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Mary Immaculate Hospital: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Mary Immaculate Hospital (EIN 54-0548200)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-15
IRS object ID
201421969349301527
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-07-15T18:11:46-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

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

Filer Filer

FieldValueIRS element (for citing)
EIN540548200EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMARYNameControl
Phone7578866000Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameMichael K KernerName
TitleChief Executive Officer-BSHRHSTitle
Phone7578866000Phone
Date Signed2014-07-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

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

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Mary Immaculate HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatricia RobertsonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12 Bernardine DriveAddressLine1
CityNewport NewsCity
StateVAState
ZIP Code23602ZIPCode
FieldValueIRS element (for citing)
Gross Receipts189752872GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bonsecourshamptonroads.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionAcute Care HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees1106TotalNbrEmployees
Total Nbr Volunteers130TotalNbrVolunteers
Total Gross UBI200542TotalGrossUBI
Net Unrelated Business Txbl Income-111202NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2721787ContributionsGrantsPriorYear
Contributions Grants Current Year1867229ContributionsGrantsCurrentYear
Program Service Revenue Prior Year179297332ProgramServiceRevenuePriorYear
Program Service Revenue CY182521964ProgramServiceRevenueCY
Investment Income Prior Year966129InvestmentIncomePriorYear
Investment Income Current Year2635548InvestmentIncomeCurrentYear
Other Revenue Prior Year2170737OtherRevenuePriorYear
Other Revenue Current Year2580032OtherRevenueCurrentYear
Total Revenue Prior Year185155985TotalRevenuePriorYear
Total Revenue Current Year189604773TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year29302GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY16439GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year51703452SalariesEtcPriorYear
Salaries Etc Current Year53016555SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year115925849OtherExpensePriorYear
Other Expenses Current Year115928392OtherExpensesCurrentYear
Total Expenses Prior Year167658603TotalExpensesPriorYear
Total Expenses Current Year168961386TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17497382RevenuesLessExpensesPriorYear
Revenues Less Expenses CY20643387RevenuesLessExpensesCY
Total Assets BOY179981353TotalAssetsBOY
Total Assets EOY198131332TotalAssetsEOY
Total Liabilities BOY39468341TotalLiabilitiesBOY
Total Liabilities EOY26582203TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY140513012NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY171549129NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense54033277Expense
Revenue71297451Revenue
DescriptionOrthopedics is center of choice for orthopedic care in the greater Hampton Roads area, with 1 of every 5 orthopedic surgeries in the region performed at Mary Immaculate. It includes a continuum of care from pre-operative education through post-op recovery, and is supported by state-of-the-art technology, including a Mako robot and nationally renowned expert physicians, as well as a comprehensive outpatient rehab network and community outreach events. Bon Secours skilled surgeons perform minimally invasive and traditional orthopaedic and spine procedures. Bon Secours respond to the needs of all orthopaedic patients - from the young athlete to the adult sports medicine patient (weekend warrior or sports enthusiast) to the patient needing significant repair and possibly replacement of joints.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense21697135Expense
Revenue14174480Revenue
DescriptionWomen and children services provided added capacity and resources so that the needs of the community for OB care would continue to be met. Mary Immaculate also offers advanced nursery services through a neonatal specialty care nursery. Bon Secours also offers the largest curriculum of family and parenting classes through its Love & Learn program. Mary Immaculate expanded its gynecology offering by introducing gynecological oncology services (board certified and fellowship trained surgeon) and an infusion center for women suffering from such cancers.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8983050Expense
Revenue9270109Revenue
DescriptionMary Immaculate has committed significant resources to the care of cardiac patients. The comprehensive Early Detection Center, aimed at identifying cardiac disease early and referring patients to primary care, cardiology, vascular surgery, and cardiothoracic surgery as necessary for prompt and effective treatment - continues to serve area residents. The outreach has expanded to area businesses and community churches as well. In addition, the introduction of the One-Call Transfer center (for cardiac and other patients) and relationships with transport services make it easier to transfer patients in need of more advanced procedures to Bon Secours Maryview, which serves as the Bon Secours regional referral center for advanced cardiac services. In addition, a strong focus also exists on community education through seminars, classes, screenings, special events and a brand new community outreach program aimed at middle school students called The Heart Health Academy at Bon Secours. Mary Immaculate recently installed a state-of-the-art, fully digital cardiac catheterization laboratory.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense68778096Expense
Grants16439Grants
Revenue87828894Revenue
DescriptionMajor services offered by Mary Immaculate include the Hernia Center which is a comprehensive program dedicated to treating hernias. The program specializes in developing treatments based on each patient's individual needs. The program uses the latest innovations and performs many of it's procedures using state-of-the-art, minimally invasive techniques. In addition, Mary Immaculate offers Neuroscience, Gastroenterology and Pulmonary services as well as a full service 24 hour Emergency Room. See Sch H for additional information.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp68778096TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt16439TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev87828894TotalOfOtherProgramServiceRev
Total Program Service Expense153491558TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109658NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1106NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Sr Elaine Davia
MI JT Board Member2.002.00X000
Timothy J Davis
MI JT Board Member2.0048.00X01122284134895
Debra Deihl
MI JT BM (Jan-Aug)2.000.00X000
Paul W Garman
MI JT BM (Sep-Dec)2.000.00X000
Pastor Ivan T Harris
MI JT Board Member2.000.00X000
Sr Patricia Heath
MI JT Board Member2.0048.00X000
Steven B Hopson MD
MI JT BM (Sep-Dec)2.000.00X000
Sr Mary Margaret Jackson
MI JT BM (Sep-Apr)2.000.00X000
Matthew James
MI JT Board Member2.000.00X000
Sr Shaun Malone
MI JT BM (Apr-Aug)2.000.00X000
Helena Mock
MI JT BM (Jan-Aug)2.000.00X000
Jeffrey Morrison DO
MI JT BM (July-Aug)2.000.00X000
William F Pile
MI JT Board Member2.000.00X000
Sr Christen Shukwit
MI JT Board Member2.000.00X000
Robert M Yacobi
MI JT Board Member2.000.00X000
Susan B Anthony FNP
MI JT Board Sec (Jan-Aug)2.000.00X000X
John H Garrett
Chair Jan-Aug/Sec Sep-Dec3.000.00X000X
Michael K Kerner
CEO-BSHR15.5034.50X0936925132770X
Sr David Ann Niski
MI JT President3.000.00X000X
Jon A Nystrom
MI JT Chairman (Sept-Dec)3.000.00X000X
Melinda Hancock
CFO-Bon Secours VA3.0047.00034394127968X
Patricia Robertson
CEO MIH & Extended Care45.005.00047582227272X
Charmaine Rochester
MI JT Treas/VP Finance (Jan-Aug)15.5034.50013541713585X
Jeffrey N Doucette
VP of Patient Care Services50.000.00203823038131X
Devin T McKeever
COO Bon Secours Medical Group5.0045.00019935012010X
James B Sherwood
Chief Admin Officer10.0040.00028524938182X
Darlene Stephenson
VP Operations50.000.00170120041195X
Thomas J Hoffmier MD
Physician50.000.00468041025614X
Nauman Naseer MD
Physician (Sep-June)50.000.00440410040273X
Allen B Nichols MD
Physician50.000.00629493042733X
Anthony D Terracina MD
Physician50.000.00913430039550X
Leslie A Webb MD
Physician50.000.0019713903123X
Joe Buchheit
Former CFO-BSHR0.0050.00032640025031X
Ernie Padden
Former Int. CFO-BSHR0.000.0002015003120X
James H Sammons
Former VP of Med. Affairs0.000.00224590018095X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3247046TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4026888TotalReportableCompFrmRltdOrgs
Total Other Compensation663547TotalOtherCompensation
Number Individuals GT100 K33NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Rehabcare Group East Incorporated
PO Box 502096St LouisMO631502096Rehabilitative Services2701370
Tidewater Physicians Multispecialty Grou
860 Omni Blvd 304Newport NewsVA23606Physician Services1915627
Anesthesia Associates of Hampton
110 Three Point CtYorktownVA23692Physician Services1500000
Aramark CTS Inc
12483 Collections Center DrChicagoIL60693Biomedical Engineering929599
Shared Hospital Svcs
3530 Elmhurst LanePortsmouthVA23701Linen/Laundry Service561700
FieldValueIRS element (for citing)
Number Of Contractors GT100 K35NumberOfContractorsGT100K
Fundraising Events54762FundraisingEvents
Related Organizations83742RelatedOrganizations
Government Grants1541664GovernmentGrants
All Other Contributions187061AllOtherContributions
Noncash Contributions439NoncashContributions
Total Contributions1867229TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code622110BusinessCode
Total Revenue Column182521964TotalRevenueColumn
Related Or Exempt Function Income182383231RelatedOrExemptFunctionIncome
Unrelated Business Revenue138733UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue182521964TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column573848TotalRevenueColumn
Exclusion$573,848ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column2049TotalRevenueColumn
Exclusion$2,049ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real68805Real
Personal3550Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real14377Real
Personal3550Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real54428Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column54428TotalRevenueColumn
Unrelated Business Revenue21510UnrelatedBusinessRevenue
Exclusion$32,918ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2164612Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other104961Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2164612Securities
Other-104961Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2059651TotalRevenueColumn
Exclusion$2,059,651ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events29607GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events54762CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses25211FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column4396TotalRevenueColumn
Exclusion$4,396ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Joint venture income9000991680316$1,680,316
Rehab Services900099187703187703
Cafe/Vending/Dietary722514184076$184,076

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column469113TotalRevenueColumn
Unrelated Business Revenue40299UnrelatedBusinessRevenue
Exclusion$428,814ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2521208TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column189604773TotalRevenueColumn
Related Or Exempt Function Income182570934RelatedOrExemptFunctionIncome
Unrelated Business Revenue200542UnrelatedBusinessRevenue
Exclusion$4,966,068ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total13063Total
Program Services13063ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total3376Total
Program Services3376ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total447600Total
Program Services402840ProgramServices
Management And General44760ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41541862Total
Program Services37387676ProgramServices
Management And General4154186ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2195831Total
Program Services1976248ProgramServices
Management And General219583ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5002260Total
Program Services4502034ProgramServices
Management And General500226ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3829002Total
Program Services3446102ProgramServices
Management And General382900ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total117080Total
Program Services105372ProgramServices
Management And General11708ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total90248Total
Program Services81223ProgramServices
Management And General9025ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total28992Total
Program Services26093ProgramServices
Management And General2899ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7986464Total
Program Services7187818ProgramServices
Management And General798646ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total120008Total
Program Services108007ProgramServices
Management And General12001ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2669327Total
Program Services2402394ProgramServices
Management And General266933ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total105952Total
Program Services95357ProgramServices
Management And General10595ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2562802Total
Program Services2306522ProgramServices
Management And General256280ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total167664Total
Program Services150898ProgramServices
Management And General16766ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total82590Total
Program Services74331ProgramServices
Management And General8259ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1390896Total
Program Services1390896ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6406274Total
Program Services5765647ProgramServices
Management And General640627ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1250262Total
Program Services1125236ProgramServices
Management And General125026ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies46738863420649774673886
Purchased Services28664517257980652866452
Bad Debt Expense1285576512855765
BSHSI Mgmt Allocation26119092350718261191

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2078779Total
Program Services1870900ProgramServices
Management And General207879ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total168961386Total
Program Services153491558ProgramServices
Management And General15469828ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2955BOY
EOY3480EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY79452701BOY
EOY97528313EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY95782BOY
EOY109516EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21741465BOY
EOY18777276EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3947664BOY
EOY4291144EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY408341BOY
EOY791812EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis90792108LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec55380471LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY33589287BOY
EOY35411637EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY26428069BOY
EOY29243495EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1738260BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY81069BOY
EOY81069EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12495760BOY
EOY11893590EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY179981353BOY
EOY198131332EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14035856BOY
EOY12896199EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1471122BOY
EOY2515904EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY11361907BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12599456BOY
EOY11170100EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY39468341BOY
EOY26582203EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY139822964BOY
EOY170644225EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY645178BOY
EOY848027EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY44870BOY
EOY56877EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY140513012BOY
EOY171549129EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY179981353BOY
EOY198131332EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses20643387ReconcilationRevenueExpenses
Reconciliation Unrealized Invest218244ReconciliationUnrealizedInvest
Reconcilation Other Changes10174486ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers1Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$16,465DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$12,527OtherActivitiesAmount
Total Lobbying Expenditures IIB28992TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance44871BeginningOfYearBalance
Contributions521Contributions
Investment Earnings Or Losses11749InvestmentEarningsOrLosses
Grants Or Scholarships263GrantsOrScholarships
End Of Year Balance56878EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance48147BeginningOfYearBalance
Investment Earnings Or Losses384InvestmentEarningsOrLosses
Other Expenditures3660OtherExpenditures
End Of Year Balance44871EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance50349BeginningOfYearBalance
Other Expenditures2202OtherExpenditures
End Of Year Balance48147EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance28574BeginningOfYearBalance
Investment Earnings Or Losses22025InvestmentEarningsOrLosses
Other Expenditures250OtherExpenditures
End Of Year Balance50349EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance112350BeginningOfYearBalance
Investment Earnings Or Losses-83276InvestmentEarningsOrLosses
Grants Or Scholarships500GrantsOrScholarships
End Of Year Balance28574EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3352921OtherCostOrOtherBasis
Book Value3352921BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis34885973OtherCostOrOtherBasis
Depreciation18098812Depreciation
Book Value16787161BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis390703OtherCostOrOtherBasis
Depreciation187160Depreciation
Book Value203543BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50357372OtherCostOrOtherBasis
Depreciation36167609Depreciation
Book Value14189763BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1805139OtherCostOrOtherBasis
Depreciation926890Depreciation
Book Value878249BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings35411637TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
LT Non-Cash Inv - HPL/GL5723878
Due from Affiliates2801893
Accrued Revenue2000212
Deferred Fin Costs437754
3rd Party Payors117681
Inv in Surgery centers812172
FieldValueIRS element (for citing)
Total Book Value Other Assets11893590TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
HPL/GL Liability$5,723,878
LT Liab-Pension Liability$2,486,427
Fin 47 LT Asbestos Liab$1,729,546
Medicare/Medicaid Liabilities$855,969
Deferred Rent and other$242,898
Due to Affiliates$110,178
Due to BSHSI$19,864
Unclaimed Property Liabilities$1,340
FieldValueIRS element (for citing)
Total Of Amounts11170100TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:Earnings are to used to assist the needy.
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740 (Formerly FIN48). ASC 740 (Formerly FIN48) addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and de-recognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 (Formerly FIN48) by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $66,681 and $95,733 of net operating loss carryforwards as of August 31, 2013 and 2012, respectively, which expire in varying periods through 2032 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2013 and 2012. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GolfNameOfEvent1
Gross Receipts Event148466GrossReceiptsEvent1
Charitable Contributions Event126866CharitableContributionsEvent1
Gross Revenue Event121600GrossRevenueEvent1
Rent Facility Costs Event125211RentFacilityCostsEvent1
Name Of Event2GalaNameOfEvent2
Gross Receipts Event235903GrossReceiptsEvent2
Charitable Contributions Event227896CharitableContributionsEvent2
Gross Revenue Event28007GrossRevenueEvent2
Gross Receipts Total84369GrossReceiptsTotal
Charitable Contributions Total54762CharitableContributionsTotal
Gross Revenue Total Events29607GrossRevenueTotalEvents
Rent Facility Costs Total Events25211RentFacilityCostsTotalEvents
Direct Expense Summary Events25211DirectExpenseSummaryEvents
Net Income Summary4396NetIncomeSummary

Schedule H IRS990ScheduleH

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

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2591893TotalCommunityBenefitExpense
Net Community Benefit Expense2591893NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13136803TotalCommunityBenefitExpense
Direct Offsetting Revenue9161051DirectOffsettingRevenue
Net Community Benefit Expense3975752NetCommunityBenefitExpense
Percent Of Total Expense0.02550PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense2957686TotalCommunityBenefitExpense
Direct Offsetting Revenue1637459DirectOffsettingRevenue
Net Community Benefit Expense1320227NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense18686382TotalCommunityBenefitExpense
Direct Offsetting Revenue10798510DirectOffsettingRevenue
Net Community Benefit Expense7887872NetCommunityBenefitExpense
Percent Of Total Expense0.05050PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs21NumberOfActivitiesOrPrograms
Persons Served12279PersonsServed
Total Community Benefit Expense829002TotalCommunityBenefitExpense
Direct Offsetting Revenue5508DirectOffsettingRevenue
Net Community Benefit Expense823494NetCommunityBenefitExpense
Percent Of Total Expense0.00530PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served615PersonsServed
Total Community Benefit Expense182619TotalCommunityBenefitExpense
Net Community Benefit Expense182619NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served6243PersonsServed
Total Community Benefit Expense284586TotalCommunityBenefitExpense
Net Community Benefit Expense284586NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs35NumberOfActivitiesOrPrograms
Persons Served19137PersonsServed
Total Community Benefit Expense1296207TotalCommunityBenefitExpense
Direct Offsetting Revenue5508DirectOffsettingRevenue
Net Community Benefit Expense1290699NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs35NumberOfActivitiesOrPrograms
Persons Served19137PersonsServed
Total Community Benefit Expense19982589TotalCommunityBenefitExpense
Direct Offsetting Revenue10804018DirectOffsettingRevenue
Net Community Benefit Expense9178571NetCommunityBenefitExpense
Percent Of Total Expense0.05880PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense5455TotalCommunityBuildingExpense
Net Community Building Expense5455NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served399PersonsServed
Total Community Building Expense9358TotalCommunityBuildingExpense
Net Community Building Expense9358NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served399PersonsServed
Total Community Building Expense14813TotalCommunityBuildingExpense
Net Community Building Expense14813NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,011,130BadDebtExpenseAmount
Amount Reimbursed By Medicare44798386AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare48099989CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3301603MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12 Bernardine DrAddressLine1
CityNewport NewsCity
StateVAState
ZIP Code23602ZIPCode
FieldValueIRS element (for citing)
Website Addresshttp://bshr.com/WebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Mary Immaculate Phys Therapy Denbigh
14703 Warwick Blvd Suite BNewport NewsVA23608Physical Therapy
In-Motion Boo Williams Sportsplex
5 Armistead Pointe ParkwayHamptonVA23666Physical Therapy
Mary Immaculate Phys Therapy Victory
101-A Long Green BlvdYorktownVA23693Physical Therapy
Cardiovascular Specialists
12720 McManus Blvd Ste 201Newport NewsVA23602Physician Practice
Tidewater Surgical Specialists
12720 McManus Blvd Ste 311Newport NewsVA23602Physician Practice
Bon Secours Pulmonary Specialists
12720 McManus Blvd Ste 303Newport NewsVA23602Physician Practice
Bon Secours Occumed
14703 Warwick Blvd Suite ANewport NewsVA23608Occupational Medicine

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: Annually, Bon Secours Hampton Roads Health System (BSHRHS) publishes a report for the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is available to the public each year on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours. This report is available online at www.bshr.org.
Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, L7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $12,855,765
Part II: Bon Secours Mary Immaculate Hospital provided facility space, dietary contributions and staff support to local community boards, coalitions, and civic groups to discuss and address health and social concerns across the community. These meetings enabled various community groups to plan programs and activities to improve the health of community residents across different health and social conditions. In addition, Mary Immaculate is working with other community organizations to address the homeless issue in the Newport News area.
Part III, Line 4: Part III, line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.Part III, Line 4: Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on pages 10-11 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for doubtful accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 41 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS.
Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service.
Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending Financial Assistance Program (FAP) account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.
Part V, Section B, Line 3: Mary Immaculate Hospital (MIH) contracted with Community Health Solutions (CHS) to conduct an electronic survey of key stakeholder to determine the top healthcare needs of the community. MIH developed a list of key stakeholders who were asked to provide their viewpoints on important healthcare concerns in the community, significant gaps in the community, and ideas for addressing health concerns and service gaps. Stakeholders included individuals who have special knowledge and expertise in public health, as well as the deans of area colleges and universities with medical degree programs. In addition, MIH surveyed representatives of medically underserved, minority populations, and those with chronic conditions. MIH also met with representatives from the Peninsula Health Center to review the key findings from the survey and seek additional input. Upon receipt of all information, MIH convened a small group to review the list of key needs and gaps identified to prioritize the needs using criteria developed against which to evaluate each need.Mary Immaculate Hospital
Part V, Section B, Line 7: While Mary Immaculate Hospital (MIH) recognizes the importance of all the needs identified, there are other providers and organizations within the community addressing mental illness, dental/oral health, tobacco use, substance abuse, prenatal and pregnancy care, sexually transmitted diseases, teen pregnancy, and Alzheimer's disease with specialized programs and services and it would result in duplication of services if MIH were to address those needs. MIH currently provides comprehensive diabetes education with weekly education sessions covering understanding diabetes, nutrition, foot care, exercise, and medication. MIH also has a comprehensive community-based program in place to address domestic violence through parenting education programs that offer positive learning opportunities for parents, child development, age-appropriate expectations, and health and safety issues as it relates to children from birth through the teenage years.Mary Immaculate Hospital
Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Mary Immaculate Hospital
Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Mary Immaculate Hospital
Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Mary Immaculate Hospital
Part VI, Line 2: In partnership with Bon Secours Virginia Health System, Mary Immaculate Hospital uses multiple approaches to assess the health needs of the communities it serves. Health care needs of the community are assessed and updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to Mary Immaculate Hospital. National Research Corporation (NRC) is also utilized.
Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), as adjusted by the Medicare geographic wage index for each community served to reflect that community's relative cost of living ("Adjusted FPG"). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are also eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4: As of 2011, Hampton Roads is a very diverse community within an MSA of nearly 1.6 million people residing in 16 cities and counties, stretching from northeastern North Carolina to Williamsburg. The area is characterized by racial diversity, a significant military population and a growing elderly population. African Americans comprise 50% of the population in Hampton, 41% in Newport News, 1% in Poquoson, 14% in Williamsburg, 14% in York County and James City County. Seniors currently in the Mary Immaculate service area account for 17.5% of the population. The population served by Bon Secours Mary Immaculate Hospital (MIH), Newport News, VA is estimated to change from 463,658 to 503,313, resulting in a growth of 8.6%. Over the next five years, the population is projected to grow by 2.4%. Currently the largest populations are white (57%), Black or African American (34%), Hispanic or Latino (6%) and Asian (6%). The current year median age for this area is 35.0, while the average age is 36.2. Five years from now, the median age is projected to be 35.8.The most prevalent chronic conditions among adults include high blood pressure (29%), high cholesterol (36%), arthritis (24%), diabetes (10%), and asthma (7%). Morbidity rates per 10,000: heart disease (92.0), cerebrovascular disease (25.3), chronic obstructive pulmonary disease (10.1), diabetes (12.0) and asthma (10.0). Mortality rates (age-adjusted per 100,000) for this area are cancer (173.6), ischemic heart disease (164.5), cerebrovascular disease (43.9) and chronic obstructive pulmonary disease (33.3).
Part VI, Line 5: Mary Immaculate Hospital (MIH) has an open medical staff with privileges available to all qualified physicians. Emergency departments at the hospital provide service 24 hours/ day, 7days/week to ensure access for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located. MIH, through Bon Secours Hampton Roads Health System (BSHRHS), offers Care-A-Van (CAV) services to the community. The CAV, initiated on the peninsula in 2009 at two sites, has expanded in the past year to twelve sites, three in Norfolk, three in Portsmouth and three in Newport News. This is a mobile health unit that provides healthcare services to those most in need--the uninsured. Services provided include urgent and primary care (including examination, diagnosis, lab, pharmacy, and follow-up), immunizations for school, pregnancy tests, blood pressure measurement, health education, referrals for specialty care, opportunity to enroll eligible children in children's health insurance. The CAV also offers sports physicals, children's health insurance enrollment, and health education services. While the CAV primarily serves adults, some sites do provide care and referral services for children aged 12 and older. Community partners include free clinics, local health agencies, physicians, and numerous faith-based community organizations which collaborate with the Care-A-Van staff. The CAV has a staff of 10 FTEs and annual expenses of approximately $700,000.MIH, through BSHRHS, offers the Bon Secours Senior Health Program which offers a free membership program to over 54,000 individuals 65 years and older. A key component is the Successful Aging Forum, which brings national speakers to the community to discuss the latest health and wellness topics for senior citizens. The annual HealthFest provides a seniors-focused health festival with health screenings, health information and social interaction for seniors of all socio-economic backgrounds. Friday Night Dinners, held all three BSHR hospitals, serve seniors who need low cost meals and socialization. A transportation program offers transportation to medical appointments, without charge to those who are financially challenged. A quarterly publication, Good Health, provides information to 54,000 members in Hampton Roads. Seniors also play a vital role in BSHRHS advocacy efforts against reductions in Medicaid payments and to support continued funding for the State Children Health Insurance Program (SCHIP) through the Capital Hill Club. MIH supports and provides staffing for the BSHRHS Faith Community Health Ministry which builds on the skills of the registered nurse through additional, structured training in holistic (body, mind and spirit) health services; the faith community nurse partners with the congregational leadership to promote good health by serving as an educator, counselor, referral agent and advocate. Specialized training has also been developed to prepare non-licensed persons to serve in congregational health ministry. Additionally, the Influenza Vaccination Administration program provided 600 vaccines for select covenanted partners to host annual vaccine clinics. BSHRHS employs a sole Director to provide education, mentoring and support to more than 130 faith communities and 232 registered nurses and lay health promoters. MIH Family Focus is a child abuse prevention program of MIH, which targets at-risk families for child abuse and helps teach positive parenting skills. MIH employs the director for the program and provides operating funds for two locations. Family Focus, founded by BSHSI and the Bernardine Sisters of the Third Order of St. Francis, is a broad coalition of private and public organizations that provide a continuum of education, prevention and support programming for over 500 families to encourage healthy child development and nurturing environments in the home and community. In FY11 the program was expanded to include services for Spanish-speaking families.As part of the Virginia Framework for Building a Successful Regional Plan to End Homelessness, MIH is partnering with other organizations in Hampton Roads to build Hope City, a day shelter with shower and laundry facilities for the homeless. Another aspect of the plan is for a New Creation Farm where homeless and other disadvantaged individuals can get out of their current environment to work and be retooled to become independent and prosperous members of the community. MIH is currently establishing long-term relationship to move this project forward. BSHRHS' Community Sponsorship Committee reviews and financially sponsors community events that support our mission and values. Some of the contributions in FY13 that support the work of MIH in addressing unmet need include: - H.E.L.P. Free Dental Clinic to partially subsidize the cost of dental supplies to provide services to uninsured adults- American Heart Association heart healthy initiatives- American Cancer Society Relay for LifeMIH provides in-kind support to the community through its community garden. In 2013, The garden provided 453 pounds of fresh vegetables to Union Baptist Church, New Mount Zion Baptist Church, Natasha House, and Menchville House. MIH also works with other community organizations to address the homeless issue in Newport News.MIH is dedicated to promoting the health and the quality of life for the women of Hampton Roads the women health service lines. We provide community health education seminars in cardiac, orthopedics, weight loss, acupuncture, sports performance, oncology, and stroke through the Bon Secours for Women program.
Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to:- Improve Health Locally and Globally- Build Partnerships for Population HealthAs a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world."Please see Schedule R for listings of the related organizations.
VAReports Filed With StatesPart VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Makemie Woods CampBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 39AddressLine1
CityBarhamsvilleCity
StateVAState
ZIP Code23011ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient540636036EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant12913AmountOfCashGrant
Purpose Of GrantKidz N Grief Camp for ChildrenPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy J Davis
MI JT Board Member057634404190770126863011580001909501257179069776
Michael K Kerner
CEO-BSHR047571703369240124284010646702630301069695067422
Melinda Hancock
CFO-Bon Secours VA025190805336203867103924024044037190900
Patricia Robertson
CEO MIH & Extended Care02783910146397051034015000012272050309400
Jeffrey N Doucette
VP of Patient Care Services16911703379509110102780278530241954000
Devin T McKeever
COO Bon Secours Medical Group017244502598609190427707733021136000
James B Sherwood
Chief Admin Officer0201852044561038836011002027180032343100
Darlene Stephenson
VP Operations146454022613010530187970223980211315000
Thomas J Hoffmier MD
Physician2677250196118041980100000156140493655000
Nauman Naseer MD
Physician (Sep-June)43920900012010125000277730480683000
Allen B Nichols MD
Physician412418010313701139380176590250740672226000
Anthony D Terracina MD
Physician4863100425584015360137500258000952980000
Leslie A Webb MD
Physician17699002000001490913022100200262000
Joe Buchheit
Former CFO-BSHR021560605595505483908035016996035143109225
Ernie Padden
Former Int. CFO-BSHR020150000000312000020462000
James H Sammons
Former VP of Med. Affairs12743900097151079550101400242685000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationPart IIIPart I, Line 3: Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Supplemental InformationPart IIIPart I, Line 4a: Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: James H. Sammons, $73,440; Allen B. Nichols, M.D., $107,310.
Supplemental InformationPart IIIPart I, Line 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Timothy J. Davis, $101,207; Michael K. Kerner, $80,925; Joe Buchheit, $14,445.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 4The articles and bylaws were amended and restated in their entirety (effective November 13, 2012) to reflect current operational realities and governance best practices, and to reflect the transfer of canonical sponsorship of the Bon Secours Health System from the Sisters of Bon Secours to Bon Secours Ministries.
Form 990, Part VI, Section A, line 6The General Minister and General Council of the Bernardine Sisters of the Third order of St. Francis and Bon Secours Health System, Inc. are the members of Mary Immaculate Hospital.
Form 990, Part VI, Section A, line 7aThe governing body of Mary Immaculate Hospital is appointed by both members, with Bon Secours Health System, Inc. having the majority vote.
Form 990, Part VI, Section A, line 7bCertain authorities of Mary Immaculate Hospital are reserved to its members.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors' and compensation committee minutes. Form 990, Part VI, Section B, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization provides any documents open to public inspection upon request.
Form 990, Part VII:Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. The governing bodies of Mary Immaculate Hospital and Mary Immaculate Nursing Care Center are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer). These governing bodies are referred to as the Mary Immaculate Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for both entities). Sr. Patricia Heath does not receive payroll distributions as she has taken a vow of poverty.
Form 990, Part XI, line 9:BSHSI Principal debt & swaps 8,380,305. Add'l Minimum Pension Plan Liability 1,789,558. Other misc changes 4,623.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Mary Immaculate Hospital Auxiliary
2 Bernadine DriveNewport NewsVA23602546040266AuxiliaryVA501(c)(3)11c-FIN/A0
Mary Immaculate Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435311644734FundraisingVA501(c)(3)11c-FI1Mary Immaculate Hospital
Mary Immaculate Nursing Center
7007 Harbour View Blvd Suite 108SuffolkVA23435541516476Nursing Care CenterVA501(c)(3)91Mary Immaculate Hospital
Bon Secours Hampton Roads Health System Inc
7007 Harbour View Blvd Suite 108SuffolkVA23435521538513Local System Parent OrgVA501(c)(3)11b0Bon Secours Health System Inc
Bon Secours Maryview Nursing Care Center
7007 Harbour View Blvd Suite 108SuffolkVA23435521578169Nursing Care CenterVA501(c)(3)90Bon Secours Hampton Roads Health System
Bayley Properties
7007 Harbour View Blvd Suite 108SuffolkVA23435541424748RentalVA501(c)(2)N/A0Bon Secours DePaul Medical Center
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)11b0Bon Secours Inc
Bon Secours DePaul Health Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435541843876FundraisingVA501(c)(3)70Bon Secours Hampton Roads Health System
Bon Secours Maryview Foundation
7007 Harbour View Blvd Suite 108SuffolkVA23435521694731FundraisingVA501(c)(3)70Bon Secours Hampton Roads Health System
Bon Secours DePaul Medical Center Inc
7007 Harbour View Blvd Suite 108SuffolkVA23435541820093HealthcareVA501(c)(3)30Bon Secours Hampton Roads Health System
Maryview Hospital
7007 Harbour View Blvd Suite 108SuffolkVA23707540506463HealthcareVA501(c)(3)30Bon Secours Hampton Roads Health System

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

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

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Professional Health Care Mgmt Inc
150 Kingsley LaneNorfolkVA23505541241031AdministrativeVAN/AC0
Tidewater Diversified Inc
160 Kingsley LaneNorfolkVA23505541431826PharmacyVAN/AC0
OSF Inc
2 Bernadine DriveNewport NewsVA23602541369919RentalVAC1Mary Immaculate Hospital Inc8631612572171.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg