ST MARYS HEALTHCARE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HEALTHCARE (EIN 14-1347719)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201423189349302912
- Schema version
- 2013v3.0
- 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 H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T10:20:21-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141347719 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 5188421900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Joan Ehlinger | PersonNm |
| Person Title | VP of Finance & CFO | PersonTitleTxt |
| Phone | 5188421900 | PhoneNum |
| Signature | 2014-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Cody Cain | PreparerPersonNm |
| PTIN | P00902498 | PTIN |
| Phone | 5137847100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Victor Giulianelli | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $143,613,912 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.smha.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1903 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | To serve all persons with compassion and excellence, especially those who are vulnerable. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1843 | TotalEmployeeCnt |
| Total Volunteers | 157 | TotalVolunteersCnt |
| Total Gross UBI | $1,180,408 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$30,032 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,422,689 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,528,358 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $137,514,057 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $134,695,005 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,865,687 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,129,512 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,248,874 | PYOtherRevenueAmt |
| CY Other Revenue | $1,084,208 | CYOtherRevenueAmt |
| PY Total Revenue | $149,051,307 | PYTotalRevenueAmt |
| CY Total Revenue | $143,437,083 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50,325 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $68,746 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $89,256,871 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $90,568,717 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,185,270 | PYOtherExpensesAmt |
| CY Other Expenses | $49,554,882 | CYOtherExpensesAmt |
| PY Total Expenses | $137,492,466 | PYTotalExpensesAmt |
| CY Total Expenses | $140,192,345 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,558,841 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,244,738 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $158,992,703 | TotalAssetsBOYAmt |
| Total Assets EOY | $166,173,174 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $40,866,069 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $39,951,271 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $118,126,634 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $126,221,903 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Rooted in the healing ministry of Jesus, we dedicate ourselves to serve all persons with compassion and excellence, especially those who are vulnerable. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $118,423,170 | ExpenseAmt |
| Grant | $68,746 | GrantAmt |
| Revenue | $133,443,677 | RevenueAmt |
| Desc | St. Mary's Healthcare provides a substantial portion of its services to the elderly and poor. During the fiscal year ending December 31, 2013, approximately 34% of the values of services rendered were to elderly patients under the Medicare program and approximately 22% of the services were provided to patients who were deemed indigent under state, county or hospital guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's has taken proactive steps to address those issues that will affect the accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and underserved. During the fiscal year ending December 31, 2013, the estimated cost of providing care of persons living in poverty totaled $13.1 million, including $825 thousand of charity care, $4.5 million in programs for persons living in poverty, and $6.3 million in the unpaid cost of public programs. These amounts vary from Schedule H due to different methods of calculation. In 2013, St. Mary's Healthcare provided health care services to 6,321 inpatients and 404,824 outpatients, and 56,815 days of care to residents of the skilled nursing facility. The inpatient care covered medical/surgical, psychiatric, alcohol rehabilitation, physical rehabilitation, maternity and newborn patients. The outpatient visits included 28,208 emergency visits; 8,531 outpatient surgeries; 159,629 referred visits (including imaging, laboratory, therapies, and cardiac rehab); total other outpatient visits of 23,576 including 1,201 visits to nursing home patients, 8,079 adult day care visits, 9,721 urgent care visits, 3,811 occupational medicine visits and 764 visits to the diabetes center; 55,234 family health center visits; total specialty visits of 27,868 including 6,514 urology health center visits, 3,207 cancer treatment center visits and 684 specialty surgical visits, 1,707 Johnstown prenatal visits, 7,359 Amsterdam OB/GYN Center visits, 1,054 Cancer Center Chemotherapy visits, 3,895 Gastroenterology center visits, 353 Ophthalmology center visits, and 3,095 Pain Management center visits; and total mental health and alcohol visits of 102,437 including, 12,347 alcohol clinic visits, and 90,090 mental health clinic visits. St. Mary's Healthcare administers one of the most comprehensive mental health outpatient programs in New York State. In 2013, the Hospital provided a variety of services through various grant-funded programs including psych-social clubs, prevocational/employment assistance programs, mobile geriatric/senior citizen programs, and alcohol intervention service programs. In addition, caring families provided family care services and hospital personnel provided case management counseling under various grant-funded programs. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,500,000 | ExpenseAmt |
| Desc | Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, St. Mary's Healthcare has made available the following programs to the community: reduced cost programs providing senior citizens with Lifeline equipment enabling them to solicit help should the need arise; community continuing education programs providing information on a variety of subjects including child abuse, day-to-day parenting, seat belt use and safety, smoking cessation, weight loss, and other wellness programs; help and support groups for victims and their family members; and providing meeting facilities for victims of alcohol abuse. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $955,025 | ExpenseAmt |
| Revenue | $1,251,328 | RevenueAmt |
| Desc | St. Mary's Healthcare's other program service revenue includes continuing education programs, psychological services provided to Montgomery county, medical director services, cafeteria sales to visitors and employees, and rebates/refunds of expenses. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $122,878,195 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 95 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1843 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joan Ehlinger | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5188417434 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 12010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Ronald Marsh MD | |||||||||
| Chairperson (Sch O) | 2.00 | 1.00 | Yes (X) | $120,987 | $0 | $0 | |||
| Michael J Pepe End 613 | |||||||||
| Treasurer/Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Thomas F Cichy Start 713 | |||||||||
| Treasurer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sister Lauren Vandermark | |||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Gregory Abbattisti Start 713 | |||||||||
| Director | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Sister Charla Commins CSJ | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| John Daly | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Emily T Etzkorn MD | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Mohammad R Ghazi-Moghadam MD | |||||||||
| Director (Sch O) | 40.00 | 0.00 | Yes (X) | $469,999 | $0 | $19,651 | |||
| Vito L Greco | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sister Nancy Gregg | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sister Joan Mary Hartigan | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Andrew Heck | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronald Limoncelli | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert Quick Start 713 | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Brent E Phetteplace | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Joan R Pipito End 313 | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael M Sheridan DO | |||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Victor Giulianelli | |||||||||
| President & CEO | 40.00 | 2.00 | Yes (X) | $488,640 | $0 | $24,385 | Yes (X) | ||
| Joan Ehlinger | |||||||||
| VP of Finance & CFO | 40.00 | 1.00 | $209,601 | $0 | $14,320 | Yes (X) | |||
| Scott Bruce | |||||||||
| VP of Operations | 40.00 | 1.00 | $284,067 | $0 | $25,259 | Yes (X) | |||
| John Kelley | |||||||||
| VP of Mental Health | 40.00 | 0.00 | $213,659 | $0 | $23,675 | Yes (X) | |||
| Timothy Shoen | |||||||||
| VP of Medical Affairs | 40.00 | 0.00 | $349,663 | $0 | $20,973 | Yes (X) | |||
| Michele Walsh | |||||||||
| VP Of Nursing | 40.00 | 0.00 | $201,080 | $0 | $13,013 | Yes (X) | |||
| Donald Massey | |||||||||
| VP of Continuum Care | 40.00 | 0.00 | $177,395 | $0 | $22,753 | Yes (X) | |||
| James Charland MD | |||||||||
| Physician | 40.00 | 0.00 | $602,502 | $0 | $21,049 | Yes (X) | |||
| Hamid Aziz Rehman MD | |||||||||
| Physician | 40.00 | 0.00 | $542,671 | $0 | $0 | Yes (X) | |||
| Michael Finnegan MD | |||||||||
| Physician | 40.00 | 0.00 | $516,012 | $0 | $25,013 | Yes (X) | |||
| David Lehr MD | |||||||||
| Physician | 40.00 | 0.00 | $454,862 | $0 | $26,851 | Yes (X) | |||
| Jason Steindler MD | |||||||||
| Physician | 40.00 | 0.00 | $401,028 | $0 | $24,709 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,032,166 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $261,651 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 74 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| McKesson | |||||
| PO Box 848442 | Dallas | TX | 752848442 | Purchase Pharmaceutical Drugs | $3,389,910 |
| TouchPoint | |||||
| 4721 Morrision Drive Suite 300 | Mobile | AL | 36609 | Housekeeping/Dietary Services | $2,975,921 |
| Owens & Minor | |||||
| 135 Constitution Boulevard | Franklin | MA | 02038 | Supplies | $2,353,393 |
| Trimedx | |||||
| 6325 Digital Way Suite 400 | Indianapolis | IN | 46278 | Biomed Services | $1,636,667 |
| TeamHealth East | |||||
| PO Box 634850 | Cincinnati | OH | 452634850 | Medical/Physician Services | $1,123,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $130,133 | RelatedOrganizationsAmt |
| Government Grants | $4,120,977 | GovernmentGrantsAmt |
| All Other Contributions | $277,248 | AllOtherContributionsAmt |
| Total Contributions | $4,528,358 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Revenue | 621990 | $133,443,677 | $133,443,677 |
| Other Program Service | 621990 | $1,251,328 | $1,251,328 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $134,695,005 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,125,840 | TotalRevenueColumnAmt |
| Exclusion | $3,125,840 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $79,301 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $175,501 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$96,200 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$96,200 | TotalRevenueColumnAmt |
| Exclusion | -$96,200 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,328 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,672 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,672 | TotalRevenueColumnAmt |
| Exclusion | $3,672 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|
| Laboratory Services | 621500 | $855,902 | $855,902 |
| Occupational Medicine | 621400 | $256,387 | $256,387 |
| Medical Director Svcs | 623990 | $21,782 | $21,782 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,337 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $46,337 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,180,408 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $143,437,083 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $134,695,005 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,180,408 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,033,312 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,746 | TotalAmt |
| Program Services | $68,746 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,679,120 | TotalAmt |
| Program Services | $847,971 | ProgramServicesAmt |
| Management And General | $1,831,149 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,912,872 | TotalAmt |
| Program Services | $68,822,100 | ProgramServicesAmt |
| Management And General | $5,090,772 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,023,185 | TotalAmt |
| Program Services | $1,860,723 | ProgramServicesAmt |
| Management And General | $162,462 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,857,879 | TotalAmt |
| Program Services | $6,307,191 | ProgramServicesAmt |
| Management And General | $550,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,095,661 | TotalAmt |
| Program Services | $4,686,479 | ProgramServicesAmt |
| Management And General | $409,182 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,049 | TotalAmt |
| Program Services | $26,786 | ProgramServicesAmt |
| Management And General | $187,263 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,041 | TotalAmt |
| Management And General | $43,041 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,527 | TotalAmt |
| Management And General | $46,527 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,604,752 | TotalAmt |
| Program Services | $6,892,876 | ProgramServicesAmt |
| Management And General | $711,876 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $948,964 | TotalAmt |
| Program Services | $50,467 | ProgramServicesAmt |
| Management And General | $898,497 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,453,895 | TotalAmt |
| Program Services | $18,111,306 | ProgramServicesAmt |
| Management And General | $342,589 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,667,772 | TotalAmt |
| Program Services | $3,123,103 | ProgramServicesAmt |
| Management And General | $1,544,669 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,605,677 | TotalAmt |
| Program Services | $2,185,415 | ProgramServicesAmt |
| Management And General | $420,262 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,713 | TotalAmt |
| Program Services | $155,066 | ProgramServicesAmt |
| Management And General | $5,647 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,045 | TotalAmt |
| Program Services | $185,290 | ProgramServicesAmt |
| Management And General | $53,755 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,749 | TotalAmt |
| Management And General | $168,749 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,509,313 | TotalAmt |
| Management And General | $3,509,313 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,678,534 | TotalAmt |
| Program Services | $3,589,513 | ProgramServicesAmt |
| Management And General | $89,021 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473,177 | TotalAmt |
| Management And General | $473,177 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Repairs & Maintenance | $2,308,817 | $2,053,354 | $255,463 | $0 |
| Provider Tax | $1,203,441 | $1,203,441 | $0 | $0 |
| Dues & Subscriptions | $291,942 | $133,668 | $158,274 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,936,474 | TotalAmt |
| Program Services | $2,574,700 | ProgramServicesAmt |
| Management And General | $361,774 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,192,345 | TotalAmt |
| Program Services | $122,878,195 | ProgramServicesAmt |
| Management And General | $17,314,150 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,491,836 | BOYAmt |
| EOY | $860,817 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,222,063 | BOYAmt |
| EOY | $18,670,934 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,419,014 | BOYAmt |
| EOY | $1,445,374 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,561,718 | BOYAmt |
| EOY | $1,553,683 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $89,286,423 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,747,564 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,317,234 | BOYAmt |
| EOY | $45,538,859 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,407,833 | BOYAmt |
| EOY | $1,613,442 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,573,005 | BOYAmt |
| EOY | $96,490,065 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,992,703 | BOYAmt |
| EOY | $166,173,174 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,107,454 | BOYAmt |
| EOY | $14,441,338 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,539 | BOYAmt |
| EOY | $361,450 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,221 | BOYAmt |
| EOY | $95,345 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,182,855 | BOYAmt |
| EOY | $25,053,138 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,866,069 | BOYAmt |
| EOY | $39,951,271 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,075,551 | BOYAmt |
| EOY | $114,181,884 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,570,648 | BOYAmt |
| EOY | $5,551,575 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,480,435 | BOYAmt |
| EOY | $6,488,444 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,126,634 | BOYAmt |
| EOY | $126,221,903 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,992,703 | BOYAmt |
| EOY | $166,173,174 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,244,738 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,643,709 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,206,822 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $46,527 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $46,527 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Lobbying expenses include the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. St. Mary's Healthcare does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Beginning Balance | $82,221 | BeginningBalanceAmt |
| Additions During Year | $13,124 | AdditionsDuringYearAmt |
| Ending Balance | $95,345 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,241,842 | BeginningYearBalanceAmt |
| Contributions | $8,009 | ContributionsAmt |
| Investment Earnings Or Losses | $1,317,915 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,871 | OtherExpendituresAmt |
| End Year Balance | $9,561,895 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,558,720 | BeginningYearBalanceAmt |
| Contributions | $6,383 | ContributionsAmt |
| Investment Earnings Or Losses | $678,839 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,100 | OtherExpendituresAmt |
| End Year Balance | $8,241,842 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,691,978 | BeginningYearBalanceAmt |
| Contributions | $6,639 | ContributionsAmt |
| Investment Earnings Or Losses | -$117,307 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $22,590 | OtherExpendituresAmt |
| End Year Balance | $7,558,720 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $844,071 | BeginningYearBalanceAmt |
| Contributions | $5,816,684 | ContributionsAmt |
| Investment Earnings Or Losses | $1,051,298 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $20,075 | OtherExpendituresAmt |
| End Year Balance | $7,691,978 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $826,019 | BeginningYearBalanceAmt |
| Contributions | $18,052 | ContributionsAmt |
| End Year Balance | $844,071 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,591,798 | OtherCostOrOtherBasisAmt |
| Book Value | $7,591,798 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,752,125 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,493,209 | DepreciationAmt |
| Book Value | $30,258,916 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,156 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,799 | DepreciationAmt |
| Book Value | $17,357 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,691,109 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,244,296 | DepreciationAmt |
| Book Value | $7,446,813 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,215,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $991,260 | DepreciationAmt |
| Book Value | $223,975 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $45,538,859 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Interest in Investment held by Ascension Health Alliance | $82,314,558 |
| Interest in Net Assets of Foundation | $12,040,020 |
| Intangible Pension Asset | $1,302,955 |
| Other Receivables | $474,693 |
| Third Party Receivables | $298,673 |
| Physician Receivable | $59,166 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $96,490,065 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Pension Costs | $9,533,546 |
| Intercompany Debt to Ascension Health Alliance | $8,676,013 |
| Third Party Liability | $3,094,469 |
| Asset Retirement Obligation | $1,500,000 |
| Patient Credit Liabilities | $1,065,287 |
| IBNR Liability | $500,553 |
| Third Party Advance | $305,000 |
| Other Advances | $108,899 |
| Income guarantee | $73,213 |
| Other | $196,158 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $25,053,138 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Line 2b: | FormAndLineReferenceDesc |
| Explanation | The Hospital maintains custodial accounts for residents of the skilled nursing facility which totaled $95,345 at 12/31/2013. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,130,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $161,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $968,865 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $39,980,698 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,238,700 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,741,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05520 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $41,111,182 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,400,319 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,710,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06210 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,576,949 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $133,370 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,443,579 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $861,695 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $861,695 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00610 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,399,515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,979,295 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,420,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $331,821 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $331,821 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,169,980 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,112,665 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,057,315 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05740 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,281,162 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,512,984 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,768,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11950 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,274 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,274 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,274 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,274 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,790,531 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,754,206 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $46,549,045 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $49,339,716 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,790,671 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.smha.org | WebsiteAddressTxt |
| State License | 2801001H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Mary's Healthcare | Part V, Section B, Line 3: Key Informant Focus GroupsAs part of the community health assessment, three focus groups were held in Amsterdam on November 8, 2012. The focus group participants included 38 key informants, including: representatives from public health; physicians; other health professionals; social service providers; and other community leaders. A list of recommended participants for the focus groups was provided by St. Mary's Healthcare. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically-underserved populations, and those who work with persons with chronic disease conditions.Focus group candidates were first contacted by letter to request their participation. Follow-up phone calls were then made to ascertain whether or not they would be able to attend. Confirmation calls were placed the day before the groups were scheduled to insure a reasonable turnout. |
| St. Mary's Healthcare | Part V, Section B, Line 7: Community Health Priority Needs Not Addressed in the Implementation Plan:Oral Health is not addressed by SMHA in this plan because this is addressed by a partner agency New Dimensions in Healthcare which-provides dental care to low-income and individuals. Heart Disease & Stroke is not addressed specifically in this plan but is addressed by medical providers both in and out of the St. Mary's network, at health fairs and educational programs and by many community partners including community based agencies and health care coalitions. |
| St. Mary's Healthcare | Part V, Section B, Line 14g: Individual letters are mailed to all uninsured patients informing them of the financial assistance programs available. |
| St. Mary's Healthcare | Part V, Section B, Line 18e: Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of St. Mary's Healthcare 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 on billing statements throughout the billing cycle |
| St. Mary's Healthcare | Part V, Section B, Line 20d: The maximum amount charged to FAP-eligible individuals is based on the uninsured discount, which is reviewed and updated annually, as applicable. Uninsured patients with the ability to pay will be provided a discount based on the discount provided to the highest-paying payer that accounts for at least three percent of the Hospital's volume or gross patient revenues. In 2013, the Hospital provided discounts to the uninsured equal to 28% of charges for inpatients and 38% of charges for outpatients. |
| Part V, Section B, Line 5a: | http://www.smha.org/st-marys/community-health-needs-assessment1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 17 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (17 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| St Mary's Healthcare | ||||
| 4988 State Highway 30 | Amsterdam | NY | 12010 | Diagnostic Care, Primary Care, Cancer Medicine, and Inpatient Physical Rehab |
| Wilkinson Residential Health Care Facili | ||||
| 4988 State Highway 30 | Amsterdam | NY | 12010 | Residential Health Care Facility |
| Johnstown Family Health Center | ||||
| 700 S Perry Street | Johnstown | NY | 12095 | Family Health Center |
| Canajoharie Family Health Center | ||||
| 48 Erie Boulevard | Canajoharie | NY | 13317 | Family Health Center |
| Carondelet Family Health Center | ||||
| 380 Guy Park Ave | Amsterdam | NY | 12010 | Family Health Center |
| Gloversville Family Health Center | ||||
| 84 E State Street | Gloversville | NY | 12078 | Family Health Center |
| St Johnsville Family Health Center | ||||
| 7 Timmerman Ave | St Johnsville | NY | 13452 | Family Health Center |
| Northville Family Health Center | ||||
| 331 Bridge Street | Northville | NY | 12134 | Family Health Center |
| Amsterdam OBGYN Center | ||||
| 446A Guy Park Ave | Amsterdam | NY | 12010 | OB/GYN Center |
| Montgomery County Addiction Services | ||||
| 76 Guy Park Ave | Amsterdam | NY | 12010 | Addiction Services |
| Fulton County Day Rehab Addiction Svc | ||||
| 57 E Fulton Street | Gloversville | NY | 12078 | Addiction Rehabilitation Center |
| Children's Mental Health Clinic | ||||
| 8 Northhampton Road | Amsterdam | NY | 12010 | Children's Mental Health Center |
| Diagnostic Service Center | ||||
| 110 Holland Circle Drive | Amsterdam | NY | 12010 | Diagnostic Care Center |
| Riverfront Diagnostic Service Center | ||||
| 1340 Riverfront Center | Amsterdam | NY | 12010 | Diagnostic Care Center |
| Children's Day Treatment Program | ||||
| 234 Lincoln Street | Gloversville | NY | 12078 | Children's Treatment Center |
| Social Club North | ||||
| 73 North Main Street | Gloversville | NY | 12078 | Human Services |
| Social Club West | ||||
| 17 River Street | Nelliston | NY | 13410 | Human Services |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 charity care, a specific cost-to-charge ratio was applied; for other categories in the table, a cost accounting system was used. |
| Part I, Line 7g: | The organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I. |
| Part II, Community Building Activities: | St. Mary's Healthcare provided the following community building activities in 2013:- Donated the use of a "safe house" for victims of domestic violence, and provided maintenance and upkeep of the property.- Eight community organizations received much-needed Carondelet Community Fund Grants in 2013. The grants, totaling $10,800 were used to purchase hygiene items for those in need, provide meals to home-bound elderly, Habitat for Humanity Fulton County home building projects, repairs on the homeless shelter house and family expenses for the poor and vulnerable. - In September and March 2013, hosted the Victim Impact Panel in partnership with the Montgomery County District Attorney's office and the Hamilton-Fulton-Montgomery Prevention Council. This is an awareness program for offenders convicted of misdemeanor driving under the influence of alcohol or other drugs. The goal is to help offenders become more aware of the possible consequences of driving while impaired so they may think to make different choices in the future.- In 2013 St. Mary's Healthcare, together with leaders of local community agencies and the Department of Social Services continued to address the homeless issues in Amsterdam. Through their continued collaboration, the homeless shelter, named Danielle's House, continues to operate and provide critical housing services for those in emergent need. Danielle's house also offers intensive case management services, job assistance and low-income apartment rentals for those who need a more permanent place to stay and the support of a case manager. - St. Mary's donated both funding and staff time to the local Habitat for Humanity Chapter. The first house built by this chapter is currently under construction as a result of these efforts. |
| Part III, Line 4: | The provision for doubtful accounts is based upon management's assessment of historical and expected net collections considering economic conditions, 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. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Hospital may place past due patient balances with 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 Hospital's policies.The organization's share of bad debt expense in 2013 was $6,790,531 ofcharges ($1,754,206 at cost). |
| Part III, Line 8: | 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 9b: | The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance, certain collection practices do not apply. |
| Part VI, Line 2: | In 2012, the Hospital contracted with Professional Research Consultants, Inc. (PRC) to conduct St. Mary's Healthcare's Community Health Needs Assessment (CHNA). The assessment, made available to the public in March 2013, incorporated data from both quantitative and qualitative sources including random sampling of community members, key informant focus groups and secondary data sources. The focus groups consisted of input from persons who represent the community we serve, including business leaders, community-based and social service agencies, school districts and those with a special knowledge or expertise in public health. The data from this assessment was made available to the public via the hospital's website, http://smha.healthforecast.net and upon request. The hospital also used data from our county health departments' community needs surveys.Additionally, the Hospital sought input from its Board of Trustees, Medical Executive Committee, leadership staff and community partners when completing its annual Integrated Strategic, Operational, and Financial Plan (ISOFP). The ISOFP uses pertinent data and comprehensive feedback to outline current and future critical healthcare needs for the Hospital's service area, as well as the resources needed to address the identified issues. |
| Part VI, Line 3: | St. Mary's Healthcare, in keeping with the mission and policies of Ascension Health, strives to maintain a balance between providing care of the poor with the ability of the Hospital to maintain quality health care for the community it serves. As part of its financial assistance policies, the Hospital offers a self pay discount to all uninsured patients as a percentage off the standard charge; the discounts were set at 28% for inpatient services and 38% for outpatient services. In 2013, the discounts provided to the uninsured were approximately $2.6 million. The Carondelet Care assistance program is the next level of financial assistance available to the Hospital's patients. This program is available to all patients who can demonstrate a financial burden associated with their patient responsibility. Financial assistance is provided through collaboration between the health insurance enrollment and financial assistance staff. Although the two departments offer different financial assistance services, the enrollment staff is trained to help those individuals who do not qualify for any government sponsored programs to access the Carondelet Care assistance program. Similarly, the Financial Counselors often refer patients in need of insurance to our Enrollment Specialist. The enrollment staff is available to meet with community members at the main hospital, at our Memorial campus and at all six of our off-site family health centers. The staff is also trained to refer individuals to free or low cost health care programs within the community if no other options are immediately available. In 2013, 600 individuals were enrolled in health insurance programs as a direct result of these efforts. The Hospital Enrollment Specialist works collaboratively with Fidelis Care, the Cancer Services Program and community agencies to further expand their outreach. Large posters describing the Hospital's willingness to help patients with financial assistance are displayed in all main entrances to the Hospital and the off-site locations, as well as, in our multiple registration sites and waiting rooms. The informational posters are in English and Spanish and urge patients to call if they are concerned about their medical bill payment. Translation services are also available as needed via language line telephones and iPad video application.Brochures in English and Spanish are available at all service sites and offer detailed information about the various levels of assistance. In addition to offering discounts, St. Mary's offers options for payment plans and payment schedules. The English and Spanish brochures are also available on the Hospital web site. Information on financial assistance is also contained in the Patient Information Guide given to all inpatients at St. Mary's Healthcare. |
| Part VI, Line 4: | St. Mary's Healthcare serves a rural community consisting of Montgomery and Fulton counties in New York State as its primary service area (PSA). St. Mary's Healthcare is the only acute care hospital in Montgomery County. On average, 65% of hospital admissions come from Montgomery County, and 26% come from Fulton County. The main hospital campus is located in the city of Amsterdam, though a number of vital services are available on the Memorial campus in the town of Amsterdam. The Hospital operates six primary care centers: three sites in Montgomery County (two located in Amsterdam, one in Canajoharie) and three sites in Fulton County (Johnstown, Gloversville and Northville). In addition, the Hospital operates a cancer medicine center and operates specialty practices in: urology, gastroenterology, obstetrics/gynecology, ophthalmology and pain management. The Hospital's comprehensive behavioral health programs provide extensive mental health and addiction services including inpatient and outpatient treatment in Montgomery and Fulton Counties. The PSA represents one of the oldest regions in NYS. Estimates indicate that the 65 and older population will continue to increase. According to Thomson Reuters, the only segment of our population showing growth is the 65+, with a growth rate of 9.8%. In fact, within this segment, 85+ shows a 6.7% increase. The unemployment rate in Fulton and Montgomery Counties continues to be among the highest in NYS, exceeding the State average by 1.0%. There are many factors that contribute to the community's poverty levels, including the high school dropout rate in both counties. Reports indicate that 30% of ninth graders entering school will not complete high school in four years in our PSA. The lack of education affects the workforce, contributes to higher unemployment and greater risk of working without health insurance. Forty-five percent of all families in poverty are headed by a single parent with children.Research indicates a decline in the Caucasian population, which is a consistent trend over several years. The Hispanic community is our largest minority community, with the largest concentration within the city of Amsterdam. The 2010 Census indicates that 26.2% of the residents of Amsterdam are identified as Hispanic and according to the estimates this segment of our population will grow by 12.7% in the next five years. The Hospital employs bilingual and bicultural healthcare professionals to meet the needs of the Hispanic community.Health statistics relevant to the community's health status are that over 70% of the St. Mary's Healthcare Service Area is overweight. Especially alarming is that 38% of St. Mary's Healthcare Service Area children are overweight. The relationship of being overweight with other health issues such as high blood pressure, chronic depression, arthritis and diabetes are significant. Poor nutritional habits and lack of physical activity are two factors that significantly contribute to the overweight status of individuals in our community.Access to quality health care services is important for increasing the quality of life for everyone. It impacts: overall physical, social and mental health status; the prevention of disease and disability; quality of life; reduceing preventable death and increases life expectancy. Uninsured individuals comprise 13% of the population in Fulton and Montgomery Counties. Nearly 8% of the population in St. Mary's Healthcare's service area went without any type of healthcare insurance coverage at some point in the past year. Disproportionately, over 16% of those with low-income went without some type of coverage in the past year. These numbers are significantly less favorable than the US average of 4.8%. Additionally, nearly 40% of respondents reported some type of difficulty or delays in receiving needed health care in the past year. Those in the polulation who are uninsured are much more likely to report barriers when compared to the insured population. The Hospital serves a disproportionate share of the Medicaid population, and approximately 23% of the total inpatient discharges are under Medicaid. |
| Part VI, Line 5: | St. Mary's Healthcare promotes the health of its community through various activities, including the following:- In 2013, Approximately 1,750 people were provided community education on topics such as: Alzheimer's disease; Arthritis; Breast cancer; Cervical cancer and Colorectal Cancer Screenings; Health Insurance; Childbirth Education; Bone and Joint Health; Women's Safety; Brain Injury Awareness; Heart Health; Infant CPR; Lactation Support; Physical Activity and Nutrition; Suicide Prevention; Health Care Proxys and other wellness topics. St. Mary's associates gave 2,881 hours of their time engaging in these community benefit activities.- St. Mary's partnered with our local school districts hosting four school tours in 2013, providing children first-hand knowledge and experience of the operations of a hospital. Our Registered Dieticians participated in school wellness days to teach children about the importance of healthy eating and physical activity. - In 2013, St. Mary's associates gave 1,007 hours back to their community serving on various boards including The Amsterdam Homeless Coalition, Montgomery County United Way, Community Hospice, Catholic Charities of Fulton and Montgomery Counties, Community Health Center (CHC), Greater Amsterdam Volunteer Ambulance Corp (GAVAC), Regional Perinatal Outreach Advisory, Montgomery County Public Health Quality Assurance Committee, Minority Health Task Force, Sexual Assault Task Force, Fulton-Montgomery Community College, Fulmont Community Action, Liberty ARC Board, Montgomery County Office for the Aging, The Sanford Home, Montgomery County Habitat for Humanity, the Minority Health Task Force, the Suicide Prevention Task Force, Fulton-Montgomery Regional Chamber of Commerce, Glove City and Amsterdam Rotary, Children's Aid Society, New Dimensions in Healthcare and Fulton County Long-term Care Council. - In 2013, St. Mary's associates gave their time to better the community by participating in walks for the Walk Out of Darkness Suicide Prevention, Teal Ribbon for Ovarian Cancer, Rally in the Valley for Habitat for Humanity, Alzheimer's Disease, American Cancer Society's Relay for Life and other awareness walks as well as taking part in clean-up projects in both Fulton and Montgomery Counties.- Continued to be a leader and collaborator with a group of partners from local health care entities and community agencies whose mission is to improve the health status for all we serve. During 2013, we committed to carrying out this work through the development of our Implementation Strategy and Community Service Plan.- St. Mary's providers are able to refer uninsured or underinsured patients with medication needs to the Dispensary of Hope program at the Hospital. This program provides free prescription medications to those who lack prescription drug coverage.- In 2013, we continued our tenth year of distributing educational information on insurance eligibility for children through the school system, public service announcements, advertising and appearances at "back to school" events such as PTA meetings and open houses. - Enrolled 600 persons in State-sponsored insurance programs and programs through the newly created Health Insurance Marketplace. - Provided 2,215 life-saving cancer screenings to 635 uninsured individuals through the Cancer Services Program. - Supported a Promotora who provided outreach education, referral, follow-up, case management and advocacy services to our Latino and migrant community. The goal of the program is to promote needed primary health services and prevention efforts in a culturally appropriate manner. In 2013, 125 migrant clients were provided health care services through this program, most of whom had never seen a healthcare provider before. The Promotora has an average of 200 client contacts/communications per month. Additionally, there are countless other communications, educational trainings, community events, individual and family visits, and service navigation that was made available by the program. - Maintained the importance of culturally sensitive and accurate communication with Latino patients and patients with limited English proficiency through the use of translation services which include professional phone and video translation services and the translation of key documents. English and Spanish are the most prominent languages spoken in the community, so all signage is posted in both English and Spanish throughout the organization. The iPad video services also serve those who are in need of sign language services. - Developed and distributed 30,000 free copies of a Breast Cancer Awareness/Health Facts Book to the community via newspaper and outreach events. - Provided free glucose, cholesterol, and blood pressure screenings at various health fairs and community events throughout the year. - Participated in the Fulton and Montgomery County Office for Aging picnics to educate seniors on a variety of wellness topics.- Hosted eight different support groups including the Women's Cancer, Brain Injury, Behavioral/Mental Health, Ostomy, Diabetes, Survivors of a Loved One's Suicide (SOLOS) and Alzheimer's Caregiver Support and Community Hospice Groups supporting nearly 325 community members who receive peer support and educational opportunities to manage their concerns. - The Medical Explorers, a group for young adults, meets monthly for education and socialization with the goal of assisting youth to explore the various options in healthcare careers. - Club 60, an educational and social group for seniors aged 60 and above, meets monthly for updates on health-related issues such as the flu vaccine and specialized primary care services. Each event includes the opportunity to ask questions and spend time with the President/CEO or other members of the senior management team.- A majority of the Hospital's Board of Trustees is comprised of persons who reside in the organization's primary service area and are neither employees nor independent contractors of the Hospital, nor family members thereof.- The Hospital established the Carondelet Community Fund, which provides modest assistance to local programs and agencies whose values and mission align with the values of St. Mary's Healthcare. Grants from the fund are made to eligible non-profit community agencies which are located within the service area of St. Mary's Healthcare and which share the values of St. Mary's with an emphasis on service to the poor and vulnerable, and holistic care. The total amount awarded from this fund in 2013 was $10,800. |
| Part VI, Line 6: | St. Mary's Healthcare (the Hospital) is a member of Ascension Health. Ascension Health Alliance, doing business as Ascension, is the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province American Province and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province.The Hospital, located in Amsterdam, New York, is a nonprofit acute care hospital. The consolidated financial statements include the Hospital, Medical Services Enhancement, Inc. (MSE), and The Foundation of St. Mary's Hospital at Amsterdam, Inc. (Foundation). MSE operates a medical office building to retain and attract physician specialists to better serve the healthcare needs of the community. The Foundation's primary purpose is to assist the Hospital to develop and expand its services to the community by providing a focal point as the recipient for philanthropic support and by transferring funds to the Hospital.The Hospital provides acute inpatient, inpatient physical rehabilitation, outpatient, and emergency care services for the residents of Montgomery, Fulton, and Hamilton counties. The Hospital also provides an array of Behavioral Health services including inpatient mental health and alcohol rehabilitation plus outpatient mental health and alcohol related services. Admitting physicians are primarily practitioners in the local area. Additionally, the Hospital operates a 160 bed skilled nursing facility which provides housing, healthcare and other related services to residents who are severely limited in their ability to care for themselves due to illness and/or disability, and a medical adult day care program. The Hospital is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.MissionThe System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources used for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed cost of programs intentionally designed to serve persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings.Discounts are provided to all uninsured patients in the acute care facility, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS).The amount of traditional charity care provided, determined on the basis of cost, was approximately $825 and $572 Thousand for the years ended December 31, 2013 and 2012, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying supplementary information. |
| Part VI, Line 7, Reports Filed With States | NY |
| Schedule H, Part V: | St. Mary's Healthcare consists of two licensed facilities, namely, the Hospital and the Wilkinson Residential Health Care Facility, which is a skilled nursing facility. The Hospital has several locations, including two outpatient alcohol rehabilitation clinics, one diagnostic service center, and six primary care centers. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt |
|---|---|---|---|
| Family Care - Entitlement Provider | 4 | $22,889 | $0 |
| Family Care - Entitlement Provider | 11 | $6,493 | $0 |
| Intensive Care Mgmt. - Patient Service Dollars | 73 | $26,936 | $0 |
| Supportive Care Mgmt. - Patient Service Dollars | 30 | $1,476 | $0 |
| Targeted Care Mgmt. - Patient Service Dollars | 94 | $10,952 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The grant funds awarded are to clients of the family care, intensive case management, and supportive case management programs which are administered through the Hospital's behavioral health services division. The amounts are determined based on evaluation of client needs as determined by their individual case managers. All amounts are processed in accordance with the Hospital's disbursements practices which require evidence of supporting documentation for all expenditures, and required approvals. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mohammad R Ghazi-Moghadam MD | ||||||||||||||
| Director (Sch O) | $447,195 | $0 | $0 | $0 | $22,804 | $0 | $6,201 | $0 | $13,450 | $0 | $489,650 | $0 | $0 | $0 |
| Victor Giulianelli | ||||||||||||||
| President & CEO | $335,197 | $0 | $0 | $0 | $153,443 | $0 | $7,677 | $0 | $16,708 | $0 | $513,025 | $0 | $0 | $0 |
| Joan Ehlinger | ||||||||||||||
| VP of Finance & CFO | $184,491 | $0 | $0 | $0 | $25,110 | $0 | $6,079 | $0 | $8,241 | $0 | $223,921 | $0 | $0 | $0 |
| Scott Bruce | ||||||||||||||
| VP of Operations | $235,126 | $0 | $0 | $0 | $48,941 | $0 | $7,650 | $0 | $17,609 | $0 | $309,326 | $0 | $0 | $0 |
| John Kelley | ||||||||||||||
| VP of Mental Health | $157,872 | $0 | $0 | $0 | $55,787 | $0 | $5,483 | $0 | $18,192 | $0 | $237,334 | $0 | $0 | $0 |
| Timothy Shoen | ||||||||||||||
| VP of Medical Affairs | $295,380 | $0 | $0 | $0 | $54,283 | $0 | $7,650 | $0 | $13,323 | $0 | $370,636 | $0 | $0 | $0 |
| Michele Walsh | ||||||||||||||
| VP Of Nursing | $188,929 | $0 | $0 | $0 | $12,151 | $0 | $5,698 | $0 | $7,315 | $0 | $214,093 | $0 | $0 | $0 |
| Donald Massey | ||||||||||||||
| VP of Continuum Care | $164,795 | $0 | $0 | $0 | $12,600 | $0 | $5,151 | $0 | $17,602 | $0 | $200,148 | $0 | $0 | $0 |
| James Charland MD | ||||||||||||||
| Physician | $567,365 | $0 | $0 | $0 | $35,137 | $0 | $4,402 | $0 | $16,647 | $0 | $623,551 | $0 | $0 | $0 |
| Hamid Aziz Rehman MD | ||||||||||||||
| Physician | $500,716 | $0 | $0 | $0 | $41,955 | $0 | $0 | $0 | $0 | $0 | $542,671 | $0 | $0 | $0 |
| Michael Finnegan MD | ||||||||||||||
| Physician | $498,648 | $0 | $0 | $0 | $17,364 | $0 | $7,650 | $0 | $17,363 | $0 | $541,025 | $0 | $0 | $0 |
| David Lehr MD | ||||||||||||||
| Physician | $424,167 | $0 | $0 | $0 | $30,695 | $0 | $7,650 | $0 | $19,201 | $0 | $481,713 | $0 | $0 | $0 |
| Jason Steindler MD | ||||||||||||||
| Physician | $400,825 | $0 | $0 | $0 | $203 | $0 | $7,650 | $0 | $17,059 | $0 | $425,737 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Per St. Mary's Healthcare's accountability plan, spousal travel is reimbursed if there is a business purpose, however the amount reimbursed is also included as income on the individual's W-2. Certain St. Mary's Healthcare employees are reimbursed for cell phone/PDA expense, which is included on the respective employee's W-2. These payments are grossed up to include tax related obligations paid. St. Mary's Healthcare offers a fitness club membership credit to all employees to reimburse half of the cost of a yearly fitness club membership up to $150 per year. |
| Part I, Line 4b | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. St. Mary's Healthcare contributed to non-qualified supplemental retirement plan and the following individuals received payment: Victor Giulianelli - $94,043 John Kelley - $25,789 Timothy Shoen - $27,813 Scott Bruce - $14,654 Donald Massey - $5,873 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related St. Mary's Healthcare entity boards. |
| Form 990, Part VI, Section A, line 6 | St. Mary's Healthcare has a single corporate member, Ascension Health. |
| Form 990, Part VI, Section A, line 7a | St. Mary's Healthcare has a single corporate member, Ascension Health, which has the ability to elect members to the governing body of the Hospital. |
| Form 990, Part VI, Section A, line 7b | Ascension Health has designed a system of authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organization & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. The Board of Trustees has delegated the review of the Form 990 to its Finance Committee. Management presents the Form 990 to Finance Committee Members to review and answer any Committee member's questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. |
| Form 990, Part VI, Section B, line 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 will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Section B, line 15 | In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive compensation committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to CEOs at other hospitals who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining 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 Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. |
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. |
| Form 990, Part VII, Section A: | During 2013, the Hospital paid Ronald Marsh, M.D. for services rendered in his role as surgeon of the Hospital, not for his duties as a board member. During 2013, the Hospital paid Mohammad R. Ghazi-Moghadam, M.D. for services rendered in his role as a physician of the Hospital, not for his duties as a board member. |
| Form 990, Part XI, line 9: | Change in Temporary and permanently restricted interest in Foundation 1,988,936. FAS 158 Pension Adjustment -21,897. Community Benefit Distributions -12,900. Transfers to Sponsors -107,062. Transfers to Affiliates -821,088. Restricted Contributions - Capital 180,833. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | 501(c)(3) | Schedule A, Line 11a | Ascension Health Alliance | 0 | |
| Medical Services Enhancement Inc | |||||||||||
| 425 Guy Park Avenue | Amsterdam | NY | 12010 | 141776546 | Rental of Medical and Office Space | NY | 501(c)(25) | N/A | St Mary's Healthcare | Yes (1) | |
| The Foundation of St Mary's Healthcare | |||||||||||
| 427 Guy Park Avenue | Amsterdam | NY | 12010 | 133254655 | Supporting Organization | NY | 501(c)(3) | Schedule A, Line 11c | Yes (1) | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| The Foundation of StMary's Healthcare | ||
| C | $130,133 | Actual amount paid/transferred |
| Ascension Health | ||
| D | $421,248 | Actual amount paid/transferred |
| Medical Services Enhancement Inc | ||
| D | $202,736 | Actual amount paid/transferred |
| Medical Services Enhancement Inc | ||
| J | $217,715 | Actual amount paid/transferred |
| Ascension Health | ||
| P | $6,464,925 | Actual amount paid/transferred |
| Ascension Health | ||
| Q | $3,389,790 | Actual amount paid/transferred |
| The Foundation of StMary's Healthcare | ||
| Q | $172,808 | Actual amount paid/transferred |