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ST MARYS HEALTH INC DBA ASCENSION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST MARYS HEALTH INC DBA ASCENSION (EIN 35-0869065)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201421349349305632
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)
Timestamp2014-05-14T14:28:01-05:00Timestamp
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 Line1111 MONUMENT CIRCLE SUITE 2000AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code462045108ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN350869065EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S MEDICAL CENTER OF EVANSVILLE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTMANameControl
Phone8124854178Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13700 WASHINGTON AVENUEAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47750ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN L ZABROWSKIName
TitleCHIEF FINANCIAL OFFICERTitle
Phone8124854178Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSHAWNA M JIMENEZName
PTINP01222873PTIN
Phone3174648600Phone
Date Prepared2014-05-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEITH JEWELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13700 WASHINGTON AVENUEAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47750ZIPCode
FieldValueIRS element (for citing)
Gross Receipts469242685GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STMARYS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1941YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionDEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees3650TotalNbrEmployees
Total Nbr Volunteers477TotalNbrVolunteers
Total Gross UBI230955TotalGrossUBI
Net Unrelated Business Txbl Income-365094NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2307954ContributionsGrantsPriorYear
Contributions Grants Current Year1527361ContributionsGrantsCurrentYear
Program Service Revenue Prior Year438394746ProgramServiceRevenuePriorYear
Program Service Revenue CY438137652ProgramServiceRevenueCY
Investment Income Prior Year18374856InvestmentIncomePriorYear
Investment Income Current Year17885356InvestmentIncomeCurrentYear
Other Revenue Prior Year11772892OtherRevenuePriorYear
Other Revenue Current Year10819915OtherRevenueCurrentYear
Total Revenue Prior Year470850448TotalRevenuePriorYear
Total Revenue Current Year468370284TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2911410GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY21016801GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year191033245SalariesEtcPriorYear
Salaries Etc Current Year156616340SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year744206TotalFundrsngExpCurrentYear
Other Expense Prior Year209550523OtherExpensePriorYear
Other Expenses Current Year241877344OtherExpensesCurrentYear
Total Expenses Prior Year403495178TotalExpensesPriorYear
Total Expenses Current Year419510485TotalExpensesCurrentYear
Revenues Less Expenses Prior Year67355270RevenuesLessExpensesPriorYear
Revenues Less Expenses CY48859799RevenuesLessExpensesCY
Total Assets BOY567651870TotalAssetsBOY
Total Assets EOY614660665TotalAssetsEOY
Total Liabilities BOY221969770TotalLiabilitiesBOY
Total Liabilities EOY213767120TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY345682100NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY400893545NetAssetsOrFundBalancesEOY
Mission DescriptionDEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense344211902Expense
Grants21016801Grants
Revenue446118919Revenue
DescriptionST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. (SMMC) PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES SERVING VANDERBURGH AND CONTIGUOUS COUNTIES AND PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2013, SMMC TREATED 17,218 INPATIENTS IN THE COMMUNITY FOR A TOTAL OF 83,119 PATIENT DAYS OF SERVICE. SMMC ALSO PROVIDED SERVICES TO 354,550 OUTPATIENTS, INCLUDING 4,630 INPATIENT SURGERY PATIENTS, 54,869 EMERGENCY ROOM VISITS, 42,224 PHYSICIAN OFFICE VISITS, AND 22,722 CLINIC VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense33279840Expense
DescriptionSMMC PROVIDES A SUBSTANTIAL PORTION OF ITS CORE HEALTH SERVICES TO THE POOR, UNINSURED, OR UNDERINSURED AND HAS PROACTIVELY TAKEN STEPS TO ADDRESS ACCESSIBILITY, AND THE FINANCING, AND DELIVERY OF HEALTHCARE TO THE UNDERSERVED. DURING THE FISCAL YEAR ENDING JUNE 30, 2013, THE UNREIMBURSED COST OF FREE OR DISCOUNTED SERVICES PROVIDED TO PATIENTS WHO ARE DEEMED INDIGENT UNDER STATE, COUNTY, OR HOSPITAL GUIDELINES WAS $33,279,840, WHICH INCLUDED $18,852,448 OF TRADITIONAL FINANCIAL ASSISTANCE AND $14,427,392 IN UNPAID COSTS OF CARE FOR THOSE QUALIFYING FOR MEDICAID OR OTHER PUBLIC PROGRAMS FOR THE POOR. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1452585Expense
DescriptionIN ADDITION TO CORE MEDICAL SERVICES, SMMC AND COMMUNITY PARTNERS ASSESS COMMUNITY ASSETS AND NEEDS AND WORK TOGETHER TO ADDRESS ISSUES IMPACTING HEALTH AND QUALITY OF LIFE, WITH SPECIAL EMPHASIS ON THE POOR AND VULNERABLE. IN FISCAL YEAR 2013, SMMC PROVIDED $1,452,585 IN UNBILLED SERVICES TO THE POOR AND TO THE BROADER COMMUNITY. (WHEN COMBINED WITH THE COSTS OF FREE OR DISCOUNTED SERVICES FOR THE POOR LISTED IN LINE 4B, SMMC PROVIDED A TOTAL COMMUNITY BENEFIT OF $34,732,425 IN FISCAL YEAR 2013.) SMMC SERVES AND SUPPORTS ITS COMMUNITY THROUGH SUCH PROGRAMS AS SUPPORT GROUPS, PUBLIC HEALTH SCREENINGS, AND NUTRITION COUNSELING. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS.Description
FieldValueIRS element (for citing)
Total Program Service Expense378944327TotalProgramServiceExpense
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 Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
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
Number Forms Transmitted With1096275NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3650NumberOfEmployees
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN L ZABROWSKIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8124854178TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13700 WASHINGTON AVENUEAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47750ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SISTER XAVIER BALLANCE
BOARD MEMBER1.004.00X000
NADINE COUDRET
BOARD MEMBER1.001.00X000
MARIA DEL-RIO MD
BOARD MEMBER55.000.00X394937072996
DARCY ELLISON
SR VP/CNO60.001.00X2937680127565
DORON FINN MD
BOARD MEMBER1.000.00X000
PRASAD GADE MD
BOARD MEMBER1.001.00X000
JOHN GALLAGHER MD
SR VP/CMO60.001.00X4440420121575
TRICIA HENNING
BOARD MEMBER1.002.00X000
MICHAEL HERRELL MD
CHAIR1.005.00X000X
SHARON KAZEE
BOARD MEMBER1.001.00X000
SISTER SHARON RICHARDT
BOARD MEMBER1.001.00X000
GWEN SANDEFUR
EVP/COO60.006.20X381454042467
KARL SASH MD
BOARD MEMBER1.0056.00X0579307100068
KENNETH SPEAR MD
BOARD MEMBER1.002.00X000
JOHN STANLEY
BOARD MEMBER1.002.00X000
TIMOTHY FLESCH
CEO/PRESIDENT55.0011.201704596063161X
KIMBERLY HODGKINSON
CFO60.004.00368829020703X
JANICE ERNEST
VP/CARDIOVASCULAR & SYSTEM SUPPORT SERVICES60.002.00226052099254X
JOHN GREANEY
VP/STRATEGIC SERVICES60.000.00184725024016X
KATHY HALL
VP/SMHS REGIONAL ADMINISTRATOR60.000.00183210053234X
MICHAEL KLUEH
VP/CRO60.000.00198159078001X
THOMAS LILLY
SR VP/SUPPORT OPERATIONS60.001.00233955052181X
VERNON MAASMD
VP/MEDICAL AFFAIRS60.000.00224746040778X
MIKE WHITMORE
VP/CLINICAL SUPPORT & ANCILLARY SERVICES60.000.00211751066277X
KATHRYN BRYAN MD
PHYSICIAN55.000.00460866058099X
ROBERT CUTRELL MD
PHYSICIAN55.000.00368482069777X
MYLES GRANT
EXECUTIVE DIRECTOR55.000.00422516094704X
CHARLES LACKEY MD
PHYSICIAN55.000.00510134058612X
MUREENA TURNQUEST-WELLS MD
PHYSICIAN55.001.006148340109136X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7427056TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs579307TotalReportableCompFrmRltdOrgs
Total Other Compensation1352604TotalOtherCompensation
Number Individuals GT100 K89NumberIndividualsGT100K
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
AMBULATORY CARE CENTER LLC
1125 PROFESSIONAL BLVDEVANSVILLEIN47714MEDICAL SERVICES25988358
TRIMEDX
PO BOX 636129CINCINNATIOH45263HEALTH CARE EQUIPMENT MANAGEMENT4194519
AIR METHODS CORPORATION
PO BOX 172892DENVERCO802172892AIR TRANSPORT SERVICES1559206
EMERGENCY PROFESSIONAL SERVICE
PO BOX 634850CINCINNATIOH45263MEDICAL SERVICES1519667
ST MARY'S PERIPHERAL VASCULAR SERVICES
3700 WASHINGTON AVENUEEVANSVILLEIN47750MEDICAL SERVICES1181398
FieldValueIRS element (for citing)
Number Of Contractors GT100 K55NumberOfContractorsGT100K
Related Organizations1494653RelatedOrganizations
Government Grants32708GovernmentGrants
Noncash Contributions9795NoncashContributions
Total Contributions1527361TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OUTPATIENT SERVICE REV621110219888425219888425
INPATIENT SERVICE REV621110218249227218249227
FieldValueIRS element (for citing)
Total Program Service Revenue438137652TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column17922403TotalRevenueColumn
Exclusion$17,922,403ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real631776Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real522271Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real109505Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column109505TotalRevenueColumn
Exclusion$109,505ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other313083Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other350130Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-37047Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-37047TotalRevenueColumn
Related Or Exempt Function Income-37047RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
APOTHECARY44611046193704619370
CAFETERIA/MISC. SERV7223201835442108212$1,727,230
LAB SERVICES62150082875894847$733,911

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3426840TotalRevenueColumn
Related Or Exempt Function Income3398944RelatedOrExemptFunctionIncome
Unrelated Business Revenue27896UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue10710410TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column468370284TotalRevenueColumn
Related Or Exempt Function Income446118919RelatedOrExemptFunctionIncome
Unrelated Business Revenue230955UnrelatedBusinessRevenue
Exclusion$20,493,049ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total21016801Total
Program Services21016801ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6012500Total
Management And General6012500ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total118467180Total
Program Services108407324ProgramServices
Management And General9501410ManagementAndGeneral
Fundraising558446Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2647080Total
Program Services2317174ProgramServices
Management And General329906ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total20818340Total
Program Services18160756ProgramServices
Management And General2594591ManagementAndGeneral
Fundraising62993Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8671240Total
Program Services7556130ProgramServices
Management And General1080697ManagementAndGeneral
Fundraising34413Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total19911102Total
Program Services17429580ProgramServices
Management And General2481522ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total91657Total
Program Services80234ProgramServices
Management And General11423ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total125037Total
Program Services103957ProgramServices
Management And General15583ManagementAndGeneral
Fundraising5497Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4266270Total
Program Services3667527ProgramServices
Management And General531802ManagementAndGeneral
Fundraising66941Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total19069732Total
Program Services16683051ProgramServices
Management And General2376662ManagementAndGeneral
Fundraising10019Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8536938Total
Program Services7472979ProgramServices
Management And General1063959ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total418446Total
Program Services361343ProgramServices
Management And General52151ManagementAndGeneral
Fundraising4952Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total199962Total
Program Services174528ProgramServices
Management And General24921ManagementAndGeneral
Fundraising513Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total4712929Total
Program Services4125556ProgramServices
Management And General587373ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total21065232Total
Program Services18439871ProgramServices
Management And General2625361ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1543290Total
Program Services1350518ProgramServices
Management And General192340ManagementAndGeneral
Fundraising432Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES68662977601055068557471
MEDICAL SUPPLIES5794096057940960
PROVIDER TAX EXPENSE1616022116160221
COST OF GOODS SOLD60518586051858

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total13120733Total
Program Services11338453ProgramServices
Management And General1782280ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total419510485Total
Program Services378944327ProgramServices
Management And General39821952ManagementAndGeneral
Fundraising744206Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4387544BOY
EOY3446252EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY54931619BOY
EOY54541611EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY957935BOY
EOY854961EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5409364BOY
EOY6068368EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2567499BOY
EOY2562612EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis358326159LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec273102016LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY87687421BOY
EOY85224143EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY48701BOY
EOY55798EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY450788BOY
EOY279255EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY411210999BOY
EOY461627665EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY567651870BOY
EOY614660665EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY38839540BOY
EOY37975128EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY183130230BOY
EOY175791992EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY221969770BOY
EOY213767120EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY345682100BOY
EOY400893545EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY345682100BOY
EOY400893545EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY567651870BOY
EOY614660665EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses48859799ReconcilationRevenueExpenses
Reconciliation Unrealized Invest11473267ReconciliationUnrealizedInvest
Reconcilation Other Changes-5121621ReconcilationOtherChanges
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$3,199OtherActivitiesAmount
Total Lobbying Expenditures IIB3199TotalLobbyingExpendituresIIB
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
ExplanationLOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7736792OtherCostOrOtherBasis
Book Value7736792BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis92320106OtherCostOrOtherBasis
Depreciation61856222Depreciation
Book Value30463884BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis21275229OtherCostOrOtherBasis
Depreciation11422404Depreciation
Book Value9852825BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis236994032OtherCostOrOtherBasis
Depreciation199823390Depreciation
Book Value37170642BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings85224143TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY RECEIVABLES8265929
OTHER RECEIVABLES4036235
DEFERRED COMPENSATION ASSET4359995
ESTIMATED SETTLEMENTS FROM THIRD PARTIES938359
PHYSICIAN GUARANTEES ASSET19602250
OTHER CURRENT ASSETS57355
INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE424367542
FieldValueIRS element (for citing)
Total Book Value Other Assets461627665TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (10 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$5,602,628
DEFERRED COMPENSATION$4,359,995
SELF INSURANCE LIABILITY$1,475,372
ESTIMATED SETTLEMENT LIABILITY$3,001,494
AH SAVINGS LIABILITY$1,679,957
INTERCOMPANY PAYABLES$222,973
VALUATION ALLOWANCE$1,950,000
DEFERRED RENT PAYABLE$459,073
PHYSICIAN GUARANTEE LIABILITY$19,602,250
INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE$137,438,250
FieldValueIRS element (for citing)
Total Of Amounts175791992TotalOfAmounts

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegionNumber Of OfficesNumberOfOfficesNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedSpecific Services ProvidedSpecificServicesProvidedTotal ExpendituresTotalExpenditures
NORTH AMERICA00PROGRAM SERVICESLICENSES, PERMITS2712
NORTH AMERICA00PROGRAM SERVICESMEDICAL SUPPLIES8137
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent10849SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent10849TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense18852448TotalCommunityBenefitExpense
Net Community Benefit Expense18852448NetCommunityBenefitExpense
Percent Of Total Expense0.04830PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense55601119TotalCommunityBenefitExpense
Direct Offsetting Revenue41173727DirectOffsettingRevenue
Net Community Benefit Expense14427392NetCommunityBenefitExpense
Percent Of Total Expense0.04090PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense74453567TotalCommunityBenefitExpense
Direct Offsetting Revenue41173727DirectOffsettingRevenue
Net Community Benefit Expense33279840NetCommunityBenefitExpense
Percent Of Total Expense0.08920PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served892244PersonsServed
Total Community Benefit Expense1155117TotalCommunityBenefitExpense
Direct Offsetting Revenue433383DirectOffsettingRevenue
Net Community Benefit Expense721734NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense289786TotalCommunityBenefitExpense
Net Community Benefit Expense289786NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served40010PersonsServed
Total Community Benefit Expense441065TotalCommunityBenefitExpense
Net Community Benefit Expense441065NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served932254PersonsServed
Total Community Benefit Expense1885968TotalCommunityBenefitExpense
Direct Offsetting Revenue433383DirectOffsettingRevenue
Net Community Benefit Expense1452585NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served932254PersonsServed
Total Community Benefit Expense76339535TotalCommunityBenefitExpense
Direct Offsetting Revenue41607110DirectOffsettingRevenue
Net Community Benefit Expense34732425NetCommunityBenefitExpense
Percent Of Total Expense0.09270PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$4,222,693BadDebtExpenseAmount
Amount Attributable To422269AmountAttributableTo
Amount Reimbursed By Medicare113481329AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare151333702CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-37852373MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMANAGEMENTDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.75000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.75000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S MEDICAL CENTER OF EVA INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line13700 WASHINGTON AVENUEAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47750ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.STMARYS.ORG/SMLOCATIONWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Childrens HospitalXChildrensHospital
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S MEDICAL CENTER OF EVA INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities18NumberOfOtherFacilities

Other Facilities OtherFacilities (18 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
ST MARY'S SURGICARE
300 CIRCLE FRONT DRIVEEVANSVILLEIN47715GENERAL SURGICAL CENTER
ST MARY'S SURGICARE
1125 PROFESSIONAL BLVDEVANSVILLEIN47714GENERAL SURGICAL CENTER
ST MARY'S PRE-PROCEDURE CLINIC
1140 WASHINGTON AVENUEEVANSVILLEIN47714PRIMARY CARE FACILITY
ST MARY'S MATERNAL-FETAL MEDICINE
3700 WASHINGTON AVENUE SUITE 2100AEVANSVILLEIN47750OBSTETRICS/GYNECOLOGY
ST MARY'S REHAB
3900 WASHINGTON AVENUEEVANSVILLEIN47714INPATIENT REHAB CENTER
ST MARY'S OUTPATIENT REHAB
1144 WASHINGTON SQUAREEVANSVILLEIN47715OUTPATIENT REHAB CLINIC
ST MARY'S FOR CHILDREN
3900 WASHINGTON AVENUEEVANSVILLEIN47714CHILDREN'S HEALTH FACILITY
ST MARY'S CONVENIENT CARE - WEST
5320 WESTON ROADEVANSVILLEIN47712PRIMARY CARE FACILITY
ST MARY'S OCCMED
2330 LYNCH ROADEVANSVILLEIN47711OCCUPATIONAL MEDICINE CLINIC
ST MARY'S CONVENIENT CARE EAST
10444 SR 66 FRONTAGE ROAD NORTHNEWBURGHIN47630PRIMARY CARE FACILITY
ST MARY'S NORTH POINTE REHAB
2300 LYNCH ROADEVANSVILLEIN47711OUTPATIENT REHAB CLINIC
ST MARY'S IMAGING AND LAB
1138 WASHINGTON SQUAREEVANSVILLEIN47715IMAGING SERVICES/RADIOLOGY
ST MARY'S NORTHBROOK
3838 N FIRST AVENUEEVANSVILLEIN47710PRIMARY CARE FACILITY
ST MARY'S BOONVILLE PHYSICIAN OFFICE
1116 MILLIS AVENUEBOONVILLEIN47601PRIMARY CARE FACILITY
JOSLIN DIABETES CENTER
3801 BELLEMEADE AVENUEEVANSVILLEIN47714DIABETES SERVICE CENTER
ST MARY'S HEART INSTITUTE
3700 WASHINGTON AVENUEEVANSVILLEIN47714SPECIALITY CARE FACILITY
ST MARY'S WEIGHT MANAGEMENT CENTER
950 S KENMOREEVANSVILLEIN47714WEIGHT MANAGEMENT FACILITY
ST MARY'S WEST SIDE X-RAY
2345 W FRANKLIN STREETEVANSVILLEIN47712IMAGING SERVICES/RADIOLOGY

Form990 Schedule H Part VI Form990ScheduleHPartVI (26 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
PART I, LINE 3C: THE ORGANIZATION PROVIDES MEDICALLY NECESSARY CARE TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, ETHNIC ORIGIN, GENDER, DISABILITY, OR ECONOMIC STATUS. THE HOSPITAL USES A PERCENTAGE OF FEDERAL POVERTY LEVEL (FPL) TO DETERMINE FREE AND DISCOUNTED CARE. AT A MINIMUM, PATIENTS WITH INCOME LESS THAN OR EQUAL TO 200% OF THE FPL, WHICH MAY BE ADJUSTED FOR COST OF LIVING UTILIZING THE LOCAL WAGE INDEX COMPARED TO THE NATIONAL WAGE INDEX, WILL BE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF CHARGES FOR SERVICES THAT HAVE BEEN PROVIDED TO THEM. ALSO, AT A MINUMUM, PATIENTS WITH INCOMES ABOVE 200% OF THE FPL BUT NOT EXCEEDING 300% OF THE FPL, SUBJECT TO ADJUSTMENTS FOR COST OF LIVING UTILIZING THE LOCAL WAGE INDEX COMPARED TO NATIONAL WAGE INDEX, WILL RECEIVE A DISCOUNT ON THE SERVICES PROVIDED TO THEM.
PART I, LINE 7: THE COST OF PROVIDING CHARITY CARE, MEANS TESTED GOVERNMENT PROGRAMS, AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED.
PART II: ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. PROMOTES THE HEALTH OF ITS COMMUNITIIES BY STRIVING TO IMPROVE THE QUALITY OF LIFE WITHIN THE COMMUNITY. RESEARCH HAS ESTABLISHED THAT FACTORS SUCH AS ECONOMIC STATUS, EMPLOYMENT, HOUSING, EDUCATION LEVEL, AND BUILT ENVIRONMENT CAN ALL BE POWERFUL SOCIAL DETERMINANTS OF HEALTH. ADDITIONALLY, HELPING TO CREATE GREATER CAPACITY WITHIN THE COMMUNITY TO ADDRESS A BROAD RANGE OF QUALITY OF LIFE ISSUES ALSO IMPACTS HEALTH. ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. MEETS REGULARLY WITH LOCAL ORGANIZATIONS IN THE COMMUNITY TO LEARN WHAT RESOURCES ARE AVAILABLE AND PLAN COMMUNITY HEALTH IMPROVEMENT EFFORTS.
AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED, IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2013 WAS $14,594,746 AT CHARGES ($4,222,693 AT COST).PART III, LINE 2:
THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING ECONOMIC CONDITIONS, HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS.PART III, LINE 3:
THE ORGANIZATION IS A PART OF THE ST.VINCENT HEALTH SYSTEM'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 22.PART III, LINE 4:
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT.PART III, LINE 8:
THE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY AND THE FINANCIAL ASSISTANCE PROGRAM IS FOLLOWED.PART III, LINE 9B:
IN CONDUCTING ITS CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY AS WELL AS PROFESSIONAL RESEARCH CONSULTANTS, INC., A CONSULTING COMPANY THAT HAS SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH.THE HOSPITAL FACILITY CONSULTED WITH THESE PERSONS THROUGH MEETINGS AND FOCUS GROUPS.ADDITIONALLY, THE HOSPITAL CONSULTED WITH THE FOLLOWING ORGANIZATIONS AND GROUPS IN CONDUCTING ITS MOST RECENT CHNA: ECHO, UNITED WAY, WELBORN BAPTIST FOUNDATION, SMOKE FREE COMMUNITIES, YMCA, DIEHL CONSULTING, THE CITY OF EVANSVILLE'S MAYOR'S OFFICE, SOUTHWEST MENTAL HEALTH, BRENTWOOD MEADOWS, CROSSPOINTE, EVANSVILLE-VANDERBURGH DRUG TASK FORCE, WARRICK CO. SHERIFF DEPARTMENT, VANDERBURGH CO. SHERIFF DEPARTMENT, YOUTH FIRST, EVANSVILLE STATE HOSPITAL, LAMPION CENTER, WARRICK PSYCHIATRIC CARE AND THE CHILDREN'S PSYCHIATRIC HOSPITAL.PART V, SECTION B, LINE 3:
THE OTHER HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA INCLUDES ST. MARY'S WARRICK HOSPITAL, INC., DEACONESS HOSPITAL, DEACONESS GATEWAY, DEACONESS CROSSPOINTE, AND THE WOMEN'S HOSPITAL.PART V, SECTION B, LINE 4:
THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") OF THE HOSPITAL FACILITY CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTP://WWW.STMARYS.ORG/CHNA.PART V, SECTION B, LINE 5:
THE HOSPITAL FACILITY PRESENTED ITS CHNA TO THE COMMUNITY AT A LOCAL FINANCIAL INSTITUTION.PART V, SECTION B, LINE 5C:
THE HOSPITAL FACILITY'S COMMUNITY NEEDS HEALTH ASSESSMENT IDENTIFIED ACCESS TO CARE, ORAL HEALTH, AND EDUCATION TRAINING AS NEEDS OF THE COMMUNITY. THE HOSPITAL FACILITY DID NOT TAKE ACTION TO ADDRESS THESE NEEDS AS IT HAS LIMITED FINANCIAL AND OTHER RESOURCES.PART V, SECTION B, LINE 7:
THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOR PURPOSES OF QUESTION 16:- NOTIFIED EACH INDIVIDUAL OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP BY METHODS AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, PROVIDING THE FOLLOWING:- A BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED- DIRECTIONS ON HOW TO ACCESS THE FAP AND APPLICATION ON OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS- INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL- CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS- STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES- STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).PART V, SECTION B, LINE 16:
THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOR PURPOSES OF QUESTION 17:- NOTIFIED EACH INDIVIDUAL OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING:- BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED- DIRECT INDIVIDUALS TO OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS- PROVIDED INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL- PROVIDED CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS- PROVIDED STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES- PROVIDED STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).PART V, SECTION B, LINE 17:
QUESTION 18 IS MORE APPROPRIATELY ANSWERED AS NOT APPLICABLE AS THE BILLING AND COLLECTIONS POLICY OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. DOES NOT ALLOW A HOSPITAL TO ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE THE ORGANIZATION MADE REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS TAKEN INCLUDE BUT ARE NOT LIMITED TO:- NOTIFYING INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION- NOTIFYING INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE- NOTIFYING INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS REGARDING THE PATIENTS' BILLS- DOCUMENTING ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICYPART V, SECTION B, LINE 18:
THE DISCOUNT WAS DETERMINED BY REVIEWING THE LOWEST DISCOUNT PROVIDED TO MANAGED CARE PAYERS THAT COMPRISE AT LEAST 3% OF OUR VOLUME WITH AN ADDED PROMPT PAY DISCOUNT TO THE HIGHEST PAID DISCOUNT PROVIDED TO OUR MANAGED CARE PAYERS.PART V, SECTION B, LINE 20D:
THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOLLOWED FOR PURPOSES OF IDENTIFYING PATIENTS ELIGIBLE FOR ASSISTANCE UNDER THE FACILITY'S FAP:- NOTIFIED EACH INDIVIDUAL OF THE HOSPITALS'S FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING:- BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED- DIRECT INDIVIDUALS TO OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS- PROVIDED INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL- PROVIDED CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS- PROVIDED STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES- PROVIDED STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).PART V, SECTION B, LINE 21:
THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOLLOWED FOR PURPOSES OF IDENTIFYING PATIENTS ELIGIBLE FOR ASSISTANCE UNDER THE FACILITY'S FAP:- NOTIFIED EACH INDIVIDUAL OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING:- BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED- DIRECT INDIVIDUALS TO OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS- PROVIDED INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL- PROVIDED CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS- PROVIDED STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES- PROVIDED STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).PART V, SECTION B, LINE 22:
PART VI, LINE 2: COMMUNITIES ARE DYNAMIC SYSTEMS IN WHICH MULTIPLE FACTORS INTERACT TO IMPACT QUALITY OF LIFE AND HEALTH STATUS. AS PART OF THE ST. MARY'S HEALTH SYSTEM, THE GOAL OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. IS TO WORK WITH ITS COMMUNITY TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS. ASSESSMENTS MAY INCLUDE PRIMARY SURVEY DATA, SECONDARY DATA, FOCUS GROUP INPUT, COMMUNITY LEADERS' SURVEY AND OTHER DATA. RESULTS ARE MADE AVAILABLE TO ORGANIZATIONS AND INDIVIDUALS THROUGHOUT THE COMMUNITY. THESE NEEDS ASSESSMENTS ARE ALSO UTILIZED IN CREATING THE HOSPITAL'S INTEGRATED STRATEGIC FINANCIAL AND OPERATIONAL PLAN. TO THAT END, ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. HAS BROUGHT TOGETHER A COMMUNITY ROUNDTABLE WITH THE PURPOSE OF DETERMINING THE RESOURCES AND NEEDS, PRIORITIZING ACTION AND WORKING IN PARTNERSHIP TO ADDRESS IDENTIFIED CHALLENGES WITHIN A DESIGNATED AREA SURROUNDING THE HOSPITAL. ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. ALSO IDENTIFIES COMMUNITY HEALTH NEEDS BY EMPLOYING OTHER PUBLIC AGENCY NEEDS ASSESSMENTS SUCH AS WELBORN BAPTIST FOUNDATION AND THE UNITED WAY.
PART VI, LINE 3: ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. COMMUNICATES WITH PATIENTS IN MULTIPLE WAYS TO ENSURE THAT THOSE WHO ARE BILLED FOR SERVICES ARE AWARE OF THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS THEIR POTENTIAL ELIGIBILITY FOR LOCAL, STATE OR FEDERAL PROGRAMS. SIGNS ARE PROMINENTLY POSTED IN EACH SERVICE AREA. IN ADDITION, THE HOSPITAL EMPLOYS FINANCIAL COUNSELORS, HEALTH ACCESS WORKERS, AND ENROLLMENT SPECIALISTS WHO CONSULT WITH PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AND HELP PATIENTS IN APPLYING FOR ANY PUBLIC PROGRAMS FOR WHICH THEY MAY QUALIFY. ALL SELF-PAY PATIENTS RECEIVE A 15% DISCOUNT OFF THE TOP ON ALL CHARGES BEFORE STATEMENTS ARE MAILED.
PART VI, LINE 4: ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. IS LOCATED IN EVANSVILLE, INDIANA AND SERVES VANDERBURGH AND CONTINGUOUS COUNTIES IN SOUTHERN INDIANA AND NORTH-CENTRAL KENTUCKY. THE PRIMARY SERVICE AREA IS DEFINED AS VANDERBURGH, WARRICK AND POSEY COUNTIES. THE POPULATION FOR THE PRIMARY SERVICE AREA WAS 287,261 IN 2013. ALSO THE MEDIAN INCOME FOR THE PRIMARY SERVICE AREA WAS $54,016 FOR 2013 WITH 17% OF CHILDREN BELOW POVERTY LEVEL.
PART VI, LINE 5: TO PROVIDE THE HIGHEST QUALITY HEALTHCARE TO ALL PERSONS IN THE COMMUNITY, AND IN KEEPING WITH ITS NOT-FOR-PROFIT STATUS, ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.:- DELIVERS PATIENT SERVICES, INCLUDING EMERGENCY DEPARTMENT SERVICES AND URGENT CARE SITES, TO ALL INDIVIDUALS REQUIRING HEALTHCARE, WITHOUT REGARD TO PATIENT RACE, ETHNICITY, ECONOMIC STATUS, INSURANCE STATUS OR ABILITY TO PAY.- MAINTAINS AN OPEN MEDICAL STAFF THAT ALLOWS CREDENTIALED PHYSICIANS TO PRACTICE AT ITS FACILITIES.- TRAINS AND EDUCATES HEALTH CARE PROFESSIONALS- PARTICIPATES IN GOVERNMENT-SPONSORED PROGRAMS SUCH AS MEDICAID AND MEDICARE TO PROVIDE TO THE POOR AND ELDERLY. APPLICATION EVENTS ARE HELD AS WELL AS FOLLOW UP ASSISTANCE FOR INSURANCE.- HEALTH ACCESS ADVOCATES ("HAA") ARE COMMUNITY BASED STAFF WHOSE PRIMARY ROLE IS TO SIGN CHILDREN UP FOR HOOSIER HEALTHCARE INSURANCE. THEY CAN DO THIS BY ASSISTING FAMILIES IN APPLYING FOR HOOSIER HEALTHCARE INSURANCE HERE IN THE OFFICE, IN THE COMMUNITY, OR AT THE PATIENT'S HOME. DURING THIS PROCESS, THEY CAN ALSO ASSIST FAMILIES WITH BASIC NEEDS SUCH AS FOOD, SHELTER AND CLOTHING. THE ADVOCATES CAN ALSO ASSIST ADULTS WITH APPLYING FOR MEDICAID, HEALTHY INDIANA PLAN, AND OTHER RESOURCES SUCH AS PHARMACEUTICAL APPLICATIONS FOR THOSE WHO QUALIFY. HAA WILL AT TIMES TRANSPORT PATIENTS TO NECESSARY APPOINTMENTS. ADDITIONALLY, HAA PROVIDES ASSISTANCE TO THE LATINO POPULATION BY PROVIDING A BI-LINGUAL ASSOCIATE. THIS ASSOCIATE SPEARHEADS A CERTIFIED MEDICAL INTERPRETER TRAINING PROGRAM THROUGH THE BRIDGING THE GAP PROGRAM. - IS GOVERNED BY A BOARD IN WHICH INDEPENDENT COMMUNITY MEMBERS COMPRISE A MAJORITY- CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS AND HOLDS MEMBERSHIP ON OTHER PUBLIC AGENCY BOARDS TO ENHANCE WELL BEING OF THE COMMUNITY IN PARTNERSHIP PROGRAMS- PROVIDES DENTAL SERVICES FOR PRIMARY SERVICE AREA WITH MOBILE DENTAL FOR KIDS CLINIC- NUTRITION COUNSELING IS PROVIDED TO THE COMMUNITY AND SPECIFICALLY AREA SCHOOLS AND YOUTH GROUPS, SUCH AS FOOD PYRAMID PROGRAMS, STAFF HEALTH FAIR, ETC- COMPLIMENTARY THERAPIES INCLUDING MASSAGES, YOGA CLASSES, STRESS REDUCTION CLASSES AT HOPE RESOURCE CENTER FOR CANCER PATIENTS AND SURVIVORS.- MALL WALKING PROGRAMS AND MONTHLY BLOOD PRESSURE SCREENINGS AT LOCAL MALL- CHRISTMAS PROGRAMS FOR THE POOR: GREAT EXPECTATIONS. AREA FAMILIES ARE IDENTIFIED FROM LOCAL GROUPS SUCH AS UNITED WAY, CHURCHES, AND THE SCHOOL SYSTEMS, AS NEEDING ASSISTANCE WITH CHRISTMAS. ASSOCIATES OF ST. MARY'S GIVE MONIES, FOOD, CLOTHING, TOYS, ETC. TO FAMILIES IN NEED EACH YEAR. - AUTISM VISIT WITH SANTA- WNIN KIDS DAY - MOBILE DENTAL KARE LAB- CPR CLASSES GIVEN AT LOCAL DAYCARES AND SCHOOLS- JOSLIN AND DIABETIC FOOT CLINIC - LECTURES, CLASSES, EXERCISE INSERVICES.- SAFESITTERS EDUCATION FOR TEENAGERS PREPARING TO TAKE CARE OF YOUNG CHILDREN, TODDLERS, AND INFANTS- ST. MARY'S NIGHTS AT CHILDREN'S MUSEUM OF EVANSVILLE.- YOUTH FIRST RETREATS- AMERICAN RED CROSS BLOOD DRIVES- AMBULANCE, REHAB, AND MISC. BILLINGS PAID FOR PATIENTS- PATIENT CARE FOR NON-PROFIT ECHO CLINIC- TRANSPORTATION SERVICES FOR PATIENTS AND FAMILIES - MEAL TICKETS FOR PATIENT FAMILIES
PART VI, LINE 6: AS A PART OF ST. MARY'S HEALTH, INC., ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. IS DEDICATED TO IMPROVING THE HEALTH STATUS AND QUALITY OF LIFE FOR THE COMMUNITIES IT SERVES. WHILE DESIGNATED ASSOCIATES AT ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. DEVOTE ALL OR SIGNIFICANT PORTIONS OF THEIR TIME TO LEADING AND ADMINISTERING LOCAL COMMUNITY-BASED PROGRAMS AND PARTNERSHIPS, ASSOCIATES THROUGHOUT THE ORGANIZATION ARE ACTIVE PARTICIPANTS IN COMMUNITY OUTREACH. THEY ARE ASSISTED AND SUPPORTED BY DESIGNATED ST. MARY'S HEALTH COMMUNITY DEVELOPMENT AND SERVICE STAFF WHO WORK WITH EACH OF ITS HEALTHCARE FACILITIES TO ADVOCATE FOR AND PROVIDE TECHNICAL ASSISTANCE FOR COMMUNITY OUTREACH, NEEDS ASSESSMENTS AND PARTNERSHIPS AS WELL AS TO SUPPORT REGIONAL AND STATE-WIDE PROGRAMS, COMMUNITY PROGRAMS SPONSORED BY ST. MARY'S HEALTH IN WHICH ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. PARTICIPATES.
INPART VI, LINE 7REPORTS FILED WITH STATES
THE STATE OF INDIANA NO LONGER REQUIRES A SEPARATE COMMUNITY BENEFIT REPORT, BUT WILL REFERENCE THE FORM 990. ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. AND ITS RELATED ST. MARY'S HEALTH, INC. AFFILIATES PUBLISH A COMMUNITY BENEFIT REPORT WHICH IS AVAILABLE TO THE PUBLIC. A COPY OF THE FULL REPORT IS AVAILABLE AT HTTP://WWW.STMARYS.ORG/CHNA.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ST MARY'S OHIO VALLEY HEARTCARE LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750273474697501(C)(3)4605000OPERATING GRANT
ST MARY'S PHYSICIAN NETWORK LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750205023387501(C)(3)6890000OPERATING GRANT
ST MARY'S PHYSICIANS' HEALTH GROUP LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750261356310501(C)(3)2644408OPERATING GRANT
PRIMARY PHYSICIAN NETWORK LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750208775914501(C)(3)2615000OPERATING GRANT
ASCENSION HEALTH
PO BOX 45998ST LOUISMO63145311662309501(C)(3)4262393OPERATING GRANT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: ONE PERSON OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC., IS RESPONSIBLE FOR RESEARCHING AND COORDINATING GRANT PROPOSALS. THIS PERSON IS ALSO RESPONSIBLE FOR ENSURING THAT TIMELY REPORTS ARE SENT TO THE GRANTOR. THE CHIEF EXECUTIVE OF THE ENTITY OPERATIONS REVIEWS AND APPROVES ALL THE EXPENDITURES FROM THE GRANT FUNDS, ENSURING THEY ARE WITHIN THE GUIDELINES OF THE GRANT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
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 (19 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
MARIA DEL-RIO MD
BOARD MEMBER296699093874043640617750112210467933000
DARCY ELLISON
SR VP/CNO2533470366110381001099280176370421333000
JOHN GALLAGHER MD
SR VP/CMO272023085461086558010104002053505656170647920
GWEN SANDEFUR
EVP/COO336657043368014290217080207590423921000
KARL SASH MD
BOARD MEMBER0371349020648101477069649030419067937500
TIMOTHY FLESCH
CEO/PRESIDENT5196050115713402785703714302601801767757000
KIMBERLY HODGKINSON
CFO310911040177017741050000157030389532000
JANICE ERNEST
VP/CARDIOVASCULAR & SYSTEM SUPPORT S196275025756040210802140190400325306000
JOHN GREANEY
VP/STRATEGIC SERVICES1719300125230272050000190160208741000
KATHY HALL
VP/SMHS REGIONAL ADMINISTRATOR17046901196207790310540221800236444000
MICHAEL KLUEH
VP/CRO173063023408016880534140245870276160000
THOMAS LILLY
SR VP/SUPPORT OPERATIONS200213026166075760329890191920286136000
VERNON MAASMD
VP/MEDICAL AFFAIRS213933000108130196110211670265524000
MIKE WHITMORE
VP/CLINICAL SUPPORT & ANCILLARY SERV185607024523016210444080218690278028000
KATHRYN BRYAN MD
PHYSICIAN4169050004396104062601747305189650127220
ROBERT CUTRELL MD
PHYSICIAN3379270615802439704767202210504382590238150
MYLES GRANT
EXECUTIVE DIRECTOR3024980938740261440785850161190517220000
CHARLES LACKEY MD
PHYSICIAN4524950005763904249901611305687460394990
MUREENA TURNQUEST-WELLS MD
PHYSICIAN5465040480580202720832300259060723970000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationPART I, LINE 4B: ALL EMPLOYEES AND AMOUNTS LISTED ARE VOLUNTARY DEFERRALS OR COMPANY CONTRIBUTIONS TO VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. JOHN T GALLAGHER, MD $64,792 CHARLES W. LACKEY $39,499 KATHRYN BRYAN, MD $12,722 ROBERT CUTRELL, MD $23,815Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
CLAUDIA RICHARDT
- SEE PART V -74136SEE PART V0
CAROL ACKERMAN
- SEE PART V -43582SEE PART V0

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE L, PART IV:BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS(A) NAME OF PERSON: CLAUDIA RICHARDT(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SISTER-IN-LAW OF SISTER SHARON RICHARDT(C) AMOUNT OF TRANSACTION: $74,136(D) DESCRIPTION OF TRANSACTION: CLAUDIA RICHARDT IS AN EMPLOYEE OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION.(E) SHARING OF ORGANIZATION REVENUES: NO
SCHEDULE L, PART IV:BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS(A) NAME OF PERSON: CAROL ACKERMAN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SISTER-IN-LAW OF DARCY ELLISON(C) AMOUNT OF TRANSACTION: $43,582(D) DESCRIPTION OF TRANSACTION: CAROL ACKERMAN IS AN EMPLOYEE OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION.(E) SHARING OF ORGANIZATION REVENUES: NO

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART IV, LINE 24A:ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. IS A HEALTH FACILITY THAT IS PART OF THE ASCENSION HEALTH SYSTEM. ASCENSION HEALTH IS THE BORROWER FOR TAX-EXEMPT HOSPITAL REVENUE BONDS. ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE WITH ASCENSION HEALTH, AND THIS INFORMATION IS REPORTED ON THE BALANCE SHEET.
FORM 990, PART VI, SECTION A, LINE 4EFFECTIVE JULY 1, 2012, ST. MARY'S HEALTH SERVICES, INC. REPLACED ST. MARY'S HEALTH, INC. AS THE SOLE MEMBER OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.
FORM 990, PART VI, SECTION A, LINE 6ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. HAS A SINGLE CORPORATE MEMBER, ST. MARY'S HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7AST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. HAS A SINGLE CORPORATE MEMBER, ST. MARY'S HEALTH SERVICES, INC. WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.
FORM 990, PART VI, SECTION A, LINE 7BALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST. MARY'S HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION B, LINE 11ST. MARY'S HEALTH, INC.'S FINANCE COMMITTEE REVIEWS THE FORM 990 IN MARCH UPON RECEIVING DIRECTION FROM ITS TAX PREPARER. THE FORM 990 IS THEN SENT TO THE GOVERNING BODY IN APRIL TO ALLOW FOR A THOROUGH REVIEW BY THE GOVERNING BODY PRIOR TO THE FILING DATE OF MAY 15TH. THE GOVERNING BODY WILL REVIEW THE FORM 990 VIA A SECURE WEB-BASED PORTAL AND ASK ANY QUESTIONS REGARDING THE FORM 990. ANY QUESTIONS AND RESPONSES WILL BE POSTED TO THE WEB-BASED PORTAL BEFORE THE RETURN IS FILED. ALL QUESTIONS AND RESPONSES WILL BE REVIEWED AND DISCLOSED IN THE MEETING MINUTES OF THE NEXT BOARD MEETING FOLLOWING THE REVIEW OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 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 CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION DETERMINATIONS OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL ARE MADE BY A COMPENSATION COMMITTEE OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. AND/OR ST. MARY'S HEALTH, INC. IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMMITTEE OF THE ST. MARY'S HEALTH SYSTEM BOARD REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT WERE COMPARED TO OTHER HOSPITALS IN THE AREA THAT HOLD THE SAME POSITION. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. COMPENSATION DETERMINATIONS OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC.'S OTHER OFFICERS OR KEY EMPLOYEES ARE MADE BY A COMPENSATION COMMITTEE OF ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. AND/OR ST. MARY'S HEALTH, INC. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMMITTEE OF THE ST. MARY'S HEALTH SYSTEM BOARD 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 POSITION. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 16B: ST. MARY'S HEALTH, INC. AND SUBSIDIARES (ST. MARY'S) JOINT VENTURE OPERATING AGREEMENTS ARE NEGOTIATED WITH OTHER MEMBERS OF THE JOINT VENTURE TO ENSURE THAT ADEQUATE SAFEGUARDS ARE IN PLACE TO PROTECT ST. MARY'S EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH A FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. ST. MARY'S CONTINUALLY ENSURES THAT ITS EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL ST. MARY'S JOINT VENTURES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:FAS 158 PENSION 940,396. NY DEBT OBLIGATION -410,000. PROJECT SYMPHONY -6,814,833. ASSET TRANSFER FROM ST. MARY'S PHYSICIAN NETWORK, LLC 242,751. ASSET TRANSFER FROM ST. MARY'S OHIO VALLEY HEARTCARE, LLC 24,193. ASSET TRANSFER TO ST. MARY'S BUILDING CORPORATION -2,218,530. ASSET TRANSFER TO ST. MARY'S PHYSICIANS' HEALTH GROUP, LLC 3,170,281. REDEMPTION PREMIUM AMOUNT - 2002 BOND REFINANCING -55,879.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (44 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 SYSTEMMO501(C)(3)11A, IASCENSION HEALTH ALLIANCE0
CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC
2001 W 86TH STREETINDIANAPOLISIN46260351869951FREESTANDING OUTPATIENT CENTERIN501(C)(3)11C, III-FISTVINCENT HOSPITAL & HEALTH CARE CENTER INC1
JUBILEE PARTNERSHIPS INC
2301 N PARK AVENUEINDIANAPOLISIN46205352060765OUTREACH ACTIVITIESIN501(C)(3)1STVINCENT HOSPITAL & HEALTH CARE CENTER INC1
REHABILITATION HOSPITAL OF INDIANA INC
4141 SHORE DRIVEINDIANAPOLISIN46254351786005REHABILITATION HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT ANDERSON REGIONAL HOSPITAL FOUNDATION INC
2015 JACKSON STREETANDERSONIN46016352053693SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT ANDERSON REGIONAL HOSPITAL INC1
STJOSEPH HOSPITAL & HEALTH CENTER INC
1907 W SYCAMORE STREETKOKOMOIN46901350992717HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STJOSEPH FOUNDATION OF KOKOMO INDIANA INC
1907 W SYCAMORE STREETKOKOMOIN46901237313206SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTJOSEPH HOSPITAL & HEALTH CENTER INC1
STVINCENT ANDERSON REGIONAL HOSPITAL INC
2015 JACKSON STREETANDERSONIN46016460877261HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT CARMEL HOSPITAL INC
13500 N MERIDIAN STREETCARMELIN46032743107055HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT CLAY HOSPITAL INC
1206 E NATIONAL AVENUEBRAZILIN47834352112529CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT DUNN HOSPITAL INC
1600 23RD STREETBEDFORDIN47421272192831CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT FISHERS HOSPITAL INC
13861 OLIO ROADFISHERSIN46037454243702HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT FRANKFORT HOSPITAL INC
1300 S JACKSONFRANKFORTIN46041352099320CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT FRANKFORT HOSPITAL FOUNDATION INC
1300 S JACKSONFRANKFORTIN46041351531734SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT FRANKFORT HOSPITAL INC1
STVINCENT HEALTH INC
8425 HARCOURT ROADINDIANAPOLISIN46260352052591PARENT COMPANYIN501(C)(3)11C, III-FIASCENSION HEALTH0
STVINCENT HEALTH WELLNESS AND PREVENTIVE CARE INSTITUTE INC
8333 NAAB ROAD STE 301INDIANAPOLISIN46260461227327HEALTH AND WELLNESS SERVICESIN501(C)(3)9STVINCENT HEALTH INC1
STVINCENT HOSPITAL AND HEALTH CARE CENTER INC
2001 W 86TH STREETINDIANAPOLISIN46260350869066HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT HOSPITAL FOUNDATION INC
10330 N MERIDIAN STREET STE 430NINDIANAPOLISIN46290356088862SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT HOSPITAL & HEALTH CARE CENTER INC1
STVINCENT JENNINGS HOSPITAL INC
301 HENRY STREETNORTH VERNONIN47265351841606CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT MADISON COUNTY HEALTH SYSTEM INC
1331 SOUTH A STREETELWOODIN46036350876389HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT MEDICAL GROUP INC
8425 HARCOURT ROADINDIANAPOLISIN46260272039417PHYSICIAN PROFESSIONAL SERVICESIN501(C)(3)9STVINCENT HEALTH INC1
STVINCENT MERCY HOSPITAL FOUNDATION INC
1331 SOUTH A STREETELWOODIN46036311066871SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT MADISON COUNTY HEALTH SYSTEM INC1
STVINCENT NEW HOPE INC
8450 N PAYNE ROADINDIANAPOLISIN46260351733591INTERMEDIATE CARE FACILITYIN501(C)(3)9STVINCENT HEALTH INC1
STVINCENT PEDIATRIC REHAB CENTER INC
1707 W 86TH STREETINDIANAPOLISIN46260352048898SPECIALTY HOSPITALIN501(C)(3)3STVINCENT HOSPITAL & HEALTH CARE CENTER INC1
STVINCENT RANDOLPH HOSPITAL INC
473 GREENVILLE AVENUEWINCHESTERIN47394352103153CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT RANDOLPH HOSPITAL FOUNDATION INC
473 GREENVILLE AVENUEWINCHESTERIN47394352133006SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT RANDOLPH HOSPITAL INC1
STVINCENT SALEM HOSPITAL INC
911 N SHELBY STREETSALEMIN47167270847538CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT SETON SPECIALTY HOSPITAL INC
8050 TOWNSHIP LINE ROADINDIANAPOLISIN46260351712001LONG TERM CARE HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT WILLIAMSPORT HOSPITAL INC
412 N MONROE STREETWILLIAMSPORTIN47993350784551CRITICAL ACCESS HOSPITALIN501(C)(3)3STVINCENT HEALTH INC1
STVINCENT WILLIAMSPORT HOSPITAL FOUNDATION INC
412 N MONROE STREETWILLIAMSPORTIN47993743130159SUPPORTING ORGANIZATIONIN501(C)(3)11A, ISTVINCENT WILLIAMSPORT HOSPITAL INC1
SVSM INC
2001 W 86TH STREETINDIANAPOLISIN46260810607827HOLDING COMPANYIN501(C)(3)11A, ISTVINCENT HEALTH INC1
ST MARY'S AT HOME INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351899560DME/HOME CAREIN501(C)(3)11A, IST MARY'S HEALTH SERVICES INC1
ST MARY'S BUILDING CORPORATION
3700 WASHINGTON AVENUEEVANSVILLEIN47750237248362REAL ESTATE HOLDING COMPANYIN501(C)(2)ST MARY'S HEALTH SERVICES INC1
ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750205342518AMBULANCE SERVICESIN501(C)(4)ST MARY'S HEALTH SERVICES INC1
ST MARY'S HEALTH INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750352057801HEALTH MINISTRY PARENTIN501(C)(3)11C, III-FISTVINCENT HEALTH INC1
ST MARY'S PHYSICIAN NETWORK LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750205023387PHYSICIAN PROFESSIONAL SERVICESIN501(C)(3)9ST MARY'S MEDICAL GROUP LLC1
ST MARY'S HEALTH SERVICES INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351679526INVESTMENT SERVICESIN501(C)(3)11C, III-FIST MARY'S HEALTH INC1
ST MARY'S CARE PARTNERS INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351899562TAX-EXEMPT AFFILIATE REIMBURSEMENTSIN501(C)(3)11A, IST MARY'S HEALTH INC1
ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750237045370SUPPORTING ORGANIZATIONIN501(C)(3)11A, IST MARY'S MEDICAL CENTER OF EVANSVILLE INC1
ST MARY'S WARRICK HOSPITAL FOUNDATION INC
1116 MILLIS AVENUEBOONVILLEIN47601351961890SUPPORTING ORGANIZATIONIN501(C)(3)11A, IST MARY'S WARRICK HOSPITAL INC1
ST MARY'S WARRICK HOSPITAL INC
1116 MILLIS AVENUEBOONVILLEIN47601351343019HOSPITALIN501(C)(3)3ST MARY'S HEALTH SERVICES INC1
ST MARY'S OHIO VALLEY HEARTCARE LLC
901 ST MARYS DRIVEEVANSVILLEIN47714273474697CARDIOLOGY SERVICESIN501(C)(3)11A, IST MARY'S MEDICAL GROUP LLC1
ST MARY'S PHYSICIANS' HEALTH GROUP LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750261356310PHYSICIAN PROFESSIONAL SERVICESIN501(C)(3)9ST MARY'S MEDICAL GROUP LLC1
PRIMARY PHYSICIAN NETWORK LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750208775914PHYSICIAN PROFESSIONAL SERVICESIN501(C)(3)9ST MARY'S MEDICAL GROUP LLC1

Form990 Schedule R Part III Form990ScheduleRPartIII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
BREAST MRI LEASING COMPANY LLC
10330 N MERIDIAN ST STE 430NINDIANAPOLISIN46290426662493SALE AND RENTAL SERVICESINSTVINCENT HOSPITAL AND HEALTH CARE CENTER INCRELATED23064243329010.50000
CARMEL AMBULATORY SURGERY CENTER LLC
13421 OLD MERIDIAN ST STE 150CARMELIN46032320014795AMBULATORY SURGERY CENTERINSTVINCENT CARMEL HOSPITAL INCRELATED58924591896555010.45000
COOPERATIVE MANAGED CARE SERVICES LLC
9045 RIVER ROAD STE 250INDIANAPOLISIN46240351999227CASE MANAGEMENTINSTVINCENT HOSPITAL AND HEALTH CARE CENTER INCUNRELATED2126592119265010.50000
ENDOSCOPY CENTER LLC
13421 OLD MERIDIAN ST STE 150CARMELIN46032320029881ENDOSCOPY CENTERINSTVINCENT CARMEL HOSPITAL INCRELATED681952357300000.51000
HANCOCK PHYSICIAN NETWORK LLC
801 N STATE STREETGREENFIELDIN46140352051598PRIMARY CARE PHYSICIAN PRACTICESINSTVINCENT HOSPITAL AND HEALTH CARE CENTER INCRELATED-26922722094475010.50000
HCH SVH CATH LAB SERVICES LLC
1000 N 16TH STREETNEW CASTLEIN47362452087950CATH LAB SERVICESINSTVINCENT HEALTH INCRELATED-2297381629927010.50000
MERIDIAN HEIGHTS ASSOCIATES LLC
6100 W 96TH STREET STE 250INDIANAPOLISIN46278264020296REAL ESTATE HOLDINGINSTVINCENT CARMEL HOSPITAL INCRELATED3029284010.50000
NEURO ONCOLOGY EQUIPMENT LLC
10330 N MERIDIAN ST STE 430NINDIANAPOLISIN46290743103803SALE AND RENTAL SERVICESINSTVINCENT HOSPITAL AND HEALTH CARE CENTER INCRELATED1516781684704010.50000
STVINCENT HEALTHUSP LLC
15305 DALLAS PKWY STE 1600ADDISONTX75001203749962AMBULATORY SURGERY CENTERINSTVINCENT HEALTH INCRELATED136436387939010.50000
STVINCENT HEART CENTER OF INDIANA LLC
10580 N MERIDIAN STREETINDIANAPOLISIN46290364492612HEART HOSPITALINCENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INCRELATED2055223478811464000.74080
WOMEN'S PHYSICIAN SURGERY CENTER LLC
8081 TOWNSHIP LINE ROADINDIANAPOLISIN46260352086841AMBULATORY SURGERY CENTERINSTVINCENT HOSPITAL AND HEALTH CARE CENTER INCRELATED-11530252917000.58900
AMBULATORY CARE CENTER LLC
1125 PROFESSIONAL BLVDEVANSVILLEIN47714352006018OP SURGERYINST MARY'S HEALTH SERVICES INCRELATED48793964549444010.50000
SETON HEALTH SERVICES LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750270451316EQUIPMENT RENTALINST MARY'S HEALTH SERVICES INCRELATED3694399375010.50000
ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT CO LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750205062635MANAGEMENT SERVICESINST MARY'S MEDICAL CENTER OF EVANSVILLE INCRELATED211137156690010.75000

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
SVH REAL ESTATE INC
8425 HARCOURT ROADINDIANAPOLISIN46260205002285REAL ESTATE HOLDING COMPANYINSTVINCENT HEALTH INCC278429694231.000001
ST MARY'S MEDICAL GROUP INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750352076827INVESTMENTINST MARY'S HEALTH SERVICES INCC-6414237421.000001
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (29 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ASCENSION HEALTH INC
P56510766FMV OF SERVICES OR CASH
PRIMARY PHYSICIAN NETWORK LLC
J229493FMV OF SERVICES OR CASH
PRIMARY PHYSICIAN NETWORK LLC
B2615000FMV OF SERVICES OR CASH
PRIMARY PHYSICIAN NETWORK LLC
Q16446849FMV OF SERVICES OR CASH
ST MARY'S AT HOME INC
Q6588415FMV OF SERVICES OR CASH
ST MARY'S BUILDING CORPORATION LLC
K1484068FMV OF SERVICES OR CASH
ST MARY'S BUILDING CORPORATION LLC
Q1880874FMV OF SERVICES OR CASH
ST MARY'S HEALTH SERVICES INC
Q4529608FMV OF SERVICES OR CASH
ST MARY'S HEALTH INC
Q5933755FMV OF SERVICES OR CASH
ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC
C1449919FMV OF SERVICES OR CASH
ST MARY'S OHIO VALLEY HEARTCARE LLC
B4605000FMV OF SERVICES OR CASH
ST MARY'S OHIO VALLEY HEARTCARE LLC
P79750FMV OF SERVICES OR CASH
ST MARY'S OHIO VALLEY HEARTCARE LLC
Q2492502FMV OF SERVICES OR CASH
ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC
E138881FMV OF SERVICES OR CASH
ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC
L1610684FMV OF SERVICES OR CASH
ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC
Q308596FMV OF SERVICES OR CASH
ST MARY'S PHYSICIAN NETWORK LLC
B6890000FMV OF SERVICES OR CASH
ST MARY'S PHYSICIAN NETWORK LLC
Q16300171FMV OF SERVICES OR CASH
ST MARY'S PHYSICIANS' HEALTH GROUP LLC
Q5118280FMV OF SERVICES OR CASH
ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC
Q2160247FMV OF SERVICES OR CASH
ST MARY'S WARRICK HOSPITAL INC
P250000FMV OF SERVICES OR CASH
ST MARY'S WARRICK HOSPITAL INC
D83077FMV OF SERVICES OR CASH
ST MARY'S WARRICK HOSPITAL INC
Q1114355FMV OF SERVICES OR CASH
SVSM INC
P2443131FMV OF SERVICES OR CASH
ST MARY'S PHYSICIAN NETWORK LLC
S242751FMV OF SERVICES OR CASH
ST MARY'S PHYSICIANS' HEALTH GROUP LLC
B1694408FMV OF SERVICES OR CASH
ST MARY'S PHYSICIANS' HEALTH GROUP LLC
R3170281FMV OF SERVICES OR CASH
ST MARY'S BUILDING CORPORATION
R2218530FMV OF SERVICES OR CASH
ASCENSION HEALTH INC
B4262393FMV OF SERVICES OR CASH