ST VINCENT SALEM HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ST VINCENT SALEM HOSPITAL INC (EIN 27-0847538)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201541339349305719
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T17:52:54-05:00 | 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 | 46204 | 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 | 270847538 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | StVincent Salem Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STVI | BusinessNameControlTxt |
| Phone | 8128835881 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 911 N Shelby Street | AddressLine1 |
| City | Salem | City |
| State | IN | State |
| ZIP Code | 47167 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dana M Muntz | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Phone | 8128835881 | 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 | Dana Muntz | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 911 N Shelby Street | AddressLine1 |
| City | Salem | City |
| State | IN | State |
| ZIP Code | 47167 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,120,765 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stvincent.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | We are a nonprofit hospital dedicated to providing healthcare that leaves no one behind. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 153 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $43,718 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,741 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,849,351 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,619,465 | CYProgramServiceRevenueAmt |
| PY Investment Income | $248,700 | PYInvestmentIncomeAmt |
| CY Investment Income | $325,609 | CYInvestmentIncomeAmt |
| PY Other Revenue | $173,563 | PYOtherRevenueAmt |
| CY Other Revenue | $166,950 | CYOtherRevenueAmt |
| PY Total Revenue | $22,315,332 | PYTotalRevenueAmt |
| CY Total Revenue | $23,120,765 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,987,671 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,574,713 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,743,201 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,354,380 | PYOtherExpensesAmt |
| CY Other Expenses | $12,632,005 | CYOtherExpensesAmt |
| PY Total Expenses | $20,929,093 | PYTotalExpensesAmt |
| CY Total Expenses | $22,362,877 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,386,239 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $757,888 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,650,336 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,525,386 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,123,833 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,736,916 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,526,503 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,788,470 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | St.Vincent Salem Hospital is dedicated to providing spiritually-centered, holistic healthcare that sustains and improves the health of those served, with special attention to the poor and vulnerable. Both inpatient and outpatient health services are provided without regard to patient race, creed, national origin, economic status, insurance status or ability to pay. This mission extends well beyond the provision of core medical services to encompass medical and scientific research programs, the training and educating of health care professionals and active support of community-based partnerships and programs to improve health and quality of life. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,540,368 | ExpenseAmt |
| Grant | $1,987,671 | GrantAmt |
| Revenue | $22,619,465 | RevenueAmt |
| Desc | St.Vincent Salem Hospital is a 25-bed, critical access hospital serving rural Washington and contiguous counties and providing services without regard to patient race, creed, national origin, economic status, or ability to pay. St.Vincent Salem Hospital provides inpatient and outpatient health care services with a 24 hour emergency department that is staffed with an on-site physician. During fiscal year 2014, St.Vincent Salem Hospital treated 238 adults and children for a total of 884 inpatient days of service. The hospital also provided services for 29,285 outpatient visits, including 1,399 outpatient surgeries and 8,275 emergency room and minor care visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,330,111 | ExpenseAmt |
| Desc | St.Vincent Salem Hospital provides a substantial portion of its core health services to the poor, uninsured or underinsured and has proactively taken steps to address the accessibility, financing, and delivery of healthcare to the underserved. During the fiscal year ending June 30, 2014, the unreimbursed cost of free or discounted services provided to patients who were deemed indigent under state, county, or hospital guidelines was $3,330,111 which included $1,212,649 of traditional charity care and $2,117,462 in unpaid costs of care for those qualifying for Medicaid or other public programs for the poor. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $18,249 | ExpenseAmt |
| Desc | In addition to core medical services, St.Vincent Salem Hospital partners with its community to assess community assets and needs and to work together to address issues impacting health and quality of life, with special emphasis on the poor and vulnerable. In fiscal year 2014, St.Vincent Salem Hospital provided $18,249 in unbilled services to the poor and to the broader community. (When combined with the costs of free or discounted services for the poor listed in Line 4b, St.Vincent Salem Hospital provided a total Community Benefit of $3,348,360 in fiscal year 2014.) St.Vincent Salem Hospital serves and supports its community through such programs student training, health fairs, and screenings. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $19,888,728 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 153 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | Marla S Hannah | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8128835881 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 911 N Shelby Street | AddressLine1 |
| City | Salem | City |
| State | IN | State |
| ZIP Code | 47167 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Aaron Lee | ||||||||
| Chair | 0.20 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Carroll Tash | ||||||||
| Vice Chair | 0.20 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Fultz | ||||||||
| Treasurer | 0.20 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Stephen E Kemker MD | ||||||||
| Director | 0.20 | 40.00 | Yes (X) | $0 | $93,988 | $10,919 | ||
| John Mishler | ||||||||
| Director | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jeffrey G Morgan MD | ||||||||
| Director | 0.20 | 40.00 | Yes (X) | $0 | $587,677 | $30,955 | ||
| Janette L Helm | ||||||||
| Director | 0.20 | 40.20 | Yes (X) | $0 | $101,876 | $22,012 | ||
| Wayne Knight Thru 122013 | ||||||||
| CFO | 15.00 | 45.20 | Yes (X) | $0 | $156,694 | $25,355 | ||
| Joe Kubala | ||||||||
| CFO | 15.00 | 30.00 | Yes (X) | $0 | $124,391 | $8,916 | ||
| Dana M Muntz | ||||||||
| Administrator | 40.00 | 0.00 | Yes (X) | $128,326 | $0 | $5,939 | ||
| James D Passereni | ||||||||
| Pharmacy Manager | 40.00 | 0.00 | $130,708 | $0 | $24,434 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $259,034 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,064,626 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $128,530 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Mid America Clinical Laboratories LLC | |||||
| 6704 Reliable Parkway | Chicago | IL | 606860067 | Lab services | $1,115,158 |
| StVincent Emergency Physicians | |||||
| 4420 N Pennsylvania | Indianapolis | IN | 462051728 | Physician services | $390,000 |
| Insight Investments LLC | |||||
| Wells Fargo Bank NW NA | Salt Lake City | UT | 84116 | Medical equipment services | $213,523 |
| Ameripath Indianapolis LLC | |||||
| 2650 N Shadeland Ave | Indianapolis | IN | 46219 | Physician services | $163,902 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $777 | RelatedOrganizationsAmt |
| All Other Contributions | $7,964 | AllOtherContributionsAmt |
| Total Contributions | $8,741 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient revenues | 621990 | $12,179,255 | $12,179,255 |
| Net Medicare/Medicaid | 621990 | $10,440,210 | $10,440,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,619,465 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $325,609 | TotalRevenueColumnAmt |
| Exclusion | $325,609 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $110,924 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $110,924 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,924 | TotalRevenueColumnAmt |
| Exclusion | $110,924 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Cafeteria revenue | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $56,026 | TotalRevenueColumnAmt |
| Exclusion | $56,026 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $56,026 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,120,765 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,619,465 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $492,559 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,987,671 | TotalAmt |
| Program Services | $1,987,671 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,265 | TotalAmt |
| Management And General | $134,265 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,729,375 | TotalAmt |
| Program Services | $4,934,716 | ProgramServicesAmt |
| Management And General | $794,659 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,490,662 | TotalAmt |
| Program Services | $1,283,909 | ProgramServicesAmt |
| Management And General | $206,753 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $388,899 | TotalAmt |
| Program Services | $334,959 | ProgramServicesAmt |
| Management And General | $53,940 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,055,930 | TotalAmt |
| Program Services | $909,474 | ProgramServicesAmt |
| Management And General | $146,456 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,896 | TotalAmt |
| Program Services | $37,808 | ProgramServicesAmt |
| Management And General | $6,088 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,295 | TotalAmt |
| Program Services | $8,867 | ProgramServicesAmt |
| Management And General | $1,428 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,757 | TotalAmt |
| Program Services | $159,993 | ProgramServicesAmt |
| Management And General | $25,764 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,168 | TotalAmt |
| Program Services | $665,069 | ProgramServicesAmt |
| Management And General | $107,099 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,228 | TotalAmt |
| Program Services | $24,313 | ProgramServicesAmt |
| Management And General | $3,915 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $949,086 | TotalAmt |
| Program Services | $817,449 | ProgramServicesAmt |
| Management And General | $131,637 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,350 | TotalAmt |
| Program Services | $22,350 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Community benefit | $3,348,360 | $3,348,360 | |
| Purchased services | $3,046,244 | $2,623,733 | $422,511 |
| Supplies | $1,071,059 | $922,504 | $148,555 |
| Corporate expense | $772,688 | $665,517 | $107,171 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,325,944 | TotalAmt |
| Program Services | $1,142,036 | ProgramServicesAmt |
| Management And General | $183,908 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,362,877 | TotalAmt |
| Program Services | $19,888,728 | ProgramServicesAmt |
| Management And General | $2,474,149 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,556 | BOYAmt |
| EOY | $30,956 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,138,891 | BOYAmt |
| EOY | $3,084,027 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,528 | BOYAmt |
| EOY | $388,544 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,890 | BOYAmt |
| EOY | $158,643 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,350,750 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,361,442 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,407,227 | BOYAmt |
| EOY | $989,308 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $661,742 | BOYAmt |
| EOY | $243,799 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,474,502 | BOYAmt |
| EOY | $8,630,109 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,650,336 | BOYAmt |
| EOY | $13,525,386 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,439,726 | BOYAmt |
| EOY | $1,375,167 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,684,107 | BOYAmt |
| EOY | $1,361,749 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,123,833 | BOYAmt |
| EOY | $2,736,916 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,469,916 | BOYAmt |
| EOY | $10,726,250 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,587 | BOYAmt |
| EOY | $62,220 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,526,503 | BOYAmt |
| EOY | $10,788,470 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,650,336 | BOYAmt |
| EOY | $13,525,386 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $757,888 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $579,162 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$75,083 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,487 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,487 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St.Vincent Salem Hospital, Inc. does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,877,174 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,152,755 | DepreciationAmt |
| Book Value | $724,419 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $436,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $208,687 | DepreciationAmt |
| Book Value | $227,355 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,534 | OtherCostOrOtherBasisAmt |
| Book Value | $37,534 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $989,308 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Receivable from third party programs | $300,647 |
| Due from St.Vincent Health, Inc. | $586,805 |
| Restricted by donor | $62,220 |
| Other assets | $8,658 |
| Interest in investments held by Ascension Health Alliance | $7,671,779 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,630,109 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to third party payors | $723,485 |
| Due to St.Vincent Health, Inc. | $595,978 |
| Pension liability | $42,286 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,361,749 | TotalLiabilityAmt |
| 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 H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,212,649 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,212,649 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05420 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,330,350 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,212,888 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,117,462 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09470 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,542,999 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,212,888 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,330,111 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14890 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4203 | PersonsServedCnt |
| Total Community Benefit Expns | $28,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,494 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,384 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 118 | PersonsServedCnt |
| Total Community Benefit Expns | $3,445 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,445 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 288247 | PersonsServedCnt |
| Total Community Benefit Expns | $5,420 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,420 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 292568 | PersonsServedCnt |
| Total Community Benefit Expns | $37,743 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,494 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,249 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 292568 | PersonsServedCnt |
| Total Community Benefit Expns | $4,580,742 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,232,382 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,348,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14970 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 100125 | PersonsServedCnt |
| Total Community Benefit Expns | $2,510 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,510 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6 | PersonsServedCnt |
| Total Community Benefit Expns | $65 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $160 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $240 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $240 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 34122 | PersonsServedCnt |
| Total Community Benefit Expns | $2,355 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,355 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 134304 | PersonsServedCnt |
| Total Community Benefit Expns | $5,330 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,330 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $500,630 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $150,189 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,142,882 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,072,160 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $70,722 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | StVincent Salem Hospital Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 911 N Shelby Street | AddressLine1 |
| City | Salem | City |
| State | IN | State |
| ZIP Code | 46167 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://www.stvincent.org/salem/ | WebsiteAddressTxt |
| State License | 14-005087-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | StVincent Salem Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.stvincent.org/CHNA/ | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St.Vincent Salem Hospital, Inc. | Part V, Section B, Line 3: In conducting its CHNA, the hospital facility took into account input from representatives of the community as well as those with special knowledge or expertise in public health. These included, but are not limited to, Pauline Shen, an Indiana-based epidemiologist and consultant with extensive experience in public health, Washington County School Corporation, YMCA, Hoosier Uplands, Washington County Health Department, Youth First, Washington County Chamber of Commerce, and Washington County Service Providers. |
| St.Vincent Salem Hospital, Inc. | Part V, Section B, Line 7: Affordable Health Care/Medication - St.Vincent Health is in the process of planning communications regarding the new healthcare coverage options resulting from the Affordable Care Act.Substance Abuse - The hospital lacks the resources to fully address this issue. However, it does support AA, 12-Step Program, and Substance Abuse Council. A local mental health agency, LifeSpring, offers prevention, intervention and treatment services.Unemployment - Addressing this issue is not a direct priority of our hospital; however, we do partner with the organization, Experience Works, by offering work experience for their participants. |
| St.Vincent Salem Hospital, Inc. | Part V, Section B, Line 20d: The discount was determined by reviewing the lowest discount provided to managed care payers that comprise at least 3% of our volume with an added prompt pay discount to the highest paid discount provided to our managed care payers. |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The organization provides medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. The hospital uses a percentage of federal poverty level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to the national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 200% of the FPL but not exceeding 400% of the FPL, subject to adjustments for cost of living utilizing the local wage index compared to national wage index, will receive a discount on the services provided to them. |
| Part I, Line 7: | The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. |
| Part II, Community Building Activities: | St.Vincent Salem Hospital promotes the health of its communities by striving to improve the quality of life within the community. Research has established that factors such as economic status, employment, housing, education level, and built environment can all be powerful social determinants of health. Additionally, helping to create greater capacity within the community to address a broad range of quality of life issues also impacts health. St.Vincent Salem Hospital meets regularly with local organizations in the community to learn what resources are available and plan community health improvement efforts. In fiscal year 2014, these organizations included: Washington County School Corporation, YMCA, Hoosier Uplands, Youth First, Washington County Chamber of Commerce, and Washington County Service Providers. |
| Part III, Line 2: | After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2014 was $1,540,042 at charges, ($500,630 at cost). |
| Part III, Line 3: | The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. |
| Part III, Line 4: | The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19. |
| Part III, Line 8: | A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Part III, Line 9b: | The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. |
| Part VI, Line 2: | Communities are dynamic systems in which multiple factors interact to impact quality of life and health status. In addition to the formal CHNA conducted every 3 years, St.Vincent Salem Hospital participates in many coalitions, including Washington County Service Providers whose purpose is to assess needs within the community, prioritize action and work in partnership to address identified challenges. The coalition works closely with its member organizations which come from multiple sectors of the community, including local government, business, education, faith communities, public health, health care providers and other social and human service organizations. In addition, the coalition works closely with other coalitions as well as the local and state health departments to stay abreast of changing needs within the community by identifying evidence-based and promising practices to address these needs. |
| Part VI, Line 3: | St.Vincent Salem Hospital communicates with patients in multiple ways to ensure that those who are billed for services are aware of the hospital's financial assistance program as well as their potential eligibility for local, state or federal programs. Signs are prominently posted in each service area, and bills contain a formal notice explaining the hospital's charity care program. In addition, the hospital employs financial counselors, health access workers, and enrollment specialists who consult with patients about their eligibility for financial assistance programs and help patients in applying for any public programs for which they may qualify. |
| Part VI, Line 4: | St.Vincent Salem Hospital is located in Salem, Indiana and serves rural Washington and contiguous counties, in south Central Indiana. Washington County has an estimated population of 27,595. There has been a decline of 2.4 percent in the overall population from 2010 to 2014. The population is 97.1 percent White, .7 percent African American, .3 percent Asian, and 1.7 percent Hispanic. Per Capita Personal Income and Median Household Income is below the state average. Manufacturing is the county's leading industry. |
| Part VI, Line 5: | To provide the highest quality healthcare to all persons in the community, and in keeping with its not-for-profit status, St.Vincent Salem Hospital:- delivers patient services, including emergency department services, to all individuals requiring healthcare, without regard to patient race, ethnicity, economic status, insurance status or ability to pay- maintains an open medical staff that allows credentialed physicians to practice at its facilities- trains and educates health care professionals- participates in government-sponsored programs such as Medicaid and Medicare to provide healthcare to the poor and elderly- is governed by a board in which independent persons who are representative of the community comprise a majority |
| Part VI, Line 6: | As part of the St.Vincent Health System, St.Vincent Salem Hospital is dedicated to improving the health status and quality of life for the communities it serves. While designated associates at St.Vincent Salem Hospital devote all or a significant portion of their time to leading and administering local community-based programs and partnerships, associates throughout the organization are active participants in community outreach. They are assisted and supported by designated St.Vincent Health Community Development associates and other support staff who work with each of its healthcare facilities to advocate for and provide technical assistance for community outreach, needs assessments and partnerships as well as to support regional and state-wide programs, and community programs sponsored by St.Vincent Health in which St.Vincent Salem Hospital participates. |
| Form 990, Part III, Line 4a, 4b and 4c: | Community Benefit ReportSt.Vincent Salem Hospital provides the following hospital services: Emergency Medicine, Immediate Care, Laboratory Services, Outpatients Services, Pastoral Care, Radiology, Rehabilitation Therapy, and Surgery. Some of these services operate at a loss in order to ensure that comprehensive services are available to the community.Such community-focused programs improve access to healthcare, advocate for the poor and vulnerable, promote health through free education and screenings and help to build better communities by improving quality of life. |
| Community Benefit Overview | St.Vincent Salem Hospital is part of St.Vincent Health, a non-profit healthcare system consisting of 22 locally-sponsored ministries serving over 47 counties throughout Central Indiana. Sponsored by Ascension Health, the nation's largest Catholic healthcare system, St.Vincent Health is one of the largest healthcare employers in the state. As part of St.Vincent Health, the St.Vincent Salem vision is to deliver a continuum of holistic, high-quality health services and improve the lives and health of Indiana individuals and communities, with special attention to the poor and vulnerable. This is accomplished through strong partnerships with businesses, community organizations, local, state and federal government, physicians, St.Vincent Salem associates and others. Working with its partners, and utilizing the CHNA completed every three years, St.Vincent Salem Hospital is committed to addressing community health needs and developing and executing an implementation strategy to meet identified needs to improve health outcomes within the community. Community benefit is not the work of a single department or group within St.Vincent Salem, but is part of the St.Vincent mission and cultural fabric. The hospital leadership team provides direction and resources in developing and executing the Implementation Strategy in conjunction with the St.Vincent Health Community Development Department, but associates at all levels of the organization contribute to community benefit and health improvement. |
| Community Building Activities | Research shows that social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on improving the quality of life within a community, ultimately influence and improve health status. Christmas AssistanceEach year, St.Vincent Salem associates reach into their pockets to purchase Christmas gift items for families in need. During work time, department associates contact families, create needs lists, collect donations, shop items, wrap items and deliver food and packages to these families.Community Building Cash and In-Kind ContributionsThe hospital makes cash and in-kind donations to a variety of community organizations focused on building the community. These take the form of cash donations to outside organizations, the donation of employee time/services to outside organizations and the representation of the hospital on community boards and committees working to improve infrastructure for the community. |
| Charity Care and Certain Other Community Benefits at Cost | Patient Services for Poor and Vulnerable Hospital and outpatient care is provided to patients that cannot pay for services, including hospitalizations, surgeries, prescription drugs, medical equipment and medical supplies. Patients with income less than 200% of the Federal Poverty level (FPL) are eligible for 100% charity care for services. Patients with incomes at or above 200% of the FPL, but not exceeding 400% of the FPL, receive discounted services based on an income-dependent sliding scale. Hospital financial counselors and health access workers assist patients in determining eligibility and in completing necessary documentation. St.Vincent Salem Hospital is committed to 100% access, and is proactive in providing healthcare that leaves no one behind. Public Program Participation St.Vincent Salem Hospital participates in government programs including Medicaid, SCHIP (Hoosier Healthwise), Healthy Indiana Plan (HIP), the Insurance Exchange and Medicare and assists patients in enrolling for programs for which they are eligible. Per Catholic Health Association guidelines and St.Vincent Health's conservative approach, Medicare shortfall is not included as community benefit. Community Health Needs Assessment True community benefit responds to the particular needs and challenges of the community, building on its unique strengths and assets. The hospital leads a community health needs assessment every 3 years. Using a variety of tools, including surveys, key person interviews, focus groups, secondary data, and data analysis professionals, the team identifies community issues and concerns. These are shared with the community at large, and a consensus is reached about priorities and available resources. To provide community input and a basis for collaboration within the community to address health needs, St.Vincent leads or participates in a community roundtable or forum. This group brings together individuals and organizations from throughout the community who share a common interest in improving health status and quality of life and provide expertise in a variety of community areas including public health needs. Tobacco use, physical inactivity, poor nutrition, educational attainment, and infant mortality have all been identified as key community needs.Implementation Strategy Using the CHNA completed in fiscal year 2013, the hospital developed a 2014-2016 Implementation Strategy to address priority community health needs. These strategies include:1. Tobacco Use Prevent youth from initiating the use of tobacco, reduce exposure to secondhand smoke and increase cessation - As a member of the Community Readiness Committee of the Washington County Tobacco Prevention & Cessation Coalition, support the initiative to implement a comprehensive smoke free air ordinance for the city of Salem.2. Physical Inactivity Increase physical activity in order to prevent obesity and reduce the prevalence of chronic health conditions- As a member of the W.O.W. Committee, create a strategic plan which includes identifying funding opportunities and creating documents showcasing existing walking and biking paths.3. Poor Nutrition Educate the community about proper nutrition in order to prevent chronic health conditions- Offer 12 diabetes support group sessions to the community per year.- As a board member of the Washington County Artisans and Farmers Market, work to procure SNAP benefits as an acceptable form of payment and promote this fact to low-income and underserved populations.4. Educational Attainment Increase educational attainment in order to reduce barriers to healthcare and to the ability to practice healthy behaviors- Participate in/support "Put Your Nose in a Book" reading program, "The Dictionary Class" and/or "Adult Tutoring Training Class" at least 3 times a year.- As a member of the Washington County Education Matters Advisory Committee, create a strategic plan to increase educational attainment by collaborating with local business and partners outside of Washington County.5. Infant Mortality Provide education regarding preventive measures to reduce infant deaths within the first year of life- As a member of the Child Protection Coalition, educate the community about safe sleeping habits and the risks associated with secondhand smoke exposure to prevent infant deaths by distributing educational information in obstetrics and pediatrics physician offices, W.I.C., at the county fair, and in the local newspaper. Cancer Crusaders Support GroupSt.Vincent Salem sponsors a monthly support group to help those recently diagnosed with cancer, or family members of cancer patients, cope with the significant health challenges and family issues surrounding a cancer diagnosis. Topics such as medications, side effects of treatment, grief issues and other health concerns are covered. St.Vincent Salem provides expert facilitation, meeting coordination, materials and meeting space for each support group. Diabetes Support GroupDiabetes is a major and growing health concern in Southern Indiana. If uncontrolled, it can take a significant toll on an individual's health and life. St.Vincent Salem sponsors a Diabetes Support Group held monthly, free of charge. A registered dietitian addresses problems surrounding living with and managing diabetes. The dietitian assists individuals living with diabetes in gaining a better understanding of the disease; teaching them how to adjust their lifestyles and behaviors to develop diabetes self-management skills that will help them live healthier, longer lives. Relay for Life Each year, the American Cancer Society hosts Relay for Life, a 24-hour walk to raise funds and awareness for all forms of cancer. St.Vincent Salem is a major sponsor of this event. The Washington County Relay for Life was held at the Salem High School track. St.Vincent Salem Hospital and their associates raised money by holding several different fundraisers, including a bake sale, a BBQ dinner, a 5K run/walk in honor of an associate who died of cancer, and a basket auction. Over $11,000 was raised by the hospital for the 2014 Washington County Relay for Life.Health Fairs and ScreeningsSt.Vincent Salem participated in several health fairs and screenings throughout the year, and sponsored the Community Health Screening Day held at the hospital. Participants were tested for blood pressure, pulmonary, cholesterol, and more at low or no cost. Materials on health information and preventive services are a vital part of health fairs and screenings. During fiscal year 2014, St.Vincent Salem served nearly 250 people through its participation in these health fairs and screenings.Health Professionals Clinical TrainingIn an effort to prepare future healthcare professionals, St.Vincent Salem Hospital offers a variety of clinical settings and internships to undergraduate and vocational allied health professionals. During fiscal year 2014, students from Ivy Tech Community College, Marian College and Vincennes University were provided training. Student TrainingSt.Vincent Salem staff provided an introduction to health care professions for local high school students from West Washington High School and Salem High School. Students received a broad overview of the hospital from many departments including the following: Surgery, Laboratory, Radiology, Pharmacy, Physical Therapy, Emergency Department, Dietary, Human Resource and Public Relations. L.I.F.E. (Lifetime Individual Fitness & Eating) for Kids ProgramObesity among children has become a national epidemic, particularly in Indiana where 1 out of 3 children and 2 out of 3 adults are overweight or obese. Life-threatening conditions such as type 2 diabetes, hypertension and heart disease, just to name a few, are also increasing among this population. L.I.F.E. for Kids is a year-long healthy lifestyle weight management program especially designed for children and adolescents. This program was designed to help families develop healthier eating and physical activity habits through integrated education and counseling from a registered dietitian and physical therapist. Community Benefit Cash and In-Kind ContributionsIn addition to the outreach programs operated by the hospital, the hospital makes cash and in-kind donations to a variety of community organizations focused on improving health status in the community. These take the form of cash donations to outside organizations, the donation of employee time/services to outside organizations and the representation of the hospital on community boards and committees working to improve health status and quality of life within the community. |
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 | StVincent Health Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10330 N Meridian Street Suite 430N | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46290 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 352052591 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $1,987,671 | CashGrantAmt |
| Purpose Of Grant | Net cash transfer to parent company's centralized cash account | 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 | The finance committee ensures that funds are distributed appropriately according to Ascension Health's strategic business plan and consistent with corporate policies and procedures. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffrey G Morgan MD | ||||||||||||||
| Director | $0 | $216,732 | $0 | $370,462 | $0 | $483 | $0 | $3,834 | $0 | $27,121 | $0 | $618,632 | $0 | $0 |
| Wayne Knight Thru 122013 | ||||||||||||||
| CFO | $0 | $153,735 | $0 | $0 | $0 | $2,959 | $0 | $9,463 | $0 | $15,892 | $0 | $182,049 | $0 | $0 |
| James D Passereni | ||||||||||||||
| Pharmacy Manager | $128,133 | $0 | $0 | $0 | $2,575 | $0 | $5,284 | $0 | $19,150 | $0 | $155,142 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | St.Vincent Salem Hospital, Inc. included imputed income for two of the listed officers/directors and highest compensated employees in Part VII. St.Vincent Salem Hospital, Inc. "grossed up" applicable non-business expenses and included in the employees' W-2 as additional taxable compensation. |
| Part I, Line 3 | St.Vincent Health, Inc., a related organization of St.Vincent Salem Hospital, Inc., 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 4a | The following officer received severance payments from the organization or related organization during the calendar year 2013: Joseph Kubala - $34,385 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | St.Vincent Salem Hospital, Inc. has a single corporate member, St.Vincent Health, Inc. |
| Form 990, Part VI, Section A, line 7a | St.Vincent Salem Hospital, Inc. has a single corporate member, St.Vincent Health, Inc. who has the ability to elect members to the governing body of St.Vincent Salem Hospital, Inc. |
| Form 990, Part VI, Section A, line 7b | All decisions that have a material impact to St.Vincent Salem Hospital, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, St.Vincent Health, Inc. |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form 990 to a designated committee of the Board to review and answer any questions. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board member questions. |
| 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 committee 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 15b | Compensation determinations of St.Vincent Salem Hospital, Inc.'s CEO, executive director, or top management official is made by St.Vincent Health, Inc.'s management. The process includes a review and approval by independent persons and comparability data. In review of the compensation, the CEO, executive director, and top management were compared to other hospitals in the area that hold the same position. Compensation determinations of St.Vincent Salem Hospital, Inc.'s other officers or key employees are made by St.Vincent Salem Hospital, 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 other hospitals' employees in the area that hold the same position. |
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. |
| Form 990, Part IX, Line 1: | During the fiscal year, St.Vincent Salem Hospital, Inc.'s parent, St.Vincent Health, Inc., moved to a centralized bank account for all of their related organizations. Some of the amounts shown on Form 990, Part IX, Line 1 represent cash transfers to their parent organization's centralized bank account. |
| Form 990, Part XI, line 9: | FAS 158 deferred pension adjustment -75,083. |
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 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 Ohio Valley Heartcare LLC | |||||||||||
| 901 St Marys Drive | Evansville | IN | 47714 | 273474697 | Cardiology services | IN | 501(C)(3) | 11A, I | Yes (1) | St Mary's Health 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | StVincent Health Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $1,987,671 | InvolvedAmt |
| Method Of Amount Determination | Fair market value | MethodOfAmountDeterminationTxt |