Mary Immaculate Hospital: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- Mary Immaculate Hospital (EIN 54-0548200)
- Tax period
- 2014-09-01 to 2015-08-31
- Filed
- 2016-07-12
- IRS object ID
- 201601949349301100
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-07-12T13:33:28-05:00 | ReturnTs |
| Tax Period End | 2015-08-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Deloitte Tax LLP 191 Peachtree St | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303031749 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540548200 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Immaculate Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARY | BusinessNameControlTxt |
| Phone | 7578866000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7007 Harbour View Blvd No 108 | AddressLine1Txt |
| City | Suffolk | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23435 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michael K Kerner | PersonNm |
| Person Title | CEO - BSHRHS | PersonTitleTxt |
| Phone | 7578866000 | PhoneNum |
| Signature | 2016-07-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | John W Sadoff Jr | PreparerPersonNm |
| PTIN | P00540589 | PTIN |
| Phone | 4042201500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bon Secours Mary Immaculate Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michael K Kerner | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7007 Harbour View Blvd No 108 | AddressLine1Txt |
| City | Suffolk | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23435 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $186,313,784 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://bshr.com/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | Acute Care Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 1104 | TotalEmployeeCnt |
| Total Volunteers | 108 | TotalVolunteersCnt |
| Total Gross UBI | $118,491 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,439 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,176,563 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,158,457 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $181,545,135 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $181,634,071 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,357,515 | PYInvestmentIncomeAmt |
| CY Investment Income | $918,732 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,148,022 | PYOtherRevenueAmt |
| CY Other Revenue | $2,555,403 | CYOtherRevenueAmt |
| PY Total Revenue | $186,227,235 | PYTotalRevenueAmt |
| CY Total Revenue | $186,266,663 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,376 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $25,184 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,954,329 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $54,062,489 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $114,440,032 | PYOtherExpensesAmt |
| CY Other Expenses | $113,744,164 | CYOtherExpensesAmt |
| PY Total Expenses | $169,405,737 | PYTotalExpensesAmt |
| CY Total Expenses | $167,831,837 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,821,498 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $18,434,826 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $210,958,735 | TotalAssetsBOYAmt |
| Total Assets EOY | $228,432,529 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,640,965 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,396,578 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $189,317,770 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $206,035,951 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $157,746,421 | ExpenseAmt |
| Grant | $25,184 | GrantAmt |
| Revenue | $181,530,573 | RevenueAmt |
| Desc | Mary 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. In the last year, 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 | $157,746,421 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 77 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1104 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | James Pirtle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7572152709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7007 Harbour View Blvd Suite 108 | AddressLine1Txt |
| City | Suffolk | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23435 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Michael Archuleta | ||||||||||
| Board Member (Jan-Aug) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Brother Arthur Caliman | ||||||||||
| Board Member | 2.00 | 48.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sister Elaine Davia | ||||||||||
| Board Member | 2.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||||
| Timothy Davis | ||||||||||
| Board Member | 2.00 | 48.00 | Yes (X) | $0 | $1,019,679 | $151,683 | ||||
| Debra Deihl | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gabriel Franco | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| John Garrett | ||||||||||
| Chairman (Sep-Dec) | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Rev Ivan Harris | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Matthew James | ||||||||||
| Board Member (Sep-Dec) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Vincent Joseph Dr | ||||||||||
| Board Member (Jan-Aug) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Deborah Jones | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Michael Kerner | ||||||||||
| CEO - BSHR | 15.00 | 35.00 | Yes (X) | $0 | $958,311 | $131,925 | Yes (X) | |||
| Sister Sandra Lyons | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sister Shaun Malone | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Helena Mock | ||||||||||
| Secretary (Jan-Aug) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Jeffrey Morrison DO | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sister David Niski | ||||||||||
| President | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| William Pile | ||||||||||
| Sec (Sep-Dec)/Chair (Jan-Aug) | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Joseph Ritchie | ||||||||||
| Board Member (Jan-Aug) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Caroline Sorokos | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Robert Yacobi | ||||||||||
| Board Member (Sep-Dec) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Charmaine Rochester | ||||||||||
| Treasurer/VP Finance | 15.00 | 35.00 | $0 | $243,142 | $16,388 | Yes (X) | ||||
| Patricia Robertson | ||||||||||
| CEO - MIH & Ext Care (Sep-Oct) | 45.00 | 5.00 | $0 | $442,986 | $27,267 | Yes (X) | ||||
| Darlene Stephenson | ||||||||||
| CEO - MIH (Oct-Aug) | 47.50 | 2.50 | $139,007 | $80,871 | $22,095 | Yes (X) | ||||
| Jeffrey Doucette | ||||||||||
| VP Patient Care Services | 50.00 | 0.00 | $216,851 | $0 | $40,798 | Yes (X) | ||||
| Anthony Terracina MD | ||||||||||
| General Surgeon | 50.00 | 0.00 | $1,091,989 | $0 | $41,480 | Yes (X) | ||||
| Thomas Hoffmier MD | ||||||||||
| Cardiologist | 50.00 | 0.00 | $353,928 | $0 | $31,944 | Yes (X) | ||||
| Leslie Webb MD | ||||||||||
| Cardiologist | 50.00 | 0.00 | $288,502 | $0 | $19,454 | Yes (X) | ||||
| Krishna Padiyar MD | ||||||||||
| Medical Director, Occ. Med. | 50.00 | 0.00 | $159,810 | $0 | $29,853 | Yes (X) | ||||
| John Austin | ||||||||||
| Pharmacy Clinical Specialist | 50.00 | 0.00 | $374,665 | $0 | $38,469 | Yes (X) | ||||
| James Sherwood | ||||||||||
| Former Key Employee | 0.00 | 0.00 | $0 | $102,699 | $11,733 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,624,752 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,847,688 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $563,089 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 33 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Morrison Management Specialists Inc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Dietary Services | $3,003,124 |
| Aramark CTS Inc | |||||
| 12483 Collections Ctr Dr | Chicago | IL | 60693 | Biomedical Engineering | $2,656,622 |
| Anesthesia Assoc of Hampton | |||||
| 110 Three Point Ct | Yorktown | VA | 23692 | Physician Services | $1,575,000 |
| Tidewater Physicians Multispecialty Grou | |||||
| 860 Omni Blvd Suite 401 | Newport News | VA | 23606 | Physician Services | $1,411,571 |
| Delta Locum Tenens LLC | |||||
| PO Box 202940 | Dallas | TX | 753202056 | Physician Services | $1,196,032 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 34 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $20,916 | FundraisingAmt |
| Related Organizations | $120,929 | RelatedOrganizationsAmt |
| Government Grants | $746,772 | GovernmentGrantsAmt |
| All Other Contributions | $269,840 | AllOtherContributionsAmt |
| Total Contributions | $1,158,457 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Rev. | 622110 | $181,620,388 | $181,516,890 | $103,498 |
| Bon Secours Ambulatory | 900099 | $13,683 | $13,683 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $181,634,071 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $404,805 | TotalRevenueColumnAmt |
| Exclusion | $404,805 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $67,472 | RealAmt |
| Personal | $5,667 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,409 | RealAmt |
| Personal | $4,345 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,063 | RealAmt |
| Personal | $1,322 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,385 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $14,993 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,392 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $470,027 | SecuritiesAmt |
| Other | $43,900 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $470,027 | SecuritiesAmt |
| Other | $43,900 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $513,927 | TotalRevenueColumnAmt |
| Exclusion | $513,927 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $17,280 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $20,916 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $27,367 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,087 | TotalRevenueColumnAmt |
| Exclusion | -$10,087 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Joint Venture Income | 900099 | $1,356,303 | $1,356,303 |
| Outpatient Pharmacy | 446110 | $546,077 | $546,077 |
| Managed Care Fee | 900099 | $186,327 | $186,327 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $423,398 | TotalRevenueColumnAmt |
| Exclusion | $423,398 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,512,105 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $186,266,663 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $181,530,573 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $118,491 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,459,142 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,184 | TotalAmt |
| Program Services | $25,184 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,496 | TotalAmt |
| Program Services | $321,747 | ProgramServicesAmt |
| Management And General | $35,749 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,691,411 | TotalAmt |
| Program Services | $38,422,270 | ProgramServicesAmt |
| Management And General | $4,269,141 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,071,540 | TotalAmt |
| Program Services | $1,864,386 | ProgramServicesAmt |
| Management And General | $207,154 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,141,932 | TotalAmt |
| Program Services | $4,627,739 | ProgramServicesAmt |
| Management And General | $514,193 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,800,110 | TotalAmt |
| Program Services | $3,420,099 | ProgramServicesAmt |
| Management And General | $380,011 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,042 | TotalAmt |
| Program Services | $113,438 | ProgramServicesAmt |
| Management And General | $12,604 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,793 | TotalAmt |
| Program Services | $3,414 | ProgramServicesAmt |
| Management And General | $379 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,776 | TotalAmt |
| Program Services | $28,598 | ProgramServicesAmt |
| Management And General | $3,178 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,930,698 | TotalAmt |
| Program Services | $8,930,698 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,676 | TotalAmt |
| Program Services | $6,008 | ProgramServicesAmt |
| Management And General | $668 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,430,527 | TotalAmt |
| Program Services | $1,287,474 | ProgramServicesAmt |
| Management And General | $143,053 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,644 | TotalAmt |
| Program Services | $137,380 | ProgramServicesAmt |
| Management And General | $15,264 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,505,968 | TotalAmt |
| Program Services | $3,155,371 | ProgramServicesAmt |
| Management And General | $350,597 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,604 | TotalAmt |
| Program Services | $158,044 | ProgramServicesAmt |
| Management And General | $17,560 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,240 | TotalAmt |
| Program Services | $24,516 | ProgramServicesAmt |
| Management And General | $2,724 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,552,407 | TotalAmt |
| Program Services | $1,552,407 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,214,802 | TotalAmt |
| Program Services | $5,593,322 | ProgramServicesAmt |
| Management And General | $621,480 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,946 | TotalAmt |
| Program Services | $967,451 | ProgramServicesAmt |
| Management And General | $107,495 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $46,009,544 | $46,009,544 | $0 |
| Purchased Services | $29,937,178 | $26,943,460 | $2,993,718 |
| Bad Debt Expense | $10,459,843 | $10,459,843 | $0 |
| BSHSI Mgmt Allocation | $3,337,137 | $3,003,423 | $333,714 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $767,339 | TotalAmt |
| Program Services | $690,605 | ProgramServicesAmt |
| Management And General | $76,734 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,831,837 | TotalAmt |
| Program Services | $157,746,421 | ProgramServicesAmt |
| Management And General | $10,085,416 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,205 | BOYAmt |
| EOY | $3,205 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,705,946 | BOYAmt |
| EOY | $125,894,712 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,203 | BOYAmt |
| EOY | $95,689 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,816,845 | BOYAmt |
| EOY | $19,591,336 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,501,002 | BOYAmt |
| EOY | $4,111,482 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,939 | BOYAmt |
| EOY | $462,509 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $96,209,513 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $61,952,336 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,874,083 | BOYAmt |
| EOY | $34,257,177 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,598,653 | BOYAmt |
| EOY | $32,738,938 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,069 | BOYAmt |
| EOY | $77,030 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,916,790 | BOYAmt |
| EOY | $11,200,451 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,958,735 | BOYAmt |
| EOY | $228,432,529 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,016,023 | BOYAmt |
| EOY | $11,811,861 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,306,144 | BOYAmt |
| EOY | $1,153,800 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,318,798 | BOYAmt |
| EOY | $9,430,917 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,640,965 | BOYAmt |
| EOY | $22,396,578 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,392,577 | BOYAmt |
| EOY | $205,069,587 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $865,493 | BOYAmt |
| EOY | $910,007 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,700 | BOYAmt |
| EOY | $56,357 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,317,770 | BOYAmt |
| EOY | $206,035,951 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,958,735 | BOYAmt |
| EOY | $228,432,529 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $18,434,826 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$614,649 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,101,996 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $18,714 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,062 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $31,776 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $59,700 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$3,024 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$318 | OtherExpendituresAmt |
| Administrative Expenses | $1 | AdministrativeExpensesAmt |
| End Year Balance | $56,993 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $56,877 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,213 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,390 | OtherExpendituresAmt |
| End Year Balance | $59,700 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $44,871 | BeginningYearBalanceAmt |
| Contributions | $521 | ContributionsAmt |
| Investment Earnings Or Losses | $11,749 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $263 | GrantsOrScholarshipsAmt |
| End Year Balance | $56,878 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $48,147 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $384 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,660 | OtherExpendituresAmt |
| End Year Balance | $44,871 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $50,349 | BeginningYearBalanceAmt |
| Other Expenditures | $2,202 | OtherExpendituresAmt |
| End Year Balance | $48,147 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,352,921 | OtherCostOrOtherBasisAmt |
| Book Value | $3,352,921 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,800,091 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,876,736 | DepreciationAmt |
| Book Value | $16,923,355 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $390,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $292,945 | DepreciationAmt |
| Book Value | $97,758 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,349,976 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,836,625 | DepreciationAmt |
| Book Value | $12,513,351 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,315,822 | OtherCostOrOtherBasisAmt |
| Depreciation | $946,030 | DepreciationAmt |
| Book Value | $1,369,792 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,257,177 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| MedMal & Gen Liab | $4,933,253 |
| Fin 47 LT Asbestos Liab | $1,763,479 |
| Patient Credit Balances | $1,110,204 |
| Due to BSHSI | $728,486 |
| Due to Affiliates | $365,718 |
| Medicare/Medicaid Liabilities | $330,826 |
| Deferred Rent and Other | $197,996 |
| Unclaimed Prop Liab | $955 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,430,917 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. The System's taxable subsidiaries have approximately $84,748 and $61,513 of net operating loss carryforwards as of August 31, 2015 and 2014, respectively, which expire in varying periods through 2035 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2015 and 2014 as the System considers it more likely than not that these amounts will not be recognized. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf | Event1Nm |
| Gross Receipts Event1 | $31,803 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $14,523 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $17,280 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $22,597 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,770 | OtherDirectExpensesEvent1Amt |
| Event2 | Gala | Event2Nm |
| Gross Receipts Event2 | $6,393 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $6,393 | CharitableContriEvent2Amt |
| Gross Receipts Total | $38,196 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,916 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $17,280 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $22,597 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,770 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $27,367 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$10,087 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,330,348 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $110,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,219,933 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,793,310 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,772,017 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,021,293 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01920 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,123,658 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,882,432 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,241,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02700 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 20 | ActivitiesOrProgramsCnt |
| Persons Served | 35401 | PersonsServedCnt |
| Total Community Benefit Expns | $1,073,859 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,071,634 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 563 | PersonsServedCnt |
| Total Community Benefit Expns | $200,368 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $200,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 19 | PersonsServedCnt |
| Total Community Benefit Expns | $1,218 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 8015 | PersonsServedCnt |
| Total Community Benefit Expns | $301,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $301,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 32 | ActivitiesOrProgramsCnt |
| Persons Served | 43998 | PersonsServedCnt |
| Total Community Benefit Expns | $1,577,395 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,575,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 32 | ActivitiesOrProgramsCnt |
| Persons Served | 43998 | PersonsServedCnt |
| Total Community Benefit Expns | $16,701,053 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,884,657 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,816,396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03700 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $172 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $172 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 410 | PersonsServedCnt |
| Total Community Benefit Expns | $3,753 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,753 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 410 | PersonsServedCnt |
| Total Community Benefit Expns | $3,925 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,925 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,459,843 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $44,790,907 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $50,120,559 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,329,652 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Immaculate Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 Bernardine Dr | AddressLine1Txt |
| City | Newport News | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23602 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://bshr.com | WebsiteAddressTxt |
| State License | H1873 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Immaculate Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://bshr.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://bshr.com | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Mary Immaculate Hospital | Part V, Section B, Line 5: Mary Immaculate Hospital (MIH) contracted with Community Health Solutions (CHS) to conduct an electronic survey of key stakeholder 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 met with representatives from the Peninsula Health Center to review the key findings from the survey and seek additional input. Upon receipt of all information, MIH convened a small group to review the list of key needs and gaps identified to prioritize the needs using criteria developed against which to evaluate each need. |
| Mary Immaculate Hospital | Part V, Section B, Line 11: Through development of an implementation plan from the previous CHNA, MIH identified the health priorities in the related service areas. Mary Immaculate Hospital (MIH) has an open medical staff with privileges available to all qualified physicians. Emergency departments at MIH provide 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 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 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 Portsmouth, Suffolk, and Norfolk. 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, 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. CAV staff had 841 patient contacts in Newport News with over $5,695 in lab services provided at no cost to the patient. The CAV has a staff of 11 FTEs and annual expenses of approximately $247,000.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 help set up ongoing care at federally subsidized clinics or with the Care-A-Van, a mobile clinic operated by Bon Secours Hampton Roads Health System for the Newport News area. MIH Life Coaches had 1391 patient contacts, scheduled 423 appointments with primary care physicians, assisted 74 patients with medication needs, and connected 201 patients with other community resources. Within the community, there are other providers and organizations addressing dental care/oral health and tobacco use with specialized programs and services and it would result in duplication of services if Mary Immaculate Hospital (MIH) were to address the need. MIH currently provides comprehensive diabetes education with weekly education sessions covering understanding diabetes, nutrition, foot care, exercise, and medication. MIH also has a comprehensive community-based program in place to address domestic violence through parenting education programs that offer positive learning opportunities for parents, child development, age-appropriate expectations, and health and safety issues as it relates to children from birth through the teenage years. |
| Mary Immaculate Hospital | Part 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 Hospital | Part V, Section B, Line 16i: Information regarding the FAP is available on our websites and 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 Hospital | Part 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. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Mary Immaculate Hospital Part V, Section B, line 16b website: | http://bshr.com |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Mary Immaculate Phys Therapy Denbigh | ||||
| 14703 Warwick Blvd Suite B | Newport News | VA | 23608 | Physical Therapy |
| In-Motion Boo Williams Sportsplex | ||||
| 5 Armistead Pointe Parkway | Hampton | VA | 23666 | Physical Therapy |
| Mary Immaculate Phys Therapy Victory | ||||
| 101-A Long Green Blvd | Yorktown | VA | 23693 | Physical Therapy |
| Cardiovascular Specialists | ||||
| 12720 McManus Blvd Ste 201 | Newport News | VA | 23602 | Physician Practice |
| Bon Secours Surgical Specialists | ||||
| 12720 McManus Blvd Ste 311 | Newport News | VA | 23602 | Physician Practice |
| Bon Secours Pulmonary Specialists | ||||
| 12720 McManus Blvd Ste 303 | Newport News | VA | 23602 | Physician Practice |
| Bon Secours Occumed | ||||
| 14703 Warwick Blvd Suite A | Newport News | VA | 23608 | Occupational Medicine |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 www.bshr.org. |
| 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 nonpatient 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: $10,459,843. |
| Part I, Line 3b: | For patients with income above 200% of the FPG, the organization utilizes a sliding scale with no cap. |
| Part II, Community Building Activities: | Bon Secours Mary Immaculate Hospital provided facility space, dietary contributions and staff support to local community boards, coalitions, and civic groups to discuss and address health and social concerns across the community. These meetings enabled various community groups to plan programs and activities to improve the health of community residents across different health and social conditions. In addition, Mary Immaculate is working with other community organizations to address the homeless issue in the Newport News area. |
| 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 "accounts receivable" on pages 11-12 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for uncollectible accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 45 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 nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable 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: $507,753. |
| 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 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 Mary Immacualte Hospital. 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: | As of 2014, 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. African Americans comprise 48% of the population in Hampton, 40% in Newport News, 2% in Poquoson, 16% in Williamsburg, 14% in York County and 14% in James City County. Seniors currently in Bon Secours Mary Immaculate Hospital's (Mary Immaculate) service area account for 20.6% of the population, growing by 16.5% within the next five years. The primary service area population served by Mary Immaculate, Newport News, VA, is estimated to change from 425,449 to 439,307 with a projected growth of 2.4% over the next five years. Currently the largest populations are white (55%), Black or African American (32%), Hispanic or Latino (6%) and Asian (3%). The current year median age for this area is 37.6. The most prevalent chronic conditions among adults within Mary Immaculate's market include high blood pressure (39%), smokers (26.5%), high cholesterol (24.5%), arthritis (20.9%), depression/anxiety disorder (16.6%), and allergies (15.3%). Morbidity rates per 10,000: heart disease (92.0), cerebrovascular disease (25.3), chronic obstructive pulmonary disease (10.1), diabetes (12.0) and asthma (10.0). Mortality rates (age-adjusted per 100,000) for the state of Virginia are cancer (169.5), ischemic heart disease (161.3), cerebrovascular disease (41.4) and chronic obstructive pulmonary disease (38.4). |
| Part VI, Line 5: | Mary Immaculate Hospital (MIH) has an open medical staff with privileges available to all qualified physicians. The emergency department at the hospital provides service 24 hours/ day, 7days/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 supports and provides staffing for the BSHRHS Faith Community Health Ministry which builds on the skills of the registered nurse through additional, structured training in holistic (body, mind and spirit) health services; the faith community nurse partners with the congregational leadership to promote good health by serving as an educator, counselor, referral agent and advocate. Specialized training has also been developed to prepare non-licensed persons to serve in congregational health ministry. Additionally, the Influenza Vaccination Administration program provided 600 vaccines for select covenanted partners to host annual vaccine clinics. BSHR employs a sole Director to provide education, mentoring and support to more than 136 faith communities and 199 registered nurses and lay health promoters.MIH Family Focus provides an array of services to families, which include parent education classes, support groups for parents and caregivers, the Al's Pal's preschool program, and parent-child interactive learning groups. Additional programs are available for Hispanic parents, (Circulo de Padres Hispanos at First Baptist Church and St. George's Episcopal). Family Focus also includes programs to prevent child abuse, which targets at-risk families and helps teach positive parenting skills. MIH employs the director for the program and provides operating funds. Family Focus, founded by BSHSI and the Bernardine Sisters of the Third Order of St. Francis, is a broad coalition of private and public organizations that provide a continuum of education, prevention and support programming for over 500 families to encourage healthy child development and nurturing environments in the home and community. Three main goals direct all the Family Focus programs and activities: to reduce parent isolation by increasing parent-to-parent support and linking families to valuable community resources, to increase parents' knowledge of childhood behaviors and development through parent education, to promote positive nurturing parenting practices. MIH offers the Bon Secours SeniorHealth Program which provides a free membership program to 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. The MIH SeniorHealth transportation program provided transportation for 1,059 patients to medical appointments. A quarterly publication, Good Health, provides information to 48,000 members in Hampton Roads area. Seniors also play a vital role in BSHRHS' 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. MIH is dedicated to promoting the health and the quality of life for the women of Hampton Roads through the women health service lines. We provide community health education seminars in cardiac, orthopedics, weight loss, acupuncture, sports performance, oncology, and stroke through the Bon Secours for Women program. |
| Part VI, Line 6: | Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock 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. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to: - Improve Health Locally and Globally- Build Partnerships for Population Health 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. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations. |
| Part VI, Line 7, Reports Filed With States | VA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Rita Welsh Adult Literacy Program Inc | |||||||
| PO Box 8795 | Williamsburg | VA | 23185 | 541085026 | 501(C)(3) | $15,000 | Literacy for Life Heal Program Implementation |
| Makemie Woods Camp | |||||||
| PO Box 39 | Barhamsville | VA | 23011 | 540636036 | 501(C)(3) | $10,184 | Bereavement Camp for Children |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Timothy Davis | ||||||||||||||
| Board Member | $0 | $617,514 | $0 | $191,208 | $0 | $210,957 | $0 | $132,084 | $0 | $19,599 | $0 | $1,171,362 | $0 | $135,985 |
| Michael Kerner | ||||||||||||||
| CEO - BSHR | $0 | $527,082 | $0 | $221,442 | $0 | $209,787 | $0 | $101,956 | $0 | $29,969 | $0 | $1,090,236 | $0 | $125,798 |
| Charmaine Rochester | ||||||||||||||
| Treasurer/VP Finance | $0 | $195,153 | $0 | $47,816 | $0 | $173 | $0 | $12,271 | $0 | $4,117 | $0 | $259,530 | $0 | $0 |
| Patricia Robertson | ||||||||||||||
| CEO - MIH & Ext Care (Sep-Oct) | $0 | $291,541 | $0 | $100,199 | $0 | $51,246 | $0 | $15,600 | $0 | $11,667 | $0 | $470,253 | $0 | $0 |
| Darlene Stephenson | ||||||||||||||
| CEO - MIH (Oct-Aug) | $131,561 | $40,196 | $0 | $40,496 | $7,446 | $179 | $2,157 | $1,662 | $14,583 | $3,693 | $155,747 | $86,226 | $0 | $0 |
| Jeffrey Doucette | ||||||||||||||
| VP Patient Care Services | $171,031 | $0 | $45,038 | $0 | $782 | $0 | $11,358 | $0 | $29,440 | $0 | $257,649 | $0 | $0 | $0 |
| Anthony Terracina MD | ||||||||||||||
| General Surgeon | $488,994 | $0 | $601,404 | $0 | $1,591 | $0 | $13,000 | $0 | $28,480 | $0 | $1,133,469 | $0 | $0 | $0 |
| Thomas Hoffmier MD | ||||||||||||||
| Cardiologist | $265,165 | $0 | $84,919 | $0 | $3,844 | $0 | $10,400 | $0 | $21,544 | $0 | $385,872 | $0 | $0 | $0 |
| Leslie Webb MD | ||||||||||||||
| Cardiologist | $287,912 | $0 | $0 | $0 | $590 | $0 | $13,000 | $0 | $6,454 | $0 | $307,956 | $0 | $0 | $0 |
| Krishna Padiyar MD | ||||||||||||||
| Medical Director, Occ. Med. | $144,837 | $0 | $0 | $0 | $14,973 | $0 | $8,450 | $0 | $21,403 | $0 | $189,663 | $0 | $0 | $0 |
| John Austin | ||||||||||||||
| Pharmacy Clinical Specialist | $300,453 | $0 | $73,334 | $0 | $878 | $0 | $10,400 | $0 | $28,069 | $0 | $413,134 | $0 | $0 | $0 |
| James Sherwood | ||||||||||||||
| Former Key Employee | $0 | $60,330 | $0 | $0 | $0 | $42,369 | $0 | $1,485 | $0 | $10,248 | $0 | $114,432 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee |
| Part I, Line 4b | The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and 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, $181,617; Michael Kerner, $164,862. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The 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 7a | The 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 7b | Certain authorities of Mary Immaculate Hospital are reserved to its members. |
| Form 990, Part VI, Section B, line 11 | The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). |
| Form 990, Part VI, Section B, line 15b | The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. |
| Form 990, Part VI, Section C, line 19 | The filing organization 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 -1,010,222. Transfer Goodwill Impairment -4,039. Pension Defined Benefit Transaction -62,735. MIHA Contributions -25,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mary Immaculate Hospital Auxiliary | |||||||||||
| 7007 Harbourview Blvd | Suffolk | VA | 23435 | 546040266 | Auxiliary | VA | 501(c)(3) | Line 9 | N/A | 0 | |
| Mary Immaculate Foundation | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 311644734 | Fundraising | VA | 501(c)(3) | Line 11c, III-FI | Yes (1) | Mary Immaculate Hospital | |
| Mary Immaculate Nursing Center | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 541516476 | Nursing Care Center | VA | 501(c)(3) | Line 9 | Yes (1) | Mary Immaculate Hospital | |
| Bon Secours Hampton Roads Health System Inc | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 521538513 | Local System Parent Org. | VA | 501(c)(3) | Line 11c, III-FI | 0 | Bon Secours Health System Inc | |
| Bon Secours Maryview Nursing Care Center | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 521578169 | Nursing Care Center | VA | 501(c)(3) | Line 9 | 0 | Bon Secours Hampton Roads Health System | |
| Bayley Properties | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 541424748 | Rental | VA | 501(c)(2) | 0 | Bon Secours DePaul Medical Center | ||
| Bon Secours Health System Inc | |||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org. Management Services | MD | 501(c)(3) | Line 11c, III-FI | 0 | Bon Secours Inc | |
| Bon Secours DePaul Health Foundation | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 541843876 | Fundraising | VA | 501(c)(3) | Line 7 | 0 | Bon Secours Hampton Roads Health System | |
| Bon Secours Maryview Foundation | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 521694731 | Fundraising | VA | 501(c)(3) | Line 7 | 0 | Bon Secours Hampton Roads Health System | |
| Bon Secours DePaul Medical Center Inc | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 541820093 | Healthcare | VA | 501(c)(3) | Line 3 | 0 | Bon Secours Hampton Roads Health System | |
| Maryview Hospital | |||||||||||
| 7007 Harbour View Blvd Suite 108 | Suffolk | VA | 23435 | 540506463 | Healthcare | VA | 501(c)(3) | Line 3 | 0 | Bon Secours Hampton Roads Health System | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Province Place of Maryview LLC | |||||||
| One Bon Secours Way | Portsmouth | VA | 23703 | 541842697 | Assisted Living | VA | N/A |
| Province Place of DePaul LLC | |||||||
| 6403 Granby Street | Norfolk | VA | 23505 | 541950880 | Assisted Living | VA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Professional Health Care Mgmt Inc | |||||||||||||
| 150 Kingsley Lane | Norfolk | VA | 23505 | 541241031 | Administrative | VA | N/A | C | 0 | ||||
| Tidewater Diversified Inc | |||||||||||||
| 160 Kingsley Lane | Norfolk | VA | 23505 | 541431826 | Pharmacy | VA | N/A | C | 0 | ||||
| OSF Inc | |||||||||||||
| 2 Bernadine Drive | Newport News | VA | 23602 | 541369919 | Rental | VA | C | Yes (1) | Mary Immaculate Hospital Inc | $78,082 | $1,128,615 | 1.00000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |