ST MARY'S HOSPITAL FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST MARY'S HOSPITAL FOUNDATION (EIN 23-7001007)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-03
- IRS object ID
- 201643089349301194
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-03T14:08:00-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237001007 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 9702981954 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2635 N 7TH STREET | AddressLine1Txt |
| City | GRAND JUNCTION | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81502 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARMEN SHIPLEY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9702981954 | PhoneNum |
| Signature | 2016-11-03 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARMEN SHIPLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2635 N 7TH STREET | AddressLine1Txt |
| City | GRAND JUNCTION | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81502 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,543,559 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STMARYGJ.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 28 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 64 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,211,489 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,023,716 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $218,765 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $197,446 | CYProgramServiceRevenueAmt |
| PY Investment Income | $316,838 | PYInvestmentIncomeAmt |
| CY Investment Income | $187,934 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$64,320 | PYOtherRevenueAmt |
| CY Other Revenue | -$33,625 | CYOtherRevenueAmt |
| PY Total Revenue | $4,682,772 | PYTotalRevenueAmt |
| CY Total Revenue | $4,375,471 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,103,024 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,697,560 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,685,807 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,975,757 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $9,200 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $602,984 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,231,876 | PYOtherExpensesAmt |
| CY Other Expenses | $1,121,390 | CYOtherExpensesAmt |
| PY Total Expenses | $4,029,907 | PYTotalExpensesAmt |
| CY Total Expenses | $4,794,707 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $652,865 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$419,236 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,462,636 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,458,421 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $654,482 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,069,504 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,808,154 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,388,917 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OFTHE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POORAND VULNERABLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,758,953 | ExpenseAmt |
| Grant | $1,697,560 | GrantAmt |
| Revenue | $197,446 | RevenueAmt |
| Desc | SEE SCHEDULE "O" | Desc |
| Total Program Service Expenses | $3,758,953 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (1) | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 28 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KYLE ENGMAN | PersonNm |
| Phone | 3038135543 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 ELDORADO BLVD SUITE 4200 | AddressLine1Txt |
| City | BROOMFIELD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| CAROL ACUFF | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN ALVILLAR | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAKE AUBERT | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT BENJAMIN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM BLANCHARD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH BREMAN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAUN BURNS | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TERRI CHINN | ||||||||
| DIRECTOR/SMHMC VP FINANCE | 1.00 | 50.00 | Yes (X) | $0 | $285,900 | $49,714 | ||
| BRIAN DAVIDSON MD | ||||||||
| DIRECTOR/SMHMC INTERIM CEO | 1.00 | 50.00 | Yes (X) | $0 | $369,769 | $69,764 | ||
| FRANK DESANTIS | ||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ROY ERB MD | ||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ED FORSMAN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE HUERKAMP | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JACKIE HUNT | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN JONES MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD KAUL | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD KELLER | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JENNIFER LANDINI | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW MAYER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL MCBRIDE | ||||||||
| DIRECTOR/UNTIL SEPT. | 1.00 | 50.00 | Yes (X) | $0 | $729,680 | $166,145 | ||
| SARA PEREIRA MD | ||||||||
| DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $690,364 | $42,759 | ||
| JAY SEATON | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHELLE SHIAO | ||||||||
| DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $120,737 | $30,645 | ||
| CARMEN SHIPLEY CFRE | ||||||||
| EXECUTIVE DIRECTOR FOUNDATION | 50.00 | 0.00 | Yes (X) | $0 | $108,063 | $21,049 | Yes (X) | |
| MATTHEW SWELSTAD MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| VANCE WAGNER | ||||||||
| CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CANDICE WALTON | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN WITWER MD | ||||||||
| DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $1,204,955 | $37,573 | ||
| LEEANN ZETMEIR | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FOREST BINDER | ||||||||
| FORMER OFFICER | 0.00 | 50.00 | $0 | $344,665 | $70,895 | Yes (X) | ||
| ROBERT LADENBURGER | ||||||||
| FORMER OFFICER | 0.00 | 50.00 | $0 | $703,851 | $12,600 | Yes (X) | ||
| MARTY JACOBSON | ||||||||
| FORMER HIGHEST PAID | 0.00 | 50.00 | $0 | $121,347 | $27,964 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,679,331 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $529,108 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $27,172 | FederatedCampaignsAmt |
| Fundraising | $294,720 | FundraisingAmt |
| Related Organizations | $1,093,964 | RelatedOrganizationsAmt |
| Government Grants | $1,222,868 | GovernmentGrantsAmt |
| All Other Contributions | $1,384,992 | AllOtherContributionsAmt |
| Noncash Contributions | $101,028 | NoncashContributionsAmt |
| Total Contributions | $4,023,716 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GRAY GOURMET | Desc |
| Business | 624210 | BusinessCd |
| Total Revenue Column | $197,446 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $197,446 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $197,446 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $214,049 | TotalRevenueColumnAmt |
| Exclusion | $214,049 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $26,115 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$26,115 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$26,115 | TotalRevenueColumnAmt |
| Exclusion | -$26,115 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $108,348 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $294,720 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $141,973 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$33,625 | TotalRevenueColumnAmt |
| Exclusion | -$33,625 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,375,471 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $197,446 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $154,309 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,697,560 | TotalAmt |
| Program Services | $1,697,560 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,112 | TotalAmt |
| Program Services | $55,479 | ProgramServicesAmt |
| Management And General | $56,848 | ManagementAndGeneralAmt |
| Fundraising | $16,785 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,390,602 | TotalAmt |
| Program Services | $1,112,065 | ProgramServicesAmt |
| Management And General | $97,759 | ManagementAndGeneralAmt |
| Fundraising | $180,778 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,988 | TotalAmt |
| Program Services | $41,053 | ProgramServicesAmt |
| Management And General | $8,338 | ManagementAndGeneralAmt |
| Fundraising | $15,597 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,003 | TotalAmt |
| Program Services | $199,234 | ProgramServicesAmt |
| Management And General | $27,168 | ManagementAndGeneralAmt |
| Fundraising | $56,601 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,052 | TotalAmt |
| Program Services | $72,914 | ProgramServicesAmt |
| Management And General | $11,367 | ManagementAndGeneralAmt |
| Fundraising | $23,771 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,936 | TotalAmt |
| Program Services | $183,107 | ProgramServicesAmt |
| Management And General | $183,107 | ManagementAndGeneralAmt |
| Fundraising | $54,722 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,545 | TotalAmt |
| Program Services | $394 | ProgramServicesAmt |
| Management And General | $394 | ManagementAndGeneralAmt |
| Fundraising | $31,757 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,350 | TotalAmt |
| Program Services | $12,400 | ProgramServicesAmt |
| Management And General | $12,400 | ManagementAndGeneralAmt |
| Fundraising | $17,550 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,929 | TotalAmt |
| Program Services | $42,929 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,143 | TotalAmt |
| Program Services | $18,881 | ProgramServicesAmt |
| Management And General | $18,881 | ManagementAndGeneralAmt |
| Fundraising | $122,381 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,141 | TotalAmt |
| Program Services | $2,066 | ProgramServicesAmt |
| Management And General | $2,065 | ManagementAndGeneralAmt |
| Fundraising | $1,010 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| FOOD-GRAY GOURMET | $312,405 | $289,443 | $0 | $22,962 |
| BANK CHARGES | $49,446 | $7,417 | $9,889 | $32,140 |
| NON-MEDICAL SUPPLIES | $27,411 | $504 | $0 | $26,907 |
| MAINTENANCE SERVICES | $12,725 | $12,725 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,359 | TotalAmt |
| Program Services | $10,782 | ProgramServicesAmt |
| Management And General | $4,554 | ManagementAndGeneralAmt |
| Fundraising | $23 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,794,707 | TotalAmt |
| Program Services | $3,758,953 | ProgramServicesAmt |
| Management And General | $432,770 | ManagementAndGeneralAmt |
| Fundraising | $602,984 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $854,007 | BOYAmt |
| EOY | $848,838 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $975,216 | BOYAmt |
| EOY | $937,238 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,100 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,100 | BOYAmt |
| EOY | $90,100 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,495,969 | BOYAmt |
| EOY | $13,460,044 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,344 | BOYAmt |
| EOY | $122,201 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,462,636 | BOYAmt |
| EOY | $15,458,421 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,812 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,482 | BOYAmt |
| EOY | $1,056,692 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,482 | BOYAmt |
| EOY | $1,069,504 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,619,004 | BOYAmt |
| EOY | $9,808,806 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,833,901 | BOYAmt |
| EOY | $4,217,915 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $355,249 | BOYAmt |
| EOY | $362,196 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,808,154 | BOYAmt |
| EOY | $14,388,917 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,462,636 | BOYAmt |
| EOY | $15,458,421 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$419,236 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840425720 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $1,697,560 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $1,697,560 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,887,364 | BeginningYearBalanceAmt |
| Contributions | $142,535 | ContributionsAmt |
| Investment Earnings Or Losses | $127,160 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $458,622 | OtherExpendituresAmt |
| End Year Balance | $8,698,437 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,632,352 | BeginningYearBalanceAmt |
| Contributions | $130,991 | ContributionsAmt |
| Investment Earnings Or Losses | $416,575 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $292,554 | OtherExpendituresAmt |
| End Year Balance | $8,887,364 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,949,114 | BeginningYearBalanceAmt |
| Contributions | $69,271 | ContributionsAmt |
| Investment Earnings Or Losses | $941,428 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $327,461 | OtherExpendituresAmt |
| End Year Balance | $8,632,352 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,419,628 | BeginningYearBalanceAmt |
| Contributions | $924,523 | ContributionsAmt |
| Investment Earnings Or Losses | $686,603 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $81,640 | OtherExpendituresAmt |
| End Year Balance | $7,949,114 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,462,683 | BeginningYearBalanceAmt |
| Contributions | $168,214 | ContributionsAmt |
| Investment Earnings Or Losses | $50,698 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $261,967 | OtherExpendituresAmt |
| End Year Balance | $6,419,628 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.95840 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.04160 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,100 | OtherCostOrOtherBasisAmt |
| Book Value | $20,100 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $70,000 | InvestmentCostOrOtherBasisAmt |
| Book Value | $70,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $90,100 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| GIFT ANNUITIES | $924,782 |
| INTERCOMPANY PAYABLES | $131,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,056,692 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | ENDOWMENT FUNDS ARE HELD BY THE ST. MARY'S HOSPITAL FOUNDATION FOR THE BENEFIT OF ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. BOARD ENDOWMENT - QUASI-ENDOWMENT FUNDS ARE USED FOR AREAS OF GREATEST NEED AS DETERMINED BY SENIOR LEADERSHIP OF ST. MARY'S HOSPITAL & MEDICAL CENTER,INC. CUMMINGS FAMILY ENDOWMENT - QUASI-ENDOWMENT FUND TO ASSIST CANCER PATIENTS WITH NON-MEDICAL EXPENSES. SACCOMANNO RESEARCH INSTITUTE - QUASI-ENDOWMENT FUND DEDICATED TO RESEARCH. BRUCE E. DIXSON PULMONARY REHABILITATION ENDOWMENT - ASSIST LOW INCOME PULMONARY PATIENTS WITH NON-MEDICAL EXPENSES. WORLEY FAMILY INFECTION CONTROL ENDOWMENT -- SUPPORT OF INFECTION CONTROL SERVICES. DR. LYNN JAMES PULMONARY ENDOWMENT - ASSIST LOW INCOME PULMONARY PATIENTS WITH NON-MEDICAL EXPENSES. SUPPORT OF ST. MARY'S ASSOCIATES WITH PULMONARY SERVICES EDUCATION. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ST. MARY'S BALL | Event1Nm |
| Gross Receipts Event1 | $280,509 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $220,918 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $59,591 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $1,194 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $37,414 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $46,488 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $6,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $18,255 | OtherDirectExpensesEvent1Amt |
| Event2 | FASHION SHOW | Event2Nm |
| Gross Receipts Event2 | $65,889 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $38,827 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $27,062 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $2,770 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $14,254 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $735 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $4,703 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $56,670 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $34,975 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $21,695 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $4,272 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $812 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $4,487 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $589 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $403,068 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $294,720 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $108,348 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $8,236 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $52,480 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $51,710 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $6,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $23,547 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $141,973 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$33,625 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2635 N 7TH STREET | AddressLine1Txt |
| City | GRAND JUNCTION | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81502 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 840425720 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,697,560 | CashGrantAmt |
| Purpose Of Grant | CAPITAL & OPERATIONS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | UPON APPROVAL OF THE TRANSFER OF FUNDS FROM THE ST. MARY'S HOSPITAL FOUNDATION TO ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., THE ST. MARY'S HOSPITAL FINANCE DEPARTMENT RECORDS THE FUNDS TO THE PROPER DEPARTMENT WITHIN THE HOSPITAL FOR USE AS AN OFFSET TO THE EXPENSES THAT HAVE BEEN INCURRED, OR TO CAPITAL. THE TRANSFERS ARE RECONCILED BETWEEN THE HOSPITAL AND THE FOUNDATION QUARTERLY. THE RECONCILIATIONS ARE REVIEWED BY MANAGERS AT THE HOSPITAL AND SYSTEM OFFICE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TERRI CHINN | ||||||||||||||
| DIRECTOR/SMHMC VP FINANCE | $0 | $248,431 | $0 | $33,381 | $0 | $4,088 | $0 | $40,377 | $0 | $9,337 | $0 | $335,614 | $0 | $0 |
| BRIAN DAVIDSON MD | ||||||||||||||
| DIRECTOR/SMHMC INTERIM CEO | $0 | $343,763 | $0 | $17,938 | $0 | $8,068 | $0 | $46,995 | $0 | $22,769 | $0 | $439,533 | $0 | $0 |
| MICHAEL MCBRIDE | ||||||||||||||
| DIRECTOR/UNTIL SEPT. | $0 | $377,336 | $0 | $83,509 | $0 | $268,835 | $0 | $148,928 | $0 | $17,217 | $0 | $895,825 | $0 | $0 |
| SARA PEREIRA MD | ||||||||||||||
| DIRECTOR | $0 | $637,088 | $0 | $49,300 | $0 | $3,976 | $0 | $16,430 | $0 | $26,329 | $0 | $733,123 | $0 | $0 |
| MICHELLE SHIAO | ||||||||||||||
| DIRECTOR | $0 | $113,751 | $0 | $6,304 | $0 | $682 | $0 | $6,836 | $0 | $23,809 | $0 | $151,382 | $0 | $0 |
| BRIAN WITWER MD | ||||||||||||||
| DIRECTOR | $0 | $865,856 | $0 | $335,678 | $0 | $3,421 | $0 | $19,080 | $0 | $18,493 | $0 | $1,242,528 | $0 | $0 |
| FOREST BINDER | ||||||||||||||
| FORMER OFFICER | $0 | $286,066 | $0 | $46,368 | $0 | $12,231 | $0 | $48,954 | $0 | $21,941 | $0 | $415,560 | $0 | $0 |
| ROBERT LADENBURGER | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $0 | $703,851 | $0 | $0 | $0 | $12,600 | $0 | $716,451 | $0 | $0 |
| MARTY JACOBSON | ||||||||||||||
| FORMER HIGHEST PAID | $0 | $108,798 | $0 | $9,064 | $0 | $3,485 | $0 | $8,322 | $0 | $19,642 | $0 | $149,311 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. |
| PART I, LINES 4A-B | SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE ORGANIZATION AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO FORMER EMPLOYEES. THE AMOUNTS PAID TO LISTED INDIVIDUALS FOR SEVERANCE IN 2015 WERE; ROBERT LADENBURGER - $696,280. SCHEDULE J, PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THE AMOUNTS ARE VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE VESTED IN THE CURRENT YEAR, ARE CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. NO CASH PAYMENT IS MADE DIRECTLY TO THE PARTICIPANT AND THE REMAINING BENFIT AMOUNT STAYS IN THE RETIREMENT PLAN. THERE WERE NO AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2015. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2015. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2015 WERE: MICHAEL MCBRIDE, $194,604. IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(III). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(III) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E. |
| PART I, LINE 7 | OTHER NON-FIXED PAYMENTS THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF OPERATING INCOME AND OTHER PLAN PERFORMANCE STANDARDS. AWARDS ARE BASED ON HOW WELL THE HEALTH CARE SYSTEM OR THE CARE SITE PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED BY THE CARE SITE CEO OR THE HEALTH CARE SYSTEM SERVICES SENIOR EXECUTIVE LEADERSHIP TEAM FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE PATIENT EXPERIENCE, PATIENT SAFETY, EMPLOYEE SAFETY, COMMUNITY BENEFIT AND OPERATING INCOME. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. |
| ADDITIONAL OFFICER AND BOARD DISCLOSURES | THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF NINE HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES. SCLHS AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 19 | ContributionCnt |
| Noncash Contributions Rpt F990 | $78,421 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | APPRAISAL | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $2,567 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 38 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,786 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | VARIOUS GIFTS AND SERVICES | Desc |
| Contribution | 17 | ContributionCnt |
| Noncash Contributions Rpt F990 | $15,253 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 1 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 PART III, 4A-4D | ST. MARY'S HOSPITAL FOUNDATION 2015 THE ORGANIZATION'S PROGRAM SERVICE ACCOMPLISHMENTS: THE PROMISE OF HEALTHCARE PHILANTHROPY IS THE ABILITY TO CHANGE LIVES AND THE POWER TO SAVE LIVES. THE ST. MARY'S HOSPITAL FOUNDATION DEVELOPS THE RESOURCES THAT HELP KEEP AND EXPAND THIS PROMISE TO THE PEOPLE WHO TRUST ST. MARY'S HOSPITAL AND MEDICAL CENTER, INC., TO CARE FOR THEM. IT IS COMMITTED TO ADVANCING THE PROMISE OF LIFE THROUGH PHILANTHROPY. THE FOUNDATION'S FUNDRAISING EFFORTS ENSURE THAT THE HOSPITAL IS ABLE TO MEET THE COMMUNITY'S HEALTHCARE NEEDS. MAJOR AREAS OF SUPPORT IN 2015 INCLUDED: ROSE HILL HOSPITALITY HOUSE ROSE HILL HOUSE REFLECTS THE COMPASSION AND GENEROSITY OF OUR COMMUNITY BY PROVIDING A FREE, COMFORTABLE, HOME-LIKE SETTING WHERE FAMILIES CAN HAVE A REST FROM THE OFTEN CRITICAL CONCERNS ASSOCIATED WITH THE HEALTH OF A LOVED ONE. PATIENTS COME TO ST. MARY'S FROM MANY DISTANT PLACES TO RECEIVE MEDICAL ASSISTANCE OFTEN NOT AVAILABLE OUTSIDE OF GRAND JUNCTION. ST. MARY'S HOSPITAL FOUNDATION RECOGNIZES THE IMPORTANCE OF MEETING THE NEEDS OF FAMILY AND FRIENDS SUPPORTING A LOVED ONE IN THE HEALING PROCESS. IN 2015, THE FOUNDATION RAISED $137,937 IN CONTRIBUTIONS FOR ROSE HILL HOUSE. THE HOUSE WELCOMED 2,078 GUESTS FROM 39 DIFFERENT STATES AND 5 FOREIGN COUNTRIES WITH AN AVERAGE LENGTH OF STAY OF 4.7 NIGHTS. CANCER SURVIVORSHIP PROGRAM THE ST. MARY'S HOSPITAL FOUNDATION ALSO FINANCIALLY SUPPORTS ST. MARY'S CANCER SURVIVORSHIP PROGRAM. ST. MARY'S IS PROUD TO OFFER A COMPREHENSIVE CANCER SURVIVORSHIP PROGRAM FOR PATIENTS FROM DIAGNOSIS, THROUGH TREATMENT, AND BEYOND. AS HEALTHCARE CHANGES, WE HAVE IDENTIFIED THE NEED FOR NOT ONLY PREVENTATIVE MEDICINE, BUT TO PROVIDE HOLISTIC CARE TO OUR PATIENTS. THE CANCER SURVIVORSHIP PROGRAM EDUCATES, SUPPORTS, AND EMPOWERS THOSE AFFECTED BY CANCER TO TAKE CHARGE OF THEIR HEALTH SO THEY CAN TRULY THRIVE. SURVIVORSHIP EMBRACES THE PHYSICAL, EMOTIONAL, SOCIAL, SPIRITUAL, AND ECONOMIC ASPECTS OF LIFE THAT MAY BE INFLUENCED BY CANCER, PROVIDING A VARIETY OF SERVICES FOR CANCER PATIENTS AND THEIR FAMILY INCLUDING: ART EXPLORATION CLASSES, SUPPORT GROUPS, CANCER EDUCATION AND SCREENING EVENTS, A RESOURCE LIBRARY, EQUINE THERAPY, PATIENT ADVISORY TEAMS, REHABILITATION, THERAPEUTIC MASSAGE, AND NUTRITION AND EXERCISE RETREATS. IN 2015, ST. MARY' HOSPITAL FOUNDATION RECEIVED CONTRIBUTIONS TOTALING OVER $124,000 TO THE SURVIVORSHIP PROGRAM, ASSISTING APPROXIMATELY 4,500 CANCER SURVIVORS. SENIOR PROGRAMS ST. MARY'S HOSPITAL FOUNDATION IS PROUD TO SPONSOR THE FOSTER GRANDPARENT, SENIOR COMPANION, AND GRAY GOURMET PROGRAMS. THE FOSTER GRANDPARENT PROGRAM (FGP) IS A SUCCESSFUL NATIONWIDE VOLUNTEER PROGRAM THAT HELPS ACTIVE SENIORS USE THEIR EXPERIENCE TO IMPROVE THE LIVES OF CHILDREN IN THE CLASSROOM. IN 2015, FGP SERVED 1600 AT-RISK CHILDREN IN TWO COUNTIES. THROUGH A FEDERALLY FUNDED PROGRAM, THE FOSTER GRANDPARENT PROGRAM IS ABLE TO PAY SENIOR VOLUNTEERS AN HOURLY NON-TAXABLE STIPEND. SENIOR COMPANIONS PROVIDE SUPPORT AND FRIENDSHIP TO THOSE WHO NEED ASSISTANCE WITH GROCERY SHOPPING, ERRANDS, AND OTHER EVERYDAY TASKS NECESSARY TO MAINTAINING INDEPENDENCE. WITHOUT THIS HELP, MANY OLDER ADULTS WOULD BE FORCED TO LEAVE THEIR HOMES FOR ASSISTED LIVING FACILITIES OR NURSING HOMES. IN MESA COUNTY, SENIORS 60 YEARS AND OLDER CAN RECEIVE HELP AND FRIENDSHIP THROUGH ST. MARY'S SENIOR COMPANION PROGRAM. IN 2015, 294 SENIORS WERE ASSISTED BY SENIOR COMPANIONS. LASTLY, THE ST. MARY'S FOUNDATION RAISES FUNDS TO SUPPORT GRAY GOURMET, A HOSPITAL AND GOVERNMENT SPONSORED PROGRAM TO PROVIDE NOURISHING MEALS TO THE HOMEBOUND AND TO OTHERS THAT ARE IN NEED. PROGRAM REVENUE ASSOCIATED WITH THE PROGRAM REPRESENTS A VOLUNTARY CO-PAYMENT FOR THE MEALS AND IS NOT A REQUIREMENT FOR RECEIVING A MEAL. IN 2015, GRAY GOURMET SERVED 21,000 MEALS WITH OVER 50 VOLUNTEERS PER DAY ASSISTING. |
| FORM 990, PART V, LINE 1A | EXPLANATION FOR NUMBER REPORTED IN BOX 3 OF FORM 1096: THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED. |
| FORM 990, PART V, LINE 2A | EXPLANATION FOR NUMBER REPORTED ON FORM W-3: THE ORGANIZATION LEASES EMPLOYEES FROM A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED W-3 AND RELATED W-2 TAX FORMS FOR THESE INDIVIDUALS. ACCORDING TO THE FORM 990 INSTRUCTIONS FOR PART IX, WE REFLECT THE LEASED EMPLOYEE'S COMPENSATION ON THE FORM 990, PART IX AS IF THE ORGANIZATION COMPENSATES THESE INDIVIDUALS. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OR STOCKHOLDERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., (SMHMC) IS THE SOLE MEMBER OF ST. MARY'S HOSPITAL FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | POWER TO ELECT OR APPOINT MEMBERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., THE SOLE MEMBER OF ST. MARY'S HOSPITAL FOUNDATION, APPOINTS MEMBERS OF ST. MARY'S HOSPITAL FOUNDATION BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. |
| FORM 990, PART VI, SECTION B, LINE 11 | PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY. ST. MARY'S HOSPITAL FOUNDATION AND THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (COLLECTIVELY REFERRED TO AS SCL HEALTH), REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCLHS' PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS SUGGESTIVE OF A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: * BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; * SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); * EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); * MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; * DEPARTMENT DIRECTORS AND MANAGERS; AND * OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR EXECUTIVE INTEGRITY AND COMPLIANCE COMMITTEE, THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. |
| FORM 990, PART VI, SECTION B, LINE 15 | FORM 990, PART VI, SECTION B (POLICIES) LINES 15(A) & 15(B) THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, SECTION B | INDEPENDENT CONTRACTORS THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC | |||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 237379161 | MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES | KS | 501(C)(3) | LINE 11C, III-FI | N/A | 0 | |
| INTEGRITY HEALTH | |||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 474520350 | SUPPORTING ORGANIZATION | CO | 501(C)(3) | LINE 11C, III-FI | 0 | SCLHS | |
| BRIGHTON COMMUNITY HOSPITAL ASSOCIATION | |||||||||||
| 1600 PRAIRIE CENTER PARKWAY | BRIGHTON | CO | 80601 | 840482695 | HOSPITAL SERVICES | CO | 501(C)(3) | LINE 3 | 0 | INTEGRITY HEALTH | |
| PLATTE VALLEY MEDICAL CENTER FOUNDATION | |||||||||||
| 1600 PRAIRIE CENTER PARKWAY | BRIGHTON | CO | 80601 | 742255936 | SUPPORTING ORGANIZATION | CO | 501(C)(3) | LINE 11A, I | 0 | BRIGHTON COMMUNITY HOSPITAL ASSOCIATION | |
| MOUNT ST VINCENT HOME INC | |||||||||||
| 4159 LOWELL BOULEVARD | DENVER | CO | 80211 | 840405260 | RESIDENT CARE | CO | 501(C)(3) | LINE 9 | 0 | SCLHS | |
| NJH-SJH INC | |||||||||||
| 500 ELDORADO BLVD SUITE 4300 | DENVER | CO | 80211 | 471194849 | MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES | CO | 501(C)(3) | LINE 11A, I | 0 | SCLHS | |
| SAINT JOSEPH HOSPITAL INC | |||||||||||
| 1375 E 19TH AVENUE | DENVER | CO | 80218 | 840417134 | HOSPITAL SERVICES | CO | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| SAINT JOSEPH HOSPITAL FOUNDATION | |||||||||||
| 1375 E 19TH AVENUE | DENVER | CO | 80218 | 840735096 | SUPPORTING ORGANIZATION | CO | 501(C)(3) | LINE 11A, I | 0 | SAINT JOSEPH HOSPITAL INC | |
| SCL HEALTH - FRONT RANGE INC | |||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 841103606 | HOSPITAL SERVICES | CO | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| GOOD SAMARITAN MEDICAL CENTER FOUNDATION | |||||||||||
| 200 EXEMPLA CIRCLE | LAFAYETTE | CO | 80026 | 841649162 | SUPPORT RELATED TAX EXEMPT ORGANIZATIONS | CO | 501(C)(3) | LINE 7 | 0 | SCL HEALTH-FRONT RANGE INC | |
| LUTHERAN MEDICAL CENTER FOUNDATION | |||||||||||
| 8300 WEST 38TH AVENUE | WHEAT RIDGE | CO | 80033 | 208846152 | SUPPORT RELATED TAX EXEMPT ORGANIZATIONS | CO | 501(C)(3) | LINE 7 | 0 | SCL HEALTH-FRONT RANGE INC | |
| ST MARYS HOSPITAL & MEDICAL CENTER INC | |||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81501 | 840425720 | HOSPITAL SERVICES | CO | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| CARITAS CLINICS INC | |||||||||||
| 818 NORTH 7TH STREET | LEAVENWORTH | KS | 66048 | 481009910 | CLINIC SERVICES | KS | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| MARIAN CLINIC INC | |||||||||||
| 3164 EAST SIXTH AVENUE | TOPEKA | KS | 66607 | 481046905 | CLINIC SERVICES | KS | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| ST FRANCIS HEALTH CENTER INC | |||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 480547719 | HOSPITAL SERVICES | KS | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| ST FRANCIS HEALTH CENTER FOUNDATION | |||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 481092520 | SUPPORTING ORGANIZATION | KS | 501(C)(3) | LINE 11A, I | 0 | ST FRANCIS HEALTH CENTER INC | |
| HOLY ROSARY HEALTHCARE | |||||||||||
| 2600 WILSON STREET | MILES CITY | MT | 59301 | 810231792 | HOSPITAL SERVICES | MT | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| HOLY ROSARY HEALTHCARE FOUNDATION INC | |||||||||||
| 2600 WILSON STREET | MILES CITY | MT | 59301 | 202270238 | SUPPORTING ORGANIZATION | MT | 501(C)(3) | LINE 11A, I | 0 | HOLY ROSARY HEALTHCARE | |
| ST JAMES HEALTHCARE | |||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 810231785 | HOSPITAL SERVICES | MT | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| ST JAMES HEALTHCARE FOUNDATION INC | |||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 651202190 | SUPPORTING ORGANIZATION | MT | 501(C)(3) | LINE 11A, I | 0 | ST JAMES HEALTHCARE | |
| ST VINCENT HEALTHCARE | |||||||||||
| 1233 NORTH 30TH STREET | BILLINGS | MT | 59101 | 810232124 | HOSPITAL SERVICES | MT | 501(C)(3) | LINE 3 | 0 | SCLHS | |
| ST VINCENT HEALTHCARE FOUNDATION INC | |||||||||||
| 1106 NORTH 30TH STREET | BILLINGS | MT | 59101 | 810468034 | SUPPORT RELATED TAX EXEMPT ORGANIZATIONS | MT | 501(C)(3) | LINE 7 | 0 | ST VINCENT HEALTHCARE | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| DENVER WEST ENDOSCOPY CENTER LLC | |||||||
| 382 S ARTHUR AVENUE | LOUISVILLE | CO | 80027 | 460788218 | OP ENDOSCOPY | CO | N/A |
| EKG INTERPRETATION SERVICE | |||||||
| 3464 S WILLOW STREET SUITE 111 | DENVER | CO | 80231 | 840927945 | EKG INTERPRETATION | CO | N/A |
| GRAND VALLEY SURGICAL CENTER LLC | |||||||
| 710 WELLINGTON | GRAND JUNCTION | CO | 81501 | 841505075 | OP SURGERY | CO | N/A |
| HEALTHCARE MANAGEMENT LLC | |||||||
| PO BOX 1929 | GRAND JUNCTION | CO | 81502 | 841238904 | MANAGEMENT SERVICES | CO | N/A |
| LUTHERAN CAMPUS ASC LLC | |||||||
| 3455 LUTHERAN PKWY STE 150 | WHEATRIDGE | CO | 80033 | 020749532 | OP SURGERY | CO | N/A |
| PAVILION IMAGING LLC | |||||||
| 750 WELLINGTON | GRAND JUNCTION | CO | 81501 | 030516198 | RADIOLOGY | CO | N/A |
| SAN JUAN CANCER CENTER LLC | |||||||
| 600 SOUTH 5TH STREET | MONTROSE | CO | 81401 | 202856331 | OP CANCER | CO | N/A |
| SMHMMH AIR MEDICAL TRANSPORT LLC | |||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 473525381 | MEDICAL AIR TRANSPORT | CO | N/A |
| SCL HOME HEALTH SOLUTIONS LLC | |||||||
| 500 ELDORADO BLVD SUITE 4200 | BROOMFIELD | CO | 80021 | 462418729 | HOME CARE | DE | N/A |
| SCLTDI JV LLC | |||||||
| 5214 MARYLAND WAY SUITE 200 | BRENTWOOD | TN | 37027 | 472294770 | RADIOLOGY | DE | N/A |
| ATHLETIC MEDICINE & PERFORMANCE LLC | |||||||
| 1144 NORTH 28TH STREET | BILLINGS | MT | 59101 | 272270640 | PHYSICAL THERAPY | MT | N/A |
| MED-MAP LLC | |||||||
| PO BOX 1295 | BILLINGS | MT | 59103 | 810491356 | RENTAL REAL ESTATE | MT | N/A |
| NORTHERN ROCKIES HEALTHCARE ALLIANCE LLC | |||||||
| 2475 VILLAGE LANE SUITE 302 | BILLINGS | MT | 59102 | 383978770 | MEDICAL PROVIDER NETWORK | MT | N/A |
| YELLOWSTONE SURGERY CENTER LLC | |||||||
| 1144 NORTH 28TH STREET | BILLINGS | MT | 59101 | 721519467 | OP SURGERY | MT | N/A |
| CODY MEDICAL ARTS COMPLEX LLC | |||||||
| 720 LINDSAY LANE | CODY | WY | 82414 | 331031839 | RENTAL REAL ESTATE | WY | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| APEX SURGICAL PARTNERS INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 2 | BRIGHTON | CO | 80601 | 473268324 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| EAGLE RIDGE MEDICAL INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 2 | BRIGHTON | CO | 80601 | 462387681 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| HIGH PLAINS HEART AND VASCULAR CENTER INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 3 | BRIGHTON | CO | 80601 | 272038197 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| INTEGRATIVE INTERNAL MEDICINE AND MEDICAL ACUPUNCTURE INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 3 | BRIGHTON | CO | 80601 | 274433325 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| MOUNTAIN VIEW ORTHOPEDICS INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 1 | BRIGHTON | CO | 80601 | 275382523 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| PVMC MEDICAL TEAM INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 2 | BRIGHTON | CO | 80601 | 473988808 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| PVMC PHYSICIAN SERVICES INC | ||||||||||||||
| 1606 PRAIRIE CENTER PARKWAY SUITE 2 | BRIGHTON | CO | 80601 | 943458548 | MEDICAL SERVICES | CO | N/A | C | 0 | |||||
| CARITAS INC AND SUBSIDIARIES | ||||||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 480941069 | HEALTHCARE | KS | N/A | C | 0 | |||||
| PROVIDENCE MEDICAL CENTER INC | ||||||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 480784446 | HOSPITAL SERVICES | KS | N/A | C | 0 | |||||
| SAINT JOHN HOSPITAL INC | ||||||||||||||
| 500 ELDORADO BLVD SUITE 4300 | BROOMFIELD | CO | 80021 | 480543768 | HOSPITAL SERVICES | KS | N/A | C | 0 | |||||
| ST FRANCIS ACCOUNTABLE HEALTH NETWORK INC | ||||||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 462874128 | HEALTHCARE | KS | N/A | C | 0 | |||||
| LEAVEN INSURANCE COMPANY LTD | ||||||||||||||
| 980370522 | INSURANCE | N/A | C | 0 | 23 LIME TREE BAY AVENUE WEST BAY R | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |