2016-06-27T14:27:57-05:00 2015-08-31 990 2014-09-01 134290167 St Francis Physician Services Inc STFR 8642551000 One St Francis Drive Greenville SC 29601 Ronnie Hyatt CFO - BSSFHS 8642551000 2016-06-27 0 2014 2016-09-27 15:27:22Z Bon Secours Express Care Craig McCoy One St Francis Drive Greenville SC 29601 148130242 0 X www.stfrancishealth.org X 2004 SC Primary, urgent, and specialty care 12 4 1504 4 0 0 0 1267436 141898266 144816860 0 0 44550 2045946 141942816 148130242 0 0 0 0 133493379 141589706 0 0 0 51084274 54394705 184577653 195984411 -42634837 -47854169 33421446 36648425 255669533 306750679 -222248087 -270102254 X 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. St. Francis Physician Services, Inc. serves this mission as the vehicle for physician employment relationships in the Bon Secours St. Francis Health System, Inc. 0 0 178482168 145323836 St. Francis Physician Services, Inc. (SFPS) operates as an affiliate model in the provision of services to the residents of Greenville, South Carolina and the surrounding communities including primary care, urgent care, and various specialties. A member of Bon Secours St. Francis Health System, Inc., SFPS continues to expand to meet the needs of the community residents. The various practices that comprise SFPS are strategically located with the area to most effectively meet the needs of the community. 178482168 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 304 0 1 1504 1 0 0 0 0 0 0 0 0 0 0 X 12 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Ronnie Hyatt CFO 8642551000 One St Francis Drive Greenville SC 29601 X Katherine Arbuckle Board Member (Jan-Aug) 0.50 2.00 X 0 0 0 Thomas Baumgarten MD Board Member 50.00 0.00 X 1426455 0 43859 Stacy Bizzell MD Board Member (Sep-Dec) 50.00 0.00 X 346085 0 39015 Brother Peter Campbell CFX Board Member (Sep-Dec) 0.50 2.00 X 0 0 0 Mark Grabarczyk MD Board Member (Jan-Aug) 50.00 0.00 X 595415 0 41374 Camilla Hertwig Board Member 0.50 3.00 X 0 0 0 Fletcher Kirkland Jr Board Member 0.50 2.00 X 0 0 0 Craig McCoy CEO-BSSFHS (Jun-Aug) 8.00 42.00 X 0 0 0 Wayne McDonald MD Chairman 0.50 2.00 X X 0 0 0 Thomas Morris PhD President 0.50 49.50 X X 0 436432 59475 Raana Naidu MD Board Member 50.00 0.00 X 318254 0 22702 Mark Nantz CEO - BSSFHS (Sep-Jun) 10.00 40.00 X 0 898579 117360 Steven Newman MD Board Member 50.00 0.00 X 323538 0 33644 Anselmo Nunez MD CEO - SFPS 49.90 0.10 X X 0 501615 17601 James Wallace MD Board Member 50.00 0.00 X 528757 0 44002 Daniel Duggan COO (Sep-Dec) 8.00 42.00 X 0 437442 34303 Ronnie Hyatt Treasurer/CFO - BSSFHS 8.00 42.00 X 0 587104 33508 Courtney Ouzts Secretary 50.00 0.00 X 61369 0 28311 Cheryl Fairley VP - Network Operations 50.00 0.00 X 0 209843 27486 John Vann MD Surgeon 50.00 0.00 X 1526267 0 43874 Christopher Kavolus MD Surgeon 50.00 0.00 X 1464014 0 46080 John Womack III Surgeon 50.00 0.00 X 1027905 0 43386 James Jennings MD Surgeon 50.00 0.00 X 1371348 0 41613 Michael Tollison MD Surgeon 50.00 0.00 X 1141545 0 43392 Scott Pietras Former EVP 0.00 0.00 X 0 252898 26654 10130952 3323913 787639 216 1 1 0 United Allergy Services 100 NE Loop 410 Ste 200 San Antonio TX 78216 Lab Services 1130555 Godshall & Godshall PO Box 1984 Greenville SC 29602 Contract Labor 695130 Barton Associates 10 Dearborn Rd Peabody MA 01960 Contract Labor 693415 Allscripts 24630 Network Place Chicago IL 60673 Equip Maint Services 665064 Spartanburg Regional Medical Center 101 E Wood St Spartanburg SC 29303 Radiology/Oncology Services 662992 16 1267436 1267436 Net Patient Svc Rev. 621110 144816860 144816860 144816860 244774 0 244774 244774 244774 Clinical Research 900099 506976 506976 Medical Directorships 900099 384475 384475 Refunds 900099 347619 347619 562102 562102 1801172 148130242 145323836 0 1538970 4092546 3683291 409255 114788738 103309864 11478874 3808201 3427381 380820 12252190 11026971 1225219 6648031 5983228 664803 310749 279674 31075 2796372 2796372 342876 308588 34288 1751700 1576530 175170 1198024 1078222 119802 13221460 11899314 1322146 565728 509155 56573 86123 77511 8612 259422 259422 997704 897934 99770 2468297 2221467 246830 Medical Supplies 10853427 10853427 Purchased Services 9821294 8839165 982129 Bad Debt 4558424 4558424 Medical Equip Rental 2494339 2494339 2668766 2401889 266877 195984411 178482168 17502243 0 39541 50600 10288513 10708755 63593 76653 4926031 6759019 799781 297625 0 502156 18103768 18551242 33421446 36648425 9728318 14584484 245941215 292166195 255669533 306750679 X -222248087 -270102254 -222248087 -270102254 33421446 36648425 X -47854169 2 X 0 1 X 1 0 X 1267436 1267436 107982858 133976483 142262334 141898266 144816860 670936801 107982858 133976483 142262334 141898266 146084296 672204237 0 0 0 672204237 244774 244774 244774 244774 438698 281533 100921 54105 1801172 2676429 108421556 134258016 142363255 141952371 148130242 675125440 0.99570 0.99780 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 799781 297625 502156 502156 LT Non-Cash HPL/GL 13790728 Misc A/R - Phys Services 4673371 Non-Compete 87143 18551242 Due to BSHSI 278260463 HPL/GL Liability 13790728 LT Deferred Rent 115004 292166195 X 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. X 0 0 1 1 0 0 0 0 0 0 0 Thomas Baumgarten MD Board Member 735758 0 686348 0 4349 0 15600 0 28259 0 1470314 0 0 0 Stacy Bizzell MD Board Member (Sep-Dec) 219427 0 125013 0 1645 0 12893 0 26122 0 385100 0 0 0 Mark Grabarczyk MD Board Member (Jan-Aug) 593172 0 0 0 2243 0 15600 0 25774 0 636789 0 0 0 Thomas Morris PhD President 0 297010 0 95892 0 43530 0 39792 0 19683 0 495907 0 16418 Raana Naidu MD Board Member 222573 0 90239 0 5442 0 13440 0 9262 0 340956 0 0 0 Mark Nantz CEO - BSSFHS (Sep-Jun) 0 619520 0 178094 0 100965 0 94520 0 22840 0 1015939 0 46250 Steven Newman MD Board Member 216682 0 105314 0 1542 0 6750 0 26894 0 357182 0 0 0 Anselmo Nunez MD CEO - SFPS 0 377117 0 106368 0 18130 0 2203 0 15398 0 519216 0 0 James Wallace MD Board Member 304309 0 218794 0 5654 0 15600 0 28402 0 572759 0 0 0 Daniel Duggan COO (Sep-Dec) 0 319223 0 45334 0 72885 0 15600 0 18703 0 471745 0 18206 Ronnie Hyatt Treasurer/CFO - BSSFHS 0 343822 0 46077 0 197205 0 15600 0 17908 0 620612 0 82875 Cheryl Fairley VP - Network Operations 0 189185 0 19265 0 1393 0 10623 0 16863 0 237329 0 0 John Vann MD Surgeon 827148 0 688012 0 11107 0 15600 0 28274 0 1570141 0 0 0 Christopher Kavolus MD Surgeon 842711 0 613714 0 7589 0 15600 0 30480 0 1510094 0 0 0 John Womack III Surgeon 412712 0 613527 0 1666 0 15600 0 27786 0 1071291 0 0 0 James Jennings MD Surgeon 829570 0 534397 0 7381 0 15600 0 26013 0 1412961 0 0 0 Michael Tollison MD Surgeon 810432 0 326764 0 4349 0 15600 0 27792 0 1184937 0 0 0 Scott Pietras Former EVP 0 29378 0 0 0 223520 0 3289 0 23365 0 279552 0 37838 Part I, Line 1a Tax indemnification and gross-up: Certain full time individuals (1) listed on Form 990, Part VII received gift cards valued at $10. The value of the gift cards were reported as taxable compensation. In an effort to reduce the tax impact of these gifts, each recipient received additional taxable compensation of $7 which was added to their paycheck. 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, Lines 4a-b Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: Scott Pietras, $131,544. The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Daniel Duggan, $20,658; Ronnie Hyatt, $136,535; Thomas Morris, PhD, $20,852; Mark Nantz, $57,876; Scott Pietras, $45,742. Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of St. Francis Physician Services, Inc. Form 990, Part VI, Section A, line 7a The governing body of is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of St. Francis Physician Services, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15b The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 The filing organization provides any documents open to public inspection upon request. Form 990, Part VII - Additional Disclosure: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment. Form 990, Part XI, line 9: Rounding 2. Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. Management Services MD 501(c)(3) Line 11c, III-FI Bon Secours Inc 0 St Francis Hospital Inc One St Francis Drive Greenville SC 29601 582504530 Health Care SC 501(c)(3) Line 3 Bon Secours St Francis Health System Inc 0 St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)(3) Line 7 St Francis Hospital Inc 0 Bon Secours St Francis Health System Inc One St Francis Drive Greenville SC 296013955 582504528 Local System Parent Org. SC 501(c)(3) Line 11c, III-FI Bon Secours Health System Inc 0 Upstate Surgery Center One St Francis Drive Greenville SC 29601 562186977 Ambulatory Surgery Center SC N/A 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0