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Mary Immaculate Hospital: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
Mary Immaculate Hospital (EIN 54-0548200)
Tax period
2015-09-01 to 2016-08-31
Filed
2017-07-10
IRS object ID
201721919349300122
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-07-10T09:44:13-05:00ReturnTs
Tax Period End2016-08-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1Deloitte Tax LLP 191 Peachtree StAddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP303031749ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540548200EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMARYBusinessNameControlTxt
Phone7578866000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMichael K KernerPersonNm
Person TitleCEO - BSHRHSPersonTitleTxt
Phone7578866000PhoneNum
Signature2017-07-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJohn W Sadoff JrPreparerPersonNm
PTINP00540589PTIN
Phone4042201500PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMichael K KernerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$185,917,254GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addressbonsecours.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionAcute Care HospitalActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee1080TotalEmployeeCnt
Total Volunteers120TotalVolunteersCnt
Total Gross UBI$84,916TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$17,577NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,158,457PYContributionsGrantsAmt
CY Contributions Grants$835,837CYContributionsGrantsAmt
PY Program Service Revenue$181,634,071PYProgramServiceRevenueAmt
CY Program Service Revenue$181,714,333CYProgramServiceRevenueAmt
PY Investment Income$918,732PYInvestmentIncomeAmt
CY Investment Income$892,900CYInvestmentIncomeAmt
PY Other Revenue$2,555,403PYOtherRevenueAmt
CY Other Revenue$2,443,033CYOtherRevenueAmt
PY Total Revenue$186,266,663PYTotalRevenueAmt
CY Total Revenue$185,886,103CYTotalRevenueAmt
PY Grants And Similar Paid$25,184PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$74,710CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,062,489PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,965,533CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$113,744,164PYOtherExpensesAmt
CY Other Expenses$114,659,640CYOtherExpensesAmt
PY Total Expenses$167,831,837PYTotalExpensesAmt
CY Total Expenses$169,699,883CYTotalExpensesAmt
PY Revenues Less Expenses$18,434,826PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$16,186,220CYRevenuesLessExpensesAmt
Total Assets BOY$228,432,529TotalAssetsBOYAmt
Total Assets EOY$242,150,281TotalAssetsEOYAmt
Total Liabilities BOY$22,396,578TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,619,993TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$206,035,951NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$221,530,288NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$159,328,713ExpenseAmt
Grant$74,710GrantAmt
Revenue$181,629,417RevenueAmt
DescMary Immaculate Hospital provides medical care to patients without regard to their ability to pay. Among the major services provided to the residents of Hampton Roads, three major areas of focus are orthopedics, general surgery and women's health.Orthopedics -Mary Immaculate continues a strong focus on orthopaedic care for residents of the greater Hampton Roads area. Bon Secours skilled surgeons perform minimally invasive and traditional orthopaedic and spine procedures, and are complemented by a strong physiatry network. The orthopaedic service includes a continuum of care from pre-operative education through post-op recovery, and is supported by state-of-the-art technology, including a Mako surgical robot to assist in orthopaedic surgeries, and expert physicians, some with a national reputation, as well as a comprehensive inpatient and outpatient rehabilitation network. In addition, a strong focus exists on community education through seminars and classes, as well as innovative electronic risk assessments SpineAware and JointAware.General Surgery - Mary Immaculate has a special focus on bariatric surgery, including a comprehensive program, expert physicians, and a commitment to patient support for the duration of their weight loss journey. Bon Secours is part of the only weight loss surgery program that does not charge a fee to participants in the region. Bon Secours also offers a medically-managed weight loss program as part of its Weight Loss Institute and an exercise-nutrition program for those who may choose this more traditional approach. Mary Immaculate surgeons perform bariatric surgery using a variety of techniques, including the traditional roux-en-y approach, the gastric sleeve, and also the lap band. As a result, Mary Immaculate is now the market leader in bariatric surgery, with more than a quarter of all bariatric inpatient surgeries in Hampton Roads now performed at the hospital. Since 2013, Mary Immaculate added gynecological oncologists on its staff, and this surgical expertise has helped grow the hospital's market share in the service, especially from Peninsula residents. Women's Services - Mary Immaculate's Women's and Children's services provided added capacity and resources so that the needs of the community for obstetrical care would continue to be met after another facility closed its doors recently. Mary Immaculate's strong service legacy and its comprehensive service has led it to have higher birth rate amongst the Bon Secours hospitals in Hampton Roads. Bon Secours also offers the largest curriculum of family and parenting classes through its Love & Learn program. Mary Immaculate renovated its nursery to better meet the needs of babies and moms. In addition, Mary Immaculate also expanded its gynecology offering by introducing gynecological oncology services (board certified and fellowship trained surgeons) and an infusion center for women suffering from such cancers. Finally, as with other services and part of our mission, a strong focus exists on community education through seminars, classes, support groups, and innovative electronic risk assessment tools for various female cancers (BreastAware, LungAware, and ColonAware).Please see Schedule H for additional information regarding programs, community benefit programs and Charity Care.Desc
Total Program Service Expenses$159,328,713TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document80IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1080EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7572152709PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd Suite 108AddressLine1Txt
CitySuffolkCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23435ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Susan Anthony
Board Member (Jan-Aug)2.000.00Yes (X)$0$0$0
Michael Archuleta
Board Member (Sep)2.000.00Yes (X)$0$0$0
Brother Arthur Caliman
Board Member2.0048.00Yes (X)$0$0$0
Sister Elaine Davia
Board Member2.0048.00Yes (X)$0$400$0
Timothy Davis
Board Member2.0048.00Yes (X)$0$1,652,431$96,308
Debra Deihl
Board Member2.000.00Yes (X)$0$0$0
Gabriel Franco
Board Member2.000.00Yes (X)$0$0$0
Rev Ivan Harris
Board Member2.000.00Yes (X)$0$0$0
Dr Vincent Joseph
Board Member2.000.00Yes (X)$0$0$0
Deborah Jones
Board Member2.000.00Yes (X)$0$0$0
Michael Kerner
CEO - BSHR14.0036.00Yes (X)$0$1,121,910$124,973Yes (X)
Sister Sandra Lyons
Board Member2.000.00Yes (X)$0$0$0
Sister Shaun Malone
Board Member2.000.00Yes (X)$0$0$0
Helena Mock
Secretary2.000.00Yes (X)$0$0$0Yes (X)
Jeffrey Morrison DO
Board Member2.000.00Yes (X)$23,000$0$0
Sister David Niski
President3.000.00Yes (X)$0$0$0Yes (X)
William Pile
Chairman3.000.00Yes (X)$0$0$0Yes (X)
Joseph Ritchie
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Caroline Sorokos
Board Member (Sep-Dec)2.000.00Yes (X)$0$0$0
Charmaine Rochester PhD
Treasurer/VP Finance15.0035.00$0$277,873$16,234Yes (X)
Darlene Stephenson
CEO - MIH47.502.50$0$326,350$33,466Yes (X)
Herbert Cummings
COO - BSMG25.0025.00$0$302,100$38,105Yes (X)
Jeffrey Doucette
VP Patient Care Services50.000.00$244,849$0$43,781Yes (X)
Vickie Humphries
VP of Human Resources25.0025.00$0$228,417$12,312Yes (X)
James McNamara
VP of Ortho25.0025.00$0$275,726$22,121Yes (X)
Terri Spence
VP & Regional CIO25.0025.00$0$269,054$14,451Yes (X)
Anthony Terracina MD
General Surgeon50.000.00$1,063,431$0$45,605Yes (X)
Edward Pak
Internist50.000.00$372,318$0$10,600Yes (X)
Thomas Hoffmier MD
Cardiologist50.000.00$370,440$0$33,433Yes (X)
Nathanael Tilghman
Preventative Medicine50.000.00$224,421$0$17,745Yes (X)
John Austin
Pharmacist50.000.00$383,258$0$41,148Yes (X)
Patricia Robertson
Former Officer0.0050.00$0$533,486$28,189Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,681,717TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,987,747TotReportableCompRltdOrgAmt
Total Other Compensation$578,471TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K48IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WM Jordan Co Inc
PO Box 1337Newport NewsVA236010337Construction$3,739,885
Morrison Management Specialists Inc
PO Box 102289AtlantaGA303682289Dietary Services$2,674,777
Tidewater Physicians Multispecialty Grou
860 Omni Blvd Suite 401Newport NewsVA23606Physician Services$2,394,014
Aramark CTS Inc
12483 Collections Ctr DrChicagoIL60693Biomedical Engineering$2,281,885
Anesthesia Assoc of Hampton
110 Three Point CtYorktownVA23692Physician Services$1,314,375
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K33CntrctRcvdGreaterThan100KCnt
Fundraising$11,750FundraisingAmt
Related Organizations$177,441RelatedOrganizationsAmt
Government Grants$37,168GovernmentGrantsAmt
All Other Contributions$609,478AllOtherContributionsAmt
Noncash Contributions$25,600NoncashContributionsAmt
Total Contributions$835,837TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service Rev.Desc
Business622110BusinessCd
Total Revenue Column$181,714,333TotalRevenueColumnAmt
Related Or Exempt Func Income$181,629,417RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$84,916UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$181,714,333TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$719,164TotalRevenueColumnAmt
Exclusion$719,164ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$40,123RealAmt
Personal$2,635PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$8,541RealAmt
Personal$1,880PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$31,582RealAmt
Personal$755PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,337TotalRevenueColumnAmt
Exclusion$32,337ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$170,440SecuritiesAmt
Other$3,296OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$170,440SecuritiesAmt
Other$3,296OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$173,736TotalRevenueColumnAmt
Exclusion$173,736ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$20,415FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$11,750ContriRptFundraisingEventAmt
Fundraising Direct Expenses$20,730FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$315TotalRevenueColumnAmt
Exclusion-$315ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Joint Venture Income900099$1,263,957$1,263,957
Outpatient Pharmacy446110$564,978$564,978
Physical Therapy Svcs900099$275,774$275,774

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$306,302TotalRevenueColumnAmt
Exclusion$306,302ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,411,011OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$185,886,103TotalRevenueColumnAmt
Related Or Exempt Func Income$181,629,417RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$84,916UnrelatedBusinessRevenueAmt
Exclusion$3,335,933ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$74,710TotalAmt
Program Services$74,710ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$291,247TotalAmt
Program Services$262,122ProgramServicesAmt
Management And General$29,125ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$43,977,504TotalAmt
Program Services$39,579,754ProgramServicesAmt
Management And General$4,397,750ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,523,749TotalAmt
Program Services$1,371,374ProgramServicesAmt
Management And General$152,375ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,222,336TotalAmt
Program Services$4,700,102ProgramServicesAmt
Management And General$522,234ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,950,697TotalAmt
Program Services$3,555,627ProgramServicesAmt
Management And General$395,070ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$286,539TotalAmt
Program Services$257,885ProgramServicesAmt
Management And General$28,654ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$28,550TotalAmt
Program Services$25,695ProgramServicesAmt
Management And General$2,855ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,287,425TotalAmt
Program Services$9,287,425ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,749TotalAmt
Program Services$9,674ProgramServicesAmt
Management And General$1,075ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,418,675TotalAmt
Program Services$2,176,809ProgramServicesAmt
Management And General$241,866ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$187,119TotalAmt
Program Services$168,407ProgramServicesAmt
Management And General$18,712ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,304,123TotalAmt
Program Services$2,973,711ProgramServicesAmt
Management And General$330,412ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$157,464TotalAmt
Program Services$141,718ProgramServicesAmt
Management And General$15,746ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,342TotalAmt
Program Services$5,708ProgramServicesAmt
Management And General$634ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,782,096TotalAmt
Program Services$1,782,096ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,593,028TotalAmt
Program Services$5,933,725ProgramServicesAmt
Management And General$659,303ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$609,308TotalAmt
Program Services$548,377ProgramServicesAmt
Management And General$60,931ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$44,540,957$44,540,957
Purchased Services$31,113,979$28,002,581$3,111,398
Bad Debt Expense$10,302,991$10,302,991
BSHSI Allocation$3,197,887$2,878,098$319,789

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$832,408TotalAmt
Program Services$749,167ProgramServicesAmt
Management And General$83,241ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$169,699,883TotalAmt
Program Services$159,328,713ProgramServicesAmt
Management And General$10,371,170ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,205BOYAmt
EOY$3,205EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$125,894,712BOYAmt
EOY$138,467,253EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$95,689BOYAmt
EOY$119,067EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$19,591,336BOYAmt
EOY$18,774,088EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,111,482BOYAmt
EOY$3,784,652EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$462,509BOYAmt
EOY$855,946EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$101,661,682LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$66,582,819LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$34,257,177BOYAmt
EOY$35,078,863EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$32,738,938BOYAmt
EOY$33,757,493EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$77,030BOYAmt
EOY$77,030EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,200,451BOYAmt
EOY$11,232,684EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$228,432,529BOYAmt
EOY$242,150,281EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,811,861BOYAmt
EOY$10,585,815EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,153,800BOYAmt
EOY$1,122,358EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,430,917BOYAmt
EOY$8,911,820EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,396,578BOYAmt
EOY$20,619,993EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$205,069,587BOYAmt
EOY$220,408,597EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$910,007BOYAmt
EOY$1,062,772EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$56,357BOYAmt
EOY$58,919EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$206,035,951BOYAmt
EOY$221,530,288EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$228,432,529BOYAmt
EOY$242,150,281EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$16,186,220ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$559,856NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,251,739OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$17,071DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$11,479OtherActivitiesAmt
Total Lobbying Expenditures$28,550TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. The filing organization also conducted advocacy relating to education of legislative body regarding hospital and healthcare reform and how it impacts communities. The lobbying expense related to this activity is included on Line 1g.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,357BeginningYearBalanceAmt
Contributions$451ContributionsAmt
Investment Earnings Or Losses$2,111InvestmentEarningsOrLossesAmt
End Year Balance$58,919EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,700BeginningYearBalanceAmt
Investment Earnings Or Losses-$3,024InvestmentEarningsOrLossesAmt
Other Expenditures-$318OtherExpendituresAmt
Administrative Expenses-$1AdministrativeExpensesAmt
End Year Balance$56,357EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,878BeginningYearBalanceAmt
Investment Earnings Or Losses$4,213InvestmentEarningsOrLossesAmt
Other Expenditures-$1,391OtherExpendituresAmt
End Year Balance$59,700EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$44,871BeginningYearBalanceAmt
Contributions$521ContributionsAmt
Investment Earnings Or Losses$11,749InvestmentEarningsOrLossesAmt
Grants Or Scholarships-$263GrantsOrScholarshipsAmt
End Year Balance$56,878EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$48,147BeginningYearBalanceAmt
Investment Earnings Or Losses$384InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures-$3,660OtherExpendituresAmt
End Year Balance$44,871EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,352,921OtherCostOrOtherBasisAmt
Book Value$3,352,921BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,777,413OtherCostOrOtherBasisAmt
Depreciation$20,998,334DepreciationAmt
Book Value$19,779,079BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$390,703OtherCostOrOtherBasisAmt
Depreciation$345,837DepreciationAmt
Book Value$44,866BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$55,902,833OtherCostOrOtherBasisAmt
Depreciation$44,285,672DepreciationAmt
Book Value$11,617,161BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,237,812OtherCostOrOtherBasisAmt
Depreciation$952,976DepreciationAmt
Book Value$284,836BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$35,078,863TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDescAmtAmt
HPL/GL Liability$4,940,256
Fin 47 LT Asbestos Liab$1,752,540
Patient Credit Balances$934,556
Medicare/Medicaid Liabilities$396,533
Due to Affiliates$363,047
Due to BSHSI$362,555
Deferred Rent$138,397
Other Misc Liabilities$23,936
FieldValueIRS element (for citing)
Total Liability$8,911,820TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Earnings are used to assist the needy.
Part X, Line 2:Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. The System's taxable subsidiaries had approximately $89,895 and $84,748 of net operating loss carryforwards as of August 31, 2016 and 2015, respectively, which expire in varying periods through 2036 and are available to offset future taxable income. The System accounts for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to be in effect during the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Income tax liabilities are recorded for the impact of positions taken on income tax returns, which management believes are not more likely than not to be sustained on tax audit. Interest and penalties related to income taxes are accounted for as income tax expense. The System's deferred tax assets are fully reserved at August 31, 2016 and 2015 as the System considers it more likely than not that these amounts will not be recognized.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GolfEvent1Nm
Gross Receipts Event1$25,195GrossReceiptsEvent1Amt
Charitable Contri Event1$11,750CharitableContriEvent1Amt
Gross Revenue Event1$13,445GrossRevenueEvent1Amt
Rent Facility Costs Event1$17,834RentFacilityCostsEvent1Amt
Event2Holiday BrunchEvent2Nm
Gross Receipts Event2$6,970GrossReceiptsEvent2Amt
Gross Revenue Event2$6,970GrossRevenueEvent2Amt
Food And Beverage Event2$2,896FoodAndBeverageEvent2Amt
Gross Receipts Total$32,165GrossReceiptsTotalAmt
Charitable Contributions Tot$11,750CharitableContributionsTotAmt
Gross Revenue Total Events$20,415GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$17,834RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$2,896FoodAndBeverageTotalEventsAmt
Direct Expense Summary Events$20,730DirectExpenseSummaryEventsAmt
Net Income Summary-$315NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,664,157TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$137,960DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,526,197NetCommunityBenefitExpnsAmt
Total Expense0.00960TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,959,213TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,936,579DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,022,634NetCommunityBenefitExpnsAmt
Total Expense0.02520TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,623,370TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,074,539DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,548,831NetCommunityBenefitExpnsAmt
Total Expense0.03480TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs18ActivitiesOrProgramsCnt
Persons Served16305PersonsServedCnt
Total Community Benefit Expns$1,216,015TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,695DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,213,320NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served519PersonsServedCnt
Total Community Benefit Expns$336,554TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$336,554NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1988PersonsServedCnt
Total Community Benefit Expns$42,325TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$510DirectOffsettingRevenueAmt
Net Community Benefit Expns$41,815NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs7ActivitiesOrProgramsCnt
Persons Served8595PersonsServedCnt
Total Community Benefit Expns$318,172TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$318,172NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs28ActivitiesOrProgramsCnt
Persons Served27407PersonsServedCnt
Total Community Benefit Expns$1,913,066TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,205DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,909,861NetCommunityBenefitExpnsAmt
Total Expense0.01200TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs28ActivitiesOrProgramsCnt
Persons Served27407PersonsServedCnt
Total Community Benefit Expns$18,536,436TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,077,744DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,458,692NetCommunityBenefitExpnsAmt
Total Expense0.04680TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served25PersonsServedCnt
Total Community Benefit Expns$220TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$220NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served816PersonsServedCnt
Total Community Benefit Expns$15,414TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,414NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served841PersonsServedCnt
Total Community Benefit Expns$15,634TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,634NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$10,302,991BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$42,841,820ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$49,289,606CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,447,786MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12 Bernardine DrAddressLine1Txt
CityNewport NewsCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23602ZIPCd
FieldValueIRS element (for citing)
Website Addressbonsecours.comWebsiteAddressTxt
State LicenseH1873StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.000000000000FPGFamilyIncmLmtDscntCarePct
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.fa.bonsecours.comFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Mary Immaculate HospitalPart V, Section B, Line 5: Mary Immaculate Hospital (MIH) contracted with ToXcel to conduct an electronic survey of key stakeholders to determine the top healthcare needs of the community. MIH developed a list of key stakeholders who were asked to provide their viewpoints on important healthcare concerns in the community, significant gaps in the community, and ideas for addressing health concerns and service gaps. Stakeholders included individuals who have special knowledge and expertise in public health, as well as the deans of area colleges and universities with medical degree programs. In addition, MIH surveyed representatives of medically underserved, minority populations, and those with chronic conditions. MIH also conducted community forums to gather additional input from residents. Upon receipt of all information, MIH convened a community advisory board made up of 36 representatives from 40 organizations focused on community health, including Sentara and Riverside health systems and the Peninsula Health Department to review the list of key needs and gaps identified to prioritize the needs and make recommendations to MIH leadership.
Mary Immaculate HospitalPart V, Section B, Line 11: Through development of an implementation plan from the CHNA, Mary Immaculate Hospital (MIH) identified the health priorities in the related service areas. MIH has an open medical staff with privileges available to all qualified physicians. The MIH emergency department provides service 24 hours/day, 7 days/week to ensure access for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located.MIH offers health services via the Care-A-Van (CAV). The CAV is a free mobile medical service that provides general medical care to uninsured adults and children in Newport News, as well as Norfolk, Portsmouth, and Suffolk. Services provided include urgent and primary care (including examination, diagnosis, lab, pharmacy, and follow-up), immunizations for school, pregnancy tests, blood pressure measurement, health education, referrals for specialty care, and opportunity to enroll eligible children in children's health insurance. The Care-A-Van also offers sports physicals and health education services. While the CAV primarily serves adults, some sites provide care and referral services for children aged 12 and older. Community partners include free clinics, local health agencies, physicians, and numerous faith-based organizations which collaborate with CAV staff. Over 900 patient visits were rendered by the CAV in Newport News and over $9,000 in lab services were provided at no cost to the patient. The CAV has a staff of 11 FTEs and annual expenses of approximately $385,934.MIH offers support to qualified patients though the Life Coach Program. The Life Coach Program connects patients with no insurance, little resources, or no personal doctor with primary care resources to minimize their trips to the emergency room. These coaches work closely with the emergency department staff to find medical homes for patients who regularly use emergency rooms for non-emergency issues. Life Coaches help patients overcome social barriers to care, make follow up appointments, and obtain medications. If any patient meets the criteria for life coach services - low-income, lack of insurance and no regular source of primary care - life coaches call that person to provide information and offer assistance. They also help set up ongoing care with primary care physicians and the Care-A-Van, a mobile clinic operated by BSHR for the Norfolk area. MIH Life Coaches had 571 patient contacts, scheduled 246 appointments with primary care physicians, connected 136 patients with the Care-A-Van, assisted 46 patients with medication needs, and connected 280 patients with other community resources.Building healthier communities requires a systemic, ecological, multi-sector approach that acknowledges all of the social determinants of health such as housing, education, employment, public safety and social justice. MIH developed a partnership with Jim's Local Market, a restaurant in a Newport News/Hampton food desert, to provide nutritional education to residents. MIH offers the Bon Secours SeniorHealth Program which provides a free membership program to over 40,000 individuals 55 years and older. Lunch & Learn educational programs bring professionals from healthcare, the government, and the private sector in front of members for presentations and question/answer sessions six times a year. The annual Successful Aging Forum brings national speakers to discuss the latest health and wellness topics for senior citizens (over 500 people attended the event). A quarterly publication, Good Health, provides information to members in the Hampton Roads area. Seniors also play a vital role in BSHR's advocacy efforts against reductions in Medicaid payments and to support continued funding for the State Children Health Insurance Program (SCHIP) through the Bon Secours Advocates program. BSHR partnered with "As You Wish" Advanced Care Planning" to provide programming to seniors. MIH offers Home Health and Hospice Care. One-on-one care through the H2H (Hospital-to-Home) is provided to help patients recover from an illness or injury or to assist with daily living activities and pain management. Services include care coordination, physical therapies, diet education, intravenous therapy, medical/surgical care, nursing instruction, skilled clinical evaluation, and wound care. MIH is dedicated to promoting the health and the quality of life for the women of Hampton Roads through the women health service lines. MIH provides community health education seminars in cardiac, orthopedics, weight loss, acupuncture, sports performance, oncology, and stroke through the Bon Secours for Women program.MIH also offers free Community Education programs open to the public throughout Hampton Roads on health topics such as heart disease, diabetes, bone and joint conditions, women's health and other chronic diseases. Several seminars on clinical ethics were also offered to professionals in the area. MIH staff are dedicated to promoting the health and welfare of community through a variety of avenues including the United Way campaign. Bon Secours InMotion provided health screenings and presentations to approximately 1,700 people. Bon Secours Hampton Roads also partners with Virginia Supportive Housing to address the needs of the homeless. Within the community, there are other providers and organizations addressing mental health, employment, crime, transportation, community violence, education, dental health, alcohol/drugs, and access to social services with specialized programs and services and it would result in duplication of services if MIH were to address the need.
Mary Immaculate HospitalPart V, Section B, Line 13h: The facility approved free care for patients at or below 200% of the FPL. For patients above 200% of the FPL we utilize a sliding scale with no cap.
Mary Immaculate HospitalPart V, Section B, Line 16i: Information regarding the FAP is available on our websites, brochures are available at the time of registration. We have on site Counselors who can assist the patients. We have eligibility vendors who work with the patients and our statements indicate we have an FAP.
Mary Immaculate HospitalPart V, Section B, Line 22d: Bon Secours offers 75% discounts to all self-pay patients in the following markets: Virginia, South Carolina and Kentucky. We also offer an 80% discount to our patients in out New York Market.
Form 990, Schedule H, Part V, Section B, Line 14:The Community Service Adjustment was based on the average amounts paid by our insurance companies.
Form 990, Schedule H, Part V, Section B, Line 7a:https://bonsecours.com/hampton-roads/community-commitment/community-health-needs-assessment
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - In-Motion Boo Williams Sportsplex
5 Armistead Pointe ParkwayHamptonVA23666Physical Therapy
2 - Mary Immaculate Phys Therapy Victory
101-A Long Green BlvdYorktownVA23693Physical Therapy
3 - Mary Immaculate Phys Therapy Denbigh
14703 Warwick Blvd Suite BNewport NewsVA23608Physical Therapy
4 - Bon Secours Surgical Specialists
12720 McManus Blvd Ste 311Newport NewsVA23602Physician Practice
5 - Bon Secours Occumed
14703 Warwick Blvd Suite ANewport NewsVA23608Occupational Medicine
6 - Bon Secours Pulmonary Specialists
12720 McManus Blvd Ste 303Newport NewsVA23602Physician Practice

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:For patients with income above 200% of the FPG, the organization utilizes a sliding scale with no cap.
Part I, Line 6a:Annually, Bon Secours Hampton Roads Health System (BSHRHS) publishes a report for the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is available to the public each year on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours. This report is available online at https://bonsecours.com/hampton-roads.
Part I, Line 7:Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges captured in the patient accounting system and general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for non-patient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, Ln 7 Col(f):Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $10,302,991.
Part II, Community Building Activities:Bon Secours Mary Immaculate Hospital provided staff and resources in support of the Healthy Community Initiative of Bon Secours Health System, and advocated for local and state policies that would improve health across its communities. Bon Secours Hampton Roads has partnered with the Peninsula Health Department and the Peninsula Health Collaborative to address issues affecting the health of the community. Bon Secours Hampton Roads also partnered with the Greater Hampton Roads Coalition to develop a community dashboard that aggregates data for use in the CHNA and CHA processes.
Part III, Line 2:Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.
Part III, Line 3:The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.
Part III, Line 4:Please see Footnote "(2d) Accounts Receivable, net" discussing "accountsreceivable" on pages 12-13 in the attached BSHSI consolidated auditedfinancial statements ("AFS"). "Allowance for uncollectible accounts" isdiscussed in the second paragraph in Footnote "(10) Net Patient ServiceRevenue" on page 42-43 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS.
Part III, Line 8:Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and non-reimbursable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and non-reimbursable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service.In addition to the costs reported above, the organization incurred additional costs relating to Medicare support that are not includable in the Medicare Cost Report in the amount of: $349,529.
Part III, Line 9b:The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.
Part VI, Line 2:In partnership with Bon Secours Virginia Health System, Mary Immaculate Hospital (MIH) uses multiple approaches to assess the health needs of the communities it serves. Health care needs of the community are assessed and updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to MIH. National Research Corporation (NRC), Sg2 Analytics, and strategic market intelligence are also utilized.
Part VI, Line 3:Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self-pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non-partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4:Hampton Roads is a very diverse community within an MSA of over 1.7 million people residing in 16 cities and counties, stretching from northeastern North Carolina to Williamsburg. The area is characterized by racial diversity, a significant military population and a growing elderly population.The primary service area population served by Mary Immaculate Hospital (MIH), encompasses Newport News, Hampton, Williamsburg, and York County. The largest populations for the MIH service area are white (68.1%), Black or African American (23.3%), and small percentages of other groups. The median income for the MIH service area is $64,900. The City of Newport News has the highest rate of children living in poverty (25.8%) compared to Virginia (15.9%). York County has 7% of children living in poverty. The percentage of children living in single parent households (40.3%) is higher compared to Virginia (30%) and 35.8% of students are eligible for free lunch.The most prevalent chronic conditions among adults in the service area include high blood pressure (30.7%), asthma (7.9%), diabetes (8.3%), and smoking (20.5%). The leading causes of mortality in the MIH service area per 100,000 are heart disease (155), cerebrovascular disease (37.5), cancer (185.5), chronic lower respiratory diseases (65), diabetes (27.5), kidney disease (19) and septicemia (24.3). The infant mortality rate (per 1,000 live births) in the DMC service area is 10.8% compared to 6.4% in Virginia.
Part VI, Line 5:Mary Immaculate Hospital has an open medical staff with privileges available to all qualified physicians. Emergency departments at the three hospitals provide service 24 hours/day, 7 days/week to ensure access for emergency care for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located.
Part VI, Line 6:Bon Secours Health System, Inc., a Maryland nonprofit, non-stock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, non-stock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. BSHSI's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2016-2018). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents.- Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that the struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression.- Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSHSI and the SQP.
Part VI, Line 7, Reports Filed With StatesVA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Literacy For LifeBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 8795AddressLine1Txt
CityWilliamsburgCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23185ZIPCd
FieldValueIRS element (for citing)
Recipient EIN541085026RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$74,430CashGrantAmt
Purpose Of GrantHEAL ProgramPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Timothy Davis
Board Member$0$658,643$0$496,834$0$496,954$0$75,673$0$20,635$0$1,748,739$0$329,759
Michael Kerner
CEO - BSHR$0$559,739$0$403,723$0$158,448$0$93,156$0$31,817$0$1,246,883$0$91,467
Charmaine Rochester PhD
Treasurer/VP Finance$0$207,596$0$41,583$0$28,694$0$12,118$0$4,116$0$294,107$0$0
Darlene Stephenson
CEO - MIH$0$204,970$0$81,112$0$40,268$0$13,268$0$20,198$0$359,816$0$0
Herbert Cummings
COO - BSMG$0$237,395$0$64,499$0$206$0$10,600$0$27,505$0$340,205$0$0
Jeffrey Doucette
VP Patient Care Services$190,869$0$53,799$0$181$0$12,578$0$31,203$0$288,630$0$0$0
Vickie Humphries
VP of Human Resources$0$165,089$0$35,245$0$28,083$0$3,054$0$9,258$0$240,729$0$0
James McNamara
VP of Ortho$0$230,605$0$44,615$0$506$0$12,247$0$9,874$0$297,847$0$0
Terri Spence
VP & Regional CIO$0$225,003$0$43,560$0$491$0$3,975$0$10,476$0$283,505$0$0
Anthony Terracina MD
General Surgeon$498,974$0$563,236$0$1,221$0$13,250$0$32,355$0$1,109,036$0$0$0
Edward Pak
Internist$327,696$0$44,213$0$409$0$10,600$0$0$0$382,918$0$0$0
Thomas Hoffmier MD
Cardiologist$275,388$0$91,491$0$3,561$0$10,600$0$22,833$0$403,873$0$0$0
Nathanael Tilghman
Preventative Medicine$224,274$0$0$0$147$0$0$0$17,745$0$242,166$0$0$0
John Austin
Pharmacist$320,659$0$62,105$0$494$0$13,250$0$27,898$0$424,406$0$0$0
Patricia Robertson
Former Officer$0$309,884$0$172,647$0$50,955$0$15,900$0$12,289$0$561,675$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Line 4bThe filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Timothy Davis, $406,381; Michael Kerner, $112,117.

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution8ContributionCnt
Noncash Contributions Rpt F990$25,600NoncashContributionsRptF990Amt
Method Of Determining RevenuesCost or selling priceMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Column (b):FormAndLineReferenceDesc
ExplanationThe amount reported in Column (b) refers to the number of contributions.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The General Minister and General Council of the Bernardine Sisters of the Third order of St. Francis and Bon Secours Health System, Inc. are the members of Mary Immaculate Hospital.
Form 990, Part VI, Section A, line 7aThe governing body of Mary Immaculate Hospital is appointed by both members, with Bon Secours Health System, Inc. having the majority vote.
Form 990, Part VI, Section A, line 7bCertain authorities of Mary Immaculate Hospital are reserved to its members.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15bThe compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization makes all documents available to the general public upon request.
Form 990, Part VII - Additional Disclosure:Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. The governing bodies of Mary Immaculate Hospital and Mary Immaculate Nursing Care Center are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer). These governing bodies are referred to as the Mary Immaculate Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for both entities. Br. Art Caliman does not receive payroll distributions as he has taken a vow of poverty.
Form 990, Part XI, line 9:BSHSI Principal Debt & Swaps -1,206,089. Accrual Write-off -45,650.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Mary Immaculate Hospital Auxiliary
7007 Harbourview BlvdSuffolkVA23435546040266AuxiliaryVA501(c)(3)Line 9N/A0
Mary Immaculate Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435311644734FundraisingVA501(c)(3)Line 11c, III-FIYes (1)Mary Immaculate Hospital
Mary Immaculate Nursing Center
7007 Harbour View Blvd Suite 108SuffolkVA23435541516476Nursing Care CenterVA501(c)(3)Line 9Yes (1)Mary Immaculate Hospital
Bon Secours Hampton Roads Health System Inc
7007 Harbour View Blvd Suite 108SuffolkVA23435521538513Local System Parent Org.VA501(c)(3)Line 11c, III-FI0Bon Secours Health System Inc
Bon Secours Maryview Nursing Care Center
7007 Harbour View Blvd Suite 108SuffolkVA23435521578169Nursing Care CenterVA501(c)(3)Line 90Bon Secours Hampton Roads Health System
Bayley Properties
7007 Harbour View Blvd Suite 108SuffolkVA23435541424748RentalVA501(c)(2)0Bon Secours DePaul Medical Center
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)Line 11c, III-FI0Bon Secours Inc
Bon Secours DePaul Health Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435541843876FundraisingVA501(c)(3)Line 70Bon Secours Hampton Roads Health System
Bon Secours Maryview Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435521694731FundraisingVA501(c)(3)Line 70Bon Secours Hampton Roads Health System
Bon Secours DePaul Medical Center Inc
7007 Harbour View Blvd Suite 108SuffolkVA23435541820093HealthcareVA501(c)(3)Line 30Bon Secours Hampton Roads Health System
Maryview Hospital
7007 Harbour View Blvd Suite 108SuffolkVA23435540506463HealthcareVA501(c)(3)Line 30Bon Secours Hampton Roads Health System

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Province Place of Maryview LLC
One Bon Secours WayPortsmouthVA23703541842697Assisted LivingVAN/A
Province Place of DePaul LLC
6403 Granby StreetNorfolkVA23505541950880Assisted LivingVAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Professional Health Care Mgmt Inc
150 Kingsley LaneNorfolkVA23505541241031AdministrativeVAN/AC0
Tidewater Diversified Inc
160 Kingsley LaneNorfolkVA23505541431826PharmacyVAN/AC0
OSF Inc
2 Bernadine DriveNewport NewsVA23602541369919RentalVACYes (1)Mary Immaculate Hospital Inc$818,343$1,076,3901.00000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd