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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T14:28:01-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2000 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462045108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350869065 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STMA | NameControl |
| Phone | 8124854178 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN L ZABROWSKI | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8124854178 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHAWNA M JIMENEZ | Name |
| PTIN | P01222873 | PTIN |
| Phone | 3174648600 | Phone |
| Date Prepared | 2014-05-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEITH JEWELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 469242685 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARYS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1941 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | DEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 3650 | TotalNbrEmployees |
| Total Nbr Volunteers | 477 | TotalNbrVolunteers |
| Total Gross UBI | 230955 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -365094 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2307954 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1527361 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 438394746 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 438137652 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 18374856 | InvestmentIncomePriorYear |
| Investment Income Current Year | 17885356 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 11772892 | OtherRevenuePriorYear |
| Other Revenue Current Year | 10819915 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 470850448 | TotalRevenuePriorYear |
| Total Revenue Current Year | 468370284 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2911410 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 21016801 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 191033245 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 156616340 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 744206 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 209550523 | OtherExpensePriorYear |
| Other Expenses Current Year | 241877344 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 403495178 | TotalExpensesPriorYear |
| Total Expenses Current Year | 419510485 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 67355270 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 48859799 | RevenuesLessExpensesCY |
| Total Assets BOY | 567651870 | TotalAssetsBOY |
| Total Assets EOY | 614660665 | TotalAssetsEOY |
| Total Liabilities BOY | 221969770 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 213767120 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 345682100 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 400893545 | NetAssetsOrFundBalancesEOY |
| Mission Description | DEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 344211902 | Expense |
| Grants | 21016801 | Grants |
| Revenue | 446118919 | Revenue |
| Description | ST. 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 33279840 | Expense |
| Description | SMMC 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1452585 | Expense |
| Description | IN 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 378944327 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 275 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 3650 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN L ZABROWSKI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8124854178 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (29 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| SISTER XAVIER BALLANCE | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | X | 0 | 0 | 0 | |||
| NADINE COUDRET | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| MARIA DEL-RIO MD | |||||||||
| BOARD MEMBER | 55.00 | 0.00 | X | 394937 | 0 | 72996 | |||
| DARCY ELLISON | |||||||||
| SR VP/CNO | 60.00 | 1.00 | X | 293768 | 0 | 127565 | |||
| DORON FINN MD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| PRASAD GADE MD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| JOHN GALLAGHER MD | |||||||||
| SR VP/CMO | 60.00 | 1.00 | X | 444042 | 0 | 121575 | |||
| TRICIA HENNING | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL HERRELL MD | |||||||||
| CHAIR | 1.00 | 5.00 | X | 0 | 0 | 0 | X | ||
| SHARON KAZEE | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| SISTER SHARON RICHARDT | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| GWEN SANDEFUR | |||||||||
| EVP/COO | 60.00 | 6.20 | X | 381454 | 0 | 42467 | |||
| KARL SASH MD | |||||||||
| BOARD MEMBER | 1.00 | 56.00 | X | 0 | 579307 | 100068 | |||
| KENNETH SPEAR MD | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | |||
| JOHN STANLEY | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | |||
| TIMOTHY FLESCH | |||||||||
| CEO/PRESIDENT | 55.00 | 11.20 | 1704596 | 0 | 63161 | X | |||
| KIMBERLY HODGKINSON | |||||||||
| CFO | 60.00 | 4.00 | 368829 | 0 | 20703 | X | |||
| JANICE ERNEST | |||||||||
| VP/CARDIOVASCULAR & SYSTEM SUPPORT SERVICES | 60.00 | 2.00 | 226052 | 0 | 99254 | X | |||
| JOHN GREANEY | |||||||||
| VP/STRATEGIC SERVICES | 60.00 | 0.00 | 184725 | 0 | 24016 | X | |||
| KATHY HALL | |||||||||
| VP/SMHS REGIONAL ADMINISTRATOR | 60.00 | 0.00 | 183210 | 0 | 53234 | X | |||
| MICHAEL KLUEH | |||||||||
| VP/CRO | 60.00 | 0.00 | 198159 | 0 | 78001 | X | |||
| THOMAS LILLY | |||||||||
| SR VP/SUPPORT OPERATIONS | 60.00 | 1.00 | 233955 | 0 | 52181 | X | |||
| VERNON MAASMD | |||||||||
| VP/MEDICAL AFFAIRS | 60.00 | 0.00 | 224746 | 0 | 40778 | X | |||
| MIKE WHITMORE | |||||||||
| VP/CLINICAL SUPPORT & ANCILLARY SERVICES | 60.00 | 0.00 | 211751 | 0 | 66277 | X | |||
| KATHRYN BRYAN MD | |||||||||
| PHYSICIAN | 55.00 | 0.00 | 460866 | 0 | 58099 | X | |||
| ROBERT CUTRELL MD | |||||||||
| PHYSICIAN | 55.00 | 0.00 | 368482 | 0 | 69777 | X | |||
| MYLES GRANT | |||||||||
| EXECUTIVE DIRECTOR | 55.00 | 0.00 | 422516 | 0 | 94704 | X | |||
| CHARLES LACKEY MD | |||||||||
| PHYSICIAN | 55.00 | 0.00 | 510134 | 0 | 58612 | X | |||
| MUREENA TURNQUEST-WELLS MD | |||||||||
| PHYSICIAN | 55.00 | 1.00 | 614834 | 0 | 109136 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7427056 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 579307 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1352604 | TotalOtherCompensation |
| Number Individuals GT100 K | 89 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| AMBULATORY CARE CENTER LLC | |||||
| 1125 PROFESSIONAL BLVD | EVANSVILLE | IN | 47714 | MEDICAL SERVICES | 25988358 |
| TRIMEDX | |||||
| PO BOX 636129 | CINCINNATI | OH | 45263 | HEALTH CARE EQUIPMENT MANAGEMENT | 4194519 |
| AIR METHODS CORPORATION | |||||
| PO BOX 172892 | DENVER | CO | 802172892 | AIR TRANSPORT SERVICES | 1559206 |
| EMERGENCY PROFESSIONAL SERVICE | |||||
| PO BOX 634850 | CINCINNATI | OH | 45263 | MEDICAL SERVICES | 1519667 |
| ST MARY'S PERIPHERAL VASCULAR SERVICES | |||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | MEDICAL SERVICES | 1181398 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 55 | NumberOfContractorsGT100K |
| Related Organizations | 1494653 | RelatedOrganizations |
| Government Grants | 32708 | GovernmentGrants |
| Noncash Contributions | 9795 | NoncashContributions |
| Total Contributions | 1527361 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OUTPATIENT SERVICE REV | 621110 | 219888425 | 219888425 |
| INPATIENT SERVICE REV | 621110 | 218249227 | 218249227 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 438137652 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17922403 | TotalRevenueColumn |
| Exclusion | $17,922,403 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 631776 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 522271 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 109505 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 109505 | TotalRevenueColumn |
| Exclusion | $109,505 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 313083 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 350130 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -37047 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -37047 | TotalRevenueColumn |
| Related Or Exempt Function Income | -37047 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| APOTHECARY | 446110 | 4619370 | 4619370 | ||
| CAFETERIA/MISC. SERV | 722320 | 1835442 | 108212 | $1,727,230 | |
| LAB SERVICES | 621500 | 828758 | 94847 | $733,911 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3426840 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3398944 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 27896 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 10710410 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 468370284 | TotalRevenueColumn |
| Related Or Exempt Function Income | 446118919 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 230955 | UnrelatedBusinessRevenue |
| Exclusion | $20,493,049 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21016801 | Total |
| Program Services | 21016801 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6012500 | Total |
| Management And General | 6012500 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118467180 | Total |
| Program Services | 108407324 | ProgramServices |
| Management And General | 9501410 | ManagementAndGeneral |
| Fundraising | 558446 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2647080 | Total |
| Program Services | 2317174 | ProgramServices |
| Management And General | 329906 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20818340 | Total |
| Program Services | 18160756 | ProgramServices |
| Management And General | 2594591 | ManagementAndGeneral |
| Fundraising | 62993 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8671240 | Total |
| Program Services | 7556130 | ProgramServices |
| Management And General | 1080697 | ManagementAndGeneral |
| Fundraising | 34413 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19911102 | Total |
| Program Services | 17429580 | ProgramServices |
| Management And General | 2481522 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91657 | Total |
| Program Services | 80234 | ProgramServices |
| Management And General | 11423 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125037 | Total |
| Program Services | 103957 | ProgramServices |
| Management And General | 15583 | ManagementAndGeneral |
| Fundraising | 5497 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4266270 | Total |
| Program Services | 3667527 | ProgramServices |
| Management And General | 531802 | ManagementAndGeneral |
| Fundraising | 66941 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19069732 | Total |
| Program Services | 16683051 | ProgramServices |
| Management And General | 2376662 | ManagementAndGeneral |
| Fundraising | 10019 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8536938 | Total |
| Program Services | 7472979 | ProgramServices |
| Management And General | 1063959 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418446 | Total |
| Program Services | 361343 | ProgramServices |
| Management And General | 52151 | ManagementAndGeneral |
| Fundraising | 4952 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199962 | Total |
| Program Services | 174528 | ProgramServices |
| Management And General | 24921 | ManagementAndGeneral |
| Fundraising | 513 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4712929 | Total |
| Program Services | 4125556 | ProgramServices |
| Management And General | 587373 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21065232 | Total |
| Program Services | 18439871 | ProgramServices |
| Management And General | 2625361 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1543290 | Total |
| Program Services | 1350518 | ProgramServices |
| Management And General | 192340 | ManagementAndGeneral |
| Fundraising | 432 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 68662977 | 60105506 | 8557471 |
| MEDICAL SUPPLIES | 57940960 | 57940960 | |
| PROVIDER TAX EXPENSE | 16160221 | 16160221 | |
| COST OF GOODS SOLD | 6051858 | 6051858 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13120733 | Total |
| Program Services | 11338453 | ProgramServices |
| Management And General | 1782280 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419510485 | Total |
| Program Services | 378944327 | ProgramServices |
| Management And General | 39821952 | ManagementAndGeneral |
| Fundraising | 744206 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4387544 | BOY |
| EOY | 3446252 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54931619 | BOY |
| EOY | 54541611 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 957935 | BOY |
| EOY | 854961 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5409364 | BOY |
| EOY | 6068368 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2567499 | BOY |
| EOY | 2562612 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 358326159 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 273102016 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87687421 | BOY |
| EOY | 85224143 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48701 | BOY |
| EOY | 55798 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 450788 | BOY |
| EOY | 279255 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 411210999 | BOY |
| EOY | 461627665 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 567651870 | BOY |
| EOY | 614660665 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38839540 | BOY |
| EOY | 37975128 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 183130230 | BOY |
| EOY | 175791992 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 221969770 | BOY |
| EOY | 213767120 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345682100 | BOY |
| EOY | 400893545 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345682100 | BOY |
| EOY | 400893545 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 567651870 | BOY |
| EOY | 614660665 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 48859799 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 11473267 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -5121621 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $3,199 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3199 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | LOBBYING 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7736792 | OtherCostOrOtherBasis |
| Book Value | 7736792 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 92320106 | OtherCostOrOtherBasis |
| Depreciation | 61856222 | Depreciation |
| Book Value | 30463884 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21275229 | OtherCostOrOtherBasis |
| Depreciation | 11422404 | Depreciation |
| Book Value | 9852825 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 236994032 | OtherCostOrOtherBasis |
| Depreciation | 199823390 | Depreciation |
| Book Value | 37170642 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 85224143 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INTERCOMPANY RECEIVABLES | 8265929 |
| OTHER RECEIVABLES | 4036235 |
| DEFERRED COMPENSATION ASSET | 4359995 |
| ESTIMATED SETTLEMENTS FROM THIRD PARTIES | 938359 |
| PHYSICIAN GUARANTEES ASSET | 19602250 |
| OTHER CURRENT ASSETS | 57355 |
| INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE | 424367542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 461627665 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (10 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 175791992 | TotalOfAmounts |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|---|
| NORTH AMERICA | 0 | 0 | PROGRAM SERVICES | LICENSES, PERMITS | 2712 |
| NORTH AMERICA | 0 | 0 | PROGRAM SERVICES | MEDICAL SUPPLIES | 8137 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 10849 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 10849 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 0 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18852448 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18852448 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04830 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55601119 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41173727 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14427392 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04090 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 74453567 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41173727 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 33279840 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08920 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 892244 | PersonsServed |
| Total Community Benefit Expense | 1155117 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 433383 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 721734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 289786 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 289786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 40010 | PersonsServed |
| Total Community Benefit Expense | 441065 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 441065 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 932254 | PersonsServed |
| Total Community Benefit Expense | 1885968 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 433383 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1452585 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 932254 | PersonsServed |
| Total Community Benefit Expense | 76339535 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41607110 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 34732425 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09270 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $4,222,693 | BadDebtExpenseAmount |
| Amount Attributable To | 422269 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 113481329 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 151333702 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -37852373 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | MANAGEMENT | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.75000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.75000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVA INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STMARYS.ORG/SMLOCATION | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Childrens Hospital | X | ChildrensHospital |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 18 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (18 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ST MARY'S SURGICARE | ||||
| 300 CIRCLE FRONT DRIVE | EVANSVILLE | IN | 47715 | GENERAL SURGICAL CENTER |
| ST MARY'S SURGICARE | ||||
| 1125 PROFESSIONAL BLVD | EVANSVILLE | IN | 47714 | GENERAL SURGICAL CENTER |
| ST MARY'S PRE-PROCEDURE CLINIC | ||||
| 1140 WASHINGTON AVENUE | EVANSVILLE | IN | 47714 | PRIMARY CARE FACILITY |
| ST MARY'S MATERNAL-FETAL MEDICINE | ||||
| 3700 WASHINGTON AVENUE SUITE 2100A | EVANSVILLE | IN | 47750 | OBSTETRICS/GYNECOLOGY |
| ST MARY'S REHAB | ||||
| 3900 WASHINGTON AVENUE | EVANSVILLE | IN | 47714 | INPATIENT REHAB CENTER |
| ST MARY'S OUTPATIENT REHAB | ||||
| 1144 WASHINGTON SQUARE | EVANSVILLE | IN | 47715 | OUTPATIENT REHAB CLINIC |
| ST MARY'S FOR CHILDREN | ||||
| 3900 WASHINGTON AVENUE | EVANSVILLE | IN | 47714 | CHILDREN'S HEALTH FACILITY |
| ST MARY'S CONVENIENT CARE - WEST | ||||
| 5320 WESTON ROAD | EVANSVILLE | IN | 47712 | PRIMARY CARE FACILITY |
| ST MARY'S OCCMED | ||||
| 2330 LYNCH ROAD | EVANSVILLE | IN | 47711 | OCCUPATIONAL MEDICINE CLINIC |
| ST MARY'S CONVENIENT CARE EAST | ||||
| 10444 SR 66 FRONTAGE ROAD NORTH | NEWBURGH | IN | 47630 | PRIMARY CARE FACILITY |
| ST MARY'S NORTH POINTE REHAB | ||||
| 2300 LYNCH ROAD | EVANSVILLE | IN | 47711 | OUTPATIENT REHAB CLINIC |
| ST MARY'S IMAGING AND LAB | ||||
| 1138 WASHINGTON SQUARE | EVANSVILLE | IN | 47715 | IMAGING SERVICES/RADIOLOGY |
| ST MARY'S NORTHBROOK | ||||
| 3838 N FIRST AVENUE | EVANSVILLE | IN | 47710 | PRIMARY CARE FACILITY |
| ST MARY'S BOONVILLE PHYSICIAN OFFICE | ||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | PRIMARY CARE FACILITY |
| JOSLIN DIABETES CENTER | ||||
| 3801 BELLEMEADE AVENUE | EVANSVILLE | IN | 47714 | DIABETES SERVICE CENTER |
| ST MARY'S HEART INSTITUTE | ||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47714 | SPECIALITY CARE FACILITY |
| ST MARY'S WEIGHT MANAGEMENT CENTER | ||||
| 950 S KENMORE | EVANSVILLE | IN | 47714 | WEIGHT MANAGEMENT FACILITY |
| ST MARY'S WEST SIDE X-RAY | ||||
| 2345 W FRANKLIN STREET | EVANSVILLE | IN | 47712 | IMAGING SERVICES/RADIOLOGY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (26 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| 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 POLICY | PART 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. | ||
| IN | PART VI, LINE 7 | REPORTS 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| ST MARY'S OHIO VALLEY HEARTCARE LLC | |||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 273474697 | 501(C)(3) | 4605000 | OPERATING GRANT |
| ST MARY'S PHYSICIAN NETWORK LLC | |||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205023387 | 501(C)(3) | 6890000 | OPERATING GRANT |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | |||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 261356310 | 501(C)(3) | 2644408 | OPERATING GRANT |
| PRIMARY PHYSICIAN NETWORK LLC | |||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 208775914 | 501(C)(3) | 2615000 | OPERATING GRANT |
| ASCENSION HEALTH | |||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | 501(C)(3) | 4262393 | OPERATING GRANT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARIA DEL-RIO MD | ||||||||||||||
| BOARD MEMBER | 296699 | 0 | 93874 | 0 | 4364 | 0 | 61775 | 0 | 11221 | 0 | 467933 | 0 | 0 | 0 |
| DARCY ELLISON | ||||||||||||||
| SR VP/CNO | 253347 | 0 | 36611 | 0 | 3810 | 0 | 109928 | 0 | 17637 | 0 | 421333 | 0 | 0 | 0 |
| JOHN GALLAGHER MD | ||||||||||||||
| SR VP/CMO | 272023 | 0 | 85461 | 0 | 86558 | 0 | 101040 | 0 | 20535 | 0 | 565617 | 0 | 64792 | 0 |
| GWEN SANDEFUR | ||||||||||||||
| EVP/COO | 336657 | 0 | 43368 | 0 | 1429 | 0 | 21708 | 0 | 20759 | 0 | 423921 | 0 | 0 | 0 |
| KARL SASH MD | ||||||||||||||
| BOARD MEMBER | 0 | 371349 | 0 | 206481 | 0 | 1477 | 0 | 69649 | 0 | 30419 | 0 | 679375 | 0 | 0 |
| TIMOTHY FLESCH | ||||||||||||||
| CEO/PRESIDENT | 519605 | 0 | 1157134 | 0 | 27857 | 0 | 37143 | 0 | 26018 | 0 | 1767757 | 0 | 0 | 0 |
| KIMBERLY HODGKINSON | ||||||||||||||
| CFO | 310911 | 0 | 40177 | 0 | 17741 | 0 | 5000 | 0 | 15703 | 0 | 389532 | 0 | 0 | 0 |
| JANICE ERNEST | ||||||||||||||
| VP/CARDIOVASCULAR & SYSTEM SUPPORT S | 196275 | 0 | 25756 | 0 | 4021 | 0 | 80214 | 0 | 19040 | 0 | 325306 | 0 | 0 | 0 |
| JOHN GREANEY | ||||||||||||||
| VP/STRATEGIC SERVICES | 171930 | 0 | 12523 | 0 | 272 | 0 | 5000 | 0 | 19016 | 0 | 208741 | 0 | 0 | 0 |
| KATHY HALL | ||||||||||||||
| VP/SMHS REGIONAL ADMINISTRATOR | 170469 | 0 | 11962 | 0 | 779 | 0 | 31054 | 0 | 22180 | 0 | 236444 | 0 | 0 | 0 |
| MICHAEL KLUEH | ||||||||||||||
| VP/CRO | 173063 | 0 | 23408 | 0 | 1688 | 0 | 53414 | 0 | 24587 | 0 | 276160 | 0 | 0 | 0 |
| THOMAS LILLY | ||||||||||||||
| SR VP/SUPPORT OPERATIONS | 200213 | 0 | 26166 | 0 | 7576 | 0 | 32989 | 0 | 19192 | 0 | 286136 | 0 | 0 | 0 |
| VERNON MAASMD | ||||||||||||||
| VP/MEDICAL AFFAIRS | 213933 | 0 | 0 | 0 | 10813 | 0 | 19611 | 0 | 21167 | 0 | 265524 | 0 | 0 | 0 |
| MIKE WHITMORE | ||||||||||||||
| VP/CLINICAL SUPPORT & ANCILLARY SERV | 185607 | 0 | 24523 | 0 | 1621 | 0 | 44408 | 0 | 21869 | 0 | 278028 | 0 | 0 | 0 |
| KATHRYN BRYAN MD | ||||||||||||||
| PHYSICIAN | 416905 | 0 | 0 | 0 | 43961 | 0 | 40626 | 0 | 17473 | 0 | 518965 | 0 | 12722 | 0 |
| ROBERT CUTRELL MD | ||||||||||||||
| PHYSICIAN | 337927 | 0 | 6158 | 0 | 24397 | 0 | 47672 | 0 | 22105 | 0 | 438259 | 0 | 23815 | 0 |
| MYLES GRANT | ||||||||||||||
| EXECUTIVE DIRECTOR | 302498 | 0 | 93874 | 0 | 26144 | 0 | 78585 | 0 | 16119 | 0 | 517220 | 0 | 0 | 0 |
| CHARLES LACKEY MD | ||||||||||||||
| PHYSICIAN | 452495 | 0 | 0 | 0 | 57639 | 0 | 42499 | 0 | 16113 | 0 | 568746 | 0 | 39499 | 0 |
| MUREENA TURNQUEST-WELLS MD | ||||||||||||||
| PHYSICIAN | 546504 | 0 | 48058 | 0 | 20272 | 0 | 83230 | 0 | 25906 | 0 | 723970 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | PART 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 $23,815 | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| CLAUDIA RICHARDT | |||
| - SEE PART V - | 74136 | SEE PART V | 0 |
| CAROL ACKERMAN | |||
| - SEE PART V - | 43582 | SEE PART V | 0 |
Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 4 | EFFECTIVE 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 6 | ST. 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 7A | ST. 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 7B | ALL 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 11 | ST. 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 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE 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 15 | COMPENSATION 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 19 | THE 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/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | 11A, I | ASCENSION HEALTH ALLIANCE | 0 |
| CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC | ||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 351869951 | FREESTANDING OUTPATIENT CENTER | IN | 501(C)(3) | 11C, III-FI | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | 1 |
| JUBILEE PARTNERSHIPS INC | ||||||||||
| 2301 N PARK AVENUE | INDIANAPOLIS | IN | 46205 | 352060765 | OUTREACH ACTIVITIES | IN | 501(C)(3) | 1 | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | 1 |
| REHABILITATION HOSPITAL OF INDIANA INC | ||||||||||
| 4141 SHORE DRIVE | INDIANAPOLIS | IN | 46254 | 351786005 | REHABILITATION HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT ANDERSON REGIONAL HOSPITAL FOUNDATION INC | ||||||||||
| 2015 JACKSON STREET | ANDERSON | IN | 46016 | 352053693 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT ANDERSON REGIONAL HOSPITAL INC | 1 |
| STJOSEPH HOSPITAL & HEALTH CENTER INC | ||||||||||
| 1907 W SYCAMORE STREET | KOKOMO | IN | 46901 | 350992717 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STJOSEPH FOUNDATION OF KOKOMO INDIANA INC | ||||||||||
| 1907 W SYCAMORE STREET | KOKOMO | IN | 46901 | 237313206 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STJOSEPH HOSPITAL & HEALTH CENTER INC | 1 |
| STVINCENT ANDERSON REGIONAL HOSPITAL INC | ||||||||||
| 2015 JACKSON STREET | ANDERSON | IN | 46016 | 460877261 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT CARMEL HOSPITAL INC | ||||||||||
| 13500 N MERIDIAN STREET | CARMEL | IN | 46032 | 743107055 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT CLAY HOSPITAL INC | ||||||||||
| 1206 E NATIONAL AVENUE | BRAZIL | IN | 47834 | 352112529 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT DUNN HOSPITAL INC | ||||||||||
| 1600 23RD STREET | BEDFORD | IN | 47421 | 272192831 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT FISHERS HOSPITAL INC | ||||||||||
| 13861 OLIO ROAD | FISHERS | IN | 46037 | 454243702 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT FRANKFORT HOSPITAL INC | ||||||||||
| 1300 S JACKSON | FRANKFORT | IN | 46041 | 352099320 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT FRANKFORT HOSPITAL FOUNDATION INC | ||||||||||
| 1300 S JACKSON | FRANKFORT | IN | 46041 | 351531734 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT FRANKFORT HOSPITAL INC | 1 |
| STVINCENT HEALTH INC | ||||||||||
| 8425 HARCOURT ROAD | INDIANAPOLIS | IN | 46260 | 352052591 | PARENT COMPANY | IN | 501(C)(3) | 11C, III-FI | ASCENSION HEALTH | 0 |
| STVINCENT HEALTH WELLNESS AND PREVENTIVE CARE INSTITUTE INC | ||||||||||
| 8333 NAAB ROAD STE 301 | INDIANAPOLIS | IN | 46260 | 461227327 | HEALTH AND WELLNESS SERVICES | IN | 501(C)(3) | 9 | STVINCENT HEALTH INC | 1 |
| STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | ||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 350869066 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT HOSPITAL FOUNDATION INC | ||||||||||
| 10330 N MERIDIAN STREET STE 430N | INDIANAPOLIS | IN | 46290 | 356088862 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | 1 |
| STVINCENT JENNINGS HOSPITAL INC | ||||||||||
| 301 HENRY STREET | NORTH VERNON | IN | 47265 | 351841606 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT MADISON COUNTY HEALTH SYSTEM INC | ||||||||||
| 1331 SOUTH A STREET | ELWOOD | IN | 46036 | 350876389 | HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT MEDICAL GROUP INC | ||||||||||
| 8425 HARCOURT ROAD | INDIANAPOLIS | IN | 46260 | 272039417 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | STVINCENT HEALTH INC | 1 |
| STVINCENT MERCY HOSPITAL FOUNDATION INC | ||||||||||
| 1331 SOUTH A STREET | ELWOOD | IN | 46036 | 311066871 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT MADISON COUNTY HEALTH SYSTEM INC | 1 |
| STVINCENT NEW HOPE INC | ||||||||||
| 8450 N PAYNE ROAD | INDIANAPOLIS | IN | 46260 | 351733591 | INTERMEDIATE CARE FACILITY | IN | 501(C)(3) | 9 | STVINCENT HEALTH INC | 1 |
| STVINCENT PEDIATRIC REHAB CENTER INC | ||||||||||
| 1707 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 352048898 | SPECIALTY HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HOSPITAL & HEALTH CARE CENTER INC | 1 |
| STVINCENT RANDOLPH HOSPITAL INC | ||||||||||
| 473 GREENVILLE AVENUE | WINCHESTER | IN | 47394 | 352103153 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT RANDOLPH HOSPITAL FOUNDATION INC | ||||||||||
| 473 GREENVILLE AVENUE | WINCHESTER | IN | 47394 | 352133006 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT RANDOLPH HOSPITAL INC | 1 |
| STVINCENT SALEM HOSPITAL INC | ||||||||||
| 911 N SHELBY STREET | SALEM | IN | 47167 | 270847538 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT SETON SPECIALTY HOSPITAL INC | ||||||||||
| 8050 TOWNSHIP LINE ROAD | INDIANAPOLIS | IN | 46260 | 351712001 | LONG TERM CARE HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT WILLIAMSPORT HOSPITAL INC | ||||||||||
| 412 N MONROE STREET | WILLIAMSPORT | IN | 47993 | 350784551 | CRITICAL ACCESS HOSPITAL | IN | 501(C)(3) | 3 | STVINCENT HEALTH INC | 1 |
| STVINCENT WILLIAMSPORT HOSPITAL FOUNDATION INC | ||||||||||
| 412 N MONROE STREET | WILLIAMSPORT | IN | 47993 | 743130159 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | STVINCENT WILLIAMSPORT HOSPITAL INC | 1 |
| SVSM INC | ||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 810607827 | HOLDING COMPANY | IN | 501(C)(3) | 11A, I | STVINCENT HEALTH INC | 1 |
| ST MARY'S AT HOME INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351899560 | DME/HOME CARE | IN | 501(C)(3) | 11A, I | ST MARY'S HEALTH SERVICES INC | 1 |
| ST MARY'S BUILDING CORPORATION | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237248362 | REAL ESTATE HOLDING COMPANY | IN | 501(C)(2) | ST MARY'S HEALTH SERVICES INC | 1 | |
| ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205342518 | AMBULANCE SERVICES | IN | 501(C)(4) | ST MARY'S HEALTH SERVICES INC | 1 | |
| ST MARY'S HEALTH INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 352057801 | HEALTH MINISTRY PARENT | IN | 501(C)(3) | 11C, III-FI | STVINCENT HEALTH INC | 1 |
| ST MARY'S PHYSICIAN NETWORK LLC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205023387 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | ST MARY'S MEDICAL GROUP LLC | 1 |
| ST MARY'S HEALTH SERVICES INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351679526 | INVESTMENT SERVICES | IN | 501(C)(3) | 11C, III-FI | ST MARY'S HEALTH INC | 1 |
| ST MARY'S CARE PARTNERS INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351899562 | TAX-EXEMPT AFFILIATE REIMBURSEMENTS | IN | 501(C)(3) | 11A, I | ST MARY'S HEALTH INC | 1 |
| ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237045370 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | 1 |
| ST MARY'S WARRICK HOSPITAL FOUNDATION INC | ||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351961890 | SUPPORTING ORGANIZATION | IN | 501(C)(3) | 11A, I | ST MARY'S WARRICK HOSPITAL INC | 1 |
| ST MARY'S WARRICK HOSPITAL INC | ||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351343019 | HOSPITAL | IN | 501(C)(3) | 3 | ST MARY'S HEALTH SERVICES INC | 1 |
| ST MARY'S OHIO VALLEY HEARTCARE LLC | ||||||||||
| 901 ST MARYS DRIVE | EVANSVILLE | IN | 47714 | 273474697 | CARDIOLOGY SERVICES | IN | 501(C)(3) | 11A, I | ST MARY'S MEDICAL GROUP LLC | 1 |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 261356310 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | ST MARY'S MEDICAL GROUP LLC | 1 |
| PRIMARY PHYSICIAN NETWORK LLC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 208775914 | PHYSICIAN PROFESSIONAL SERVICES | IN | 501(C)(3) | 9 | ST MARY'S MEDICAL GROUP LLC | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BREAST MRI LEASING COMPANY LLC | |||||||||||||
| 10330 N MERIDIAN ST STE 430N | INDIANAPOLIS | IN | 46290 | 426662493 | SALE AND RENTAL SERVICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | 230642 | 43329 | 0 | 1 | 0.50000 |
| CARMEL AMBULATORY SURGERY CENTER LLC | |||||||||||||
| 13421 OLD MERIDIAN ST STE 150 | CARMEL | IN | 46032 | 320014795 | AMBULATORY SURGERY CENTER | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | 5892459 | 1896555 | 0 | 1 | 0.45000 |
| COOPERATIVE MANAGED CARE SERVICES LLC | |||||||||||||
| 9045 RIVER ROAD STE 250 | INDIANAPOLIS | IN | 46240 | 351999227 | CASE MANAGEMENT | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | UNRELATED | 212659 | 2119265 | 0 | 1 | 0.50000 |
| ENDOSCOPY CENTER LLC | |||||||||||||
| 13421 OLD MERIDIAN ST STE 150 | CARMEL | IN | 46032 | 320029881 | ENDOSCOPY CENTER | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | 681952 | 357300 | 0 | 0 | 0.51000 |
| HANCOCK PHYSICIAN NETWORK LLC | |||||||||||||
| 801 N STATE STREET | GREENFIELD | IN | 46140 | 352051598 | PRIMARY CARE PHYSICIAN PRACTICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | -2692272 | 2094475 | 0 | 1 | 0.50000 |
| HCH SVH CATH LAB SERVICES LLC | |||||||||||||
| 1000 N 16TH STREET | NEW CASTLE | IN | 47362 | 452087950 | CATH LAB SERVICES | IN | STVINCENT HEALTH INC | RELATED | -229738 | 1629927 | 0 | 1 | 0.50000 |
| MERIDIAN HEIGHTS ASSOCIATES LLC | |||||||||||||
| 6100 W 96TH STREET STE 250 | INDIANAPOLIS | IN | 46278 | 264020296 | REAL ESTATE HOLDING | IN | STVINCENT CARMEL HOSPITAL INC | RELATED | 3029284 | 0 | 1 | 0.50000 | |
| NEURO ONCOLOGY EQUIPMENT LLC | |||||||||||||
| 10330 N MERIDIAN ST STE 430N | INDIANAPOLIS | IN | 46290 | 743103803 | SALE AND RENTAL SERVICES | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | 151678 | 1684704 | 0 | 1 | 0.50000 |
| STVINCENT HEALTHUSP LLC | |||||||||||||
| 15305 DALLAS PKWY STE 1600 | ADDISON | TX | 75001 | 203749962 | AMBULATORY SURGERY CENTER | IN | STVINCENT HEALTH INC | RELATED | 136436 | 387939 | 0 | 1 | 0.50000 |
| STVINCENT HEART CENTER OF INDIANA LLC | |||||||||||||
| 10580 N MERIDIAN STREET | INDIANAPOLIS | IN | 46290 | 364492612 | HEART HOSPITAL | IN | CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC | RELATED | 20552234 | 78811464 | 0 | 0 | 0.74080 |
| WOMEN'S PHYSICIAN SURGERY CENTER LLC | |||||||||||||
| 8081 TOWNSHIP LINE ROAD | INDIANAPOLIS | IN | 46260 | 352086841 | AMBULATORY SURGERY CENTER | IN | STVINCENT HOSPITAL AND HEALTH CARE CENTER INC | RELATED | -11530 | 252917 | 0 | 0 | 0.58900 |
| AMBULATORY CARE CENTER LLC | |||||||||||||
| 1125 PROFESSIONAL BLVD | EVANSVILLE | IN | 47714 | 352006018 | OP SURGERY | IN | ST MARY'S HEALTH SERVICES INC | RELATED | 4879396 | 4549444 | 0 | 1 | 0.50000 |
| SETON HEALTH SERVICES LLC | |||||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 270451316 | EQUIPMENT RENTAL | IN | ST MARY'S HEALTH SERVICES INC | RELATED | 36943 | 99375 | 0 | 1 | 0.50000 |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT CO LLC | |||||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205062635 | MANAGEMENT SERVICES | IN | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | RELATED | 211137 | 156690 | 0 | 1 | 0.75000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SVH REAL ESTATE INC | ||||||||||||
| 8425 HARCOURT ROAD | INDIANAPOLIS | IN | 46260 | 205002285 | REAL ESTATE HOLDING COMPANY | IN | STVINCENT HEALTH INC | C | 2784 | 2969423 | 1.00000 | 1 |
| ST MARY'S MEDICAL GROUP INC | ||||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 352076827 | INVESTMENT | IN | ST MARY'S HEALTH SERVICES INC | C | -641423 | 742 | 1.00000 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (29 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ASCENSION HEALTH INC | ||
| P | 56510766 | FMV OF SERVICES OR CASH |
| PRIMARY PHYSICIAN NETWORK LLC | ||
| J | 229493 | FMV OF SERVICES OR CASH |
| PRIMARY PHYSICIAN NETWORK LLC | ||
| B | 2615000 | FMV OF SERVICES OR CASH |
| PRIMARY PHYSICIAN NETWORK LLC | ||
| Q | 16446849 | FMV OF SERVICES OR CASH |
| ST MARY'S AT HOME INC | ||
| Q | 6588415 | FMV OF SERVICES OR CASH |
| ST MARY'S BUILDING CORPORATION LLC | ||
| K | 1484068 | FMV OF SERVICES OR CASH |
| ST MARY'S BUILDING CORPORATION LLC | ||
| Q | 1880874 | FMV OF SERVICES OR CASH |
| ST MARY'S HEALTH SERVICES INC | ||
| Q | 4529608 | FMV OF SERVICES OR CASH |
| ST MARY'S HEALTH INC | ||
| Q | 5933755 | FMV OF SERVICES OR CASH |
| ST MARY'S MEDICAL CENTER FOUNDATION OF EVANSVILLE INC | ||
| C | 1449919 | FMV OF SERVICES OR CASH |
| ST MARY'S OHIO VALLEY HEARTCARE LLC | ||
| B | 4605000 | FMV OF SERVICES OR CASH |
| ST MARY'S OHIO VALLEY HEARTCARE LLC | ||
| P | 79750 | FMV OF SERVICES OR CASH |
| ST MARY'S OHIO VALLEY HEARTCARE LLC | ||
| Q | 2492502 | FMV OF SERVICES OR CASH |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC | ||
| E | 138881 | FMV OF SERVICES OR CASH |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC | ||
| L | 1610684 | FMV OF SERVICES OR CASH |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC | ||
| Q | 308596 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIAN NETWORK LLC | ||
| B | 6890000 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIAN NETWORK LLC | ||
| Q | 16300171 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | ||
| Q | 5118280 | FMV OF SERVICES OR CASH |
| ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC | ||
| Q | 2160247 | FMV OF SERVICES OR CASH |
| ST MARY'S WARRICK HOSPITAL INC | ||
| P | 250000 | FMV OF SERVICES OR CASH |
| ST MARY'S WARRICK HOSPITAL INC | ||
| D | 83077 | FMV OF SERVICES OR CASH |
| ST MARY'S WARRICK HOSPITAL INC | ||
| Q | 1114355 | FMV OF SERVICES OR CASH |
| SVSM INC | ||
| P | 2443131 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIAN NETWORK LLC | ||
| S | 242751 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | ||
| B | 1694408 | FMV OF SERVICES OR CASH |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | ||
| R | 3170281 | FMV OF SERVICES OR CASH |
| ST MARY'S BUILDING CORPORATION | ||
| R | 2218530 | FMV OF SERVICES OR CASH |
| ASCENSION HEALTH INC | ||
| B | 4262393 | FMV OF SERVICES OR CASH |