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Holy Cross Hospital Inc: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Holy Cross Hospital Inc (EIN 86-0575938)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201421349349301007
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)
Timestamp2014-05-14T08:51:14-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

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 Line1250 East Fifth Street Suite 1900AddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860575938EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Cross Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLYNameControl
Phone5202853000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAlan StraussName
TitleCEO - CHNTitle
Phone5202853000Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRebecca LyonsName
PTINP01487105PTIN
Phone5137847100Phone
Date Prepared2014-05-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDebra KnapheideNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20648936GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.carondelet.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionProviding various types of advanced medical/surgical services to our patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees217TotalNbrEmployees
Total Nbr Volunteers16TotalNbrVolunteers
Total Gross UBI124384TotalGrossUBI
Net Unrelated Business Txbl Income-2006NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year70562ContributionsGrantsPriorYear
Contributions Grants Current Year25742ContributionsGrantsCurrentYear
Program Service Revenue Prior Year20959667ProgramServiceRevenuePriorYear
Program Service Revenue CY19376795ProgramServiceRevenueCY
Investment Income Prior Year37218InvestmentIncomePriorYear
Investment Income Current Year39179InvestmentIncomeCurrentYear
Other Revenue Prior Year1431944OtherRevenuePriorYear
Other Revenue Current Year1202869OtherRevenueCurrentYear
Total Revenue Prior Year22499391TotalRevenuePriorYear
Total Revenue Current Year20644585TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10622179SalariesEtcPriorYear
Salaries Etc Current Year10489752SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year15219445OtherExpensePriorYear
Other Expenses Current Year12705690OtherExpensesCurrentYear
Total Expenses Prior Year25841624TotalExpensesPriorYear
Total Expenses Current Year23195442TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3342233RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2550857RevenuesLessExpensesCY
Total Assets BOY8873873TotalAssetsBOY
Total Assets EOY8861816TotalAssetsEOY
Total Liabilities BOY11203387TotalLiabilitiesBOY
Total Liabilities EOY13721923TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2329514NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-4860107NetAssetsOrFundBalancesEOY
Mission DescriptionProvide for the healthcare needs of the community; to embrace the person in mind, body and spirit; and to serve all people with dignity.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense14754400Expense
Revenue20150160Revenue
DescriptionHoly Cross Hospital is a 25-bed facility that provides general medical/surgical services, 24-hour emergency care, rehabilitation, mammography, ultrasound, chemotherapy, and home health. We also offer advanced technology such as renal dialysis, teleradiology, and lithotripsy programs. Holy Cross Hospital's community benefit information is included in the community benefit report for Carondelet Health Network.Description
Total Program Service Expense14754400TotalProgramServiceExpense
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 Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
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 Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees217NumberOfEmployees
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 Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Alan StraussBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5202853000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Mark Valenzuela
Chairman0.500.00X000
Imogene Juby Bell
Director0.500.00X000
Jose Duran MD
Director0.500.00X000
Jeffrey T Maudlin
Director0.500.00X000
William Neubauer
Director0.500.00X000
Sr Irma Odabashian
Director0.500.00X000
James Ross
Director0.500.00X000
Amy Beiter Ex-Officio
Pres./CEO-CSM & Director-HCH5.0055.00X032262841188
James K Beckmann Jr
President/CEO - CHN5.0055.000209676157959X
Alan Strauss
CFO-CHN5.0055.000110779150301X
Dorothy Sawyer end 0613
CEO-CSM/HCH10.0040.00038858639771X
Debra K Knapheide
VP COO/CNO-HCH40.000.00018786930970X
Roy Farrell
CMO-HCH40.000.00020750726884X
Celia Torres
Dir- Pharmacy40.000.00013128422536X
Catherine Fairbanks
MGR-Perioperative Svcs40.000.0001063037316X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4548729TotalReportableCompFrmRltdOrgs
Total Other Compensation276925TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
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
Morrison Management Specialists
5801 Peachtree Dunwoody RdAtlantaGA30342Nutritional Services1087862
TriMedx LLC
PO Box 636129CincinnatiOH45263Equipment Maintenance519079
Alliance Healthcare Services
FILE 55826Los AngelesCA90074Radiology Services294373
Medefis Consolidated
PO Box 5068New YorkNY10087Clinical Contract Labor215092
Arcadia Health Services Inc
26777 Central Park BlvdSouthfieldMI48076Health Services167109
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Related Organizations12775RelatedOrganizations
Government Grants12967GovernmentGrants
Total Contributions25742TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service RevDescription
Business Code621400BusinessCode
Total Revenue Column19376795TotalRevenueColumn
Related Or Exempt Function Income19376795RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue19376795TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column39179TotalRevenueColumn
Exclusion$39,179ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real162566Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real4351Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real158215Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column158215TotalRevenueColumn
Exclusion$158,215ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
EHR Incentive Payment900099647071647071
Cafeteria Revenue722210146905$146,905
Reference Lab621500124384124384

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column126294TotalRevenueColumn
Related Or Exempt Function Income126294RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1044654TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20644585TotalRevenueColumn
Related Or Exempt Function Income20150160RelatedOrExemptFunctionIncome
Unrelated Business Revenue124384UnrelatedBusinessRevenue
Exclusion$344,299ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8816062Total
Program Services7561342ProgramServices
Management And General1254720ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total344570Total
Program Services310113ProgramServices
Management And General34457ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total614427Total
Program Services516893ProgramServices
Management And General97534ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total714693Total
Program Services643224ProgramServices
Management And General71469ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total7346Total
Management And General7346ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total603Total
Program Services603ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3821239Total
Program Services2211207ProgramServices
Management And General1610032ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total18825Total
Management And General18825ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total166552Total
Program Services166078ProgramServices
Management And General474ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total58007Total
Program Services52206ProgramServices
Management And General5801ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total339227Total
Program Services308067ProgramServices
Management And General31160ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total39285Total
Program Services24417ProgramServices
Management And General14868ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total183173Total
Program Services164856ProgramServices
Management And General18317ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total655512Total
Program Services589961ProgramServices
Management And General65551ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total479403Total
Program Services431463ProgramServices
Management And General47940ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraisingProgram ServicesProgramServices
Shared Svcs Allocation478593347859330
Supplies16005406461301535927
Restructuring1600781600780
Food Service143220315080111712

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total246747Total
Program Services126331ProgramServices
Management And General120416ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total23195442Total
Program Services14754400ProgramServices
Management And General8441042ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY875BOY
EOY21309EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2830992BOY
EOY2519930EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY71174BOY
EOY41347EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY62075BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY694529EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY339217BOY
EOY331029EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY75350BOY
EOY70425EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9868603LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4906879LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5229753BOY
EOY4961724EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY264437BOY
EOY221523EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8873873BOY
EOY8861816EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1102793BOY
EOY731716EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10100594BOY
EOY12990207EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11203387BOY
EOY13721923EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2339221BOY
EOY-4880531EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9707BOY
EOY20424EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2329514BOY
EOY-4860107EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8873873BOY
EOY8861816EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2550857ReconcilationRevenueExpenses
Reconcilation Other Changes20264ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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 Required0FederalGrantAuditRequired

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)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$603OtherActivitiesAmount
Total Lobbying Expenditures IIB603TotalLobbyingExpendituresIIB
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
ExplanationOther activities represent the portion of dues paid to national and state hospital associations that is expended by the associations for lobbying and travel expenses to attend association lobbyist meetings. Holy Cross Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public offices.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis815007OtherCostOrOtherBasis
Book Value815007BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6292333OtherCostOrOtherBasis
Depreciation2874835Depreciation
Book Value3417498BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Depreciation-2088Depreciation
Book Value2088BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2705479OtherCostOrOtherBasis
Depreciation1992380Depreciation
Book Value713099BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis55784OtherCostOrOtherBasis
Depreciation41752Depreciation
Book Value14032BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4961724TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$12,091,144
Estimated Settlements to Third Party Payors$392,593
Other Current Liabilities$149,861
Self Insurance Liability$247,890
Other Non-Current Liabilities$108,719
FieldValueIRS element (for citing)
Total Of Amounts12990207TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage400.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
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)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served369PersonsServed
Total Community Benefit Expense931285TotalCommunityBenefitExpense
Net Community Benefit Expense931285NetCommunityBenefitExpense
Percent Of Total Expense0.04040PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served10114PersonsServed
Total Community Benefit Expense9845721TotalCommunityBenefitExpense
Direct Offsetting Revenue6956069DirectOffsettingRevenue
Net Community Benefit Expense2889652NetCommunityBenefitExpense
Percent Of Total Expense0.12540PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served10483PersonsServed
Total Community Benefit Expense10777006TotalCommunityBenefitExpense
Direct Offsetting Revenue6956069DirectOffsettingRevenue
Net Community Benefit Expense3820937NetCommunityBenefitExpense
Percent Of Total Expense0.16580PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served906PersonsServed
Total Community Benefit Expense102839TotalCommunityBenefitExpense
Net Community Benefit Expense102839NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served11PersonsServed
Total Community Benefit Expense75238TotalCommunityBenefitExpense
Net Community Benefit Expense75238NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2390846TotalCommunityBenefitExpense
Direct Offsetting Revenue1539207DirectOffsettingRevenue
Net Community Benefit Expense851639NetCommunityBenefitExpense
Percent Of Total Expense0.03690PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served917PersonsServed
Total Community Benefit Expense2568923TotalCommunityBenefitExpense
Direct Offsetting Revenue1539207DirectOffsettingRevenue
Net Community Benefit Expense1029716NetCommunityBenefitExpense
Percent Of Total Expense0.04450PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs15NumberOfActivitiesOrPrograms
Persons Served11400PersonsServed
Total Community Benefit Expense13345929TotalCommunityBenefitExpense
Direct Offsetting Revenue8495276DirectOffsettingRevenue
Net Community Benefit Expense4850653NetCommunityBenefitExpense
Percent Of Total Expense0.21030PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

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Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

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Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense1238TotalCommunityBuildingExpense
Net Community Building Expense1238NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense884TotalCommunityBuildingExpense
Net Community Building Expense884NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

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Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

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Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

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Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense2948TotalCommunityBuildingExpense
Net Community Building Expense2948NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

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Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

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Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense118TotalCommunityBuildingExpense
Net Community Building Expense118NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

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Total Total

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Total Community Building Expense5188TotalCommunityBuildingExpense
Net Community Building Expense5188NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
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Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$605,265BadDebtExpenseAmount
Amount Attributable To363705AmountAttributableTo
Amount Reimbursed By Medicare5385517AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6168044CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-782527MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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Cost Accounting SystemXCostAccountingSystem
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Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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Facility Number1FacilityNumber

Name Name

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Business Name Line1Holy Cross Hospital IncBusinessNameLine1

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Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode
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Website Addresswww.carondelet.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherRuralOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

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Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
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Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
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 Percent400.000000000000FPGFreePercent
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FPG Discount Percent400.000000000000FPGDiscountPercent
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Income LevelXIncomeLevel
Asset LevelXAssetLevel
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Insurance StatusXInsuranceStatus
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Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: The organization prepares and files an annual Community Benefit Plan Report. This report is prepared on a consolidated basis and includes data for Carondelet Health Network, Holy Cross Hospital, Carondelet Foundation, and Carondelet Heart & Vascular Institute.
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 costing 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.
Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services.
Part II: Holy Cross Hospital's leadership team collaboartes actively with a variety or community organizations in community building activities to advance the economic and overall growth and vitality of the region. This is done through active participation on economic development and chamber of commerce activities, through coalition building with community partners, and through advocacy for community health improvements around access to care and public health initiatives. This includes being members of the Southern AZ Coalition and Vivir Mejor! Consortium, a community coalition to improve the health of the community.
Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance (which includes the activity of Holy Cross Hospital, Inc.):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. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.The organization's bad debt expense in 2012 was $2,238,800 at charges($605,264 at cost).
Part III, Line 8: Holy Cross Hospital follows 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. Patients who are cooperating in good faith to resolve their hospital bills will not receive from Holy Cross Hospital liens on primary residences or wage garnishments and unpaid bills will not be sent to collection agencies.
Part V, Section B, Line 3: In addition to conducting surveys, the following key informants were consulted during the CHNA process:Santa Cruz County Community Health Needs Assessment Name Title Affiliation Role Special Knowledge and/or Expertise: -Marcelino Varona (Member Nogales Unified School District Governing Board), Santa Cruz Provisional Community College Governing Board; -Pat Trulock, Volunteer Santa Cruz Community Foundation Facilitate community events, binational cross border issues, grant writing, fundraising to support NGOs, capactity building for local NPOs, Identify currently emerging issues and strengthen community resources to address those issues; -Marcella Chavez Coordinator, Executive Director Rebuilding Together, United Way Grant writing & program coordination, campaign manager, 11 years with RBT, 6 years grant writing; -Kimberly Munoz Physical Therapist Carondelet Holy Cross Hospital, Self Contractor, Santa Cruz Valley Unified School District Resident of Santa Cruz County since 1995, 17 years as physical therapist, worked in home health, acute care, long term care, subacute care and outpation with pediatrics through adults/geriatrics; -Dina Sanchez, Director of Planning/Community Relations Carondelet Holy Cross Hospital Knowledge of local health care system and community affiliation; -Debra Knapheide, Site Administrator/CNO/COO Carondelet Holy Cross Hospital Overall healthcare needs of acute care patient population; -Michael Vetter, Executive Director Catholic Community Services of Southern AZ; -Suzanne David, Assistant Director South East Arizona Health Education Center (SEAHEC) Continuing education for health care providers; -Joyce Hospodar, Manager, Health Systems Development Center for Rural Health, MEZCOPH U of A Working with rural hospitals and first responders; -Alexa Bathe, Membership manager Arizona Lifeline Air Medical Care Paramedic, awareness manager of the membership program; -Yvonne Delgado, Executive Director Nogales Community Development Working with Mariposa Community Health Center and local partners on a Healthy Foods Intitiative, working with/provide support for the Southwest Rural Policy Network; -Cassalyn David, Network Director Mariposa Community Health Center, Santa Cruz County Adolescent Wellness Adolescent health and wellness, rural health networks, health equity; -Joyce LaTura, Maternal & Child Health Manager Mariposa CHC Maternal & Child health issues, community engagement, promotora (community health workers) training; -William Sanchez, Nogales Fire Department; -Gerry Castro, Nogales Fire Department; -Octavio Gradillas, Nogales Police Department; -Shane Dille, City Manager; -Nogales Christine Young, ADHS Office of Border; -Health Gail Emrick, Executive Director SEAHEC Public Health Administration/Planning/Management, health workforce development, border health issues, international health; -Jeffrey Maudlin, MD Carondelet Medical Group Community physician and chief of staff, Carondelet Holy Cross Hospital; -Christia Bridges-Jones, Breastfeeding Coordinator ADHS Maternal & child health nutrition, program coordinator/breastfeeding services; -Lisa Nieri, Director of Community Development and Special Populations Arizona Association of Community Health Centers Migrant & seasonal farmworker health, community health centers; -Kelly Watters, Project Coordinator Somos La Semilla, Community Food Bank of Southern AZ Community food systems development (farmers markets, food production and education); -William Neubauer, MD Chairman, Co-Chair, Trustee Santa Cruz Community Foundation, Arizona Mexico Commission, Carondelet Holy Cross Hospital Medical doctorHoly Cross Hospital, Inc.
Part V, Section B, Line 5c: In addition to being available upon request, HCH's CHNA is also widely available to the public in the following manner:-Newspaper article in the Nogales International in September 2013.Holy Cross Hospital, Inc.
Part V, Section B, Line 7: Priorities Not Being Addressed Rationale Access to Healthcare1. Mental health services are lacking This priority will not be addressed. This need is being addressed in Santa Cruz County by a variety of organizations. Community resources include: 1. Community Intervention Associates 2. Community Connection 3. Mariposa Community Health Center 4. Southern Arizona Behavior Health Services 5. Corazon Behavior Health ServicesHealth Status (Leading Causes of Death)2. Cardiovascular Disease, Respiratory Disease, and Cancer This priority will not be addressed. Carondelet Medical Group routinely screens, treats, and educates patients on these diseases. Carondelet Holy Cross provides routine imaging services. Santa Cruz County is served by three cardiology groups (Pima Heart Physicians, The University of Arizona Medical Center Pediatric Cardiologists, and Tucson Heart Group) Mariposa Community Health Center offers cancer and cardiovascular prevention and education programs.Modifiable Risk Factors3. Obesity - Kids This priority will not be addressed. Carondelet Holy Cross will continue with its healthy eating program in its cafeteria. The Vivir Mejor! Consortium is working to educate families on healthy eating and physical activity. Numerous farmers markets are located throughout Santa Cruz County. Local school districts have begun to serve healthier foods during school and following after school programs.4. Adolescent Excessive Drinking This priority will not be addressed. This issue is best addressed by the Santa Cruz County Health Department and local school districts. 5. Smoking This priority will not be addressed. Carondelet Holy Cross does maintain a smoke free campus. Carondelet Medical Group routinely counsels patients on the adverse effects of smoking and provides resources, including ASHLine, to patients who wish to quit smoking. Mariposa Community Health Center provides school-based tobacco prevention education and other tobacco use prevention and cessation classes. Women and Children Services6. Highest Infant Mortality Rate in the State This priority will not be addressed. From 2000 to 2009 infant mortality rates in Santa Cruz County were above the state average only once (2004). In 2010, the infant mortality rate in Santa Cruz County was more than double that of the state. It is Carondelet Holy Cross's belief that 2010 represents an anomaly in which there was a rash of severe health issues with several babies born in Santa Cruz County. The infant mortality rate in 2011 (4.3/1,000) returned to a level below that of the state (5.9/1,000). 7. Fewer women receive pap smear and mammography screenings in Santa Cruz County than the StateThis priority will not be addressed. Carondelet Medical Group will continue to educate women on the benefits of routine pap smear and mammography screenings. Carondelet Holy Cross and Mariposa Community Health Center provide mammography screenings. Nogales Unified School District offers mobile mammography screening for eligible employees. 8. High rates of women who received no prenatal care or lower than average number of prenatal care visitsThis priority will not be addressed. Carondelet Medical Group will continue to educate patients on the benefits of early and regular prenatal care. Mariposa Community Health Center provides prenatal care and classes on prenatal education. 9. High Rates of Teen PregnancyThis priority will not be addressed. Mariposa Community Health Center offers Teen Maze, a program designed to help teens and preteens better understand potential outcomes to life decisions concerning sex, substance abuse, vocational and education issues.Reportable Diseases10. Campylobacteriosis, Shigellosis, Salmonellosis, Amebiasis, Meningococcal DiseaseThis priority will not be addressed. Relative to population, these numbers are not significantly high. Natural and Built Environment11. Air Quality - The number of particulate matter days in the Santa Cruz County is higher than the state and national benchmark. This priority will not be addressed. The city of Nogales Parks and Recreation Department has begun to fly air quality flags at the Fleischer Park flag pole in Nogales. This is part of an informational program by the Arizona Department of Environmental Quality. The flags help area residents make informed decisions about outdoor activities. Additionally, the Arizona Department of Environmental Quality sends out regular emails with projected air quality levels. 12. Access to Healthy Food This priority will not be addressed. Carondelet Holy Cross does maintain a healthy eating program in its cafeteria. Local school districts have begun to serve healthier foods during school and following after school programs. The Vivir Mejo! Consortium is working with the Community Food Bank of Southern Arizona to serve diabetic friendly food boxes. Social Environment13. Transportation This priority will not be addressed. This need is best addressed by Santa Cruz County and the cities and towns with in its boundary. 14. Domestic Violence This priority will not be addressed. Carondelet Holy Cross will explore starting a Domestic Violence screening program in the Emergency Department. Other community resources include: 1. Santa Cruz County Coordinated Response Team and Task Force Against Domestic Violence (CCRT and Task Force) 2. Our House/Nuestra Casa Domestic Violence Shelter15. Senior Care This priority will not be addressed. Carondelet Holy Cross will continue with its semi-monthly senior wellness clinic Centro De Salud Nogales Clinic. This clinic provides health screenings (including weight: blood pressure and blood glucose) medication review and education, health information, and referral. Other community resources include: 1. Santa Cruz council on Aging 2. Southeastern Arizona Governments Organization 3. Mariposa Community Health CenterHoly Cross Hospital, Inc.
Part V, Section B, Line 20d: Per the Carondelet Health Network Financial Assistance Policy:Charges for emergency or other medically necessary care provided to persons who are eligible for financial assistance under this policy shall not exceed the amounts generally billed to individuals who have insurance coverage for such care.Holy Cross Hospital, Inc.
Part VI, Line 2: Carondelet Holy Cross Hospital follows the Catholic Healthcare Association Guidelines which state that a Community Needs Assessment ("CHNA") should be completed every three years. The Community Needs Assessment was commissioned in 2012 and delivered in February 2013 as a result of a collaboration with the the Arizona Department of Health Services. Carondelet engaged a graduate student from the UA College of Public Health to lead the CHNA efforts. The graduate student worked with an internal committee for guidance of the needs assessment. The student worked with her Public Health Professors and the ADHS to perform community focus groups and key informant surveys. Other internal and external strategic documents were used to identify community needs along with hospital data.
Part VI, Line 3: Upon admission, patients are encouraged to apply for the state medicaid program if they are uninsured as well as other public benefits such as TANF or SNAP if the patient has a need. If patients prove they meet at least one (1) of eight (8) criteria outlined in the policy, they will be eligible for charity care. The patient will be placed in pre-emptive charity care status and after all bills are finalized a request for the total amount will be made on the patient's behalf by their financial counselor. Trained financial counselors will work with patients if it is not easily determined that a patient qualifies for charity care or to what level of financial assistance a patient may qualify. The Pre-emptive Charity Care Policy is posted in the Emergency Department, Admitting, hospital lobbies, other public areas as well as summarized on the Carondelet website and is to be included with the patients' bills when sent. The Network participates in "Tu Salud", a Southern AZ community Collaboration CHIPRA funded outreach program, which provides a community outreach worker/financial counselor at community events to facilitate enrollment into government and community assistance programs. CHN led a Southern Arizona "Phonathon," which was a one day event, to increase awareness of state Medicaid eligibility requirements and other public funding resources as well as to facilitate enrollment of qualifying individuals and families.
Part VI, Line 4: The primary and secondary service area includes Pima, Santa Cruz and Cochise Counties. The population is 1.21 million individuals based on 2010 census data. This growth is 2.05% from 2000. The average household size is 2.53. The median age is 37.4 which is at the national average. 51.7% of the population earns less than $50,000 with the median household income at $48,208 and the per capita income at $24,171. 27.2% of the population is over the age of 55.The demographics of the area with regard to ethnicity are as follows: 36% of Hispanic origin, 3.8% two or more races, 15.6% some other race alone, 0.2% Pacific Islander alone, 2.2% Asian American, 2.8% American Indian alone, 3.5% Black and 36% White alone.
Part VI, Line 5: Carondelet Holy Cross Hospital ("HCH") provides a wide variety of services to the communities where it has a presence. Activities include: social service enrollment, support groups for patients, families and the community at large, chronic disease education to patients, families and outside medical professionals, spiritual care services and senior wellness services at the Santa Cruz Senior Nutrition Center. CHN works with community partners to provide border health outreach, promotion of state Medicaid enrollment, education on chronic diseases to schools, patients, churches and health and human service organizations.Associates serve on various Boards of Directors for local and regional organizations. Additional community outreach includes: health screenings, health fairs and educational conferences and events throughout the year. The following are the organizations which Carondelet leadership is engaged in key community coalition building activities, community events, or initiatives: Catholic Community Services of Southern Arizona, American Diabetes Association, American Heart Association, American Cancer Society, Lions Club, Catholic Foundation, United Way, and American Red Cross.
Part VI, Line 6: Carondelet Health Network is a member of Ascension Health Alliance. Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province, became part of Ascension Health on April 1, 2013. In addition, Alexian Brothers Health System, which was previously sponsored by the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province, became part of Ascension Health on January 1, 2012. Carondelet Health Network located in Tucson, Arizona, consists of two nonprofit acute care hospitals. The hospitals within Carondelet Health Network provide inpatient, outpatient, and emergency care services for theresidents of Tucson, Arizona. Admitting physicians are primarily practitioners in the local area. Carondelet Health Network is related to Ascension Health's other sponsored organizations through common control.Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: 1. Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured.2. Unpaid cost of public programs represents the unpaid cost of servicesprovided to persons covered by public programs for the persons living inpoverty and other vulnerable persons.3. Cost of other programs for the persons living in poverty and othervulnerable persons includes programs intentionally designed to serve thepersons living in poverty and other vulnerable persons of the communityincluding substance abusers, the homeless, victims of child abuse andpersons with acquired immune deficiency syndrome.4. Community benefit consists of the unreimbursed costs of communitybenefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, including health promotion and education, health clinics and screenings and medicalresearch.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. The amount of traditional charity care provided, determined on the basis of cost, was $524,605 and $466,916 for the years ended June 30, 2013 and 2012, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost is reported in the accompanying supplementary information.
Carondelet Health NetworkCommunity Benefit ReportFiscal Year 2013First All-Hospital Community Needs Assessment Identifies Major Health Issues: For the very first time, all the nonprofit hospitals in the Tucson area worked together to create a community needs assessment to identify opportunities for health improvement among residents. Research was conducted in both Pima and Santa Cruz counties. Carondelet St. Joseph's Hospital, Carondelet St. Mary's Hospital, Tucson Medical Center and University of Arizona Medical Center staff found a number of areas needing improvement in southern Arizona. Some topics were identified all over the region, including the following: - Diabetes prevention - Rising obesity rates - Cardiovascular disease - Preventable hospitalizations - Access to health care - primary care providers - Shortage of mental health care - Lack of health insurance And further south . . . Carondelet Holy Cross Hospital worked with community partners Arizona Department of Health Services, Mariposa Community Health Center and Arizona Area Health Education Center to evaluate community needs in Santa Cruz County. The top issues in this part of the state are a lack of health insurance, a shortage of primary health providers and diabetes. Armed with a new understanding of specific needs, all the hospitals in the Tucson and Nogales communities are working to improve health care wherever possible.Carondelet leads the way in Chronic DiseaseCarondelet-Pima Council on Aging Coalition: When asked by other hospitals, why our Care Transitions Program is successful in reducing readmissions, we answer it takes a village or better yet, a Coalition. The Carondelet PCOA Transitional Care Navigation Coalition was formed in July 2012 and meets quarterly to review readmission rates and explore opportunities to improve care for our patients when they leave our hospitals. The Coalition membership includes Carondelet and PCOA leadership and Care Transition team members, community agencies such as Mobile Meals and CPSA, and our Carondelet Preferred Providers. As part of the effort in the Care Transitions Program, Carondelet established a Preferred Provider relationship with skilled nursing facilities, home health, infusion therapy and hospice/palliative care. Together, these Preferred providers work with Carondelet to ensure our patients are seamlessly transitioned to a different level of care. Our Preferred Providers also follow the same evidence-based guidelines and utilize our patient education tools that were initiated in the hospital. Carondelet emphasizes person-centered care and our preferred providers embrace our efforts, says Dr. Denmark.Transitional Care Program Means Better Recovery,Fewer Hospital Readmissions:For patients with certain medical conditions, being readmitted to the hospital shortly after leaving is unfortunately all too common. Carondelet is working hard to change that with a variety of outreach programs. In 2012, the Centers for Medicaid and Medicare Services (CMS) selected Carondelet Health Network as a Community-Based Care Transitions Program, in partnership with Pima Council on Aging (PCOA). Together, we provide the needed health and social support many patients need after they leave the hospital. This program manages Medicare patients with multiple chronic illnesses and includes a special focus on the following health conditions:- Heart failure- Acute myocardial infarction (heart attack)- Pneumonia- COPD (chronic obstructive pulmonary disease)- Renal (kidney) failureThe overall goals are to improve the quality and safety of patient care while reducing preventable hospital readmissions. Carondelet's Care Transitions Program follows high-risk Medicare patients from the hospital to their homes or other community venues such as a skilled nursing or assisted living facilities. From the beginning, the program has been successful in reducing hospital readmissions. In the Care Transitions Program, at-risk patients are placed in a 60-day intervention plan based on the level of their health risks. High-risk patients receive a home visit by the nurse and/or social worker within 24 hours of the patient's departure from the hospital. These patients are also equipped with telehome monitoring devices to record and report their vital signs wirelessly to nurses. In addition, a nurse accompanies patients to their follow-up doctor's appointments. For high-risk patients, that's just the beginning. The nurses also call the patients regularly to make sure they understand their medications, know how to identify red flags with their health condition and are going to their follow-up doctor's appointments. They keep in touch with the patient's doctors to help coordinate care, too.Low- and moderate-risk patients, a nurse and/or social worker keeps in touch by telephone to make sure they are managing their health they are taking their medications properly and going to their follow-up doctor's appointments. These patients are trained on self-management practices and medication adherence using proven methods for successful learning. The Transitional Care Program:Sandra Wente, RN, BSN, recounted a case from early 2013 that made a big difference for a family.A legally blind patient with diabetes was released from the hospital after experiencing heart failure. The patient lived with her daughter, grandson and great-grandchildren."I discovered that the patient was not taking her medication properly because she couldn't read the bottles," Sandra said. "She wouldn't let her daughter help manage her medications because she wanted to maintain some independence, but the result was that she was taking the wrong pills and wrong doses."Fortunately, Sandra was able to convince the patient to allow her daughter organize her medications. Sandra brought them a pill container, which helped ensure proper dosages and timing.Another problem was that the daughter, who did all the family cooking, was disabled herself. As a result, she did not have the energy to prepare meals from scratch, relying instead on frozen foods with a high sodium content. Too much sodium is especially problematic for those with heart failure. This diet caused the patient to suffer constantly from edema (swelling), putting an extra strain on the heart. Sandra brought a scale with remote reporting capability to the patient's home. This would help Sandra teach her patient and family about the importance of weight fluctuations caused by edema. Creating additional work for the patient's daughter by asking her to prepare separate meals for her mother was out of the question. So Sandra contacted the Pima Council on Aging social worker, who arranged for the patient to get her meals from Mobile Meals of Tucson. This service delivers healthy meals each day to the patient, with no disruption in the family's meal plans.About two weeks after Sandra made these changes in medication process and diet, the patient improved dramatically. "She was more alert, had much more energy (previously, walking from her bed to the bathroom took a great effort) and was not experiencing swelling," Sandra explained.The experience was happy for everyone. The patient was able to enjoy her family because she felt better, the family didn't have to worry about her so much, and Sandra was more than pleased with the results. "The next time I saw her, she gave me a big hug and said "You changed my life!" said Sandra. "It was such a satisfying experience."Telehome Monitoring Keeps Patients In Close Touch with Health Care:Carondelet Health Network is working to improve the health of those in our community through the telehome monitoring program. Registered nurses Rose Quiroga, Amy Salgado and Sandra Wente follow up with patients after they are discharged from the hospital to make sure they are on track with their medications and getting the proper care. This prevents many readmissions to the hospital.This also includes remote monitoring equipment for some patients, making it easy for patient's vital signs to be monitored from home. The information is sent wirelessly to a Carondelet computer, where the nurses can make sure things are going well. When numbers begin to change in a negative way, nurses can quickly intervene before a patient develops serious problems.The program has been a big success, with a 24 percent improvement in readmission rates. Patients are recovering better, saving money and enjoying life more because they are getting healthier.Community Benefit Report:
Better Health with Diabetes Management:Carondelet's diabetes continuum of care provides a special program that involves a comprehensive team of experts to help Carondelet Medical Group patients better manage their diabetes. A special component of the program is the telehome monitoring service. Lily Ramos is the diabetes navigator who coordinates care for dozens of diabetes patients each week. Lily sets up patients referred from Carondelet Medical Group with home diabetes testing technology. This allows the patient's blood glucose to be transmitted to a website where a Carondelet Health Network diabetes team member care review the results twice a day. When a patient's numbers are high, Lily contacts the diabetes nurse, who calls the patient to figure out what the trouble may be. In some cases, the physician needs to readjust the medications. For many patients, problem-solving with a diabetes educator and a dietitian makes all the difference."One lady's numbers stayed high until she met with the dietitian. As soon as she learned how to make better food choices, her numbers really went down," Lily noted. Learning how to manage diabetes successfully is vital for patients who are diagnosed with the disease. Telehome monitoring technology serves as an excellent teaching tool to coach the patient in real-time, helping them understand how they can make changes and give them a "a high five" when we see improvement. Patients typically stay in the telehome monitoring program about two months while becoming skilled and independent. For people who need help managing their diabetes, the telehome program makes all the difference. Getting diabetes under control helps patients avoid serious complications such as kidney disease, vision loss and even amputation. Diabetes navigator Lily Ramos (right) shows patient Alexandra Budeac how to use the blood glucose monitor.The Role of the Telemedicine Clinical Coordinator:For the past three years, Karen Wright, MS, RN, has served as Carondelet's Clinical Coordinator of Telemedicine. Bringing the telestroke program live was one of her first responsibilities Coordinating the various telemedicine programs means being on top of a lot of details and working with a wide range of health professionals and facilities. Karen collaborates with Linda Manalo, Stroke Program Coordinator at Carondelet Neurological Institute, to organize the on-site training of the specialists/neurologists and the emergency department staff at the rural hospitals. To be sure these outlying hospitals are ready for critical patient care and able to manage the videoconferencing elements, the team conducts periodic mock patient tests.In addition to the vital hands-on training, Karen is in close communication with the telemedicine information technology (IT) team to avoid problems, troubleshoot any issues and develop solutions. The IT group provides needed support to fix any connectivity issues and update software.Among her many responsibilities as telemedicine coordinator, Karen keeps Carondelet leadership updated on the status of the various telemedicine programs. Together, they plan for the future of the telemedicine program. Without this highly skilled team, there would be no telemedicine program. All the hard work that goes into this effort pays off every day in lives saved in remote locations, so it is a truly satisfying responsibility. Telemedicine Program Saves Lives:For people who live in rural parts of southern Arizona, immediate medical care isn't always an option. Specialty care can be even less accessible, particularly in an emergency.Fortunately for those who live in southern Arizona, lifesaving care for emergencies is available through Carondelet's telemedicine program. Telemedicine connects Tucson-area specialists with staff members at smaller local hospitals to bring critical care right to the patient via remote access. For stroke patients, time is a critical factor in preserving function. Patients need the right care fast in order to have the best chance of recovery. Telemedicine provides rural patients with specialists that can help make a difference in their recovery.Carondelet's telestroke program is a 24/7 consultation service provided by the neurologists of Western Neurosurgery Ltd., a private practice group of neurologists and neurosurgeons that practices exclusively at the Carondelet Neurological Institute. These highly trained experts collaborate with emergency physicians at rural hospitals who need rapid neurology consultation for patients with stroke symptoms. Using telemedicine, Emergency Department staff and specialists are able to interact in real time using videoconferencing software. By directly examining the patient and viewing test results such as a CT scan the neurologist can help determine whether the patient is a candidate for t-PA, a medicine that can dissolve blood clots causing stroke. This medicine is only approved to treat stroke patients within three hours of the onset of symptoms, making treatment time a critical factor when evaluating stroke patients in the Emergency Department.The telestroke program at Carondelet Neurological Institute (CNI), on the campus of St. Joseph's Hospital, currently provides services to Mt. Graham Regional Medical Center (Safford) and Sierra Vista Regional Medical Center. Other rural hospitals are soon to be added. Vascular neurologist Roderick Anderson, MD, leads the Carondelet telestroke program. Dr. Anderson and five associate neurologists can assess a patient many miles away and help the local hospital staff provide proper treatment. "Telestroke is more effective in treating acute stroke patients compared to phone consultation, making it the preferred method in which rural hospitals treat stroke patients," Dr. Anderson explained. Following the initial assessment, patients are often then transported to Tucson for further testing and treatment. The telestroke team relies on six neurosurgeons to help treat stroke patients requiring neurosurgical consultation, including Emun Abdu, MD, a vascular neurosurgeon. Adaeze Onouha, MD, is a neurointensivist involved with accepting stroke patients into the neurological intensive care unit. Linda Manalo is the Stroke Coordinator, and Emily Baughman, RN, is the Rural Market Physician Liaison. Karen Wright is the Clinical Coordinator of Telemedicine. According to Leah Shea, PMP, MHI, Neurosciences Service Line Director, "Carondelet and CNI are committed to meeting the needs of rural Arizona communities, especially for stroke care. These rural communities often transport patients to CNI when complex care is needed."Telestroke Care Saved Sierra Vista Patient:Recently, an 82-year-old woman arrived at Sierra Vista Regional Health Center with signs of stroke. The patient's daughter had received a phone call from her mother, who was unable to talk. She was unable to say words, so the daughter called 911.Upon arrival, the patient scored high on a national measure to evaluate strokes. In the emergency department, a neurology consultation was quickly conducted with one of the Carondelet Neurologic Institute (CNI) neurologists. When the neurologist evaluated the patient, the decision was made to give her medication to dissolve blood clots. She was then transferred to CNI, on the campus of at St. Joseph's Hospital. Additional testing at CNI revealed that the patient had a clot in a large blood vessel, making her a candidate for thrombolytic therapy. Immediately, a vascular neurosurgeon treated her with procedures to break up or remove a clot from the blood vessel.After treatment, the patient showed a marked improvement. She was able to regain her speech and make a good recovery.
ED Navigators Go Many Extra Miles, While Adding a Caring Touch:When a patient comes into the emergency department (ED) at a Carondelet hospital, lots of things happen. In addition to the immediate needs for assessment and proper treatment, some special associates begin evaluating how they might offer extra help after the emergency is over.A Carondelet ED Navigator gets involved when a patient needs more than just emergency medical care. For patients who are without insurance and without a home, the ED Navigator helps connect them to the resources they need. If someone uses the ED for all their health care even when the situation isn't an emergency the ED Navigator can arrange care in a more appropriate setting. She'll also follow up with the patient. And it's all done with kindness and caring support. Better Care at a Lower Cost: The ED Navigators help an average of 100 to 200 people each month with a wide range of needs. However, the benefits provided extend beyond the individual patients served. By helping people find more appropriate sites than the ED for non-emergency health care and by preventing avoidable hospital readmissions (with follow-up attention to ensure patients get proper care after leaving the hospital), ED Navigators are making more efficient use of community resources. This saves a lot of money.Health care costs keep rising, and the savings gained when patients get their medical care in an appropriate setting makes a big difference to us all. The Carondelet ED Navigators are helping reduce costs, while at the same time increasing appropriate care forpatients a win/win situation.For example, in about six months, the St. Mary's ED Navigator's efforts resulted in a savings of more than $200,000. By reducing the use of the ED and getting more appropriate care elsewhere, patient's health and well-being improved, too. At CarondeletSt. Joseph's Hospital :Margaret Rweikiza-Polk, BSPA, serves as ED Navigator at St. Joseph's Hospital. She has many stories about people she's helped, but a recent case really resonated with her.A young man had spent his childhood in foster care in California. The week he turned 18, he was no longer eligible to remain in the system and was sent to Tucson to live with cousins. Within a week, the cousins were no longer able to let him stay there. The young man had no place to go, didn't know anyone in Tucson and was afraid.In tears, all he could think to do was come to the nearby emergency room at St. Joseph's and ask for help. The ED Navigator was able to find him a place to stay at a local shelter. The shelter also offered a program to help him find a job and eventually get an apartment. This young man was very relieved to have a place to go and a chance for a better life.At Carondelet St. Mary's Hospital: Renee Perez is the ED Navigator at St. Mary's Hospital. She spends a lot of time helping people get establish as patients with primary care health providers when they don't have one. Other common scenarios include helping people apply for medical assistance, Nutrition Assistance and cash assistance using the Online Application Health-e-Arizona.A recent case proved particularly satisfying for everyone involved: the patient, the ED staff and Renee. A woman in her 50s had lost her job and become uninsured because her health problems prevented her from being able to work. The woman came to the St. Mary's ED over and over with knee pain. When it was determined that the patient needed knee surgery, Renee helped her file disability paperwork. Her application was approved, and she was able to get the surgery she needed. The operation was a success, and the patient recovered fully. She hasn't been back to the ED since. Nurse Practitioner Training Expands Primary Care in Arizona:Across the country, primary care providers are in short supply. Arizona faces the same challenges in many parts of the state. Primary care providers are critical for ensuring better coordinated care and better health outcomes for patients. The Affordable Care Act includes provisions that address the shortage of these providers by making their training a top priority. The Centers for Medicare and Medicaid (CMS) launched a program in 2012 to train more primary care health providers. Carondelet Health Network has joined a clinical partnership in Arizona that is helping train advanced practice registered nurses (APRN) across the state. Students from the University of Arizona, Grand Canyon University, Arizona State University and Northern Arizona University can train at Carondelet.APRNs are a vital part of the U.S. health system. They are registered nurses educated at Masters or post-Masters levels and in specific roles. APRNs are prepared by education and certification to assess, diagnose and manage patient problems, order tests and prescribe medications.The primary goal of the CMS project is to expand qualified training to APRN students. This training provides APRNs with the clinical skills necessary to provide primary care, preventive care, transitional care, chronic care management and other services. While CMS focuses on Medicare beneficiaries, adding APRNs helps entire communities.Ten students from the University of Arizona completed their required semester clinical training with Carondelet primary care professionals in various Tucson offices in FY 2013. Carondelet's primary care providers served as preceptors and mentors for the students in training, giving the students vital clinical training experience. "Carondelet is excited to be a participant in this program and to help to provide primary care learning experiences for Advanced Practice Nurses in Tucson," said Lateefah Collingwood, RN, NNP, MSN, Carondelet's Director of Integrated Learning.Vivir Mejor Telehealth Program Brings Diabetes Care to Santa Cruz County:During FY 2013, Carondelet partnered with Mariposa Community Health Center to provide diabetes outreach services through a HRSA Rural Health Grant for its Vivir Mejor! system of diabetes care in Santa Cruz County. The goal was to prevent and treat diabetes in a high-risk Hispanic population through improved primary care, enhanced self-management, increased family involvement/support and healthy lifestyle services.Carondelet Registered Dieticians and Certified Diabetes Educators provided nutrition counseling for high-risk diabetics via telehealth services. The counseling was provided in Spanish eight hours a week.

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 (7 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
Amy Beiter Ex-Officio
Pres./CEO-CSM & Director-HCH030070401701604908019410021778036381600
James K Beckmann Jr
President/CEO - CHN0605278014727500187330340000239590215472000
Alan Strauss
CFO-CHN04992760322744028577101942503087601158092085540
Dorothy Sawyer end 0613
CEO-CSM/HCH0291772013943082871018760021011042835700
Debra K Knapheide
VP COO/CNO-HCH01657120174560470102109809872021883900
Roy Farrell
CMO-HCH01968390001066807644019240023439100
Celia Torres
Dir- Pharmacy0130705000579436701816902253613128400

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 3Carondelet Health Network, a related organization of Holy Cross Hospital, Inc., uses the following to establish the compensation of the organization's CEO: -Compensation Committee, -Independent Compensation Committee, -Compensation Survey or Study, and -Approval by the Board or Compensation Committee.
Part I, Lines 4a-bEligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The organization made payments from the supplemental nonqualified retirement plan in the amounts as noted: Debra K. Knapheide - $3,570 Roy Farrell - $6,923 Celia Torres - $4,009
Part IIISchedule J, Part II: The 2012 compensation amounts shown for Alan Strauss were paid by a related organization. $580,676 of the compensation was paid for Mr. Strauss's services as the CFO of Carondelet Health Network. His remaining compensation was paid for his services as the CFO of the related organization.Supplemental Information

Schedule L IRS990ScheduleL

Loan Table LoanTable

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Jose Duran MDBusinessNameLine1
FieldValueIRS element (for citing)
Relationship With OrganizationBoard MemberRelationshipWithOrganization
Purpose Of LoanTo purchase medical office buildingPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$245,735OriginalPrincipalAmount
Balance Due41347BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due41347TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Number of Forms 1099 filed:Form 990, Part V, Line 1a:Carondelet Health Network, a related organization of Holy Cross Hospital, uses a centralized accounting system to compensate all independent contractors used within the Health System. The number attributable to each hospital is not easily distinguishable. The total amount of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of Carondelet Health Network's Form 990.
Form 990, Part VI, Section A, line 6Holy Cross Hospital, Inc. has a single corporate member, Carondelet Health Network.
Form 990, Part VI, Section A, line 7aHoly Cross Hospital, Inc. has a single corporate member, Carondelet Health Network, who has the ability to elect members to the governing body of Holy Cross Hospital, Inc.
Form 990, Part VI, Section A, line 7bAll decisions that have a material impact to Holy Cross Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Carondelet Health Network.
Form 990, Part VI, Section B, line 11Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, 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 Members questions.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting 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 conflict 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 15In determining compensation of the organization's CEO, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. 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 title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
Form 990, Part VI, Section C, line 19The organization will provide any documents open to public inspection upon request.
Other FeesForm 990, Part IX, line 11g0: Program service expenses 2,211,207. Management and general expenses 1,610,032. Fundraising expenses 0. Total expenses 3,821,239.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Transfer of Assets from CHVI 54,259. Net Assets Released from Restriction -2,250. Transfers to Sponsor - Ascension Health -31,745.
Form 990, Part XII, Line 2:The financial statements of Carondelet Health Network (which include the activity of Holy Cross Hospital, Inc.) fall under the limited scope audit of Ascension Heatlh Alliance. The activity of Carondelet Health Network and other members of the Carondelet Health Network are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit report of Carondelet Health Network is completed.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Ascension Health
PO Box 45998St LouisMO63145311662309National Health SystemMOSection 501(c)(3)Schedule A, Line 11aAscension Health Alliance0
Carondelet Health Network
2202 N Forbes BlvdTucsonAZ85745860455920HospitalAZSection 501(c)(3)Schedule A, Line 3Ascension Health0
Carondelet Heart & Vascular Institute
4888 N Stone AveTucsonAZ85704561943271HospitalAZSection 501(c)(3)Schedule A, Line 3Carondelet Health Network1
Carondelet Foundation Inc
120 N Tucson BlvdTusconAZ85716860749574FoundationAZSection 501(c)(3)Schedule A, Line 11aCarondelet Health Network1
Southwest Catholic Health Network (DBA Mercy Care Plan)
4350 E Cotton Center Blvd Bldg DPhoenixAZ85040860527381InsuranceAZSection 501(c)(3)Schedule A, Line 11aCHN & Cthlc Hlthcare W AZ0
Chalon Living Inc
8553 E San Alberto DrScottsdaleAZ85258860805615Elderly/Disabled HousingAZSection 501(c)(3)Schedule A, Line 7Holy Cross Hospital Inc1
The Centurions
2202 N Forbes BlvdTucsonAZ85745854088322FoundationAZSection 501(c)(3)Schedule A, Line 11aCarondelet Foundation Inc1

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Carondelet Medical Group PC
2202 N Forbes BlvdTucsonAZ85745860836126Medical GroupAZN/AC0
Carondelet Specialist Group Inc
2202 N Forbes BlvdTucsonAZ85745281558773Physician PracticeAZN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Carondelet Health NetworkBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeQTransactionType
Amount Involved2651147AmountInvolved
Method Of Amt DeterminationActual Amount TransferredMethodOfAmtDetermination