ST MARYS OHIO VALLEY HEARTCARE LLC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS OHIO VALLEY HEARTCARE LLC (EIN 27-3474697)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201521339349305937
- Schema version
- 2013v4.0
- 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 D
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T22:16:59-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2000 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462045108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273474697 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S OHIO VALLEY HEARTCARE LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 8124854178 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN L ZABROWSKI | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8124854178 | PhoneNum |
| Signature | 2015-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNA M JIMENEZ | PreparerPersonNm |
| PTIN | P01222873 | PTIN |
| Phone | 3174648600 | PhoneNum |
| Preparation | 2015-05-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEITH JEWELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,028,997 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STMARYS.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LLC | OtherOrganizationDsc |
| Formation | 2011 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | ST. MARY'S OHIO VALLEY HEARTCARE, LLC IS DEDICATED TO PROVIDING CARDIAC PATIENTS AND THEIR FAMILIES WITH EXCELLENCE IN THE PREVENTION, TREATMENT, AND DIAGNOSIS OF HEART DISEASE. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 81 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,605,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,700,345 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,614,248 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,077,419 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,587 | PYInvestmentIncomeAmt |
| CY Investment Income | $959 | CYInvestmentIncomeAmt |
| PY Other Revenue | $449,402 | PYOtherRevenueAmt |
| CY Other Revenue | $250,274 | CYOtherRevenueAmt |
| PY Total Revenue | $11,670,237 | PYTotalRevenueAmt |
| CY Total Revenue | $8,028,997 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,399,171 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,520,158 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,147,759 | PYOtherExpensesAmt |
| CY Other Expenses | $1,310,432 | CYOtherExpensesAmt |
| PY Total Expenses | $12,546,930 | PYTotalExpensesAmt |
| CY Total Expenses | $7,836,590 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$876,693 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $192,407 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $845,613 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,321,474 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$475,861 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ST. MARY'S OHIO VALLEY HEARTCARE, LLC IS DEDICATED TO PROVIDING CARDIAC PATIENTS AND THEIR FAMILIES WITH EXCELLENCE IN THE PREVENTION, TREATMENT, AND DIAGNOSIS OF HEART DISEASE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,380,147 | ExpenseAmt |
| Grant | $6,000 | GrantAmt |
| Revenue | $4,327,693 | RevenueAmt |
| Desc | ST. MARY'S OHIO VALLEY HEARTCARE, LLC HAS ESTABLISHED A STRATEGIC RELATIONSHIP WITH ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. TO OFFER CENTRALIZED DELIVERY OF OUTPATIENT CARDIAC CARE IN ADDITION TO INPATIENT SURGICAL PROCEDURES. ALSO, ST. MARY'S OHIO VALLEY HEARTCARE, LLC, CONTINUES TO TREAT BOTH ADULT AND PEDIATRIC CARDIAC PATIENTS WITH ON-SITE HIGH-TECH EQUIPMENT LOCATED ON THE ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.'S CAMPUS. NO ONE IS REFUSED NEEDED MEDICAL ATTENTION DUE TO INABILITY TO PAY FOR SERVICES. ST. MARY'S OHIO VALLEY HEARTCARE, LLC IS PART OF ASCENSION HEALTH AND FOLLOWS THE CHARITY CARE POLICIES OF ST. MARY'S HEALTH, INC. | Desc |
| Total Program Service Expenses | $7,380,147 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 81 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN L ZABROWSKI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8124854178 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ASEM RIMAWI MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $588,010 | $0 | $62,449 | ||
| ASIM REHMAN MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $911,378 | $0 | $88,126 | ||
| DAVID CURTIS MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $443,922 | $0 | $55,707 | ||
| DEEPA KUMBAR MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $218,504 | $0 | $48,719 | ||
| ELIZABETH BUTLER MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $562,467 | $0 | $5,000 | ||
| GURTEJ SINGH MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $167,274 | $0 | $19,378 | ||
| JANICE ERNEST | ||||||||
| BOARD MEMBER | 1.00 | 56.00 | Yes (X) | $0 | $223,185 | $50,258 | ||
| JOHN BROCK MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $221,657 | $0 | $5,000 | ||
| KEITH JEWELL | ||||||||
| CEO/PRESIDENT/CHAIR | 1.00 | 69.00 | Yes (X) | $0 | $10,096 | $0 | Yes (X) | |
| PHILIP CASINO MD | ||||||||
| VICE CHAIR | 55.00 | 1.00 | Yes (X) | $768,372 | $0 | $79,242 | Yes (X) | |
| PHILLIP BEHRENS MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $749,195 | $0 | $87,041 | ||
| SUZETTE HERSHMAN | ||||||||
| SECRETARY/TREASURER | 1.00 | 58.00 | Yes (X) | $0 | $220,481 | $15,528 | Yes (X) | |
| TIMOTHY FLESCH THRU 122013 | ||||||||
| CEO/PRESIDENT/CHAIR | 1.00 | 70.20 | Yes (X) | $0 | $1,661,825 | $23,492 | Yes (X) | |
| UMANG PATEL MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $857,421 | $0 | $79,651 | ||
| WAJEEHUDDIN MOHAMMED MD | ||||||||
| BOARD MEMBER | 55.00 | 0.00 | Yes (X) | $819,665 | $0 | $86,865 | ||
| CLAUDIA MERKLEY | ||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $110,763 | $0 | $12,483 | Yes (X) | ||
| VICTOR ESAN MD | ||||||||
| ADMINISTRATIVE DIRECTOR | 55.00 | 0.00 | $111,872 | $0 | $14,713 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,530,500 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,115,587 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $733,652 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTH INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | MEDICAL SERVICES | $640,275 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | MEDICAL SERVICES | $348,735 |
| MED-WRITE INC | |||||
| 515 AIRPORT RD 111 | CHATTANOOGA | TN | 37421 | BILLING SERVICES | $291,265 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,700,345 | RelatedOrganizationsAmt |
| Total Contributions | $3,700,345 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $4,077,419 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,077,419 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,077,419 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $959 | TotalRevenueColumnAmt |
| Exclusion | $959 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EKG READINGS | 621500 | $141,914 | $141,914 |
| INCOME FROM K-1'S | 900099 | $100,027 | $100,027 |
| MEDICAL DIRECTOR FEES | 561000 | $8,333 | $8,333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $250,274 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,028,997 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,327,693 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $959 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,000 | TotalAmt |
| Program Services | $6,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,404,590 | TotalAmt |
| Program Services | $4,237,830 | ProgramServicesAmt |
| Management And General | $166,760 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,246,670 | TotalAmt |
| Program Services | $1,109,536 | ProgramServicesAmt |
| Management And General | $137,134 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,063 | TotalAmt |
| Program Services | $561,171 | ProgramServicesAmt |
| Management And General | $31,892 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,835 | TotalAmt |
| Program Services | $261,002 | ProgramServicesAmt |
| Management And General | $14,833 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $319,322 | TotalAmt |
| Program Services | $319,322 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,283 | TotalAmt |
| Program Services | $2,922 | ProgramServicesAmt |
| Management And General | $361 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,609 | TotalAmt |
| Program Services | $24,572 | ProgramServicesAmt |
| Management And General | $3,037 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,846 | TotalAmt |
| Program Services | $141,373 | ProgramServicesAmt |
| Management And General | $17,473 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,026 | TotalAmt |
| Program Services | $491,303 | ProgramServicesAmt |
| Management And General | $60,723 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,726 | TotalAmt |
| Program Services | $8,656 | ProgramServicesAmt |
| Management And General | $1,070 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,670 | TotalAmt |
| Program Services | $8,606 | ProgramServicesAmt |
| Management And General | $1,064 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,524 | TotalAmt |
| Program Services | $11,146 | ProgramServicesAmt |
| Management And General | $1,378 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,676 | TotalAmt |
| Program Services | $49,552 | ProgramServicesAmt |
| Management And General | $6,124 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS AND MAINTENENCE | $54,780 | $48,754 | $6,026 |
| MEDICAL SUPPLIES | $35,077 | $35,077 | |
| PURCHASED SERVICES | $22,825 | $20,314 | $2,511 |
| EQUIPMENT RENTAL | $22,257 | $19,809 | $2,448 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,811 | TotalAmt |
| Program Services | $23,202 | ProgramServicesAmt |
| Management And General | $3,609 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,836,590 | TotalAmt |
| Program Services | $7,380,147 | ProgramServicesAmt |
| Management And General | $456,443 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,591 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,095 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,637 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,221 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,209 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,875 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,985 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $845,613 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,055,977 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,553 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,944 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,321,474 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$475,861 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$475,861 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $845,613 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $192,407 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,306 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $282,148 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Certification | Yes (X) | CertificationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350869065 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2014. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 237045370 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $6,000 | CashGrantAmt |
| Purpose Of Grant | OPERATING SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | 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 | ONE PERSON OF ST. MARY'S OHIO VALLEY HEARTCARE, LLC, IS RESPONSIBLE FOR RESEARCHING AND COORDINATING GRANT PROPOSALS. THIS PERSON IS ALSO RESPONSIBLE FOR ENSURING THAT TIMELY REPORTS ARE SENT TO THE GRANTOR. THE CHIEF EXECUTIVE OF THE ENTITY OPERATIONS REVIEWS AND APPROVES ALL THE EXPENDITURES FROM THE GRANT FUNDS, ENSURING THEY ARE WITHIN THE GUIDELINES OF THE GRANT. | 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASEM RIMAWI MD | ||||||||||||||
| BOARD MEMBER | $456,731 | $0 | $41,482 | $0 | $89,797 | $0 | $32,047 | $0 | $30,402 | $0 | $650,459 | $0 | $88,861 | $0 |
| ASIM REHMAN MD | ||||||||||||||
| BOARD MEMBER | $744,475 | $0 | $51,497 | $0 | $115,406 | $0 | $58,393 | $0 | $29,733 | $0 | $999,504 | $0 | $96,381 | $0 |
| DAVID CURTIS MD | ||||||||||||||
| BOARD MEMBER | $376,028 | $0 | $18,000 | $0 | $49,894 | $0 | $32,737 | $0 | $22,970 | $0 | $499,629 | $0 | $31,107 | $0 |
| DEEPA KUMBAR MD | ||||||||||||||
| BOARD MEMBER | $183,626 | $0 | $0 | $0 | $34,878 | $0 | $21,875 | $0 | $26,844 | $0 | $267,223 | $0 | $16,564 | $0 |
| ELIZABETH BUTLER MD | ||||||||||||||
| BOARD MEMBER | $553,908 | $0 | $5,391 | $0 | $3,168 | $0 | $5,000 | $0 | $0 | $0 | $567,467 | $0 | $0 | $0 |
| GURTEJ SINGH MD | ||||||||||||||
| BOARD MEMBER | $162,122 | $0 | $0 | $0 | $5,152 | $0 | $9,058 | $0 | $10,320 | $0 | $186,652 | $0 | $0 | $0 |
| JANICE ERNEST | ||||||||||||||
| BOARD MEMBER | $0 | $192,567 | $0 | $28,560 | $0 | $2,058 | $0 | $30,531 | $0 | $19,727 | $0 | $273,443 | $0 | $0 |
| JOHN BROCK MD | ||||||||||||||
| BOARD MEMBER | $215,714 | $0 | $0 | $0 | $5,943 | $0 | $5,000 | $0 | $0 | $0 | $226,657 | $0 | $0 | $0 |
| PHILIP CASINO MD | ||||||||||||||
| VICE CHAIR | $619,969 | $0 | $74,271 | $0 | $74,132 | $0 | $46,305 | $0 | $32,937 | $0 | $847,614 | $0 | $54,696 | $0 |
| PHILLIP BEHRENS MD | ||||||||||||||
| BOARD MEMBER | $663,207 | $0 | $18,000 | $0 | $67,988 | $0 | $54,628 | $0 | $32,413 | $0 | $836,236 | $0 | $60,905 | $0 |
| SUZETTE HERSHMAN | ||||||||||||||
| SECRETARY/TREASURER | $0 | $192,074 | $0 | $28,130 | $0 | $277 | $0 | $15,022 | $0 | $506 | $0 | $236,009 | $0 | $0 |
| TIMOTHY FLESCH THRU 122013 | ||||||||||||||
| CEO/PRESIDENT/CHAIR | $0 | $895,586 | $0 | $742,747 | $0 | $23,492 | $0 | $5,000 | $0 | $18,492 | $0 | $1,685,317 | $0 | $2 |
| UMANG PATEL MD | ||||||||||||||
| BOARD MEMBER | $742,239 | $0 | $43,019 | $0 | $72,163 | $0 | $47,799 | $0 | $31,852 | $0 | $937,072 | $0 | $53,485 | $0 |
| WAJEEHUDDIN MOHAMMED MD | ||||||||||||||
| BOARD MEMBER | $680,809 | $0 | $63,366 | $0 | $75,490 | $0 | $56,428 | $0 | $30,437 | $0 | $906,530 | $0 | $56,735 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3: | ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S OHIO VALLEY HEARTCARE, LLC, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B: | ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS OF: ASEM RIMAWI, MD $88,861 ASIM REHMAN, MD $96,381 DAVID CURTIS, MD $31,107 DEEPA KUMBAR, MD $16,564 PHILIP CASINO, MD $54,696 PHILLIP BEHRENS, MD $60,905 UMANG PATEL, MD $53,485 WAJEEHUDDIN MOHAMMED, MD $56,735 TIMOTHY FLESCH $2 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | TRANSFER OF ASSETS, LIABILITIES AND NET ASSETS TO ST. MARY'S MEDICAL GROUP, LLC | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2014-02-27 | DistributionDt |
| Fair Market Value Of Asset | $282,148 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 261356310 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL GROUP LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, LINE 2A: | THE FOLLOWING OFFICERS AND BOARD MEMBERS BECAME AN OFFICER OR BOARD MEMBER OF THE TRANSFEREE ORGANIZATION ST. MARY'S MEDICAL GROUP, LLC F/K/A ST. MARY'S PHYSICIANS' HEALTH GROUP, LLC:PHILIP CASINO, MD |
| PART II, LINE 2B: | THE FOLLOWING OFFICERS AND BOARD MEMBERS BECAME EMPLOYEES OF THE TRANSFEREE ORGANIZATION, ST. MARY'S MEDICAL GROUP, LLC, F/K/A ST. MARY'S PHYSICIANS' HEALTH GROUP, LLC:ASEM RIMAWI, MDASIM REHMAN, MDDAVID CURTIS, MDDEEPA KUMBAR, MDELIZABETH BUTLER, MDGURTEJ SINGH, MDJOHN BROCK, MDPHILIP CASINO, MDPHILLIP BEHRENS, MDUMANG PATEL, MDWAJEEHUDDIN MOHAMMED, MD |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ST. MARY'S OHIO VALLEY HEARTCARE, LLC HAS A SINGLE CORPORATE MEMBER, ST. MARY'S MEDICAL GROUP OF EVANSVILLE, LLC F/K/A ST. MARY'S MEDICAL GROUP, LLC, WHOSE SOLE MEMBER IS ST. MARY'S HEALTH, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. MARY'S OHIO VALLEY HEARTCARE, LLC HAS A SINGLE CORPORATE MEMBER, ST. MARY'S MEDICAL GROUP OF EVANSVILLE, LLC F/K/A ST. MARY'S MEDICAL GROUP, LLC, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S OHIO VALLEY HEARTCARE, LLC. |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S OHIO VALLEY HEARTCARE, LLC'S FINANCIAL INFORMATION OR COPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST. MARY'S MEDICAL GROUP OF EVANSVILLE, LLC F/K/A ST. MARY'S MEDICAL GROUP, LLC. |
| FORM 990, PART VI, SECTION B, LINE 11 | ST. MARY'S HEALTH, INC.'S FINANCE COMMITTEE REVIEWS THE FORM 990 IN MARCH UPON RECEIVING DIRECTION FROM ITS TAX PREPARER. THE FORM 990 IS THEN SENT TO THE GOVERNING BODY IN APRIL TO ALLOW FOR A THOROUGH REVIEW BY THE GOVERNING BODY PRIOR TO THE FILING DATE OF MAY 15TH. THE GOVERNING BODY WILL REVIEW THE FORM 990 VIA A SECURE WEB-BASED PORTAL AND ASK ANY QUESTIONS REGARDING THE FORM 990. ANY QUESTIONS AND RESPONSES WILL BE POSTED TO THE WEB-BASED PORTAL BEFORE THE RETURN IS FILED. ALL QUESTIONS AND RESPONSES WILL BE REVIEWED AND DISCLOSED IN THE MEETING MINUTES OF THE NEXT BOARD MEETING FOLLOWING THE REVIEW OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. |
| FORM 990, PART VI, SECTION B, LINE 15 | IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S OHIO VALLEY HEARTCARE, LLC, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. COMPENSATION DETERMINATIONS OF ST. MARY'S OHIO VALLEY HEARTCARE, LLC'S OTHER OFFICERS OR KEY EMPLOYEES ARE MADE BY ST. MARY'S HEALTH, INC.'S MANAGEMENT. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO THE OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME POSITION. FORM 990, PART VI, SECTION B, LINE 16B: ST. MARY'S HEALTH, INC. AND SUBSIDIARIES (ST. MARY'S) JOINT VENTURE OPERATING AGREEMENTS ARE NEGOTIATED WITH OTHER MEMBERS OF THE JOINT VENTURE TO ENSURE THAT ADEQUATE SAFEGUARDS ARE IN PLACE TO PROTECT ST. MARY'S EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH A FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. ST. MARY'S CONTINUALLY ENSURES THAT ITS EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL ST. MARY'S JOINT VENTURES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER WITH ST. MARY'S MEDICAL GROUP, LLC F/K/A ST. MARY'S PHYSICIANS' HEALTH GROUP, LLC 282,148. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 631455998 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | 11A, I | N/A | 0 | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | 11A, I | 0 | ASCENSION HEALTH ALLIANCE | |
| CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC | |||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 351869951 | FREESTANDING OUTPATIENT CENTER | IN | 501(C)(3) | 11C, III-FI | Yes (1) | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | |
| REHABILITATION HOSPITAL OF INDIANA INC | |||||||||||
| 4141 SHORE DRIVE | INDIANAPOLIS | IN | 46254 | 351786005 | REHABILITATION HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| SVH REAL ESTATE INC | |||||||||||
| 10330 N MERIDIAN STREET STE 430N | INDIANAPOLIS | IN | 46290 | 205002285 | REAL ESTATE HOLDING COMPANY | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT HEALTH INC | |
| STJOSEPH HOSPITAL & HEALTH CENTER INC | |||||||||||
| 1907 W SYCAMORE STREET | KOKOMO | IN | 46901 | 350992717 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STJOSEPH FOUNDATION OF KOKOMO INDIANA INC | |||||||||||
| 1907 W SYCAMORE STREET | KOKOMO | IN | 46901 | 237313206 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STJOSEPH HOSPITAL & HEALTH CENTER INC | |
| STVINCENT ANDERSON REGIONAL HOSPITAL INC | |||||||||||
| 2015 JACKSON STREET | ANDERSON | IN | 46016 | 460877261 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT ANDERSON REGIONAL HOSPITAL FOUNDATION INC | |||||||||||
| 2015 JACKSON STREET | ANDERSON | IN | 46016 | 352053693 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT ANDERSON REGIONAL HOSPITAL INC | |
| STVINCENT CARMEL HOSPITAL INC | |||||||||||
| 13500 N MERIDIAN STREET | CARMEL | IN | 46032 | 743107055 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT CLAY HOSPITAL INC | |||||||||||
| 1206 E NATIONAL AVENUE | BRAZIL | IN | 47834 | 352112529 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT DUNN HOSPITAL INC | |||||||||||
| 1600 23RD STREET | BEDFORD | IN | 47421 | 272192831 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT FISHERS HOSPITAL INC | |||||||||||
| 13861 OLIO ROAD | FISHERS | IN | 46037 | 454243702 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT FRANKFORT HOSPITAL INC | |||||||||||
| 1300 S JACKSON | FRANKFORT | IN | 46041 | 352099320 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT FRANKFORT HOSPITAL FOUNDATION INC | |||||||||||
| 1300 S JACKSON | FRANKFORT | IN | 46041 | 351531734 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT FRANKFORT HOSPITAL INC | |
| STVINCENT HEALTH INC | |||||||||||
| 10330 N MERIDIAN STREET STE 430N | INDIANAPOLIS | IN | 46290 | 352052591 | PARENT COMPANY | IN | 501(C)(3) | 11C, III-FI | 0 | ASCENSION HEALTH | |
| STVINCENT HEALTH WELLNESS AND PREVENTIVE CARE INSTITUTE INC | |||||||||||
| 8333 NAAB ROAD STE 301 | INDIANAPOLIS | IN | 46260 | 461227327 | HEALTH AND WELLNESS SERVICES | IN | 501(C)(3) | 9 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | |||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 350869066 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT HOSPITAL FOUNDATION INC | |||||||||||
| 10330 N MERIDIAN STREET STE 430N | INDIANAPOLIS | IN | 46290 | 356088862 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | |
| STVINCENT JENNINGS HOSPITAL INC | |||||||||||
| 301 HENRY STREET | NORTH VERNON | IN | 47265 | 351841606 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT MADISON COUNTY HEALTH SYSTEM INC | |||||||||||
| 1331 SOUTH A STREET | ELWOOD | IN | 46036 | 350876389 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT MEDICAL GROUP INC | |||||||||||
| 8425 HARCOURT ROAD | INDIANAPOLIS | IN | 46260 | 272039417 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT MERCY HOSPITAL FOUNDATION INC | |||||||||||
| 1331 SOUTH A STREET | ELWOOD | IN | 46036 | 311066871 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT MADISON COUNTY HEALTH SYSTEM INC | |
| STVINCENT NEW HOPE INC | |||||||||||
| 8450 N PAYNE ROAD | INDIANAPOLIS | IN | 46260 | 351733591 | INTERMEDIATE CARE FACILITY | IN | 501(C)(3) | 9 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT RANDOLPH HOSPITAL INC | |||||||||||
| 473 GREENVILLE AVENUE | WINCHESTER | IN | 47394 | 352103153 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT RANDOLPH HOSPITAL FOUNDATION INC | |||||||||||
| 473 GREENVILLE AVENUE | WINCHESTER | IN | 47394 | 352133006 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT RANDOLPH HOSPITAL INC | |
| STVINCENT SALEM HOSPITAL INC | |||||||||||
| 911 N SHELBY STREET | SALEM | IN | 47167 | 270847538 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT SETON SPECIALTY HOSPITAL INC | |||||||||||
| 8050 TOWNSHIP LINE ROAD | INDIANAPOLIS | IN | 46260 | 351712001 | LONG TERM CARE HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT WILLIAMSPORT HOSPITAL INC | |||||||||||
| 412 N MONROE STREET | WILLIAMSPORT | IN | 47993 | 350784551 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | STVINCENT HEALTH INC | |
| STVINCENT WILLIAMSPORT HOSPITAL FOUNDATION INC | |||||||||||
| 412 N MONROE STREET | WILLIAMSPORT | IN | 47993 | 743130159 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT WILLIAMSPORT HOSPITAL INC | |
| SVSM INC | |||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 810607827 | HOLDING COMPANY | IN | 501(C)(3) | 11A, I | Yes (1) | STVINCENT HEALTH INC | |
| ST MARY'S AT HOME INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351899560 | DME/HOME CARE | IN | 501(C)(3) | 11A, I | Yes (1) | ST MARY'S HEALTH SERVICES INC | |
| ST MARY'S BUILDING CORPORATION | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237248362 | REAL ESTATE HOLDING COMPANY | IN | 501(C)(2) | Yes (1) | ST MARY'S HEALTH SERVICES INC | ||
| ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205342518 | AMBULANCE SERVICES | IN | 501(C)(4) | Yes (1) | ST MARY'S HEALTH SERVICES INC | ||
| ST MARY'S HEALTH INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 352057801 | HEALTH MINISTRY PARENT | IN | 501(C)(3) | 11C, III-FI | Yes (1) | STVINCENT HEALTH INC | |
| ST MARY'S PHYSICIAN NETWORK LLC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205023387 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | Yes (1) | ST MARY'S HEALTH INC | |
| ST MARY'S HEALTH SERVICES INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351679526 | INVESTMENT SERVICES | IN | 501(C)(3) | 11C, III-FI | Yes (1) | ST MARY'S HEALTH INC | |
| ST MARY'S CARE PARTNERS INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351899562 | TAX-EXEMPT AFFILIATE REIMBURSEMENTS | IN | 501(C)(3) | 11A, I | Yes (1) | ST MARY'S HEALTH INC | |
| ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237045370 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | |
| ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 350869065 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | ST MARY'S HEALTH SERVICES INC | |
| ST MARY'S WARRICK HOSPITAL FOUNDATION INC | |||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351961890 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | Yes (1) | ST MARY'S WARRICK HOSPITAL INC | |
| ST MARY'S WARRICK HOSPITAL INC | |||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351343019 | HOSPITAL | IN | 501(C)(3) | 3 | Yes (1) | ST MARY'S HEALTH SERVICES INC | |
| ST MARY'S MEDICAL GROUP LLC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 261356310 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | Yes (1) | ST MARY'S HEALTH INC | |
| PRIMARY PHYSICIAN NETWORK LLC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 208775914 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | Yes (1) | ST MARY'S HEALTH INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BREAST MRI LEASING COMPANY LLC | |||||||||||||
| 10330 N MERIDIAN ST STE 430N | INDIANAPOLIS | IN | 46290 | 426662493 | SALE AND RENTAL SERVICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | $235,288 | $43,117 | 0 | Yes (1) | 0.50000 |
| CARMEL AMBULATORY SURGERY CENTER LLC | |||||||||||||
| 13421 OLD MERIDIAN ST STE 150 | CARMEL | IN | 46032 | 320014795 | AMBULATORY SURGERY CENTER | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | $3,732,048 | $1,498,768 | 0 | Yes (1) | 0.51000 |
| COOPERATIVE MANAGED CARE SERVICES LLC | |||||||||||||
| 9045 RIVER ROAD STE 250 | INDIANAPOLIS | IN | 46240 | 351999227 | CASE MANAGEMENT | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | UNRELATED | $158,622 | $2,278,545 | 0 | Yes (1) | 0.50000 |
| ENDOSCOPY CENTER LLC | |||||||||||||
| 13421 OLD MERIDIAN ST STE 150 | CARMEL | IN | 46032 | 320029881 | ENDOSCOPY CENTER | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | $578,601 | $314,246 | 0 | 0 | 0.51000 |
| HANCOCK PHYSICIAN NETWORK LLC | |||||||||||||
| 801 N STATE STREET | GREENFIELD | IN | 46140 | 352051598 | PRIMARY CARE PHYSICIAN PRACTICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | -$3,111,767 | $2,034,584 | 0 | Yes (1) | 0.50000 |
| HCH SVH CATH LAB SERVICES LLC | |||||||||||||
| 1000 N 16TH STREET | NEW CASTLE | IN | 47362 | 452087950 | CATH LAB SERVICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | -$357,761 | $1,333,459 | 0 | Yes (1) | 0.50000 |
| MERIDIAN HEIGHTS ASSOCIATES LLC | |||||||||||||
| 6100 W 96TH STREET STE 250 | INDIANAPOLIS | IN | 46278 | 264020296 | REAL ESTATE HOLDING | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | $3,773,781 | 0 | Yes (1) | 0.50000 | |
| NAAB ROAD SURGERY CENTER LLC | |||||||||||||
| 8260 NAAB ROAD STE 100 | INDIANAPOLIS | IN | 46260 | 351991390 | AMBULATORY SURGERY CENTER | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | $3,167,357 | $1,838,718 | 0 | Yes (1) | 0.51000 |
| NEURO ONCOLOGY EQUIPMENT LLC | |||||||||||||
| 10330 N MERIDIAN ST STE 430N | INDIANAPOLIS | IN | 46290 | 743103803 | SALE AND RENTAL SERVICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | $396,120 | $1,386,917 | 0 | Yes (1) | 0.50000 |
| STVINCENT HEALTHUSP LLC | |||||||||||||
| 15305 DALLAS PKWY STE 1600 | ADDISON | TX | 75001 | 203749962 | AMBULATORY SURGERY CENTER | IN | STVINCENT HEALTH INC | RELATED | $84,964 | $161,818 | 0 | Yes (1) | 0.50000 |
| STVINCENT HEART CENTER OF INDIANA LLC | |||||||||||||
| 10580 N MERIDIAN STREET | INDIANAPOLIS | IN | 46290 | 364492612 | HEART HOSPITAL | IN | CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC | RELATED | $24,931,443 | $79,758,894 | 0 | 0 | 0.74080 |
| WOMEN'S PHYSICIAN SURGERY CENTER LLC | |||||||||||||
| 8081 TOWNSHIP LINE ROAD | INDIANAPOLIS | IN | 46260 | 352086841 | AMBULATORY SURGERY CENTER | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | -$122,846 | $45,663 | 0 | 0 | 0.58900 |
| AMBULATORY CARE CENTER LLC | |||||||||||||
| 1125 PROFESSIONAL BLVD | EVANSVILLE | IN | 47714 | 352006018 | OP SURGERY | IN | ST MARY'S HEALTH SERVICES INC | RELATED | $5,266,312 | $5,068,766 | 0 | Yes (1) | 0.50000 |
| SETON HEALTH SERVICES LLC | |||||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 270451316 | EQUIPMENT RENTAL | IN | ST MARY'S HEALTH SERVICES INC | RELATED | $45,743 | $55,336 | 0 | Yes (1) | 0.50000 |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT CO LLC | |||||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205062635 | MANAGEMENT SERVICES | IN | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | RELATED | $465,380 | $321,989 | 0 | Yes (1) | 0.75000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL GROUP INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352076827 | EIN |
| Primary Activities | INVESTMENT | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | -$1,556,561 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $257,378 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | ||
| C | $3,700,345 | FMV OF SERVICES OR CASH |
| ST MARY'S MEDICAL GROUP LLC FKA ST MARY'S PHYSICIANS' HEALTH GROUP LLC | ||
| R | $282,148 | FMV OF SERVICES OR CASH |
| ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | ||
| P | $1,386,408 | FMV OF SERVICES OR CASH |
| ST MARY'S HEALTH INC | ||
| P | $355,227 | FMV OF SERVICES OR CASH |