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Bellefonte Physician Services Inc: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
Bellefonte Physician Services Inc (EIN 35-2320780)
Tax period
2014-09-01 to 2015-08-31
Filed
2016-06-27
IRS object ID
201641799349300044
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-06-27T14:00:21-05:00ReturnTs
Tax Period End2015-08-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN352320780EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Bellefonte Physician Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBELLBusinessNameControlTxt
Phone6068334235PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJoe BuchheitPersonNm
Person TitleCFO - BSKHSPersonTitleTxt
Phone6068364002PhoneNum
Signature2016-06-27SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKevin HalterPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 St Christopher DriveAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$27,282,801GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://www.olbh.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionPrimary, urgent and specialty careActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee332TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$516,619PYContributionsGrantsAmt
CY Contributions Grants$268,902CYContributionsGrantsAmt
PY Program Service Revenue$26,114,218PYProgramServiceRevenueAmt
CY Program Service Revenue$26,804,512CYProgramServiceRevenueAmt
PY Investment Income$27PYInvestmentIncomeAmt
CY Investment Income$25CYInvestmentIncomeAmt
PY Other Revenue$163,724PYOtherRevenueAmt
CY Other Revenue$209,362CYOtherRevenueAmt
PY Total Revenue$26,794,588PYTotalRevenueAmt
CY Total Revenue$27,282,801CYTotalRevenueAmt
PY Grants And Similar Paid$150PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,580,287PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$29,967,602CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,263,683PYOtherExpensesAmt
CY Other Expenses$12,544,110CYOtherExpensesAmt
PY Total Expenses$39,844,120PYTotalExpensesAmt
CY Total Expenses$42,511,712CYTotalExpensesAmt
PY Revenues Less Expenses-$13,049,532PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$15,228,911CYRevenuesLessExpensesAmt
Total Assets BOY$6,354,173TotalAssetsBOYAmt
Total Assets EOY$5,916,973TotalAssetsEOYAmt
Total Liabilities BOY$62,201,442TotalLiabilitiesBOYAmt
Total Liabilities EOY$76,993,153TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$55,847,269NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$71,076,180NetAssetsOrFundBalancesEOYAmt
MissionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$38,685,073ExpenseAmt
Grant$0GrantAmt
Revenue$26,917,713RevenueAmt
DescCharity & Indigent Care - Bellefonte Physician Services (BPS) utilizes an affiliate model to provide residents of the tri-state with a variety of services, from primary care to pediatric, urgent and specialty care. A member of the Bon Secours Kentucky Health System, BPS continues to expand to meet the needs of community residents, especially the those in charily and indigent need. The various practices that comprise BPS are strategically located throughout the region to bring the highest quality health care close to home with convenient locations.Desc
Total Program Service Expenses$38,685,073TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document53IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee332EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Joe BuccheitBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6068333700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 St Christopher DrAddressLine1Txt
CityAshlandCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Kevin Halter FACHE
Chairman/CEO-BSKY10.0040.00Yes (X)Yes (X)$0$477,490$54,826
Augustinus Lobach MD
Board Member0.5049.50Yes (X)$0$258,955$13,604
Thomas Morris PhD
President0.5049.50Yes (X)Yes (X)$0$436,432$59,475
James Payne PhD
Board Member0.500.00Yes (X)$0$0$0
Samuel Ross MD
Board Member0.5049.50Yes (X)$0$832,778$87,464
Joe Buchheit
CFO-BSKY10.0040.00Yes (X)$0$331,669$28,215
Troy Connett
Secretary0.5049.50Yes (X)$53,936$0$10,877
Tyler Walters
Treasurer0.5049.50Yes (X)$0$144,136$27,035
Charles Rhodes MD
Cardiologist50.000.00$817,782$0$30,903Yes (X)
Richard Mailloux MD
Gastroenterologist50.000.00$545,002$0$37,602Yes (X)
Brian Defade MD
Urologist50.000.00$443,838$0$21,373Yes (X)
Diane Settles MD
Internist50.000.00$432,580$0$17,714Yes (X)
Deborah Chadwick MD
Surgeon50.000.00$428,726$0$35,117Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,721,864TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,481,460TotReportableCompRltdOrgAmt
Total Other Compensation$424,205TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K44IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AthenaHealth Inc
311 Arsenal CourtWatertownMA02472Billing Agent$1,201,680
Roland Benton PSC
413 Country Club DriveAshlandKY41101Contract Physician$444,617
Dirtbusters Janitorial Services
6433 Route 60 Suite 100BarboursvilleWV25504Cleaning Services$106,773
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$268,902GovernmentGrantsAmt
Total Contributions$268,902TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service Rev.Desc
Business621110BusinessCd
Total Revenue Column$26,804,512TotalRevenueColumnAmt
Related Or Exempt Func Income$26,804,512RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$26,804,512TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$25TotalRevenueColumnAmt
Exclusion$25ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
EKG Reading Fees900099$113,201$113,201
Skin Care Products900099$54,180$54,180
Contract Nursing Serv.900099$24,938$24,938

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,043TotalRevenueColumnAmt
Exclusion$17,043ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$209,362OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,282,801TotalRevenueColumnAmt
Related Or Exempt Func Income$26,917,713RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$96,186ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$70,543TotalAmt
Program Services$63,489ProgramServicesAmt
Management And General$7,054ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,523,582TotalAmt
Program Services$22,071,224ProgramServicesAmt
Management And General$2,452,358ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$839,939TotalAmt
Program Services$755,945ProgramServicesAmt
Management And General$83,994ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,859,350TotalAmt
Program Services$2,573,415ProgramServicesAmt
Management And General$285,935ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,674,188TotalAmt
Program Services$1,506,769ProgramServicesAmt
Management And General$167,419ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,734TotalAmt
Program Services$10,561ProgramServicesAmt
Management And General$1,173ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$648,541TotalAmt
Program Services$648,541ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$26,246TotalAmt
Program Services$23,621ProgramServicesAmt
Management And General$2,625ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$462,049TotalAmt
Program Services$415,844ProgramServicesAmt
Management And General$46,205ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,189,269TotalAmt
Program Services$2,870,342ProgramServicesAmt
Management And General$318,927ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$128,529TotalAmt
Program Services$115,676ProgramServicesAmt
Management And General$12,853ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$42,551TotalAmt
Program Services$38,296ProgramServicesAmt
Management And General$4,255ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$50,623TotalAmt
Program Services$50,623ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$712,050TotalAmt
Program Services$640,845ProgramServicesAmt
Management And General$71,205ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$528,576TotalAmt
Program Services$475,718ProgramServicesAmt
Management And General$52,858ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Purchased Services$2,619,899$2,357,909$261,990
Medical Supplies$2,072,788$2,072,788$0
Bad Debt$1,473,373$1,473,373$0
Physician Recruitment$282,880$254,592$28,288

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$295,002TotalAmt
Program Services$265,502ProgramServicesAmt
Management And General$29,500ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$42,511,712TotalAmt
Program Services$38,685,073ProgramServicesAmt
Management And General$3,826,639ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,260BOYAmt
EOY$5,309EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$252,213BOYAmt
EOY$193,382EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,069,748BOYAmt
EOY$2,036,480EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,632BOYAmt
EOY$799EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$248,996BOYAmt
EOY$314,904EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,006,881BOYAmt
EOY$1,936,114EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,064,867LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,757,167LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,320,777BOYAmt
EOY$1,307,700EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$448,666BOYAmt
EOY$122,285EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,354,173BOYAmt
EOY$5,916,973EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,157,780BOYAmt
EOY$1,144,901EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$36,060BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$61,007,602BOYAmt
EOY$75,848,252EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$62,201,442BOYAmt
EOY$76,993,153EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$55,847,269BOYAmt
EOY-$71,076,180EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$55,847,269BOYAmt
EOY-$71,076,180EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,354,173BOYAmt
EOY$5,916,973EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$15,228,911ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$212,500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus1 Year$516,619CurrentTaxYearMinus1YearAmt
Current Tax Year$268,902CurrentTaxYearAmt
Total$998,021TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,632,747CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,624,340CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,171,523CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,114,218CurrentTaxYearMinus1YearAmt
Current Tax Year$26,804,512CurrentTaxYearAmt
Total$123,347,340TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,845,247CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,624,340CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,171,523CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,630,837CurrentTaxYearMinus1YearAmt
Current Tax Year$27,073,414CurrentTaxYearAmt
Total$124,345,361TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$124,345,361PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$44CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$30CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27CurrentTaxYearMinus1YearAmt
Current Tax Year$25CurrentTaxYearAmt
Total$165TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$44CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$30CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27CurrentTaxYearMinus1YearAmt
Current Tax Year$25CurrentTaxYearAmt
Total$165TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,849CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,944CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$37,805CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$163,724CurrentTaxYearMinus1YearAmt
Current Tax Year$209,362CurrentTaxYearAmt
Total$450,684TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,863,135CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,646,328CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,209,358CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,794,588CurrentTaxYearMinus1YearAmt
Current Tax Year$27,282,801CurrentTaxYearAmt
Total$124,796,210TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99640PublicSupportCY509Pct
Public Support PY5090.99770PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12, Explanation of Other Income:FormAndLineReferenceDesc
ExplanationSkin Care Products - 2010 Amount: $ 17,154. 2011 Amount: $ 18,116. 2012 Amount: $ 31,606. 2013 Amount: $ 16,585. 2014 Amount: $ 54,180. Purchase Discounts - 2010 Amount: $ 695. 2011 Amount: $ 3,828. 2012 Amount: $ 6,199. EKG Reading Fees - 2013 Amount: $ 108,659. 2014 Amount: $ 113,201. Gift Shop - 2013 Amount: $ 21,537. All Other Revenue - 2013 Amount: $ 16,943. 2014 Amount: $ 41,981.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$129,053OtherCostOrOtherBasisAmt
Depreciation$26,190DepreciationAmt
Book Value$102,863BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$284,232OtherCostOrOtherBasisAmt
Depreciation$105,281DepreciationAmt
Book Value$178,951BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,573,467OtherCostOrOtherBasisAmt
Depreciation$2,602,425DepreciationAmt
Book Value$971,042BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$78,115OtherCostOrOtherBasisAmt
Depreciation$23,271DepreciationAmt
Book Value$54,844BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,307,700TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Due to BSHSI$75,512,641
Medicaid Settlement$164,565
Due to Affiliate$134,986
Deferred Rent$36,060
FieldValueIRS element (for citing)
Total Liability$75,848,252TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationSchedule 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.ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Kevin Halter FACHE
Chairman/CEO-BSKY$0$321,216$0$110,244$0$46,030$0$24,861$0$29,965$0$532,316$0$3,452
Augustinus Lobach MD
Board Member$0$203,480$0$33,625$0$21,850$0$3,749$0$9,855$0$272,559$0$0
Thomas Morris PhD
President$0$297,010$0$95,892$0$43,530$0$39,792$0$19,683$0$495,907$0$16,418
Samuel Ross MD
Board Member$0$559,362$0$191,202$0$82,214$0$68,261$0$19,203$0$920,242$0$21,657
Joe Buchheit
CFO-BSKY$0$225,440$0$65,389$0$40,840$0$9,647$0$18,568$0$359,884$0$0
Tyler Walters
Treasurer$0$124,224$0$19,195$0$717$0$2,793$0$24,242$0$171,171$0$0
Charles Rhodes MD
Cardiologist$742,983$0$500$0$74,299$0$11,700$0$19,203$0$848,685$0$0$0
Richard Mailloux MD
Gastroenterologist$542,414$0$1,000$0$1,588$0$11,700$0$25,902$0$582,604$0$0$0
Brian Defade MD
Urologist$416,449$0$18,547$0$8,842$0$11,700$0$9,673$0$465,211$0$0$0
Diane Settles MD
Internist$407,753$0$15,862$0$8,965$0$1$0$17,713$0$450,294$0$0$0
Deborah Chadwick MD
Surgeon$341,371$0$86,822$0$533$0$7,802$0$27,315$0$463,843$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Line 4bThe filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to 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: Samuel Ross, MD, $34,046; Thomas Morris, Ph.D., $20,852; Kevin Halter, FACHE, $4,608.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc is the sole member of Bon Secours Kentucky Health System, which in turn is the sole member of Bellefonte Physician Services, Inc.
Form 990, Part VI, Section A, line 7aThe governing body of Bellefonte Physician Services, Inc. is appointed by its Member, Bon Secours Kentucky Health System, Inc. and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Bellefonte Physician Services, Inc. are reserved to its member or to Bon Secours Health System, Inc.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15bThe compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization 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 and do not receive additional compensation for their board responsibilities.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. - Management ServicesMD501(c)(3)Line 11c, III-FIBon Secours Inc0
Our Lady of Bellefonte Hospital Inc
1000 St Christopher DriveAshlandKY41101611356023HealthcareKY501(c)(3)Line 3Bon Secours Kentucky Health System0
Our Lady of Bellefonte Hospital Foundation
1000 St Christopher DriveAshlandKY41101611381952Grant Making FoundationKY501(c)(3)Line 7Bon Secours Kentucky Health System0
Bon Secours Kentucky Health System
1000 St Christopher DriveAshlandKY41101611356024Local System Parent Org.KY501(c)(3)Line 11c, III-FIBon Secours Health System Inc0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd