 | PYOtherExpensesAmt |
| CY Other Expenses | $64,196,842 | CYOtherExpensesAmt |
| PY Total Expenses | $151,650,402 | PYTotalExpensesAmt |
| CY Total Expenses | $166,143,475 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,407,915 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,865,683 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $169,776,630 | TotalAssetsBOYAmt |
| Total Assets EOY | $165,325,721 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $44,191,698 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $52,289,310 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $125,584,932 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $113,036,411 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Rooted in the healing ministry of Jesus, we dedicate ourselves to serve all persons with compassion and excellence, especially those who are vulnerable. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $142,989,396 | ExpenseAmt |
| Grant | $56,359 | GrantAmt |
| Revenue | $155,884,706 | RevenueAmt |
| Desc | St. Mary's Healthcare provides a substantial portion of its services to the elderly and poor. During the twelve month period ending June 30, 2016, approximately 38% of the values of services rendered were to elderly patients under the Medicare program and approximately 19% of the services were provided to patients who were deemed indigent under state, county or hospital guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the twelve month period ending June 30, 2016, the estimated cost of providing care of persons living in poverty totaled $14.52 million, including $332,000 cost of charity care, $3.8 million in programs for persons living in poverty, and $10.3 million in the unpaid cost of public programs. These amounts vary from Schedule H due to different methods of calculation. In the twelve months ending June 30, 2016, St. Mary's Healthcare provided health care services to 7,200 inpatients and 421,928 outpatients, and 57,779 days of care to residents of the skilled nursing facility. The inpatient care covered medical/surgical, psychiatric, alcohol rehabilitation, physical rehabilitation, maternity and newborn patients. The outpatient visits included 27,279 emergency visits; 6,915 outpatient surgeries; 156,127 referred visits (including imaging, laboratory, therapies, and cardiac rehab), total other outpatient visits of 34,638 including 1,253 visits to nursing home patients, 7,465 adult day care visits, 22,962 urgent care visits, 2,111 occupational medicine visits and 847 visits to the diabetes center; 63,571 family health center visits; total specialty visits of 27,479 including 6,782 urology health center visits, 4,027 cancer treatment center visits 6,736 Amsterdam OB/GYN Center, 1,844 Johnstown OB Center, Cancer Center Chemotherapy 1,187, Gastroenterology 5,156, Rheumatology 1,747, and total mental health and alcohol visits of 106,116 including , 8,565 alcohol clinic visits, and 97,551 mental health clinic visits. St. Mary's Healthcare administers one of the most comprehensive mental health outpatient programs in New York State. In the twelve months ending June 30, 2016, the Hospital provided a variety of services through various grant-funded programs including psych-social clubs, prevocational/employment assistance programs, mobile geriatric/senior citizen programs, and alcohol intervention service programs. In addition, caring families provided family care services and hospital personnel provided case management counseling under various grant-funded programs. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,177,000 | ExpenseAmt |
| Desc | Community benefits are programs or activities that provide treatment and / or promote health and healing as a response to identified community needs. To promote healthy living, St. Mary's Healthcare has made available the following programs to the community: reduced cost programs providing senior citizens with Lifeline equipment enabling them to solicit help should the need arise; community continuing education programs providing information on a variety of subjects including child abuse, day-to-day parenting, seat belt use and safety. Smoking cessation, weight loss, and other wellness programs; help and support groups for victims and their family members; and providing meeting facilities for victims of alcohol abuse. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,350,808 | ExpenseAmt |
| Revenue | $1,461,337 | RevenueAmt |
| Desc | St. Mary's Healthcare's other program service revenue includes continuing education programs, psychological services provided to Montgomery county, medical director services, cafeteria sales to visitors and employees, and rebates / refunds of expenses. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $146,517,204 | 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 | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | Yes (true) | 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 | false | 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 | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 153 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1882 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rick Henze | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5188417434 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1Txt |
| City | Amsterdam | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12010 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 |
|---|---|---|---|---|---|---|---|---|---|
| VICTOR FRANCIS GIULIANELLI | |||||||||
| PRESIDENT & CEO | 40.0 | 2.0 | Yes (X) | Yes (X) | $783,900 | $0 | $32,990 | ||
| THOMAS F CICHY | |||||||||
| TREASURER | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| JOHN DALY | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| EMILY T ETZKORN MD | |||||||||
| SECRETARY | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MOHAMMED R GHAZI-MOGHADAM MD | |||||||||
| DIRECTOR/PHYSICIAN | 40.0 | 0 | Yes (X) | $460,782 | $0 | $32,099 | |||
| SISTER NANCY GREGG | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| ANDREW HECK | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| SISTER MARY ANNE HEENAN | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| RONALD LIMONCELLI | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| RONALD MARSH MD | |||||||||
| CHAIRPERSON/PHYSICIAN | 40.0 | 0 | Yes (X) | $160,408 | $0 | $0 | |||
| MICHAEL J PEPE | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| BRENT E PHETTEPLACE | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL M SHERIDAN DO | |||||||||
| DIRECTOR | 2.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| GREGORY J ABBATTISTI CPA | |||||||||
| DIRECTOR | 2.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JOAN EHLINGER | |||||||||
| VP OF FINANCE & CFO | 40.0 | 0 | Yes (X) | $178,772 | $0 | $8,377 | |||
| FREDERICK EDWARD HENZE JR | |||||||||
| VP OF FINANCE & CFO | 40.0 | 1.0 | Yes (X) | $142,178 | $0 | $8,102 | |||
| ALBERT VINCENT TURO | |||||||||
| VP OF DEVELOPMENT & PLANNING | 34.5 | 5.5 | $234,894 | $0 | $17,571 | Yes (X) | |||
| DONALD WILLIAM MASSEY | |||||||||
| VP OF CONTINUUM CARE | 40.0 | 0 | $214,734 | $0 | $28,363 | Yes (X) | |||
| WILLIAM DOUGLAS MAYER | |||||||||
| VP OF MEDICAL AFFAIRS | 40.0 | 0 | $387,721 | $0 | $31,092 | Yes (X) | |||
| DUANE SCOTT MILLER | |||||||||
| VP OF BEHAVIORAL HEALTH | 40.0 | 0 | $169,329 | $0 | $33,665 | Yes (X) | |||
| MICHELE MARIE WALSH | |||||||||
| VP OF NURSING | 40.0 | 0 | $273,009 | $0 | $19,720 | Yes (X) | |||
| SCOTT MICHAEL BRUCE | |||||||||
| VP OF OPERATIONS | 40.0 | 1.0 | $336,450 | $0 | $50,347 | Yes (X) | |||
| JAMES MICHAEL CHARLAND MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $616,617 | $0 | $34,006 | Yes (X) | |||
| MICHAEL JAMES FINNEGAN MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $690,000 | $0 | $38,096 | Yes (X) | |||
| DAVID JOHN LEHR MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $479,888 | $0 | $34,286 | Yes (X) | |||
| GARY SINENSKY | |||||||||
| PHYSICIAN | 40.0 | 0 | $675,614 | $0 | $27,101 | Yes (X) | |||
| DEBORAH ANN SCULCO | |||||||||
| PHYSICIAN | 35.6 | 0 | $430,341 | $0 | $20,771 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,234,639 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $416,585 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 79 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 |
|---|---|---|---|---|---|---|
| Atlantic Professional Services of RI | ||||||
| PO Box 635988 | Cincinnati | OH | 45263 | Hospitalists | $2,775,757 | |
| ARUP Laboratories | ||||||
| 500 S Cipeta Way | Salt Lake City | UT | 84108 | Laboratory Services | $954,994 | |
| MedSpeed LLC | ||||||
| 65 A Grand Ave | Elmhurst | IL | 60126 | Courier Services | $309,647 | STE 320 |
| Acute Dialysis Equipment Inc | ||||||
| 1288 Simons Rd | Castleton | NY | 12033 | Dialysis | $190,178 | |
| Synthes USA Sales LLC | ||||||
| 1301 Goshen Pkwy | West Chester | PA | 19380 | Surgical Supplies | $174,640 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $7,210,803 | RelatedOrganizationsAmt |
| Government Grants | $2,538,969 | GovernmentGrantsAmt |
| Total Contributions | $9,749,772 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Revenue | 621990 | $156,554,197 | $156,554,197 |
| Other Program Service | 621990 | $791,846 | $791,846 |
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 | $157,346,043 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $402,935 | TotalRevenueColumnAmt |
| Exclusion | $402,935 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,032 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $221,318 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$153,286 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$153,286 | TotalRevenueColumnAmt |
| Exclusion | -$153,286 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|
| Laboratory Services | 621500 | $771,108 | $771,108 |
| Occupational Med | 621400 | $202,683 | $202,683 |
| Medical Director Svcs | 623990 | $20,412 | $20,412 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $669,491 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $669,491 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,663,694 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $169,009,158 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $157,346,043 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $994,203 | UnrelatedBusinessRevenueAmt |
| Exclusion | $919,140 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,359 | TotalAmt |
| Program Services | $56,359 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,951,214 | TotalAmt |
| Program Services | $446,091 | ProgramServicesAmt |
| Management And General | $2,505,123 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,450,601 | TotalAmt |
| Program Services | $74,650,113 | ProgramServicesAmt |
| Management And General | $5,800,488 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,315,594 | TotalAmt |
| Program Services | $2,148,640 | ProgramServicesAmt |
| Management And General | $166,954 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,551,686 | TotalAmt |
| Program Services | $9,790,909 | ProgramServicesAmt |
| Management And General | $760,777 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,621,179 | TotalAmt |
| Program Services | $5,289,637 | ProgramServicesAmt |
| Management And General | $331,542 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $441,859 | TotalAmt |
| Program Services | $441,279 | ProgramServicesAmt |
| Management And General | $580 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,479 | TotalAmt |
| Management And General | $54,479 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,726 | TotalAmt |
| Management And General | $29,726 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,840,226 | TotalAmt |
| Program Services | $13,668,972 | ProgramServicesAmt |
| Management And General | $2,171,254 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,049,368 | TotalAmt |
| Program Services | $130,005 | ProgramServicesAmt |
| Management And General | $919,363 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,031 | TotalAmt |
| Program Services | $363,154 | ProgramServicesAmt |
| Management And General | $52,877 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,476,462 | TotalAmt |
| Program Services | $6,470,032 | ProgramServicesAmt |
| Management And General | $6,430 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,333,968 | TotalAmt |
| Program Services | $3,105,661 | ProgramServicesAmt |
| Management And General | $228,307 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,894 | TotalAmt |
| Program Services | $165,996 | ProgramServicesAmt |
| Management And General | $64,898 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,519 | TotalAmt |
| Program Services | $192,870 | ProgramServicesAmt |
| Management And General | $27,649 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,432,702 | TotalAmt |
| Program Services | $5,952,179 | ProgramServicesAmt |
| Management And General | $480,523 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,166,227 | TotalAmt |
| Management And General | $1,166,227 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $18,888,834 | $18,744,787 | $144,047 |
| PROVIDER TAX | $1,314,957 | $1,314,957 | |
| MINOR EQUIPMENT | $564,860 | $542,703 | $22,157 |
| PURCHASED SERVICES - AFFILIATES | $4,549,100 | $4,549,100 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,186,630 | TotalAmt |
| Program Services | $3,042,860 | ProgramServicesAmt |
| Management And General | $143,770 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,143,475 | TotalAmt |
| Program Services | $146,517,204 | ProgramServicesAmt |
| Management And General | $19,626,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,309,416 | BOYAmt |
| EOY | $1,259,052 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,552,399 | BOYAmt |
| EOY | $21,321,320 | 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 | $1,594,236 | BOYAmt |
| EOY | $1,449,565 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $843,055 | BOYAmt |
| EOY | $419,139 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $113,981,136 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $55,461,660 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,645,659 | BOYAmt |
| EOY | $58,519,476 | 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 |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,305,794 | BOYAmt |
| EOY | $1,357,018 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,526,071 | BOYAmt |
| EOY | $81,000,151 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,776,630 | BOYAmt |
| EOY | $165,325,721 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,403,209 | BOYAmt |
| EOY | $18,058,335 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $659,603 | BOYAmt |
| EOY | $1,035,402 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,574 | BOYAmt |
| EOY | $49,914 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,084,312 | BOYAmt |
| EOY | $33,145,659 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,191,698 | BOYAmt |
| EOY | $52,289,310 | EOYAmt |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,845,813 | BOYAmt |
| EOY | $105,328,979 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,237,751 | BOYAmt |
| EOY | $1,201,912 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,501,368 | BOYAmt |
| EOY | $6,505,520 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,584,932 | BOYAmt |
| EOY | $113,036,411 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,776,630 | BOYAmt |
| EOY | $165,325,721 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,865,683 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,185,648 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$13,228,556 | 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 | $29,726 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $29,726 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 Detailed description of the Lobbying activity | FormAndLineReferenceDesc |
| Explanation | Lobbying expenses include the portion of dues paid to National and State Associations that are specifically allocable to lobbying. St. Mary's Healthcare does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or its opposition to ) and candidate for public office. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,505,491 | BeginningYearBalanceAmt |
| Contributions | $4,152 | ContributionsAmt |
| Investment Earnings Or Losses | $170,156 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,256,373 | OtherExpendituresAmt |
| End Year Balance | $8,423,426 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,044,819 | BeginningYearBalanceAmt |
| Contributions | $1,760 | ContributionsAmt |
| Investment Earnings Or Losses | $466,208 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,296 | OtherExpendituresAmt |
| End Year Balance | $10,505,491 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,561,895 | BeginningYearBalanceAmt |
| Contributions | $11,814 | ContributionsAmt |
| Investment Earnings Or Losses | $471,685 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $575 | OtherExpendituresAmt |
| End Year Balance | $10,044,819 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,241,842 | BeginningYearBalanceAmt |
| Contributions | $8,009 | ContributionsAmt |
| Investment Earnings Or Losses | $1,317,915 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,871 | OtherExpendituresAmt |
| End Year Balance | $9,561,895 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,558,720 | BeginningYearBalanceAmt |
| Contributions | $6,383 | ContributionsAmt |
| Investment Earnings Or Losses | $678,839 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,100 | OtherExpendituresAmt |
| End Year Balance | $8,241,842 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.77 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.23 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,307,023 | OtherCostOrOtherBasisAmt |
| Book Value | $9,307,023 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,549,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,760,402 | DepreciationAmt |
| Book Value | $33,788,886 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,861,145 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,701,258 | DepreciationAmt |
| Book Value | $14,159,887 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,263,680 | OtherCostOrOtherBasisAmt |
| Book Value | $1,263,680 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $58,519,476 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE | $60,243,330 |
| INTEREST IN NET ASSETS OF FOUNDATION | $7,707,433 |
| INTANGIBLE PENSION ASSET | $1,601,941 |
| OTHER RECEIVABLES | $10,425,549 |
| THIRD PARTY RECEIVABLES | $801,898 |
| PHYSICIAN RECEIVABLE | $220,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $81,000,151 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (11 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION COSTS | $17,696,862 |
| INTERCOMPANY DEBT TO ASCENSION HEALTH ALLIANCE | $8,442,817 |
| THIRD PARY LIABILITY | $2,504,484 |
| ASSET RETIREMENT OBLIGATION | $1,500,000 |
| PATIENT CREDIT LIABILITIES | $270,525 |
| IBNR LIABILITY | $1,202,000 |
| THIRD PARTY ADVANCE | $401,594 |
| OTHER ADVANCES | $239,099 |
| INCOME GUARANTEE | $4,896 |
| VALUATION GUARANTEE | $433,382 |
| HISTORICAL ALLOWANCES | $450,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $33,145,659 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part IV, Line 2b Explanation of escrow agreement | The Hospital maintains accounts for residents of the skilled nursing facility which totaled $49,914 at 06/30/2016 |
| Schedule D, Part V, Line 4 Intended uses of endowment funds | The intended use of the endowment fund is to assist St. Mary's Healthcare at Amsterdam to develop and expand its services to the community. |
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 |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| 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 | $416,326 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $55,211 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $361,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0022 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,524,523 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,173,917 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,350,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0623 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| 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 | $49,940,849 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,229,128 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,711,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0645 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,017,272 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,966,972 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0179 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $665,029 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $665,029 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0040 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,529,044 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,873,366 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $655,678 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0039 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| 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 | $337,584 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $337,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $16,548,929 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,923,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,625,263 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0278 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $66,489,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $51,152,794 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,336,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0923 | 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 | $12,371 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,371 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | 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 | $12,371 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,371 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,627,906 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,219,778 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $52,808,183 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $53,789,960 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$981,777 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| 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 Mary's Healthcare | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1Txt |
| City | Amsterdam | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 120101054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.smha.org/ | WebsiteAddressTxt |
| State License | 2801001H | 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 Mary's Healthcare | 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.smha.org/st-marys/community-health-needs-assessment1 | 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.smha.org/st-marys/community-health-needs-assessment1 | 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 | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - St. Mary's Healthcare. As part of the Community Health Assessment, a Community Health Survey was conducted. A random survey of 750 individuals 18 and older in St. Mary's Healthcare service area were interviewed by telephone. An online survey was also conducted to solicit input from key informants. St. Mary's Healthcare supplied a list of recommended participants including physicians, public health representatives, other health professionals, social service providers, and a variety of community leaders. The community leaders include those who work with low-income minority populations and medically under-served populations. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - St. Mary's Hospital. St. Mary's Healthcare conducted its CHNA with the following other hospital facility: St. Mary's Hospital |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - St. Mary's Healthcare. The CHNA Steering Committee met on January 7, 2016 to determine the health needs to be prioritized for action. The Areas of Opportunity were prioritized by the Committee as follows: Substance Abuse, Mental Health, Nutrition/Physical Activity/Weight Management, Cancer, Heart Disease & Stroke and Diabetes. St. Mary's Healthcare ("St. Mary's" or "SMH") is continually working to meet the goals set forth in their Community Health Needs Assessment (CHNA) Implementation Strategy 2015-2018. Nutrition and Weight Status - St. Mary's is working with Johnstown Pediatric Center and the Memorial Family Health Center to implement a childhood obesity prevention program, "5210." This program will help providers talk to children and their families about the importance of healthy eating and physical activity. FulMont Head Start in Amsterdam is also partaking in this activity. St. Mary's Healthcare will also enforce the "5210" message to all associates. The Hospital regularly offers free glucose testing and education as requested by local school, community and civic groups. St. Mary's has a Diabetes and Nutrition Education Center to provide nutritional counseling to the community, the Pregnancy Care Center, and Cardiac Rehabilitation. Primary care providers and their staff discuss nutritional concerns with the patients they see on a regular basis. They are able to make referrals for nutritional counseling as necessary. St. Mary's began the implementation of a "Mission Cupboard," which serves as an emergency food pantry for patients. St. Mary's continues to promote "Baby Friendly" to improve maternal and child health. The goal is to increase the number of women who initiate and exclusively breastfeed without medical reason for formula to 78% by May 2019. (Baseline: 68% in 2015) During July 2015 to June 2016, approximately 500 mothers and their families were provided with Breastfeeding education. Approximately 70% (or 350) of the mothers were breastfeeding when they left the hospital. Chronic Disease - St. Mary's was the recipient of a grant from the New York State Department of Health for Peer Education. This three- to five-year grant will reduce breast cancer mortality by 10% and increase awareness and education surrounding prostate cancer. St. Mary's is in the process of hiring a Health Screening Facilitator. This facilitator will encourage eligible patients to receive their regular colonoscopies to be screened for colo-rectal cancer. Three St. Mary's associates attended a "Butt Stops Here," a tobacco cessation program, facilitator training in May 2016. The first "Butt Stops Here" program will be January 2017. Substance Abuse/Mental Health - St. Mary's Healthcare participates as a member of the Fulton Montgomery Suicide Prevention Task Force. The hospital is available to provide educational materials and resources to schools in Fulton and Montgomery counties. St. Mary's held a 3-part free community program in May 2016 called "Linger Over Lunch." Participants learned the importance of work/life balance, managing stress, and when to seek help for coping mechanisms related to mental health issues. St. Mary's held a Suicide awareness program in September 2015 at SMH and May 2016 at Gloversville Middle School. There were 70 attendees at the event in September and 50 attendees at the event in May. St. Mary's received a grant to build a new ambulatory detox center that is slated to open in early 2017. The grant was received in April 2016. Other Needs - St. Mary's Healthcare offers our Pregnancy Care Center, a comprehensive pre-natal program for uninsured, low-income women who become pregnant. The care includes routine pregnancy medical checkups, lab work and access to specialists. The Hospital provides information about pregnancy, labor and delivery as well as hospital care during pregnancy and delivery. Medical care is provided for the mother for at least two months after delivery and for the baby at least one year after birth. St. Mary's asks every patient they see for services if they use tobacco. Medical providers at primary care centers provide counseling and inpatients receive a visit from the Respiratory Therapy Department who provides smoking cessation counseling and materials. St. Mary's Healthcare Birth Center has been recognized by Healthgrades for the 2016 Labor and Delivery Excellence Award for the second year in a row. In addition, St. Mary's was also recognized by Healthgrades for Superior Performance in Labor and Delivery for two years in a row, among the top 10% of hospitals evaluated for labor and delivery for two years in a row, a Five-star recipient for natural delivery two years in a row and five-star recipient for C-Section delivery in 2016. St. Mary's provides free flu shots to the local college and BOCES's students in the CNA, LPN, and RN nursing classes and to our migrant farm workers in the rural sections of Montgomery County. St. Mary's Healthcare partnered with the local Office for Aging to provide a resource guide for our area. The guide is regularly updated and distributed by the Office for Aging. The Hospital partners with local physicians and medical providers to offer educational programs on joint, bone and back health. We have a partnership with a local orthopedic practice to offer "Joint School" which educates candidates for joint replacement on surgery, treatment, care, and management of bone and joint tissues. St. Mary's currently audits patient records to ensure that all diabetics are receiving the care they need to prevent renal disease as a result of complications from their diabetes. St. Mary's Healthcare focuses on those issues that are most pressing, most under-addressed, and most within its ability to influence. St. Mary's will not be addressing the following health issues. * Access to Healthcare Services: As evidenced by the CHNA, we have fewer primary care providers than most of NYS. However, we are out-performing most areas when it comes to patients being screened for blood pressure and children attending wellness visits. We also only have 5% of our service area un-insured. St. Mary's employs a full-time Health Insurance Enroller to provide individuals with appropriate health Insurance * Respiratory Diseases: As part of SMH's participation in and leadership of the Alliance for Better Health, a part of DSRIP (Delivery System Reform Incentive Payment Program) of New York State, Project 4.b.i will focus on tobacco cessation, contributing to respiratory diseases, including asthma and COPD. * Injury and Violence: According to our CHNA, our service area's mortality rate has decreased over much of the past decade, despite some increases in recent years. Also, our rate of children and adults wearing seatbelts has increased significantly over time from 93.7% to 98.6%. We have also had a statistical decrease in violent crimes since 2012. * Potentially Disabling Conditions: St. Mary's continuously partners with local physicians and medical providers to offer free of charge educational programs on joint, bone and back health. Additionally, A St. Mary's inter-disciplinary team partners with a local orthopedic practice to offer a "Joint School", which educates candidates for joint replacement on surgery, treatment, care and management of bone and joint issues. |
| Schedule H, Part V, Section B, Line 16 Facility , 1 | Facility , 1 - St. Mary's Healthcare. Individual letters are mailed to all uninsured patients informing them of the financial assistance programs available. |
| Schedule H, Part V, Section B, Line 22 Facility , 1 | Facility , 1 - St. Mary's Healthcare. The maximum amount charged to FAP-eligible individuals is based on the uninsured discount, which is reviewed and updated annually, as applicable. Uninsured patients with the ability to pay will be provided a discount based on the discount provided to the highest-paying payer that accounts for at least three percent of the Hospital's volume or gross patient revenues. In 2015, the Hospital provided discounts to the uninsured equal to 32% of charges for inpatients and 46% of charges for outpatients. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| St Mary's Healthcare | ||||
| 4988 State Highway 30 | Amsterdam | NY | 12010 | Diagnostic Care, Primary Care, Cancer Medicine, and Inpatient Physical Rehab |
| Wilkinson Residential Health Care Fac | ||||
| 4988 State Highway 30 | Amsterdam | NY | 12010 | Residential Health Care Facility |
| Johnstown Family Health Center | ||||
| 700 S Perry Street | Johnstown | NY | 12095 | Family Health Center |
| Canajoharie Family Health Center | ||||
| 48 Erie Boulevard | Canajoharie | NY | 13317 | Family Health Center |
| Carondelet Family Health Center | ||||
| 380 Guy Park Ave | Amsterdam | NY | 12010 | Family Health Center |
| Gloversville Family Health Center | ||||
| 84 E State Street | Gloversville | NY | 12078 | Family Health Center |
| Northville Family Health Center | ||||
| 331 Bridge Street | Northville | NY | 12134 | Family Health Center |
| Amsterdam OBGYN Center | ||||
| 446A Guy Park Ave | Amsterdam | NY | 12010 | OB/GYN Center |
| Montgomery County Addiction Services | ||||
| 76 Guy Park Ave | Amsterdam | NY | 12010 | Addiction Services |
| Fulton County Day Rehab Addiction Svc | ||||
| 57 E Fulton Street | Gloversville | NY | 12078 | Addiction Rehabilitation Center |
| Children's Mental Health Clinic | ||||
| 8 Northampton Road | Amsterdam | NY | 12010 | Children's Mental Health Center |
| Diagnostic Service Center | ||||
| 110 Holland Circle Drive | Amsterdam | NY | 12010 | Diagnostic Care Center |
| Children's Day Treatment Program | ||||
| 234 Lincoln Street | Gloversville | NY | 12078 | Children's Treatment Center |
| Social Club North | ||||
| 73 North Main Street | Gloversville | NY | 12078 | Human Services |
| Social Club West | ||||
| 17 River Street | Nelliston | NY | 13410 | Human Services |
| Broadalbin Health Center | ||||
| 3768 ST HWY 30 | Broadalbin | NY | 12025 | Family Health Center |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7g Subsidized Health Services | The organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I. |
| 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 (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For charity care, a specific cost-to-charge ratio was applied; for other categories in the table, a cost accounting system was used. |
| Schedule H, Part II Community Building Activities | Part II: St. Mary's Healthcare provided the following community building activities in July 2015 - June 2016. * Donated turkeys to 30 migrant farm families in November 2015. St. Mary's also had a gathering for them where we provided healthy food and beverages in July 2015 and February 2016. * In 2015-2016 St. Mary's Healthcare, together with leaders of local community agencies and the Department of Social Services continued to address the homeless issues in Amsterdam. Through their continued collaboration, the homeless shelter continues to operate and provide critical housing services for those in emergent need. Danielle's house also offers intensive case management services, job assistance and low-income apartment rentals for those who need a more permanent place to stay and the support of a case manager. * St. Mary's donated both funding and staff time to the local Habitat for Humanity Chapter. The first house built by this chapter is currently under construction as a result of these efforts. * St. Mary's donated various gifts and food to the children on the east end of Amsterdam for a Christmas party in December 2015. We provided healthy food, milk, bottled water, and physical activity for them. * St. Mary's provided space for a farmer's market on the Memorial Campus that began April 2016, every Wednesday, 2:00-5:00 p.m. * September 22, 2015: St. Mary's celebrated Falls Prevention Day by providing educational presentation to the adult day program on falls prevention. We distributed 25-30 brochures with information about preventing falls and ways to safe-proof your home. We also distributed state-wide materials and night lights to participants in the adult day program. * March 30, 2016: St. Mary's held a Poverty Simulation at the Carondelet Pavilion. This provided community members and associates a first-hand experience of what it might be like to live in a low-income family. * January 27, 2016: Provided a free Narcan training program at Lynch Middle School in Amsterdam. * February 27, 2016: Healthy Women's Day at the Rao Outpatient Pavilion was a day where uninsured women could receive free mammograms, PAP smears, blood pressure screenings, and lab work, along with a chance to enroll in health insurance programs. * March 14th, 2016: St. Mary's held a social work celebration for all area social workers from different agencies and organizations. St. Mary's provided the space and the food. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | St. Mary's Healthcare writes an accounts receivable off as a bad debt after collection efforts have been followed in accordance with the hospital's policies. Discounts and insurance payments have been applied to each patient account and reasonable efforts have been made to collect the remaining balance due from the patient. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | The bad debt expense attributable to patients eligible under the organization's financial assistance policy is calculated from the amount of bad debt transfers for uninsured patients. The ratio of cost to charge is applied to the total transfers less the cost of the bad debt recoveries. This bad debt is not included as a community benefit. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | From the consolidated audited financial statements of Ascension Health Alliance (which includes the activity of St. Mary's Healthcare): Certain members of Ascension formed the Ascension Credit Group (Senior Credit Group). Each Senior Credit Group member is identified as either a senior obligated group member, senior designated affiliate or senior limited designated affiliate. Senior obligated group members are jointly and severally liable under a Senior Master Trust Indenture (Senior MTI) to make all payments required with respect to obligations under the Senior MTI and may be entities not controlled directly or indirectly by Ascension. Though senior designated affiliates and senior limited designated affiliates are not obligated to make debt service payments on the obligations under the Senior MTI, Ascension may cause each senior designated affiliate to transfer such amounts as are necessary to enable the obligated group to comply with the terms of the Senior MTI, including payment of the outstanding obligations. Additionally, each senior limited designated affiliate has an independent limited designated affiliate agreement and promissory note with Ascension with stipulated repayment terms and conditions, each subject to the governing law of the senior limited designated affiliate's state of incorporation. The Hospital is a senior limited designated affiliate under the terms of the Senior MTI. Pursuant to a Supplemental Master Indenture dated February 1, 2005, senior obligated group members which are operating entities, have pledged and assigned to the Master Trustee a security interest in all of their rights, title and interest in their pledged revenues and proceeds thereof. As a senior limited designated affiliate, the Hospital has not pledged or assigned any such security interest. A Subordinate Credit Group, which is comprised of subordinate obligated group members, subordinate designated affiliates, and subordinate limited designated affiliates, was created under the Subordinate Master Trust Indenture (Subordinate MTI). The subordinate obligated group members are jointly and severally liable under the Subordinate MTI to make all payments required with respect to obligations under the Subordinate MTI and may be entities not controlled directly or indirectly by Ascension. Though subordinate designated affiliates and subordinate limited designated affiliates are not obligated to make debt service payments on the obligations under the Subordinate MTI, Ascension may cause each subordinate designated affiliate to transfer such amounts as are necessary to enable the obligated group members to comply with the terms of the Subordinate MTI, including payment of the outstanding obligations. Additionally, each subordinate limited designated affiliate has an independent subordinate limited designated affiliate agreement and promissory note with Ascension with stipulated repayment terms and conditions, each subject to the governing law of the subordinate limited designated affiliate's state of incorporation. The Hospital is a subordinate limited designated affiliate under the terms of the Subordinate MTI. |
| 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 a community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance, certain collection practices do not apply. |
| Schedule H, Part VI, Line 2 Needs assessment | In 2012 and 2015, the Hospital contracted with Professional Research Consultants, Inc. (PRC) to conduct St. Mary's Healthcare's Community Health Needs Assessment (CHNA). The assessment, completed in December 2015, incorporated data from both quantitative and qualitative sources including random sampling of community members, key informant online surveys, and secondary data sources. The key informant survey consisted of input from persons who represent the community we serve, including business leaders, community-based and social service agencies, school districts and those with a special knowledge or expertise in public health. The data from this assessment was made available to the public via the hospital's website, http://www.smha.org/st-marys/community-health-needs-assessment1 and upon request. The hospital also used data from our county health departments' community needs surveys. Additionally, the Hospital sought input from its Board of Trustees, Medical Executive Committee, leadership staff and community partners when completing its annual Integrated Strategic, Operational, and Financial Plan (ISOFP). The ISOFP uses pertinent data and comprehensive feedback to outline current and future critical healthcare needs for the Hospital's service area, as well as the resources needed to address the identified issues. In 2016, the hospital, in collaboration with our County Health Department, used indicator data from the New York State Department of Health and it's Prevention Agenda to develop the hospital's three-year (2015-2018) Community Service Plan (CSP). |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | St. Mary's Healthcare, in keeping with the mission and policies of Ascension Health, strives to maintain a balance between providing care of the poor with the ability of the Hospital to maintain quality health care for the community it serves. As part of its financial assistance policies, the Hospital offers a self pay discount to all uninsured patients as a percentage off the standard charge; the discounts were set at 32% for inpatient services and 46% for outpatient services. For the twelve month period (July 2015-June 2016), the discounts provided to the uninsured were $2,757,809. The Carondelet Care assistance program is the next level of financial assistance available to the Hospital's patients. This program is available to all patients who can demonstrate a financial burden associated with their patient responsibility. Financial assistance is provided through collaboration between the health insurance enrollment and financial assistance staff. Although the two departments offer different financial assistance services, the enrollment staff is trained to help those individuals who do not qualify for any government sponsored programs to access the Carondelet Care assistance program. Similarly, the Financial Counselors often refer patients in need of insurance to our Enrollment Specialist. The enrollment staff is available to meet with community members at the main hospital, at our Memorial campus and at all six of our off-site family health centers. Staff is also trained to refer individuals to free or low cost health care programs within the community if no other options are immediately available. From July 2015 to July 2016, 447 individuals were enrolled in health insurance programs as a direct result of these efforts. The Hospital enroller works collaboratively with community agencies to further expand its outreach. Large posters describing the Hospital's willingness to help patients with financial assistance are displayed in all main entrances to the Hospital and the off-site locations, as well as in our multiple registration sites and waiting rooms. The informational posters are in English and Spanish and urge patients to call if they are concerned about bill payment. Translation services are also available as needed via language line telephones and iPad video application. Brochures in English and Spanish are available at all service sites and offer detailed information about the various levels of assistance. In addition to offering discounts, St. Mary's offers options for payment plans and payment schedules. The English and Spanish brochures are also available on the Hospital web site. Information on financial assistance is also contained in the Patient Information Guide given to all inpatients at St. Mary's Healthcare. |
| Schedule H, Part VI, Line 4 Community information | St. Mary's Healthcare ("SMH") serves a rural community consisting of Montgomery and Fulton counties in New York State as its primary service area (PSA), and is the only acute care hospital in Montgomery County. On average, 65% of hospital admissions come from Montgomery County, and 26% come from Fulton County. The main hospital campus is located in the city of Amsterdam, though a number of vital services are available on the Memorial campus in the town of Amsterdam. The Hospital operates six primary care centers; three sites in Montgomery County (two located in Amsterdam, one in Canajoharie) and four sites in Fulton County (Johnstown, Gloversville, Broadalbin and Northville), in addition to a cancer medicine center and specialty practices in, urology, gastroenterology, obstetrics/gynecology, and ENT. SMH also has three urgent care sites located in Montgomery and Fulton Counties. The Hospital's comprehensive behavioral health programs provide extensive mental health and addiction services, including inpatient and outpatient treatment in Montgomery and Fulton Counties. The PSA represents one of the oldest regions in NYS. Estimates indicate that the 65 and older population will continue to grow. According to the US Census Bureau 16.6% of the population in our PSA are over 65. The SMH service area is "older" than the state or nation in that their median ages are higher. While the unemployment rate in Fulton and Montgomery Counties has improved it continues to be among the highest in NYS, exceeding the State average by 1.0%. There are many factors that contribute to the community's poverty levels, including the high school dropout rate in both counties. Reports indicate that 25% of ninth graders entering school will not complete high school in four years in our PSA. The lack of education affects the workforce, contributes to higher unemployment and greater risk of working without health insurance. Additionally, 52% of the children age 0-17 in the SMH PSA lives below the 200% poverty threshold. Research indicates a decline in the Caucasian population, which is a consistent trend over several years. The Hispanic community is our largest minority community, with the largest concentration within the city of Amsterdam. The 2010 Census indicates that 26.2% of the residents of Amsterdam are identified as Hispanic and according to the estimates this segment of our population will grow by 12.7% in the next five years. The Hospital employs bilingual and bicultural healthcare professionals to meet the needs of the Hispanic community. Health statistics relevant to the community's health status are as follows: Over 71% of the St. Mary's Healthcare Service Area is overweight. Especially alarming is that 34% of our children are overweight. The relationship of being overweight with other health issues such as high blood pressure, chronic depression, arthritis and diabetes are significant. Poor nutritional habits and lack of physical activity are significant contributing factors to the overweight status of our community. Access to quality health care services is important for increasing the quality of life for everyone. It impacts overall physical, social and mental health status; the prevention of disease and disability; quality of life; preventable death and life expectancy. Uninsured individuals comprise 5% of the population in Fulton and Montgomery Counties marking a significant decrease in the rate of uninsured. Nearly 6.7% of the population in St. Mary's Healthcare's service area went without any type of healthcare insurance coverage at some point in the past year. Disproportionately, over 15% of those with low-income went without some type of coverage the past year. These numbers are significantly less favorable than the US average of 4.8%. Additionally, nearly 31% of respondents reported some type of difficulty or delays in receiving needed health care in the past year, with those who are uninsured much more likely to report barriers when compared to the insured population. The Hospital serves a disproportionate share of the Medicaid population, and approximately 27% of the total inpatient discharges are Medicaid. |
| Schedule H, Part VI, Line 5 Promotion of community health | St. Mary's Healthcare promotes the health of its community through various activities, including the following: * During July 2015-June 2016, approximately 2,500 people were provided community education on topics such as Concussion Education, Alzheimer's disease, Arthritis, Breast, Cervical and Colorectal Cancer Screenings, Health Insurance, Childbirth Education, Bone and Joint Health, Brain Injury Awareness, Heart Health, Infant CPR, Lactation Support, Ebola, Physical Activity and Nutrition, Suicide Prevention, Health Care Proxys, General Mental Well-Being, Poverty, Gastroenterology, and other wellness areas. St. Mary's associates gave 3,938 hours of their time engaging in these community benefit activities. * Hosted five American Red Cross Blood Drives to address the critical need for blood in our service area. * Provided Healing Touch Treatments to women who have breast cancer or who are breast cancer survivors. * St. Mary's partnered with our local school districts hosting three school tours in the period July 2015 - June 2016, providing children first-hand knowledge and experience of the operations of a hospital. Our Registered Dieticians participated in school wellness days to teach children about the importance of healthy eating and physical activity. * In 2015 (July 2015 - June 2016) St. Mary's associates gave 1,050 hours back to their community serving on various boards including The Amsterdam Homeless Coalition, DSRIP, Teen Action Alliance, St. Jude's, NAMI, Your Home Care Network, Dear Neighbor, Breast Health Brunch Committee, Children's Steering Committee, PHIP, Health Advisory Committee, Montgomery County United Way, Community Hospice, Catholic Charities of Fulton and Montgomery Counties, Community Health Center (CHC) , Greater Amsterdam Volunteer Ambulance Corp (GAVAC), Regional Perinatal Outreach Advisory, Montgomery County Public Health Quality Assurance Committee, Minority Health Task Force, Sexual Assault Task Force, Fulton-Montgomery Community College, Fulmont Community Action, Liberty ARC Board, Montgomery County Office for the Aging, The Sanford Home, Montgomery County Habitat for Humanity, the Minority Health Task Force, the Suicide Prevention Task Force, Fulton-Montgomery Regional Chamber of Commerce, Glove City and Amsterdam Rotary, Children's Aid Society, New Dimensions in Healthcare and Fulton County Long-term Care Council Boards. * From July 2015 through June 2016, St. Mary's associates gave their time to better the community by participating in walks including the American Cancer Society's Relay for Life, Alzheimer's Association Walk to End Alzheimer's and other awareness walks as well as taking part in clean-up projects in both Fulton and Montgomery Counties. The hospital supported the work of many community groups including the Canajoharie Library, The Mental Health Association of FM Counties, The Office for Aging, Caring Together Ovarian Cancer Association, the Alzheimer's Association of NENY, Catholic Charities, St. Mary's Institute, Boy Scouts, YMCA, Liberty Foundation, Mountain Valley Hospice, Rotary Clubs, Montgomery County SPCA, Montgomery County Habitat for Humanity, Fulton County Habitat for Humanity, Wishful Thinking and numerous school clubs, sport teams and community groups through its fiscal donations. * St. Mary's providers are able to refer uninsured or underinsured patients with medication needs to the Dispensary of Hope program at the Hospital. This program provides free prescription medications to those who lack prescription drug coverage. * St. Mary's also has a partnership with Palmer's Pharmacy in Johnstown. If patients are in need of medication and cannot either pay for it or pick up their prescriptions, Palmer's will deliver to the hospital, their home, or have it ready for pick-up for the patient. * Continued to be a leader and collaborator with a group of partners from local health care entities and community agencies whose mission is to improve the health status for all we serve. During 2015, we continued to carry out our work we committed to in our Implementation Strategy and Community Service Plan. * In 2015, we continued our thirteenth year of distributing educational information on insurance eligibility for children through the school system, public service announcements, advertising and appearances at "back to school" events such as PTA meetings and open houses. * Enrolled nearly 447 individuals in State-sponsored insurance programs and programs through the newly created NY State of Health Marketplace. * Provided 545 life-saving cancer screenings to 221 uninsured individuals through the Cancer Services Program. * Supported a Promotora who provided outreach education, referral, follow-up, case management and advocacy services to our Latino and migrant community. The goal of the program is to promote needed primary health services and prevention efforts in a culturally appropriate manner. The Promotora has an average of 400 client contacts/communications per month. Additionally, there are countless other communications, educational trainings, community events, individual and family visits, and service navigation that has been made available by the program. * Maintained the importance of culturally sensitive and accurate communication with Latino patients and patients with limited English proficiency through the use of translation services which include professional phone and video translation services and the translation of key documents. English and Spanish are the most prominent languages spoken in the community, so all signage is posted in both English and Spanish throughout the organization. The iPad video services also serve those who are in need of sign language services. * Provided free blood pressure screenings at various health fairs and community events throughout the year. * Provided nutrition education to 600 individuals in the community at health events and educational programs. * Hosted eight different support groups including the Women's Cancer, Brain Injury, Behavioral/Mental Health, Ostomy, Diabetes, Survivors of a Loved One's Suicide (SOLOS), Alzheimer's Caregiver Support and Community Hospice Groups supporting nearly 150 community members who receive peer support and educational opportunities to manage their concerns. * The Medical Explorers, a group for young adults, meets monthly for education and socialization with the goal of assisting youth to explore the various options in healthcare careers. * Club 60, an educational and social group for seniors aged 60 and above, meets monthly for updates on health-related issues such as the flu vaccine and specialized primary care services. Each event includes the opportunity to ask questions and spend time with the President/CEO or other members of the senior management team. * A majority of the Hospital's Board of Trustees is comprised of persons who reside in the organization's primary service area and are neither employees nor independent contractors of the Hospital, nor family members thereof. * The Hospital established the Carondelet Community Fund, which provides modest assistance to local programs and agencies whose values and mission align with the values of St. Mary's Healthcare. Grants from the fund are made to eligible non-profit community agencies which are located within the service area of St. Mary's Healthcare and which share the values of St. Mary's with an emphasis on service to the poor and vulnerable, and holistic care. The total amount awarded from this fund during July 2015-June 2016 is $12,650. |
| Schedule H, Part VI, Line 6 Affiliated health care system | St. Mary's Healthcare (the Hospital) is a member of Ascension Health Alliance ("The System"). In December 2011, Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Hospital, located in Amsterdam, New York, is a nonprofit acute care hospital. The consolidated financial statements include the Hospital, Medical Services Enhancement, Inc. (MSE), and an equity interest in The Foundation of St. Mary's Healthcare, Inc. (Foundation). MSE operates a medical office building to retain and attract physician specialists to better serve the healthcare needs of the community. The Foundation's primary purpose is to assist the Hospital to develop and expand its services to the community by providing a focal point as the recipient for philanthropic support and by transferring funds to the Hospital. The Hospital provides acute inpatient, outpatient, and emergency care services for the residents of Montgomery, Fulton, and Hamilton counties. The Hospital also provides an array of Behavioral Health services including inpatient mental health and alcohol rehabilitation plus outpatient mental health and alcohol related services. Admitting physicians are primarily practitioners in the local area. Additionally, the Hospital operates a 160-bed skilled nursing facility which provides housing, healthcare and other related services to residents who are severely limited in their ability to care for themselves due to illness and/or disability, and a medical adult day care program. The Hospital 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. Ascension Health Alliance 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 Alliance'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 Alliance 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 cost of programs intentionally designed to serve 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. Discounts are provided to all uninsured patients in the acute care facility, 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 living in poverty 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). The amount of traditional charity care provided, determined on the basis of cost, excluding the provision for bad debt expense was approximately $332,000 for the twelve months ended June 30, 2016 and $413,000 for the twelve months ended June 30, 2015. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying other financial information. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | NY |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|
| Family Care - Entitlement Provider | 4 | $15,542 | FMV |
| Family Care - Entitlement Resident | 11 | $7,240 | FMV |
| Intensive Care Management - Patient Service Dollars | 74 | $16,052 | FMV |
| Supportive Care Management - Patient Service Dollars | 44 | $2,180 | FMV |
| Targeted Care Management - Patient Service Dollars | 113 | $15,345 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | The grant funds awarded are to clients of the family care, intensive case management, and supportive case management programs which are administered through the Hospital's behavioral health services division. The amounts are determined based on evaluation of client needs as determined by their individual case managers. All amounts are processed in accordance with the Hospital's disbursements practices which require evidence of supporting documentation for all required approvals. The usage of funding for Family Care and Case Management are in accordance with the Office of Mental Health procedural guidelines by program code and funding score. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | 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 (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VICTOR FRANCIS GIULIANELLI | ||||||||||||||
| PRESIDENT & CEO | $352,311 | $0 | $363,726 | $0 | $67,864 | $0 | $7,950 | $0 | $25,040 | $0 | $816,890 | $0 | $0 | $0 |
| MOHAMMED R GHAZI-MOGHADAM MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $417,831 | $0 | $29,604 | $0 | $13,347 | $0 | $7,950 | $0 | $24,149 | $0 | $492,881 | $0 | $0 | $0 |
| RONALD MARSH MD | ||||||||||||||
| CHAIRPERSON/PHYSICIAN | $160,408 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $160,408 | $0 | $0 | $0 |
| JOAN EHLINGER | ||||||||||||||
| VP OF FINANCE & CFO | $107,507 | $0 | $33,780 | $0 | $37,486 | $0 | $3,244 | $0 | $5,133 | $0 | $187,149 | $0 | $0 | $0 |
| FREDERICK EDWARD HENZE JR | ||||||||||||||
| VP OF FINANCE & CFO | $134,372 | $0 | $0 | $0 | $7,806 | $0 | $4,990 | $0 | $3,111 | $0 | $150,280 | $0 | $0 | $0 |
| ALBERT VINCENT TURO | ||||||||||||||
| VP OF DEVELOPMENT & PLANNING | $177,276 | $0 | $30,000 | $0 | $27,619 | $0 | $5,283 | $0 | $12,289 | $0 | $252,465 | $0 | $0 | $0 |
| DONALD WILLIAM MASSEY | ||||||||||||||
| VP OF CONTINUUM CARE | $167,795 | $0 | $28,755 | $0 | $18,184 | $0 | $5,316 | $0 | $23,047 | $0 | $243,097 | $0 | $0 | $0 |
| WILLIAM DOUGLAS MAYER | ||||||||||||||
| VP OF MEDICAL AFFAIRS | $333,656 | $0 | $43,850 | $0 | $10,215 | $0 | $19,453 | $0 | $11,639 | $0 | $418,813 | $0 | $0 | $0 |
| DUANE SCOTT MILLER | ||||||||||||||
| VP OF BEHAVIORAL HEALTH | $135,996 | $0 | $24,000 | $0 | $9,333 | $0 | $12,585 | $0 | $21,080 | $0 | $202,994 | $0 | $0 | $0 |
| MICHELE MARIE WALSH | ||||||||||||||
| VP OF NURSING | $197,709 | $0 | $32,055 | $0 | $43,245 | $0 | $10,106 | $0 | $9,614 | $0 | $292,729 | $0 | $0 | $0 |
| SCOTT MICHAEL BRUCE | ||||||||||||||
| VP OF OPERATIONS | $255,181 | $0 | $41,920 | $0 | $39,349 | $0 | $25,363 | $0 | $24,984 | $0 | $386,797 | $0 | $0 | $0 |
| JAMES MICHAEL CHARLAND MD | ||||||||||||||
| PHYSICIAN | $542,598 | $0 | $31,002 | $0 | $43,018 | $0 | $7,950 | $0 | $26,056 | $0 | $650,624 | $0 | $0 | $0 |
| MICHAEL JAMES FINNEGAN MD | ||||||||||||||
| PHYSICIAN | $494,622 | $0 | $192,382 | $0 | $2,996 | $0 | $7,950 | $0 | $30,146 | $0 | $728,096 | $0 | $0 | $0 |
| DAVID JOHN LEHR MD | ||||||||||||||
| PHYSICIAN | $397,749 | $0 | $66,068 | $0 | $16,071 | $0 | $7,950 | $0 | $26,336 | $0 | $514,174 | $0 | $0 | $0 |
| GARY SINENSKY | ||||||||||||||
| PHYSICIAN | $446,603 | $0 | $221,319 | $0 | $7,692 | $0 | $5,938 | $0 | $21,163 | $0 | $702,715 | $0 | $0 | $0 |
| DEBORAH ANN SCULCO | ||||||||||||||
| PHYSICIAN | $405,163 | $0 | $21,303 | $0 | $3,875 | $0 | $7,950 | $0 | $12,821 | $0 | $451,112 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Travel for companions | Per St. Mary's Healthcare's accountability plan, spousal travel is reimbursed if there is a business purpose, however the amount reimbursed is also included as income on the individual's W-2. Certain St. Mary's Healthcare employees are reimbursed for cell phone/PDA expense, which is included on the respective employee's W-2. These payments are grossed up to include tax related obligations paid. St. Mary's Healthcare offers a fitness club membership credit to all employees to reimburse half of the cost of a yearly fitness club membership up to $150 per year. |
| 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 executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The filing organization contributed to the supplemental nonqualified retirement plan in the amount as noted: Victor Giulianelli - $39,164 Joan Ehlinger - $9,421 Michele Walsh - $32,603 Scott Bruce - $28,387 Donald Massey - $4,864 Albert Turo - $16,073 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6 Classes of members or stockholders | St. Mary's Healthcare has a single corporate member, Ascension Health. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | St. Mary's Healthcare has a single corporation member, Ascension Health , which has the ability to elect members to the governing body of the Hospital. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Ascension Health has designed a system of authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organization and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, work diligently to complete the Form 990 and attached schedules in a thorough manner. 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 | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must describe the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board designated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board designated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax exempt purpose. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive compensation committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to CEO's at other hospitals who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees 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 19 Required documents available to the public | The organization will provide any documents open to the public inspection upon request. |
| Form 990, Part VII, Section A Compensation Paid to Director | During 2015, the Hospital paid Ronald Marsh, M.D. for services rendered in his role as surgeon of the Hospital, not for his duties as a board member. During 2015, the Hospital paid Mohammed Ghazi-Moghadam, M.D. for services rendered in his role as a physician of the Hospital, not for his duties as a board member. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Sports Medicine - Total Revenue: 669491, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 669491; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Pension Liability Adjustment - -7184219; Temporarily Restricted Interest in Foundation - -6035839; Permenently Restricted Interest in Foundation - 4152; Other - -12650; |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 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 |
| THE FOUNDATION OF ST MARY'S HEALTHCARE INC | ||||||||||
| 427 GUY PARK AVE | AMSTERDAM | NY | 12010 | 133254655 | FOUNDATION | NY | 501(c)(3 | Type III-FI | ST MARY'S HEALTHCARE | Yes (true) |
| MEDICAL SERVICES ENHANCEMENT INC | ||||||||||
| 425 GUY PARK AVE | AMSTERDAM | NY | 12010 | 141776546 | MEDICAL OFFICE BUILDING | NY | 501(c)(25 | ST MARY'S HEALTHCARE | Yes (true) | |
| 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 | Yes (true) | 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 | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Medical Service Enhancement Inc | ||
| K | $248,504 | Actual Amount Paid or Transfered |
| Medical Service Enhancement Inc | ||
| D | $202,736 | Actual Amount Paid or Transfered |
| The Foundation of St Mary's Healthcare | ||
| C | $7,210,803 | Actual Amount Paid or Transfered |
| The Foundation of St Mary's Healthcare | ||
| Q | $174,979 | Actual Amount Paid or Transfered |