2014-05-14T09:44:31-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 593650609 St Vincent's Health System Inc STVI 9043087300 4205 Belfort Road No 4015 Jacksonville FL 32216 Kimberly Hodgkinson 9043087300 2014-05-12 1 Rebecca Lyons P01487105 5137847100 2014-05-05 2012 2015-11-30 17:44:51Z St Vincent's HealthCare Moody L Chisholm 1 Shircliff Way Jacksonville FL 32204 66865460 0 0928 X www.jaxhealth.com X 2000 FL Commitment to accept and serve poor and vulnerable patients regardless of their ability to pay. 11 9 352 9 0 0 128424 2836723 61469897 63405133 396599 -4315 1957014 386815 63951934 66624356 517837 1579060 0 0 19269525 18890182 0 0 0 42067359 44550751 61854721 65019993 2097213 1604363 82424959 209202859 12928793 55047554 69496166 154155305 X St. Vincent's Health System, Inc. directs its activities to spiritually centered holistic care which sustains and improves the health of the individual and community. Its mission of service to those that are poor and vulnerable is a commitment to accept patients regardless of their ability to pay. The Health Ministry uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs. Traditional charity care includes the cost of services provided to persons unable to pay for services; unpaid cost of public programs for persons covered under public programs for the poor; costs of other programs for the poor are designed to serve the poor in a myriad of services; community benefit programs are services for all, not just the poor. 0 0 62757688 1579060 63405133 St. Vincent's Health System, Inc. provides administrative and managerial services for St. Vincent's Medical Center, a 312 bed nonprofit acute care hospital; St. Luke's-St. Vincent's Healthcare, a 162 bed nonprofit acute care hospital; St. Catherine's Laboure Manor, Inc., a 240 bed nursing home; St. Vincent's Ambulatory Care, Inc. neurosurgery, neurology, and cardiology specialty practices; St. Vincent's Physician Enterprise, Inc., a taxable entity that provides primary care services and First Coast Primary Care, a physician office network for the provision of quality accessible outpatient care. The entities of St. Vincent's Health System, Inc. provide health care services for the residents of northeast Florida and southeast Georgia. St. Vincent's Health System, Inc. seeks to improve the physical, mental, social and spiritual health status of its surrounding community. 62757688 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 52 0 1 352 1 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 X Herb Kaminsky 9043087300 4205 Belfort Road Suite 4015 Jacksonville FL 32216 X C Daniel Rice 3.00 3.00 X X 0 0 0 Sidney S Simmons II 1.00 1.00 X X 0 0 0 Richard Mullaney 1.00 1.00 X X 0 0 0 Paul J Chappano MD 1.00 1.00 X 0 0 0 Gary R Chartrand 1.00 1.00 X 0 0 0 Dudley Greenhut 1.00 1.00 X 0 0 0 David G Kulik 1.00 1.00 X 0 0 0 Ricardo Morales Jr 1.00 1.00 X 0 0 0 Sr Nancy Murphy DC 1.00 1.00 X 0 0 0 Sr Elyse Staab DC 1.00 1.00 X 0 0 0 Moody Chisholm 40.00 40.00 X X 1158135 0 55827 Mark Doyle 40.00 40.00 X 477538 0 82397 Phil C Perry 40.00 40.00 X 0 458819 36260 Karen F Darnell 40.00 40.00 X 0 323407 37679 Janice G Lipsky 40.00 40.00 X 287156 0 52598 John Meyer 40.00 40.00 X 262692 0 45614 Jeffery Middlebrooks 40.00 40.00 X 172941 0 4865 Donnie L Romine Jr 40.00 40.00 X 0 372395 106497 David G Pringle 40.00 40.00 X 230811 0 68814 Sarath Degala 40.00 0.00 X 204308 0 26696 William Mayher 40.00 0.00 X 214975 0 27935 James Sapp 40.00 0.00 X 259449 0 39575 Jon Debardeleben 40.00 0.00 X 167154 0 32158 Kevin Hammonds 40.00 0.00 X 170299 0 20285 Kaye Lunsford 40.00 0.00 X 133022 0 36201 Christopher Bayer 40.00 0.00 X 160150 0 25081 Carol Tannenbaum 40.00 0.00 X 156057 0 18905 Gene K Miyamoto 0.00 0.00 X 0 396767 19103 4054687 1551388 736490 33 1 1 0 UHS Building SOLS Inc 367 South Gulph Road King of Prussia PA 19406 Construction Services (Sch O) 25944428 Cerner Corporation PO Box 412702 Kansas City MO 641412702 Healthcare Software Solution 2825627 Brown Parker and Demarinis 3333 South Congress Avenue DelRay Beach FL 33445 Advertising Services 2382000 CDW LLC 75 Remittance Drive Suite 1515 Chicago IL 606751515 Computer Equipment 1173250 The AG Mauro Company of Florida Inc 1105 Sand Pond Road Lake Mary FL 32746 Manufacturer & Installer of Doors&Frames 505215 17 2836723 2836723 Management Fees 561110 63132941 63132941 Exempt Affiliate Rent 532000 266917 266917 Health Education Fees 611710 5275 5275 63405133 393653 236789 156864 156864 156864 4315 -4315 -4315 -4315 Debt Settlement 900099 211742 211742 Wellness Fitness Fees 713940 10290 10290 7919 7919 229951 66624356 63405133 0 382500 1579060 1579060 3672326 3341817 330509 10878743 9931961 946782 596416 596416 2431002 2397660 33342 1311695 1311695 551530 551530 169770 169770 4972447 4416076 556371 3240742 3235486 5256 1144358 1084095 60263 29377080 29377080 3125093 3121339 3754 302874 334671 -31797 -1162225 -1162225 2264390 2264390 552775 551457 1318 25061 25061 Recruiting 290368 290368 Bank Fees 141748 141748 Licenses and Permits 109805 97255 12550 Bad Debt -174357 -174357 -380708 -724665 343957 65019993 62757688 2262305 0 87849 906141 10816646 10376172 220009 200224 28615 73839576 4846232 25163236 68993344 394438 11593282 45742781 117105081 82424959 209202859 9773906 8890053 3154887 46157501 12928793 55047554 X 62619724 148410651 6876442 5744654 0 69496166 154155305 82424959 209202859 X 1604363 346036 -61053 82769793 X 0 1 X 1 0 X X X 0 0 0 St Vincent's Medical Center 590624449 3 - Hospital 1 49380075 St Catherine's Laboure Manor 591878316 3 - Hospital 1 452515 St Vincent's Ambulatory Care 592292041 9 1 2952369 St Luke's-St Vincent's Healthcare 260479484 3 - Hospital 1 12539580 St Vincent's Medical Center Clay County 461523194 3 - Hospital 1 0 5 65324539 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8725136 8725136 4877230 1597147 3280083 2889391 2693306 196085 57347819 555779 56792040 68993344 Due from Affiliates 93984943 CSV Officers' Life Insurance 718448 Deferred Compensation Asset 824575 Interest in Investments Held by Ascension Health Alliance 4481079 Investment in Unconsolidated Subsidiaries 490229 Merger/Acquisition Costs 16561201 Other 44606 117105081 Due to Affiliates 45584408 Pension Payable -301714 Deferred Compensation Liability 824575 Other 50232 46157501 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: From the consolidated financial statements of St. Vincent's Health System, Inc.: The Health Ministry accounts for uncertainty in income tax positions by appyling a recognition threshold and measurement attribute for financial statement recognition and measurement of tax position taken or expected to be taken in a tax return. 1 Way Free Medical Clinic 479 Houston Street Green Cove Springs FL 32043 760828154 501(c)(3) 10000 General Support Sulzbacher Center 611 East Adams Street Jacksonville FL 32202 593229898 501(c)(3) 30000 General Support St Luke's Catholic Church 1606 Blanding Blvd Middleburg FL 32068 592398919 501(c)(3) 80000 Sponsorship Ronald McDonald House 824 Childrens Way Jacksonville FL 32207 592625008 501(c)(3) 15000 General Support Duval County Health Department 900 University Blvd North 505 Jacksonville FL 32211 Gov't Entity 55955 General Support Emergency Pregnancy Services 1637 King Street Jacksonville FL 32204 591728078 501(c)(3) 28000 General Support Jacksonville Community Council Inc 2434 Atlantic Blvd Jacksonville FL 32207 591163905 501(c)(3) 25000 General Support Florida Catholic Conference 201 West Park Avenue Tallahassee FL 32301 591232887 501(c)(3) 12881 General Support We Care Jacksonville 900 University Boulevard North Jacksonville FL 32221 593431724 501(c)(3) 10000 General Support Health Planning Council of Northeast Florida 100 N Laura Street Jacksonville FL 32202 592247189 501(c)(3) 20542 General Support National Council of the United States Society of St Vincent De Paul Inc 58 Progress Parkway Maryland Heights MO 63043 135562362 501(c)(3) 10000 General Support Clay County Chamber of Commerce 1734 Kingsley Avenue Orange Park FL 32073 590549602 501(c)(6) 13000 General Support Concert on the Green PO Box 9000 Fleming Island FL 32006 593170544 501(c)(3) 8500 General Support National Kidney Foundation of FL 1040 Woodcock Road Suite 119 Orlando FL 32803 592190073 501(c)(3) 10000 General Support St Vincent's Medical Center Inc 4205 Belfort Road Jacksonville FL 32216 590624449 501(c)(3) 829513 General Support St Vincent's Foundation Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 592219923 501(c)(3) 85828 General Support 14 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: St. Vincent's Health System, Inc. provides only direct charitable contributions. Therefore, no monitoring of charitable contributions is performed. X X X X 1 1 0 0 0 0 0 0 0 Moody Chisholm 610753 0 417376 0 130006 0 39022 0 16805 0 1213962 0 0 0 Mark Doyle 390112 0 83118 0 4308 0 78085 0 4312 0 559935 0 0 0 Phil C Perry 0 351820 0 76093 0 30906 0 23500 0 12760 0 495079 0 0 Karen F Darnell 0 252976 0 51510 0 18921 0 22000 0 15679 0 361086 0 0 Janice G Lipsky 216316 0 53204 0 17636 0 36000 0 16598 0 339754 0 0 0 John Meyer 213014 0 47103 0 2575 0 40114 0 5500 0 308306 0 0 0 Jeffery Middlebrooks 142869 0 28839 0 1233 0 0 0 4865 0 177806 0 0 0 Donnie L Romine Jr 0 217439 0 151448 0 3508 0 89987 0 16510 0 478892 0 0 David G Pringle 178356 0 43152 0 9303 0 53854 0 14960 0 299625 0 0 0 Sarath Degala 166457 0 36831 0 1020 0 18223 0 8473 0 231004 0 0 0 William Mayher 171178 0 41437 0 2360 0 25521 0 2414 0 242910 0 0 0 James Sapp 210346 0 45272 0 3831 0 26715 0 12860 0 299024 0 0 0 Jon Debardeleben 166406 0 0 0 748 0 16984 0 15174 0 199312 0 0 0 Kevin Hammonds 160766 0 8921 0 612 0 2942 0 17343 0 190584 0 0 0 Kaye Lunsford 124444 0 7378 0 1200 0 20500 0 15701 0 169223 0 0 0 Christopher Bayer 150599 0 8711 0 840 0 8238 0 16843 0 185231 0 0 0 Carol Tannenbaum 146076 0 8711 0 1270 0 13000 0 5905 0 174962 0 0 0 Gene K Miyamoto 0 198230 0 0 0 198537 0 19103 0 0 0 415870 0 0 Supplemental Information Part III Part I, Line 4a, Severance Payment: Gene K. Miyamoto - $194,741 Supplemental Information Part III Part I, Line 4b: Eligible 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 executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. The organization contributed to the nonqualified supplemental retirement plan as follows: Mark Doyle - $44,575 David G. Pringle - $18,236 Sarath Degala - $5,500 William Mayher - $8,521 James Sapp - $14,572 John Meyer - $17,032 St. Vincent's Medical Center, Inc. (related entity) contributed to the nonqualified supplemental retirement plan as follows: Donnie L. Romine - $51,455 Gene K. Miyamoto - $8,092 Community Benefit Report: Form 990, Part III, Line 4a: This report illustrates the significant degree St. Vincent's Health System contributes to the positive health status of the residents of Jacksonville, Florida and surrounding communities. As a member of Ascension Health, the nation's largest not-for-profit Catholic healthcare system, St. Vincent's Health System continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. Our goal is to perpetuate the healing mission of the Catholic Church. We further this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. St. Vincent's Health System core values include: Service of the Poor, Reverence, Wisdom, Creativity, Dedication and Integrity drive our concern for all human life and calls us to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. In order to fully portray the expansive breadth of our contribution, the community benefit information is described below. Organizational Commitment to Providing Community Benefit St. Vincent's Health System provides administrative and managerial services for St. Vincent's Medical Center, Inc., a 528-bed nonprofit acute care hospital; St. Luke's-Vincent's Healthcare, a 313-bed nonprofit acute care hospital; St. Catherine Laboure Manor, Inc. a 240-bed nursing home; St. Vincent's Ambulatory Care's neurosurgery, neurology, cardiology specialty practices, and general surgery and ob-gyn practices; and St. Vincent's Primary Care (formerly know as First Coast Primary Care) and St. Vincent's Physician Enterprise, physician office networks for the provision of quality, accessible outpatient care. The entities of St. Vincent's Health System provide health care services for the residents of Northeast Florida and Southeast Georgia. St. Vincent's seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, St. Vincent's Health System has developed many programs to fulfill our mission: Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. To provide for those who are poor and vulnerable, St. Vincent's Health System has supported not-for-profit organizations across the community whose missions align with St. Vincent's Health System. Among the agencies it has financially supported are I.M. Sulzbacher Center for the Homeless, Hubbard House for abused persons, Community Connections, which provides shelter for homeless families, The Way Free Medical Clinic, We Care, Volunteers in Medicine, and the City Rescue Mission - all provide services for the homeless and indigent. St. Vincent's Mobile Health Outreach Ministry is an internal program that utilizes mobile clinics to deliver direct access to medical care, both acute and preventive, to the men, women and children who lack medical access regardless of their ability to pay. These clinics target remote, rural and inner city areas where medical access is unavailable. St. Vincent's Health System also supports many Community Benefit programs with particular emphasize on education. The Bayley Fund School Nurse program supports school nurse positions from the Duval Department of Health to work in local schools. Faith Community Nursing provides nurses to engage local faith community leaders in their ministries. Seton Center for Women and Children provides childbirth education and resources. Summary St. Vincent's Health System provides essential health improvement services to the community, trains and recruits healthcare professionals to serve the needs of the broader community, provides appropriate charity services to those patients who are unable to pay for their own healthcare needs, provides services to other organizations that facilitate quality services to their patients or constituents, and presents educational information classes and activities to the community in order to improve its overall health status. St. Vincent's Health System has truly made a difference in the lives of people in Northeast Florida and Southeast Georgia, especially delivering health care in innovative ways to communities that lack access to quality health services. Form 990, Part VI, Section A, line 6 St. Vincent's Health System, Inc. has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a St. Vincent's Health System, Inc. has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of St. Vincent's Health System, Inc. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review. 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 12c Officers, directors or trustees, and key employees are required to complete a Conflict of Interest Attestation Statement at the time of hiring or when their service begins. Annually, the Corporate Responsibility Officer sends the Conflict of Interest Policy and Attestation Statement to all officers, directors or trustees, and key employees for completion and return within two weeks. Three separate mailings are sent out with two week deadlines to receive a maximum response. The responses from the returned Attestation Statement are organized in a spreadsheet and are carefully reviewed by the Corporate Responsibility Officer, the Chief Legal Officer, and the Chief Executive Officer. A full report is presented to the Audit Committee and any potential conflicts of interest are handled by the Committee in an appropriate manner. Form 990, Part VI, Section B, line 15 In determining the compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees were compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section B: Compensation amount paid to UHS Building Sols, Inc. includes both construction services and materials. There is no easy way to breakout these amounts to only report services in Form 990, Part VII, Section B. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfers from Affiliates 69,491,974. Deferred Pension Costs -59,147. Investments in Subsidiaries 18,204,361. Transfer to Ascension Health -1,601,235. Symphony Non-Recurring Expenses -3,266,160. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Vincent's Medical Center Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 590624449 Hospital FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 St Luke's-St Vincent's Healthcare Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 260479484 Hospital FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 St Vincent's Ambulatory Care Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 592292041 Physician Practice FL Section 501(c)(3) Schedule A, Line 9 St Vincent's Health System Inc 1 St Vincent's Foundation Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 592219923 Fund Raising FL Section 501(c)(3) Schedule A, Line 7 St Vincent's Health System Inc 1 St Catherine's Laboure Manor Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 591878316 Nursing Home FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 St Vincent's Medical Center Clay County Inc 1580 Branan Field Road Middleburg FL 32068 461523194 Hospital FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 Consolidated Pharmacy Services Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 593398033 Retail Pharmacy & Patient Transport FL St Vincent's Health System Inc C 6179661 3133748 1.00000 0 St Vincent's Physician Enterprise Inc 4205 Belfort Road Suite 4015 Jacksonville FL 32216 271927603 Primary Care FL St Vincent's Health System Inc C 4045548 2026210 1.00000 0 Family Medicine Condominium Association Inc 1 Shircliff Way Jacksonville FL 32204 261983355 Condominium Association FL N/A C 0 0 1 1 0 0 0 0 0 1 1 0 1 0 0 0 0 1 1 1 Ascension Health S 1601235 FMV St Vincent's Medical Center Inc I 732502 FMV St Vincent's Ambulatory Care Inc L 982290 FMV St Vincent's Medical Center Inc L 13922065 FMV St Catherine's Laboure Manor Inc L 321133 FMV St Luke's-St Vincent's Healthcare L 3589135 FMV St Vincent's Foundation Inc C 2836723 FMV St Vincent's Medical Center Inc B 829513 FMV St Vincent's Foundation Inc B 85828 FMV St Vincent's Ambulatory Care Inc J 67379 FMV St Luke's-St Vincent's Healthcare J 163720 FMV St Vincent's Medical Center Inc Q 41930156 FMV St Vincent's Ambulatory Care Inc Q 5573525 FMV Consolidated Pharmacy Services Inc Q 77020 FMV St Vincent's Ambulatory Care Inc R 32786654 FMV St Luke's-St Vincent's Healthcare R 1325345 FMV Consolidated Pharmacy Services Inc R 316689 FMV First Coast Primary Care R 1724298 FMV St Vincent's Physician Enterprise Inc R 1995384 FMV