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Bon Secours DePaul Medical Center Inc: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Bon Secours DePaul Medical Center Inc (EIN 54-1820093)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-15
IRS object ID
201401969349301525
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-07-15T17:28:45-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 Peachtree Street Suite 2000AddressLine1
CityAtlantaCity
StateGAState
ZIP Code303031749ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN541820093EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours DePaul Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone7578895000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael K KernerName
TitleSecretary & CEO - BSHRHSTitle
Phone7578895000Phone
Date Signed2014-07-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDavid A CraigName
PTINP00542227PTIN
Phone4042201500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichael K KernerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1150 Kingsley LaneAddressLine1
CityNorfolkCity
StateVAState
ZIP Code23505ZIPCode
FieldValueIRS element (for citing)
Gross Receipts187997208GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bonsecourshamptonroads.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionAcute Care HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees1230TotalNbrEmployees
Total Nbr Volunteers303TotalNbrVolunteers
Total Gross UBI1472376TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year838204ContributionsGrantsPriorYear
Contributions Grants Current Year2617955ContributionsGrantsCurrentYear
Program Service Revenue Prior Year163892701ProgramServiceRevenuePriorYear
Program Service Revenue CY174322547ProgramServiceRevenueCY
Investment Income Prior Year207236InvestmentIncomePriorYear
Investment Income Current Year1133964InvestmentIncomeCurrentYear
Other Revenue Prior Year3606199OtherRevenuePriorYear
Other Revenue Current Year9266099OtherRevenueCurrentYear
Total Revenue Prior Year168544340TotalRevenuePriorYear
Total Revenue Current Year187340565TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year611514GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY371664GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year64723048SalariesEtcPriorYear
Salaries Etc Current Year69455880SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year117750031OtherExpensePriorYear
Other Expenses Current Year125304006OtherExpensesCurrentYear
Total Expenses Prior Year183084593TotalExpensesPriorYear
Total Expenses Current Year195131550TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-14540253RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7790985RevenuesLessExpensesCY
Total Assets BOY118571919TotalAssetsBOY
Total Assets EOY125980704TotalAssetsEOY
Total Liabilities BOY167384136TotalLiabilitiesBOY
Total Liabilities EOY182124543TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-48812217NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-56143839NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense24161218Expense
Revenue32635442Revenue
DescriptionDePaul continues a strong focus on orthopaedic care for residents of Norfolk and Virginia Beach. A special expertise exists in the treatment of spine disorders, with a significant cadre of spine and neurological surgeons. This service includes a continuum of care from pre-operative education through post-op recovery, and is supported by state-of-the-art technology and expert physicians, as well as a comprehensive outpatient rehab network and community outreach events for area residents suffering from joint pain. Bon Secours responds to the needs of all othopaedic patients-from the young athlete to the adult sports medicine patient (weekend warrior or sports enthusiast) to the patient needing significant repair and possibly replacement of joints. A particular focus exists on foot & ankle surgery, with a few fellowship-trained surgeons practicing at DePaul.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense11555150Expense
Revenue11194787Revenue
DescriptionDePaul has recently invested significantly in this service line. A new state-of-the-art neuroendovascular laboratory and a skilled surgeon offer services unique in the area. DePaul continues strong relationships with other Bon Secours hospitals and serves as a regional referral center for the delivery of advanced neurosciences services and interventions. In addition, DePaul is supported by an extensive network of neurologists and neurosurgeons, many of which have sub-specialties such as sleep medicine, motion disorders, pain management, etc. DePaul's board-certified team of neurology, neurological, neurointerventional, neuroradiology, and neuropsychology specialists offers the latest and most effective treatments in the management of a complete spectrum of nervous system disorders.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense10673103Expense
Revenue9403054Revenue
DescriptionDePaul operates a bariatric surgery program, modeled on the successful program already in place at sister facility Maryview. The program has met the requirements to seek Center of Excellence designation and we have submitted all the necessary documentation. DePaul has long been known for its premier gynecological oncology program, treating women from a 5-state area. Specialized OR, diagnostic, therapeutic, and nursing services are available to treat this disease, alongside specialty-trained expert physicians. DePaul is working extensively with neurosurgeons and neuroendovascualr specialists to expand this part of the surgery service. New services added include craniotomy surgery, deep brain stimulation, advanced spinal surgeries, and other neuroendovascular surgical procedures. Finally, DePaul now operates the busiest daVinci surgical robot in all of Virignia, used for gynecological, gyn oncolgical, and urological minimally invasive surgical procedures.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense131520737Expense
Grants371664Grants
Revenue127244290Revenue
DescriptionOther major services offered by Bon Secours DePaul Medical Center include a Birthing Center, Sleep, Gastroenterology and Pulmonary services. In addition, Bon Secours DePaul Medical Center offers a full service 24 hour Emergency Room.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp131520737TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt371664TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev127244290TotalOfOtherProgramServiceRev
Total Program Service Expense177910208TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109671NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1230NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7572152709TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd Suite 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Michael D Blount
HR JT BM2.000.00X000
Bruce Britton MD
HR JT BM2.000.00X000
Arthur L Collins
HR JT BM2.000.00X000
Sr Elaine Davia
HR JT BM2.000.00X000
Timothy J Davis
HR JT BM2.0048.00X01122284134895
William H Kline
HR JT BM2.000.00X000
Michael S LaRock
HR JT BM2.000.00X000
Carol Ormond
HR JT BM2.000.00X000
P Ward Robinett Jr
HR JT BM2.000.00X000
R B Seal MD
HR JT BM2.000.00X000
Stephanie Short
HR JT BM (Jan-Aug)2.000.00X000
Robert Squatrito MD
HR JT BM2.000.00X000
Deborah K Stearns
HR JT BM (Sept-Dec)2.000.00X000
Sr Rita Thomas
HR JT BM2.001.00X000
Douglas Ziegenfuss
HR JT BM (Jan-Aug)2.000.00X000
J Robert Bray
HR JT Chairman (Jan-Aug)3.000.00X000X
Sr Patricia Heath
HR President3.0047.00X000X
Linwood E Howard
HR JT Chairman (Sept-Dec)3.000.00X000X
Michael K Kerner
Sec/CEO BSHRHS15.5034.50X0936925132770X
John Barrett
CEO/DMC49.500.50038939831975X
Melinda S Hancock
CFO-Bon Secours VA3.0047.00034394127968X
Charmaine Rochester
Treas/VP Fin. (Mar-Aug)15.5034.50013541713585X
Michael J Bratton
VP of Patient Care Ser.50.000.00212818015274X
Devin T McKeever
COO-BSMG (Sep-Mar)15.0035.00019935012010X
James B Sherwood
Chief Admin Officer15.0035.00028524938182X
John R Baker MD
Physician50.000.001067907037334X
Robert B Hansen MD
Physician50.000.00409565033654X
Saumil V Patel MD
Physician50.000.00369571034027X
George Sarris MD
Physician50.000.00592833037179X
Timothy Willox MD
VP of Medical Affairs50.000.003483340256X
Joe Buchheit
Former CFO-BSHRHS0.0050.00032640025031X
Ernie Padden
Former Int. CFO-BSHRHS0.000.0002015003120X
David Setchel
Former VP Operations0.000.00205227024014X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3206255TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3940464TotalReportableCompFrmRltdOrgs
Total Other Compensation601274TotalOtherCompensation
Number Individuals GT100 K79NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Rehabcare Group East Incorporated
PO Box 502096St LouisMD631502096Rehabilitation Services4841075
Eastern Virginia Medical School
PO Box 1980NorfolkVA235011980Residency Fees/Physician Services1545752
Odell Assoc Inc
PO Box 538242AtlantaGA303538242Architecture/Engineering Services1276071
Aramark CTS Inc
12483 Collections Ctr DrChicagoIL60693Biomedical Engineering Services1247458
Bayview Physician Services
3241 Western Branch BlvdChesapeakeVA23321Medical Director/Physician Services1111904
FieldValueIRS element (for citing)
Number Of Contractors GT100 K44NumberOfContractorsGT100K
Related Organizations34235RelatedOrganizations
Government Grants2583470GovernmentGrants
All Other Contributions250AllOtherContributions
Total Contributions2617955TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code622110BusinessCode
Total Revenue Column174322547TotalRevenueColumn
Related Or Exempt Function Income172975919RelatedOrExemptFunctionIncome
Unrelated Business Revenue1346628UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue174322547TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column172504TotalRevenueColumn
Exclusion$172,504ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real693967Real
Personal14150Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real622644Real
Personal7419Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real71323Real
Personal6731Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column78054TotalRevenueColumn
Unrelated Business Revenue26187UnrelatedBusinessRevenue
Exclusion$51,867ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities988040Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other26580Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities988040Securities
Other-26580Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column961460TotalRevenueColumn
Exclusion$961,460ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
JV Inc.- SPAH & Other62199971313386532220$599,118
Resident FICA Refund900099969434969434
Ret Sales-Metabol. Rev446199253217$253,217

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column834056TotalRevenueColumn
Unrelated Business Revenue99561UnrelatedBusinessRevenue
Exclusion$734,495ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue9188045TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column187340565TotalRevenueColumn
Related Or Exempt Function Income180477573RelatedOrExemptFunctionIncome
Unrelated Business Revenue1472376UnrelatedBusinessRevenue
Exclusion$2,772,661ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total371664Total
Program Services371664ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total307087Total
Program Services276378ProgramServices
Management And General30709ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total55586047Total
Program Services50027442ProgramServices
Management And General5558605ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2910850Total
Program Services2619765ProgramServices
Management And General291085ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6199093Total
Program Services5579184ProgramServices
Management And General619909ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4452803Total
Program Services4007523ProgramServices
Management And General445280ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total570163Total
Program Services513147ProgramServices
Management And General57016ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total100050Total
Program Services90045ProgramServices
Management And General10005ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total28264Total
Program Services25438ProgramServices
Management And General2826ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10995450Total
Program Services9895905ProgramServices
Management And General1099545ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total149227Total
Program Services134304ProgramServices
Management And General14923ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3736871Total
Program Services3363184ProgramServices
Management And General373687ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total144636Total
Program Services130172ProgramServices
Management And General14464ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4616892Total
Program Services4155203ProgramServices
Management And General461689ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total212782Total
Program Services191504ProgramServices
Management And General21278ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total66664Total
Program Services59998ProgramServices
Management And General6666ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2005676Total
Program Services2005676ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9204824Total
Program Services8284342ProgramServices
Management And General920482ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1503546Total
Program Services1353191ProgramServices
Management And General150355ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services36046205324415853604620
Medical Expenses28791759259125832879176
Bad Debt Expense2054077920540779
BSHSI Mgmt Allocation35741003216690357410

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3016118Total
Program Services2714506ProgramServices
Management And General301612ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total195131550Total
Program Services177910208ProgramServices
Management And General17221342ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5173BOY
EOY5381EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY64152BOY
EOY409620EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY49513BOY
EOY4313EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21530873BOY
EOY21203700EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3309094BOY
EOY3521208EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1179995BOY
EOY1318096EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis120339587LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec82572515LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY40411198BOY
EOY37767072EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11571220BOY
EOY12805625EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY22478728BOY
EOY32143009EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY5263864BOY
EOY5263864EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12708109BOY
EOY11538816EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY118571919BOY
EOY125980704EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11803086BOY
EOY9849749EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY3023677EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY155581050BOY
EOY169251117EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY167384136BOY
EOY182124543EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-48839252BOY
EOY-56127674EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY27035BOY
EOY-16165EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-48812217BOY
EOY-56143839EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY118571919BOY
EOY125980704EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7790985ReconcilationRevenueExpenses
Reconciliation Unrealized Invest64197ReconciliationUnrealizedInvest
Reconcilation Other Changes395166ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers1Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$15,822DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$12,442OtherActivitiesAmount
Total Lobbying Expenditures IIB28264TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationThe filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. The filing organization also conducted advocacy relating to education of legislative body regarding hospital and healthcare reform and how it impacts communities.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3750383OtherCostOrOtherBasis
Book Value3750383BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis30530217OtherCostOrOtherBasis
Depreciation19519848Depreciation
Book Value11010369BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4136055OtherCostOrOtherBasis
Depreciation2448710Depreciation
Book Value1687345BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis81922932OtherCostOrOtherBasis
Depreciation60603957Depreciation
Book Value21318975BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings37767072TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (8 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Inv. in Sentara Princess Anne Hosp.29010948C
Inv. in Surgery Center510182C
Inv. - VA Health Network50000C
Inv. - Positrom Emission Tom.55000C
Inv. in Peninsula Hospital Service265423C
Inv. in Pad Svc of Hampton Roads1002010C
Inv. in Bed Licenses1142699C
Inv. in MRI106747C
FieldValueIRS element (for citing)
Total Of Book Value Program Related32143009TotalOfBookValueProgramRelated

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
LT Non-Cash Inv - HPL/GL6751140
Other & Third Party Payor1469422
Non-patient A/R1029795
Other Accrued Revenue881533
Organizational Costs439493
Other Non Accute Rec.84081
Due from Affiliates64124
Due from Champus819228
FieldValueIRS element (for citing)
Total Book Value Other Assets11538816TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
Due to BSHSI$153,868,956
Inv - HPL/GL Liability$6,751,140
Due to Affiliates$2,807,692
Pension Plan Liability$2,486,427
Medicare Liability$2,474,781
FIN 47 LT Asbestos Liability$785,774
Other Misc. LT liabilities$75,614
Unclaimed Property$733
FieldValueIRS element (for citing)
Total Of Amounts169251117TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
ExplanationSchedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740 (Formerly FIN48). ASC 740 (Formerly FIN48) addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and de-recognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 (Formerly FIN48) by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $66,681 and $95,733 of net operating loss carryforwards as of August 31, 2013 and 2012, respectively, which expire in varying periods through 2032 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2013 and 2012. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4438440TotalCommunityBenefitExpense
Net Community Benefit Expense4438440NetCommunityBenefitExpense
Percent Of Total Expense0.02540PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15298624TotalCommunityBenefitExpense
Direct Offsetting Revenue9904809DirectOffsettingRevenue
Net Community Benefit Expense5393815NetCommunityBenefitExpense
Percent Of Total Expense0.03090PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1128537TotalCommunityBenefitExpense
Direct Offsetting Revenue633645DirectOffsettingRevenue
Net Community Benefit Expense494892NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense20865601TotalCommunityBenefitExpense
Direct Offsetting Revenue10538454DirectOffsettingRevenue
Net Community Benefit Expense10327147NetCommunityBenefitExpense
Percent Of Total Expense0.05910PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served6042PersonsServed
Total Community Benefit Expense721656TotalCommunityBenefitExpense
Direct Offsetting Revenue4498DirectOffsettingRevenue
Net Community Benefit Expense717158NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served200PersonsServed
Total Community Benefit Expense1457180TotalCommunityBenefitExpense
Net Community Benefit Expense1457180NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served24PersonsServed
Total Community Benefit Expense7765TotalCommunityBenefitExpense
Net Community Benefit Expense7765NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served6544PersonsServed
Total Community Benefit Expense595312TotalCommunityBenefitExpense
Net Community Benefit Expense595312NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served12810PersonsServed
Total Community Benefit Expense2781913TotalCommunityBenefitExpense
Direct Offsetting Revenue4498DirectOffsettingRevenue
Net Community Benefit Expense2777415NetCommunityBenefitExpense
Percent Of Total Expense0.01590PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served12810PersonsServed
Total Community Benefit Expense23647514TotalCommunityBenefitExpense
Direct Offsetting Revenue10542952DirectOffsettingRevenue
Net Community Benefit Expense13104562NetCommunityBenefitExpense
Percent Of Total Expense0.07500PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served2782PersonsServed
Total Community Building Expense214055TotalCommunityBuildingExpense
Direct Offsetting Revenue1552DirectOffsettingRevenue
Net Community Building Expense212503NetCommunityBuildingExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served77PersonsServed
Total Community Building Expense9156TotalCommunityBuildingExpense
Net Community Building Expense9156NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served2859PersonsServed
Total Community Building Expense223211TotalCommunityBuildingExpense
Direct Offsetting Revenue1552DirectOffsettingRevenue
Net Community Building Expense221659NetCommunityBuildingExpense
Percent Of Total Expense0.00130PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,241,533BadDebtExpenseAmount
Amount Reimbursed By Medicare40515808AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47249745CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6733937MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1DePaul Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1150 Kingsley LaneAddressLine1
CityNorfolkCity
StateVAState
ZIP Code23505ZIPCode
FieldValueIRS element (for citing)
Website Addresshttp://bshr.com/WebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours DePaul Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities19NumberOfOtherFacilities

Other Facilities OtherFacilities (19 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Bon Secours Health Center
828 Healthy WayVirginia BeachVA23462Rehabilitation & Physician Practice
DePaul InMotion Phys Ther-Norfolk
7300 Newport Ave Suite 300NorfolkVA23505Physical, Occupational & Speech Therapy
Tidewater Surg Specialists DePaul
160 Kingsley Lane Suite 400NorfolkVA23505Physician Practice
Bon Secours In-Motion at Hilltop
1817 Laskin Rd Suite 100Virginia BeachVA23454Physical Therapy & Sports Rehab
Tidewater Surgical Spect DePaul
160 Kingsley Lane Suite 400NorfolkVA23505Physician Practice
Amelia Medical Associates
885 Kempsville Rd Suites 3003033053NorfolkVA23502Physician Practices, Physical Therapy
Patient Choice Oceana
1232 Perimeter Pkwy Suite 101Virginia BeachVA23454Physician Practice
Hampton Roads OBGYN
100 Kingsley Lane Suite 100NorfolkVA23505Physician Practice
Ghent Family Practice & Internal Med
957 W 21st St Suite ENorfolkVA23517Physician Practice
InMotion Phy Ther Healthy Way
828 Healthy Way Suite 105Virginia BeachVA23462Physicial Therapy & Sports Rehab
Bon Secours Neuroscience Ctr for Pain
4445 Corporation Lane Suite 120Virginia BeachVA23562Physician Practice
DePaul Medical Associates
100 Kingsley Lane Suite 100NorfolkVA23505Physician Practice
Cardiovascular Specialists
160 Kingsley Lane Suite 100ANorfolkVA23505Physician Practice
InMotion Phy Ther Redmill Landing
1253 Nimmo Parkway Suite 105Virginia BeachVA23456Physical Therapy
Bon Secours Neurovascular Center
110 Kingsley Lane Suite 411NorfolkVA23505Physician Practice
Bon Secours Pulmonary Specialists
150 Kingsley LaneNorfolkVA23505Physician Practice
Bon Secours Medical Associates
828 Healthy Way Suite 220Virginia BeachVA23462Physician Practice
Norma O Magpoc MD
1020 Independence Blvd Suite 206Virginia BeachVA23455Physician Practice
Saghana B Chakrabortty MD
1020 Independence Blvd Suite 305Virginia BeachVA23455Physician Practice

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: Annually, Bon Secours Hampton Roads Health System (BSHRHS) publishes a report for the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is available to the public each year on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours. This report is available online at www.bshr.org.
Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, L7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $20,540,779.
Part II: Bon Secours DePaul Medical Center provided staff and resources in support of the Healthy Community Initiative of Bon Secours Health System, and advocated for local and state policies that would improve health across its communities. Bon Secours Hampton Roads Health System is working to engage and empower the members of the East Ocean View neighborhood to support them in improving their quality of life and holistic health. East Ocean View has historically been one of the roughest neighborhoods in the community. Among the 6,000 residents, more than 25% of the households are at or below the poverty level and over 20% are single parent households. Family violence, gangs, addictions, housing affordability, access to healthcare, and a lack of educational opportunities affect the health of the individuals living in the neighborhood.
Part III, Line 4: Part III, line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.Part III, line 4: Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on pages 10-11 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for doubtful accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 41 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS.
Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service.
Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending Financial Assistance Program (FAP) account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.
Part V, Section B, Line 3: Community Survey:DePaul Medical Center (DMC) contracted with Community Health Solutions (CHS) to conduct an electronic survey of key stakeholder to determine the top healthcare needs of the community. DMC developed a list of key stakeholders who were asked to provide their viewpoints on important healthcare concerns in the community, significant gaps in the community, and ideas for addressing health concerns and service gaps. Stakeholders included individuals who have special knowledge and expertise in public health, as well as the deans of area colleges and universities with medical degree programs. In addition, DMC surveyed representatives of medically underserved, minority populations, and those with chronic conditions. DMC also met with representatives from the Norfolk Public Health to review the key findings from the survey and seek additional input. Upon receipt of all information, DMC convened a small group to review the list of key needs and gaps identified to prioritize the needs using criteria developed against which to evaluate each need.Bon Secours DePaul Medical Center, Inc.
Part V, Section B, Line 7: Dental/Oral Health:While DePaul Medical Center (DMC) recognizes the importance of all the needs identified, there are other providers and organizations within the community addressing mental illness, dental/oral health, tobacco use, arthritis, domestic violence, sexually transmitted diseases, teen pregnancy, and Alzheimer's disease with specialized programs and services and it would result in duplication of services if DMC were to address those needs. DMC currently provides comprehensive diabetes education with weekly education sessions covering understanding diabetes, nutrition, foot care, exercise, and medication. DMC also has a comprehensive program in place to address prenatal and pregnancy care.Bon Secours DePaul Medical Center, Inc.
Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours DePaul Medical Center, Inc.
Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours DePaul Medical Center, Inc.
Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours DePaul Medical Center, Inc.
Part VI, Line 2: In partnership with Bon Secours Virginia Health System, DePaul Medical Center uses multiple approaches to assess the health needs of the communities it serves. Health care needs of the community are assessed and updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to DePaul Medical Center. National Research Corporation (NRC) is also utilized.
Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), as adjusted by the Medicare geographic wage index for each community served to reflect that community's relative cost of living ("Adjusted FPG"). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are also eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4: As of 2011, Hampton Roads is a very diverse community within an MSA of nearly 1.6 million people residing in 16 cities and counties, stretching from northeastern North Carolina to Williamsburg. The area is characterized by racial diversity, a significant military population and a growing elderly population. In the DePaul Medical Center service area, African Americans comprise 43% of Norfolk, which far exceeds the national average of 31.5%, 30% of Chesapeake and 20% of Virginia Beach. Seniors currently account for 10.6% of the population, growing to 13% in the next five years. The population served by Bon Secours DePaul Medical Center (DMC), Norfolk, VA is estimated to change from 828,728 to 867,988, resulting in a growth of 4.7%. Over the next five years, the population is projected to grow by 1.0%. The current year estimated population represents white (58.6%), Black or African American (31.5%), Hispanic or Latino (6%), and small percentages other small groups. The current year median age for this area is 34.3, while the average age is 36.0. Five years from now, the median age is projected to be 35.2.The most prevalent chronic conditions among adults in the DePaul Medical Center service area include high blood pressure (28.6%), high cholesterol (35.3%), arthritis (23.6%), diabetes (9%), and asthma (7.3%). Morbidity rates per 10,000: heart disease (159.5), cerebrovascular disease (33.4), chronic obstructive pulmonary disease (29.4), diabetes (26.3), and asthma (17.5). Mortality rates (age-adjusted per 100,000) for this area are cancer (180.6), ischemic heart disease (174.9), cerebrovascular disease (41.4), and chronic obstructive pulmonary disease (43.2).
Part VI, Line 5: DePaul Medical Center (DMC) has an open medical staff with privileges available to all qualified physicians. Emergency departments at the three hospitals provide service 24 hours/day, 7days/week to ensure access for emergency care for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located.DMC, through BSHR, offers Care-A-Van (CAV) services. The CAV, initiated on the peninsula in 2009 at two sites, has expanded in the past year to twelve sites, three in Norfolk, three in Portsmouth, three in Suffolk, and three in Newport News. The CAV is a mobile health unit that provides healthcare services to those most in need--the uninsured. Services provided include urgent and primary care (including examination, diagnosis, lab, pharmacy, and follow-up), immunizations for school, pregnancy tests, blood pressure measurement, health education, referrals for specialty care, opportunity to enroll eligible children in childrens' health insurance. The Care-A-Van also offers sports physicals, children's health insurance enrollment, and health education services. While the CAV primarily serves adults, some sites do provide care and referral services for children aged 12 and older.Community partners include free clinics, local health agencies, physicians, and numerous faith-based community organizations which collaborate with the Care-A-Van staff. The CAV has a staff of 10 FTEs and annual expenses of approximately $700,000. DMC also offers a medical Life Coach navigator program. This program, developed and initiated at DMC in 2008, connects patients with no insurance, little resources, or no personal doctor with primary care resources to minimize their trips to the emergency room. The coaches work to find medical homes for patients who regularly use the emergency rooms for non-emergency issues. These coach navigators help patients overcome social barriers to care, make follow up appointments and obtain medications. Of the 1,000 patients seen by the Life Coaches, only 12 returned to the emergency room for the same condition. Partnership with Federally Qualified Health Clinic in Norfolk - DMC and Park Place Medical Center work together to provide uninsured and underinsured individuals with a medical home and receive a full range of primary care services. DMC lab services are provided to Park Place. DMC took a unique approach to address the health concerns in one of the most needy communities in Norfolk, East Ocean View. The vision involves a long-term commitment to help build a self-sustaining healthier community through direct involvement, engaging residents, and partnering with the city government and other organizations. In the initial phase, DMC staff learned firsthand of the underlying issues affecting the health and well-being of the residents in East Ocean View by building relationships with community organizations and individuals. Working with the DMC staff, the residents identified priorities and developed plans to begin working on the issues. Recent activities include working with residents to establish and maintain a community garden to provide fresh produce to families in the neighborhood, hosting Youth Survival Night in partnership with the local community center. DMC also participated in block parties, the Fourth of July Freedom Fest, and annual community Thanksgiving and Christmas dinners. DMC also assisted with the renovation and expansion of the local Storehouse Food Pantry, which was severely damaged during a flood in 2009. In addition, DMC helped residents revitalize Bay Street and to obtain city designation for Bay Oaks Park.DMC, through BSHR, offers Bon Secours Senior Health Program which offers a free membership program to over 54,000 individuals 65 years and older. A key component is the Successful Aging Forum, which brings national speakers to the community to discuss the latest health and wellness topics for senior citizens. The annual HealthFest provides a seniors-focused health festival with health screenings, health information and social interaction for seniors of all socio-economic backgrounds. Friday Night Dinners, held at area hospitals, serve seniors who need low cost meals and socialization. A transportation program offers transportation to medical appointments, without charge to those who are financially challenged. A quarterly publication, Good Health, provides information to over 54,000 members in Hampton Roads. Seniors play a vital role in DMC's advocacy efforts against reductions in Medicaid payments and to support continued funding for the State Children Health Insurance Program (SCHIP) through the BSHR Capital Hill Club. DMC supports the BSHR Faith Community Health Ministry which builds on the skills of the registered nurse through additional, structured training in holistic (body, mind and spirit) health services; the faith community nurse partners with the congregational leadership to promote good health by serving as an educator, counselor, referral agent and advocate. Specialized training has also been developed to prepare non-licensed persons to serve in congregational health ministry. Additionally, the Influenza Vaccination Administration program provided 600 vaccines for select covenanted partners to host annual vaccine clinics. BSHRHS employs a sole Director to provide education, mentoring and support to more than 130 faith communities and 232 registered nurses and lay health promoters. BSHRHS' Community Sponsorship Committee reviews and financially sponsors community events that support our mission and values. Some of the contributions in FY13 that support the work of the local community in addressing unmet need include: - A monthly contribution to Park Place Clinic to help subsidize medical care for those who are uninsured or underinsured. - For Kids organization which works to break the cycle of homelessness and poverty for families and children- Help and Emergency Response to provide shelter and to engage in dedicated efforts to eliminate domestic violence- Access Partnership to support an oral health initiative for adults with no access to dental careDMC is dedicated to promoting the health and the quality of life for the women of Hampton Roads the women health service lines. DMC provides community health education seminars in cardiac, orthopedics, weight loss, acupuncture, sports performance, oncology, and stroke through the Bon Secours for Women program.DMC offers free Community Education programs open to the public throughout Hampton Roads on health topics such as heart disease, diabetes, bone and joint conditions, women's health and other chronic diseases. Several seminars on clinical ethics were also offered to professionals in the area.
Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to:- Improve Health Locally and Globally- Build Partnerships for Population Health As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations.
VAReports Filed With StatesPart VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Bon Secours DePaul Health Foundation
7007 Harbour View BlvdSuffolkVA22102541843876501(c)(3)225438Foundation Administrative Expenses
Eastern Virginia Medical School
721 Fairfax Ave Suite 512NorfolkVA235011980546055378501(c)(3)146225Joint Academic Program Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: The organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy J Davis
HR JT BM057634404190770126863011580001909501257179069776
Michael K Kerner
Sec/CEO BSHRHS047571703369240124284010646702630301069695067422
John Barrett
CEO/DMC0260761094530034107011908020067042137300
Melinda S Hancock
CFO-Bon Secours VA025190805336203867103924024044037190900
Michael J Bratton
VP of Patient Care Ser.17217702776801287305476097980228092000
Devin T McKeever
COO-BSMG (Sep-Mar)017244502598609190427707733021136000
James B Sherwood
Chief Admin Officer0201852044561038836011002027180032343100
John R Baker MD
Physician10047710006313601250002483401105241000
Robert B Hansen MD
Physician2720210135095024490112970223570443219000
Saumil V Patel MD
Physician341999026478010940125000215270403598000
George Sarris MD
Physician54184805009508900119370252420630012000
Timothy Willox MD
VP of Medical Affairs2656140598530228670002560348590000
Joe Buchheit
Former CFO-BSHRHS021560605595505483908035016996035143109225
Ernie Padden
Former Int. CFO-BSHRHS020150000000312000020462000
David Setchel
Former VP Operations59620000145607024240215900229241000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Lines 4a-bPart I, Line 4a: Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: David Setchel, $118,866. Part I, Line 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Timothy J. Davis, $101,207; Michael K. Kerner, $80,925; Joe Buchheit, $14,445.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Board Members P. Ward Robinett, Jr. and Deborah K. Sterns have a business relationship.
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Hampton Roads Health System, Inc., which in turn is the sole member of Bon Secours DePaul Medical Center, Inc.
Form 990, Part VI, Section A, line 7aThe Board of Directors of Bon Secours DePaul Medical Center, Inc. is appointed by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bAny decision which is subject to a reserved power is subject to approval by members.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of director's and compensation committee minutes. Form 990, Part VI, Section B, Line 15B - Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization provides any documents open to public inspection upon request.
Form 990, Part VII:Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. The governing bodies of the hospitals of Bon Secours Richmond Health System, including Bon Secours St. Mary's Hospital, Bon Secours St. Francis Medical Center, Bon Secours Memorial Regional Medical Center and Richmond Community Hospital, are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer). These governing bodies are referred to as the Richmond Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for all four hospitals). Sr. Patricia Heath does not receive payroll distributions as she has taken a vow of poverty.
Form 990, Part XI, line 9:Add'l Minimun Pension Liability 1,789,558. BSHSI Principal & Swap Payments -1,394,388. Rounding -4.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Mary Immaculate Foundation
150 Kingsley LaneNorfolkVA23505311644734FundraisingVA501(c)(3)11cMary Immaculate Hospital0
Mary Immaculate Nursing Center
4 Ridgewood ParkwayNewport NewsVA23602541516476Nursing Care CenterVA501(c)(3)9Mary Immaculate Hospital0
Mary Immaculate Hospital Inc
2 Bernadine DriveNewport NewsVA23602540548200HealthcareVA501(c)(3)3Bon Secours Health Systems Inc0
Bon Secours Hampton Roads Health System Inc
5818 Harborview BlvdPortsmouthVA23435521538513Local System Parent Org.VA501(c)(3)11bBon Secours Health Systems Inc0
Bon Secours Maryview Nursing Care Center
4775 Bridge RoadSuffolkVA23435521578169Nursing Care CenterVA501(c)(3)9Bon Secours Hampton Roads Health System0
Maryview Hospital
3636 High StreetPortsmouthVA23707540506463HealthcareVA501(c)(3)3Bon Secours Hamptom Roads Health System0
Bayley Properties
150 Kingsley LaneNorfolkVA23505541424748RentalVA501(c)(2)N/ABon Secours DePaul Medical Center1
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)11bBon Secours Inc0
Bon Secours DePaul Health Foundation
150 Kingsley LaneNorfolkVA23505541843876FundraisingVA501(c)(3)7Bon Secours Hampton Roads Health System0
Bon Scours Maryview Foundation
150 Kingsley LaneNorfolkVA23505521694731FundraisingVA501(c)(3)7Bon Secours Hampton Roads Health System0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Province Place of Maryview LLC
One Bon Secours WayPortsmouthVA23703541842697Assisted LivivngVAN/A
Province Place of DePaul LLC
6403 Granby StreetNorfolkVA23505541950880Assisted LivivngVAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Professional Health Care Mgmt Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541241031AdministrativeVAN/AC0
Tidewater Diversified Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541431826PharmacyVAC1Bon Secours DePaul Medical Center Inc91131224434931.00000
OSF Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541369919RentalVAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg