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ST AGNES HEALTHCARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST AGNES HEALTHCARE INC (EIN 52-0591657)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201441359349309239
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-15T18:13:51-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 Peachtree Street NE Suite 2000AddressLine1
CityAtlantaCity
StateGAState
ZIP Code30303ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN520591657EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Agnes Healthcare IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTAGNameControl
Phone4103683130Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 Caton Avenue No 040AddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212295201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameScott FurnissName
TitleSenior VP/CFOTitle
Phone4103683130Phone
Date Signed2014-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn W Sadoff JrName
PTINP00540589PTIN
Phone4042201500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBonnie PhippsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 Caton Avenue No 040AddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212295201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts433880108GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.stagnes.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1862YearFormation
State Legal DomicileMDStateLegalDomicile
Activity Or Mission DescriptionSt. Agnes HealthCare is committed to spiritually-centered health care which is rooted in the healing ministry of Jesus, with a special concern for those who are poor and vulnerable. As a Catholic healthcare ministry, we are dedicated to the art of healing to improve the lives of those that we serve.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees3671TotalNbrEmployees
Total Nbr Volunteers325TotalNbrVolunteers
Total Gross UBI4667760TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1954390ContributionsGrantsPriorYear
Contributions Grants Current Year2757659ContributionsGrantsCurrentYear
Program Service Revenue Prior Year414255078ProgramServiceRevenuePriorYear
Program Service Revenue CY414857515ProgramServiceRevenueCY
Investment Income Prior Year-3804345InvestmentIncomePriorYear
Investment Income Current Year7903544InvestmentIncomeCurrentYear
Other Revenue Prior Year6947269OtherRevenuePriorYear
Other Revenue Current Year8361390OtherRevenueCurrentYear
Total Revenue Prior Year419352392TotalRevenuePriorYear
Total Revenue Current Year433880108TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year259282GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY321490GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year187587537SalariesEtcPriorYear
Salaries Etc Current Year205705563SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year178032348OtherExpensePriorYear
Other Expenses Current Year183150012OtherExpensesCurrentYear
Total Expenses Prior Year365879167TotalExpensesPriorYear
Total Expenses Current Year389177065TotalExpensesCurrentYear
Revenues Less Expenses Prior Year53473225RevenuesLessExpensesPriorYear
Revenues Less Expenses CY44703043RevenuesLessExpensesCY
Total Assets BOY498496130TotalAssetsBOY
Total Assets EOY524798059TotalAssetsEOY
Total Liabilities BOY152942052TotalLiabilitiesBOY
Total Liabilities EOY146523140TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY345554078NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY378274919NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSt. Agnes Healthcare is a spiritually centered hospital which is rooted in the healing ministry of Jesus. In the spirit of St. Elizabeth Ann Seton, and in collaboration with others, we continually reach out to all persons in our community with a special concern for those who are poor and vulnerable. As a catholic healthcare ministry, we are dedicated to the art of healing to improve the lives of those that we serve; we advocate for a just society.Through our words and deeds, we minister in an atmosphere of deep respect, love and compassion.Patients are our passion. Our physicians, nurses and associates are our pride. Healing is our joy. We are widely known for the way our physician, nurses and associates combine sophisticated medical technology with spirituality and compassion. Should to shoulder, we stand united in our commitment to care for those in need. We will be a leader in service excellence.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense196682655Expense
Revenue255304486Revenue
DescriptionSt. Agnes Hospital provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30,2013, approximately 44.65% of the value of services rendered was to elderly patients under the Medicare program, and approximately 15.33% of the value of services was provided to patients who were deemed indigent under state, county, or hospital guidelines. In the spirit of principles adopted by Ascension Health, St. Agnes Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $19,972,780, including $14,721,094 for charity care, and $5,251,686 of unreimbursed medicaid.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7108614Expense
Grants321490Grants
Revenue1358285Revenue
DescriptionCommunity benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. In an effort to promote healthy living, St. Agnes has made available wellness programs to the community. These programs include, but are not limited to: adult, infant and child CPR classes; asthma curricula; bariatric seminars; basic life support classes; breast health clinics and seminars; first aid classes; joint and pain seminars; running clinics; babysitting classes; blood pressure, cholesterol, and blood sugar screenings; diabetes and heart disease prevention education; international early lung care action project studies; heart health awareness programs for African American women; gastro esophageal reflux disease seminars; activities in the pediatrics waiting room of the community care clinic promoting early development of reading skills; activities related to the successful discharge of patients such as providing transportation, prescriptions, oxygen, durable medical equipment, and short-term stays in nursing or rehabilitation centers; providing gynecological services to uninsured, largely Spanish speaking persons at the Esperanza clinic; and the Well4life program, which uses a multidisciplinary approach to weight loss, exercise, lifestyle and mindset changes, focused on battling obesity challenges.St. Agnes Healthcare has a long standing tradition of providing medical education and training. St. Agnes administers a five year, fully accredited, general surgery residency program consisting of twenty surgical residents. This academically oriented, community based, university affiliated residency program is the second oldest surgical residency program in the United States. The program is active in both basic and advanced laparoscopic surgery. Residents are offered a broad- based surgical experience with exposure not only to the field of greater general surgery, but also to all the surgical specialties. There is extensive experience and training in managing the critically ill surgical patient. Additionally, the program also contains rotations in burn management, trauma, transplant and gastrointestinal endoscopy. The Department of Surgery includes more than 198 surgeons in 10 surgical specialties. There are twenty-six full-time surgeons in the department complemented by attending surgeons who are dedicated to the residency- training program and are actively involved in the teaching program. Medical students have also been a part of St. Agnes' training program for more than six decades. The opportunity for the residents to teach the students contributes significantly to the professional development of the resident and provides a vital service to the student.St. Agnes also has a medical residency program consisting of forty residents. The dynamic interaction between the faculty and the house staff creates a stimulating intellectual environment centered on the key principles of patient care, education and clinical research. Similar to the surgical residents, the medical residents are involved in the teaching of medical students. Due to St. Agnes' affiliation with the University of Maryland Medical School and Johns Hopkins School of Medicine, the residents are presented an opportunity to rotate through those hospitals, further enriching the patient care experience. The residency program allows the residents to become proficient in obtaining clinical data by patient interview, physical examination, and interpretation of laboratory data. The residents also become proficient in utilizing clinical data to prioritize problems and formulate differential diagnoses. The training program helps the residents learn to formulate diagnostic and therapeutic plans demonstrating awareness of risks, benefits, costs, patient preferences, and ethical and psychosocial issues.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense117904789Expense
Revenue153526984Revenue
DescriptionSt. Agnes Hospital provides the following inpatient and outpatient medical services to the community: ambulatory care center services, cardiovascular services, cancer treatment services, emergency care center services, laboratory services, orthopedic services, pain management, primary care physicians, radiology services, rehabilitation services, sleep studies, stroke services, obstetrics, physical therapy, occupational therapy, speech therapy, wound care, respiratory therapy, surgery, pediatrics, imaging clinic, bariatric services,respiratory therapy, women's health services, diabetes wellness programs, palliative care services, and an anticoagulation clinic. Some of the services listed operate at a loss in order to ensure that all services are available to meet community health care needs. During the fiscal year ending June 30, 2013, our Hospital treated 17,913 inpatient adults and children in the community for a total of 75,399 patient days of service. The Hospital also provided services to 512,375 outpatients, including 6,236 outpatient surgery patients, 70,606 emergency room visits, and 69,384 clinic visits.Description
FieldValueIRS element (for citing)
Total Program Service Expense321696058TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096323NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3671NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMDStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Scott FurnissBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4103683130TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 Caton AvenueAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code21229ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Sister Patricia Ann Bossle DC
Board Director1.800.00X000
Marc G Bunting
Board Director2.400.00X000
Bruce R Grindrod Jr
Board Director2.400.00X000
Sister Ellen Marie Hagar DC
Board Director2.400.00X000
Mohannad F Jishi
Board Director3.000.00X000
A Gregory Kelly Jr
Board Director3.000.00X000
Irene D Knott
Board Director1.400.00X000
M Sue Lovell
Board Director1.500.00X000
Carole B Miller MD
Board Director50.000.00X446404050040
James B Sellinger
Board Director2.700.00X000
John B Stansbury
Board Director3.100.00X000
Sister Mary Lou Stubbs
Board Director2.200.00X000
Sam V Sydney MD
Board Director2.100.00X000
Charles G Tildon III
Board Director1.400.00X000
Hector L Torres
Board Director1.500.00X000
John E Wheeler Jr
Board Director2.700.00X000
Gary N Geisel
Board Chair4.400.00X000X
Paul J Chew
Board Vice Chair/Treasurer2.100.00X000X
Bonnie Phipps
President48.601.40X1663181025950X
Carlos S Ince Jr MD
Secretary50.000.00X397290031120X
Scott Furniss
Senior VP/CFO47.202.80335323027689X
Adrian Long MD
Executive VP/CMO48.601.40466146034558X
George T Grace MD
Medical Director Plastic/Hand50.000.00887797050774X
Howard S Hessan MD
Medical Director Otolaryngology50.000.00801229042827X
Lawrence Shin MD
Orthopedic Surgeon50.000.00793354029216X
Michel A Zatina MD
Surgical Director-Cardiovascular50.000.00630816044991X
Kerry E Owens
Plastic Surgeon50.000.00576799030264X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6998339TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation367429TotalOtherCompensation
Number Individuals GT100 K273NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Eagleeye Radiology Inc
12100 Sunrise Valley DriveRestonVA20191Radiology Servicea1035735
Drs Hicken Cranley & Taylor PA
2330 W Joppa RoadLuthervilleMD21093Contractual Services803938
Emcare Inc
7032 Collection Center DriveChicagoIL60693Contractual Services771634
M Nelson Barnes & Sons Inc
117 Church LaneCockeysvilleMD21030Contractual Services733540
Orange Element Design LLC
330 S BroadwayBaltimoreMD21231Contractual Services550645
FieldValueIRS element (for citing)
Number Of Contractors GT100 K51NumberOfContractorsGT100K
Related Organizations2255400RelatedOrganizations
Government Grants502259GovernmentGrants
Total Contributions2757659TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Revenue6219904121523494074845894667760
Ancillary Joint Venture90009912760571276057
System Support900099744085744085
Medical Student900099685024685024
FieldValueIRS element (for citing)
Total Program Service Revenue414857515TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7903544TotalRevenueColumn
Exclusion$7,903,544ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real930155Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real930155Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column930155TotalRevenueColumn
Exclusion$930,155ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Cafeteria Revenue9000991509497$1,509,497
Net Assets Released From Restrict900099858030$858,030

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column5063708TotalRevenueColumn
Exclusion$5,063,708ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7431235TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column433880108TotalRevenueColumn
Related Or Exempt Function Income410189755RelatedOrExemptFunctionIncome
Unrelated Business Revenue4667760UnrelatedBusinessRevenue
Exclusion$16,264,934ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total316005Total
Program Services316005ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total5485Total
Program Services5485ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3777694Total
Management And General3777694ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total11103250Total
Program Services9585748ProgramServices
Management And General1517502ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total161988464Total
Program Services141955691ProgramServices
Management And General20032773ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1553085Total
Program Services1330681ProgramServices
Management And General222404ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total14126116Total
Program Services12103235ProgramServices
Management And General2022881ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13156954Total
Program Services11272858ProgramServices
Management And General1884096ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total518263Total
Program Services59261ProgramServices
Management And General459002ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total47651Total
Management And General47651ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total33895Total
Management And General33895ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total31816435Total
Program Services20324723ProgramServices
Management And General11491712ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1135710Total
Program Services40422ProgramServices
Management And General1095288ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3204662Total
Program Services494935ProgramServices
Management And General2709727ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11529584Total
Program Services11529584ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3363466Total
Program Services2525768ProgramServices
Management And General837698ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total187163Total
Program Services95849ProgramServices
Management And General91314ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total156683Total
Program Services138255ProgramServices
Management And General18428ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2736769Total
Management And General2736769ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total3075897Total
Management And General3075897ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17456946Total
Program Services7987784ProgramServices
Management And General9469162ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total472860Total
Program Services2560953ProgramServices
Management And General-2088093ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Medical Supplies5745524457455244
Bad Debts1770573717705737
Utilization97431129743112
Utilities41880634188063

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total18321872Total
Program Services10276665ProgramServices
Management And General8045207ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total389177065Total
Program Services321696058ProgramServices
Management And General67481007ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7916719BOY
EOY7451559EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3455326BOY
EOY290843EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49153597BOY
EOY51600085EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY385634BOY
EOY1985323EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5677080BOY
EOY7633119EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2326023BOY
EOY1949022EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis392658221LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec153069093LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY216297703BOY
EOY239589128EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2865447BOY
EOY485179EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY16875566BOY
EOY18151623EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2141499BOY
EOY1618821EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY191401536BOY
EOY194043357EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY498496130BOY
EOY524798059EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY42201112BOY
EOY42058685EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3070851BOY
EOY1000EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY79381095BOY
EOY78270252EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY28288994BOY
EOY26193203EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY152942052BOY
EOY146523140EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY333027422BOY
EOY372776608EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12402229BOY
EOY5370974EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY124427BOY
EOY127337EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY345554078BOY
EOY378274919EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY498496130BOY
EOY524798059EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses44703043ReconcilationRevenueExpenses
Reconciliation Unrealized Invest6290872ReconciliationUnrealizedInvest
Reconcilation Other Changes-18273074ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$33,895OtherActivitiesAmount
Total Lobbying Expenditures IIB33895TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationLobbying expenses represent the dues paid to national and state hospital associations, a portion of which is specifically allocable to lobbying. St. Agnes Healthcare, Inc. does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2944473BeginningOfYearBalance
Investment Earnings Or Losses-4774700InvestmentEarningsOrLosses
Other Expenditures-2401059OtherExpenditures
End Of Year Balance570832EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3098333BeginningOfYearBalance
Investment Earnings Or Losses-153860InvestmentEarningsOrLosses
End Of Year Balance2944473EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2685977BeginningOfYearBalance
Investment Earnings Or Losses412356InvestmentEarningsOrLosses
End Of Year Balance3098333EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2374969BeginningOfYearBalance
Investment Earnings Or Losses311008InvestmentEarningsOrLosses
End Of Year Balance2685977EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2926667BeginningOfYearBalance
Investment Earnings Or Losses-551698InvestmentEarningsOrLosses
End Of Year Balance2374969EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.22000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.78000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis10252790OtherCostOrOtherBasis
Book Value10252790BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis163395398OtherCostOrOtherBasis
Depreciation31710461Depreciation
Book Value131684937BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis8997953OtherCostOrOtherBasis
Depreciation1317628Depreciation
Book Value7680325BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis86213690OtherCostOrOtherBasis
Depreciation60742944Depreciation
Book Value25470746BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis123798390OtherCostOrOtherBasis
Depreciation59298060Depreciation
Book Value64500330BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings239589128TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Health System Depository (HSD)180592466
Investment - Deferred Compensation7147972
Interest in Foundation Net Assets2955022
AH Pension Asset2420331
Cash Surrender Value - LIFE859122
Investment in Exec Flex CAA68444
FieldValueIRS element (for citing)
Total Book Value Other Assets194043357TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Other Current Liabilities$13,651,396
Other Non-Current Liabilities$7,283,466
Self Insurance Liability$4,115,210
Current Portion of L/T Debt$1,143,131
FieldValueIRS element (for citing)
Total Of Amounts26193203TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Intended Use of Endowment Funds:Identifier
Return ReferencePart V, Line 4:ReturnReference
ExplanationWhiteford Endowment - 50% to be utilized to erect a wing or additional building, additional 50% may be used to support hospital operations. Jenkins Endowment - this endowment was established in 1911, a portion of the earnings from the fund is restricted for the care of cancer patients. In August 2012, the time restrictions were met and St. Agnes applied the funds to the campus revitalization project. Browne Endowment - established for use by cardiac unit to aid the indigent. Gittings Endowment - created to provide a bed in the children's ward.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense14721094TotalCommunityBenefitExpense
Net Community Benefit Expense14721094NetCommunityBenefitExpense
Percent Of Total Expense0.03960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11052122TotalCommunityBenefitExpense
Direct Offsetting Revenue5800436DirectOffsettingRevenue
Net Community Benefit Expense5251686NetCommunityBenefitExpense
Percent Of Total Expense0.01410PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense25773216TotalCommunityBenefitExpense
Direct Offsetting Revenue5800436DirectOffsettingRevenue
Net Community Benefit Expense19972780NetCommunityBenefitExpense
Percent Of Total Expense0.05370PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2501746TotalCommunityBenefitExpense
Direct Offsetting Revenue8250DirectOffsettingRevenue
Net Community Benefit Expense2493496NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3296423TotalCommunityBenefitExpense
Direct Offsetting Revenue1164480DirectOffsettingRevenue
Net Community Benefit Expense2131943NetCommunityBenefitExpense
Percent Of Total Expense0.00570PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense437872TotalCommunityBenefitExpense
Direct Offsetting Revenue185555DirectOffsettingRevenue
Net Community Benefit Expense252317NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense872573TotalCommunityBenefitExpense
Net Community Benefit Expense872573NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7108614TotalCommunityBenefitExpense
Direct Offsetting Revenue1358285DirectOffsettingRevenue
Net Community Benefit Expense5750329NetCommunityBenefitExpense
Percent Of Total Expense0.01540PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense32881830TotalCommunityBenefitExpense
Direct Offsetting Revenue7158721DirectOffsettingRevenue
Net Community Benefit Expense25723109NetCommunityBenefitExpense
Percent Of Total Expense0.06910PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense46845TotalCommunityBuildingExpense
Direct Offsetting Revenue40000DirectOffsettingRevenue
Net Community Building Expense6845NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense46845TotalCommunityBuildingExpense
Direct Offsetting Revenue40000DirectOffsettingRevenue
Net Community Building Expense6845NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$17,705,737BadDebtExpenseAmount
Amount Reimbursed By Medicare148119461AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare129579725CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall18539736MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Agnes Healthcare IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1900 Caton AvenueAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code21229ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Agnes Healthcare IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities8NumberOfOtherFacilities

Other Facilities OtherFacilities (8 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityTypeAddress Line2Address/AddressLine2
Plastic and Reconstructive Surgery
300 Frederick Road Suite 200CatonsvilleMD21228Plastic Surgery
Women's Center in Columbia
10910 Little Patuxent Pkwy Ste 100ColumbiaMD21044Blood Drawing Station
St Agnes Medical Center
700 Geipe RoadBaltimoreMD21228Blood Drawing Station
Community Center Outreach at Baltimore
900 Caton AvenueBaltimoreMD21229Blood Drawing Station
Pine Heights Professional Building
1001 Pine Heights Avenue Suite 202BaltimoreMD21229Blood Drawing Station
Benson Avenue Medical Center
3421 Benson AvenueBaltimoreMD21227Wound Care Center
Seton Imaging Center
3449 Wilkins AvenueBaltimoreMD21229Diagnostic Imaging
Surgery Center of Ellicott City
10025 Governor Warfield Pkwy SteColumbiaMD21044Outpatient Surgical Center410

Form990 Schedule H Part VI Form990ScheduleHPartVI (23 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
Part I, Line 3c: Generally, discounted care to low income individuals is provided on a sliding scale for those not exceeding 300% of the federal poverty level. For emergency department patients and other outpatients (account balances under $500.00) may be granted charity exclusively based upon the use of the automated eligibility software only. In those instances, a signed/completed application will not be required.Additionally, patients may also be eligible for charity care if they meet criteria that would determine that they are experiencing a financial hardship. Financial hardship is defined as medical debt for medically necessary services incurred by a family with income below 500% of the federal poverty level that exceeds 25% of the family income over a 12 month period. Medical debt is out of pocket expenses, excluding copayments, coinsurance and deductibles for medical costs billed by St. Agnes Healthcare. The patient and any immediate family member of the patient living in the same household are eligible.
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 17705737.
Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission (HSCRC) determines payment through a rate-setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all-payor system includes a method for referencing Uncompensated Care in each payor's rates, which does not enable Maryland hospitals to break out any directed offsetting revenue related to Uncompensated Care. Community benefit expenses are equal to Medicaid revenues in Maryland, as such, the net effect is zero; Medicaid recognizes full reimbursement. The exception to this is the impact on the hospital of its share of the Medicaid assessment. In recent years, the state of Maryland has closed fiscal gaps in the state Medicaid budget by assessing hospitals through the rate-setting system. The amounts reported in Part I,Line 7b represent unreimbursed medicaid costs for unregulated health care activities and the medicaid assessment.Part I, Line 7, Unreimbursed Medicaid - Columns C, D, E, F
Bad debt expense from Part IX, Statement of Functional Expenses, excluded from the denominator used to calculate total charity care expense was $17,705,737.Part I, Line 7, Column F
Part II: The information provided as Community Support, in Part II, Community Building Activities, represents funds spent for disaster readiness and public health emergency activities. These costs, which are partially funded by the Department of Health and Mental Hygiene, support activities such as education and preparedness training, decontamination equipment and supplies needed for victim's ease, comfort and tracking during decontamination.St. Agnes Healthcare furthers its exempt purpose by promotingthe health of the community in various ways. A majority of theorganization's governing body resides in St. Agnes Healthcare'sservice area and is neither composed of employees nor contractors ofthe organization. The governing body had eighteen votingmembers, seventeen of which were independent communitymembers. Additionally, St. Agnes Healthcare has an openmedical staff and credentials all qualified medical staff,including community based providers. St. Agnes Healthcareapplies surplus funds to improve patient care in variousways. For instance, surplus funds are used to reinvestin the latest equipment and technologies to improvepatient safety, comfort, and outcomes. Surplus funds arealso used to renovate existing facilities and constructnew facilities in order to improve the healthcare environment.As a member of a national health system, Ascension Health,surplus funds generated by St. Agnes Healthcare may alsobe directed to Ascension Health to apply towards strategicinitiatives or to be re-distributed to other memberhealthcare providers within Ascension Health. This allowsSt. Agnes to not only service the surrounding community, but also helpfund the care for the underprivileged throughout many parts of the UnitedStates.St. Agnes Healthcare is a member of Ascension Health,a national health care system. Ascension Health is thesole corporate member of St. Agnes Healthcare.St. Agnes Healthcare is the sole corporate member of SetonMedical Group Inc., which provides Primary Care, Gynecologyand Obstetrics care for patients in St. Agnes Healthcare'sservice area. St. Agnes Healthcare is also the sole corporatemember of St. Agnes Foundation, the philanthropic arm ofSt. Agnes Healthcare.
The bad debt expense reported at cost was estimated using the bad debt expense from the consolidated St. Agnes Healthcare financial statements, applying the cost to charge ratio developed using worksheet 2 from the Schedule H instructions. The state of Maryland is an "all payor" state regulated by the Health Services Cost Review Commission (HSCRC) where all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Therefore, self pay discounts are largely not applicable for regulated activity and have no impact on bad debt expense. The estimated amount of bad debt expense, at cost, attributable to patients eligible under the organization's charity care policy was estimated by examining all bad debt write-offs at the patient account level during the fiscal year. Those accounts that had an insurance classification of charity, charity pending, or Medicaid pending that was subsequently written off to bad debt, are assumed to be patients that would have been eligible for assistance under the charity care policy if sufficient information had been provided to make that determination. The sum of those accounts, multiplied by the cost to charge ratio, is reported in Section A, Line 3.Part III, Line 2 & 3, Section A, Bad Debt Expense
Net patient service revenue is reported at the estimated realizable amounts from patients, third-party payors, and others for services provided and includes estimated retroactive adjustments under reimbursement agreements with third-party payors. Revenue under certain thirdparty payor agreements is subject to audit, retroactive adjustments, and significant regulatory actions. Provisions for third-party payor settlements and adjustments are estimated in the period the related services are provided and adjusted in future periods as additional information becomes available and as final settlements are determined. Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. As a result, there is at least a possibility that recordedestimates will change by a material amount in the near term. During 2013 and 2012, approximately 44.65% and 46.2%, respectively, of net patient service revenue was received under the Medicare program and 15.33% and 15.2%, respectively, under various state Medicaid programs. The Health Ministry grants credit without collateral to its patients, most of whom are local residents insured under third-party payor arrangements. Significant concentrations of accounts receivable at June 30, 2013 and 2012 include Medicare (34.3% and 27.2%, respectively) and various states' Medicaid (22.2% and 19.6%, respectively) programs. The provision for bad debts is based upon management'sassessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible 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 bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain pastdue 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 Health Ministry's policies.Part III, Line 4, Section A, Bad Debt Expense
Included in line 5 and 6 of section B are Medicare allowable costs and reimbursement reported on the Hospital's Medicare Cost Report. This includes reimbursable acute hospital services. In addition, the Hospital has also included Medicare net revenues and expenses for non-hospital services necessary to support hospital operations. This includes professional radiology, anesthesia and other physician specialty services. The Medicare surplus of $18,539,736 for hospital services was calculated by subtracting the Medicare costs (gross Medicare revenue multiplied by the cost to charge ratios reportedon the Medicare cost report) from the Medicare payments. Non-hospital services shortfall of $14,917,555 was calculated by multiplying each non-hospital services' Medicare patient share by the non-hospital services' annual operating loss. Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission (HSCRC) determines payment through a rate setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. This unique payment system is designed for all payors to share the cost of healthcare equally, meaning the cost shifting to private payors, that is commonly seen in other states, is not experienced in Maryland. This model results in a surplus of payment over expense.Part III, Line 8, Section B, Medicare
It is St. Agnes Healthcare's policy to place accounts that have been written off to bad debt with a collection agency for additional collection effort. Patients may apply for financial assistance at any time during the revenue cycle. Patients who work to apply for charity care whose account resides at the agency will be referred to the hospital by the agency. The agency will delete the account and the hospital will work with the patient to complete the charity care application process. Emergency department patients and other outpatients (account balances under $500.00) may be granted charity exclusively based upon the use of an automated eligibility software. A signed/completed application will not be required in those instances.Part III, Line 9b, Collection Practices
Part V, Section B, Line 3: The assessment process involved both quantitative and qualitative components. Saint Agnes engaged the participation of key internal and external stakeholders who represent the broad interest of the communities served by Saint Agnes to review the quantitative analysis. The stakeholders provided input through a structured online survey and via focus groups across the assessment process during late Fiscal Year 2012 and early Fiscal Year 2013. The stakeholders were individuals with expertise in provision of health care services and public health and included community leaders, physicians, nursing, social work, pastoral care, care management, emergency outpatient and management representatives. A list of CNHA participants is provided below.COMMUNITY REPRESENTATIVES:- Raymond Bahr, MD, community representative, cardiologist- Kenneth Bancroft, community representative, former hospital CEO- Barbara Bozzuto, community representative, former member and chair hospital Board of Directors- Alan Reisinger, MD, community representative, primary care physician- Thelma Daley, PhD, community representative, former member hospital Board of Directors- Ron Kaufman, community representative, former member hospital Board Planning Committee- Stephen Plantholt, MD, community representative, cardiologist- Frank Ryan, community representative, former member hospital Board of Directors- Adil Totoonchie, MD, community representative, general surgeon, former member hospital Board of Directors- Oxiris Barbot, MD, Health Officer, Baltimore City Health DepartmentSAINT AGNES HOSPITAL:- Shadi Barakat, MD, Medical Director Diabetes Center- Paul McClelland, MD, Psychiatrist- Richard Pomerantz, MD, Chairman Department of Medicine- Carole Miller, MD, Medical Director Cancer Institute- Michael Burke, MD, Chairman Department of Pediatrics- James Richardson, MD, Section Chief Geriatric Medicine- Michael Lantz, MD, Interim Chairman Department of OB/GYN- Deborah Som, MD, Associate Program Director Baltimore Medical Systems- Daniel Hardesty, MD, Physician Advisor Care Management- Kirstan Cecil, Director of Marketing & Communications- Cathy Carr-Dardin, RN, Bariatric Surgery Nurse Coordinator- Kim Fabian, Director Maryland Metabolic Institute- Peggy Lanasa, RN, Community Outreach Nurse Morrell Park Wellness Center- Karen Reichert, RN, Nursing Director Maternal Child Health- Shirley Sutton, Director Managed Care and Government Relations- Sr. Ellen LaCapria, DC, Vice President Mission Integration- MaryKay Gardenier, Vice President Cardiovascular Institute & Clinical Support Services - Nancy Mannion, RN, Clinical Unit Coordinator Preventive Cardiology- Jerrilyn Spiegl, RN, Clinical Operations Manager Cancer Institute- Mary Austin, Assistant Vice President Cancer Institute- Carolyn Moore, Director of Rehabilitation Services- Donna Hall, RN, Director Care Management- Jennifer Broaddus, LCSW-C, OSW-C, Social Worker Cancer Institute- Chaplain Ann Hazelwood, Dmin, Director Spiritual Care- Susan Dove, RN, Nursing Director Emergency DepartmentSt. Agnes Healthcare, Inc.
Part V, Section B, Line 5c: Management gave multiple presentations of the CHNA to various community groups and the Baltimore City Health Department.St. Agnes Healthcare, Inc.
Part V, Section B, Line 7: The Community health needs assessment process surfaced a wide range of needs in the communities which Saint Agnes serves. In accordance with the criteria outlined in the Health Care Affordability Act and 501(r)(3) regulatory requirements, Saint Agnes developed an implementation strategy to address the most critical of health needs and geographies. While a focused number of community health needs and response initiatives are addressed in the implementation strategy, Saint Agnes will continue to offer its full spectrum of services to those whom seek care. For communities in which Saint Agnes is not the primary hospital provider; the primary provider is better positioned to address their community's health needs. Non-healthcare areas for which Saint Agnes does not have the requisite knowledge or expertise to address the needs, other community organizations will be better positioned to address these needs.The process of the assessment utilized quantitative and qualitative data analysis to identify and prioritize community health needs. The prioritization process utilized multiple techniques such as online survey and stakeholder focus groups which employed top-of-mind, rank scaling, open end response, and nominal group technique to achieve consensus prioritization of most critical community health needs. The followinghealth needs and geographies were identified as priority areas toward which Saint Agnes should focus its efforts:The priority needs identified were:1. Obesity & Related Conditions2. Cardiovascular Disease3. Access/Linkages to Primary Care, especially to the poor and vulnerable populationsRecognizing there are a wide variety of resources available to respond to the needs of the community, particularly the other hospital providers located in and around the Saint Agnes service area, in order to have the most impact Saint Agnes will focus community health initiatives in the communities of Southwest Baltimore City (21229), Catonsville (21228), and Arbutus (21227).The needs that are not prioritized as a critical community health need include the following:Asthma, Behavioral Health Services, Cancer, Community Care Management/Care Coordination, General Community Outreach, HIV, Medication/Treatment Plan Compliance, Special Care needs for Children, Special care needs for Immigrant Populations, Special Care needs for Seniors, Women's Health/Prenatal Care, Chronic Disease Management, Diabetes & Hypertension, Early Detection & Screening Programs, Healthy Lifestyle Behaviors, Nutrition Education & Access to Healthy Foods, Services to Poor & Vulnerable, Substance Abuse (Tobacco, Alcohol, Drugs), Community Housing/Living Conditions, Crime, Jobs/Skills Training, Literacy Education, Medication Affordability, Stress Management, Transportation.St. Agnes Healthcare, Inc.
Part V, Section B, Line 14g: A notice of charity is posted within the Baltimore Sun on an annual basis.St. Agnes Healthcare, Inc.
Part V, Section B, Line 16e: Individuals were notified of the FAP by methods as noted in Question 14. This includes, but is not limited to, providing the following:-A brief description of eligibility requirements and assistance provided-Directions on how to access the FAP and application on our website and physical location of application forms-Instructions to obtain free copy of FAP and application by mail-Contact information for an individual/nonprofit organization to assist if the individual has questions-For individuals who submitted an incomplete FAP, we provided that individual with information relevant to assist them with completion of the FAP-For individuals who submitted a complete FAP, we made and documented a determination as to whether that person was eligible under the facility's FAP-We determined eligibility based on other means such as establishing that the individual is eligible under one or more means tested programs (as noted in Question 12)St. Agnes Healthcare, Inc.
Part V, Section B, Line 17e: Individuals were notified of the FAP as noted in Question 14. This includes, but is not limited to, the following:-Brief description of eligibility requirements and assistance provided-Direct individuals to our website and physical location of application forms-Provided instructions to obtain free copy of FAP and application by mail-Provided contact information for an individual/nonprofit organization to assist if the individual has questions-For individuals who submitted an incomplete FAP, we provided that individual with information relevant to assist them with completion of the FAP-For individuals who submitted a completed FAP, we made and documented a determination as to whether that person was eligible under the facility's FAP-We determined eligibility based on other means such as establishing that the individual is eligible under one or more meansSt. Agnes Healthcare, Inc.
Part V, Section B, Line 18e: Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of St. Agnes 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 prior to discharge-Notifying individuals of the financial assistance policy in communications with the patients regarding the patients' bills-Documenting its determination of whether patients were eligible for financial assistance under the hospital facility's financial assistance policySt. Agnes Healthcare, Inc.
Part V, Section B, Line 20d: Maryland hospital regulated rates are determined by the HSCRC. By law, regulated rates charged to all payors, including self pay patients, are the same.St. Agnes Healthcare, Inc.
Part V, Section B, Line 22: Maryland hospital regulated rates are determined by the HSCRC. By law, regulated rates charged to all payors, including self pay patients, are the same.The following steps were followed and considered reasonable efforts followed for purposes of identifying patients eligible for assistance under the facility's FAP:-Brief description of eligibility requirements and assistance provided.-Direct individuals to our website and physical location of application forms-Provided instructions to obtain free copy of FAP and application by mail-Provided contact information for an individual/nonprofit organization to assist if the individual has questions-For individuals who submitted an incomplete FAP, we provided that individual with information relevant to assist them with completion of the FAP-For individuals who submitted a complete FAP, we made and documented a determination as to whether that person was eligible under the facility's FAP.St. Agnes Healthcare, Inc.
Part VI, Line 2: Saint Agnes conducted its CHNA in two phases. The first phase was a quantitative assessment utilizing readily available secondary data sources to analyze twenty six indicators of health status.Each of the eleven communities within the Saint Agnes service area was compared to Central Maryland average for each indicator to identify critical community health gaps. Within each community, if the health status for each indicator that was at least 10% worse than the Central Maryland average it was flagged as a potential critical health needs gap. The twenty six health indicators were grouped into four categories:1. Demographic and socio-economic characteristics:Age Under 5, Age 65+, High School Diploma/Less, Diversity,Primary Care Access Age 18+, Uninsured, Low Income Households2. Lifestyle & behavioral factors:Obesity, Behavioral health, HIV Positive, InsufficientPrenatal Care, Substance Abuse, Tobacco Use3. Co-morbid precursor diagnoses:Arthritis, Back and Joint Pain, Asthma, Chronic Bronchitis,Diabetes, Hypertension, Ambulatory Sensitive Admissions4. Major disease diagnoses:Cancer, Cardiovascular, Coronary Heart Disease, CoronaryHeart Failure, Heart Attack, Stroke, Joint & SpineProcedures, Infant Mortality, Cancer-GYNIn addition to the health indicator profiles, Saint Agnesreviewed the Community Health Plans of the local healthjurisdictions including Baltimore City and Anne Arundel,Baltimore, Carroll, and Howard Counties. In addition,Saint Agnes is an active participant of the CommunityHealth Planning Task Force for Baltimore City and BaltimoreCounty. The information from the local health jurisdictionswas included in the second phase of the CHNA process.The second phase of the assessment was a qualitative assessmentutilizing internal and external stakeholders that representedthe broad interest of the communities served and/or had expertisein health care services/public health. Stakeholders completedan online survey utilizing multiple techniques (top-of-mind,rank scaling, nominal group) to identify and prioritizecommunity health needs. In addition to the online survey,stakeholders participated in focus group meetings. During the focusgroups, the results of the qualitative assessment were shared as wellas the results of the online survey and local health jurisditionsummaries. The result of the stakeholder focus groups wasa recommendation to focus on the three most critical healthpriorities in Saint Agnes' community health improvementinitiatives.
Part VI, Line 3: St. Agnes Healthcare displays signage, in both English and Spanish in all registration areas that inform patients of the availability of financial assistance programs and contact information. The signage is accompanied by brochures that explain the various financial assistance programs that are available. The Maryland State Financial Assistance application is also available. Registration areas are routinely checked to insure these materials are prominently displayed. St. Agnes Healthcare has employees who are responsible for screening admissions to identify patients who may be eligible for charity, medicaid, or other state programs. Once these patients are identified, St. Agnes Healthcare employees assist them with completing the eligibility process.All inpatients are provided the Patient Billing and Financial Assistance Information Sheet at the time of admission. It is also mailed to the patient with the summary bill that is sent after discharge. The information sheet is provided in both English and Spanish and provides the patient with information regarding St. Agnes Healthcare's financial assistance policy, how to apply for financial assistance and medical assistance and the patient's rights and obligations. A public notice is also published annually in the Baltimore Sun newspaper notifying the public of the availability of uncompensated care at St. Agnes Healthcare.
Part VI, Line 4: Due to its location in the southwest segment of the Baltimore Metropolitan Area, Saint Agnes serves a diverse patient population. Saint Agnes' primary and secondary service areas (Southwest Baltimore City and Baltimore County, Northern Anne Arundel County, Eastern Howard County, and Southern Carroll County) have a population of approximately 738,000. The service area for study in the Community Health Needs assessment represents the zip codes that comprise 80% of Saint Agnes Hospital discharges, 60% of those discharges come from the primary service area, with the remaining 20% from the secondary service area. Within the service area, Saint Agnes has defined eleven different communities. The communities are groupings of zip codes in the defined service area based on similar demographic characteristics and geographic boundaries.Arbutus (Zip Code 21227):Arbutus is an older suburban community, located south of Caton andWilkens Avenue, and has a population of 33,139. Thetraditionally blue collar community is part of the BaltimoreCounty Health Jurisdiction. Saint Agnes Hospital is the primaryhospital provider best positioned to address the specifichealth needs of this community.Brooklyn-Linthicum (Zip Codes 21090,21225):Brooklyn-Linthicum is an older urban/suburban community,located southeast of Caton and Wilkens Avenues, and haspopulation of 40,179. The industrial and blue collar communityhas seen an increase in the uninsured population and ispart of both the Baltimore City and Baltimore County HealthJurisdictions. Harbor Hospital is the primary hospitalprovider best positioned to address the specific health needsof this community.Catonsville (Zip Code 21228):Catonsville is an older suburban community, located west of Caton and Wilkens Avenues, and has a population of 48,659, with a growing proportion of seniors. The traditionally white collar community is part of the Baltimore County Health Jurisdiction. Saint Agnes Hospital is the primary hospital provider best positioned to address the specific health needs of this community.Ellicott City (Zip Codes 21042, 21043, 21075):Ellicott City is a growing suburban community, locatedwest/southwest of Caton and Wilkens Avenues, and has apopulation of 48,659. The predominantly white collar communityis part of the Howard County Health Jurisdiction. Howard CountyGeneral Hospital is the primary hospital provider bestpositioned to address the specific health needs of thiscommunity.Glen Burnie (Zip Codes 21060, 21061):Glen Burnie is an older suburban community, located west/southwest of Caton and Wilkens Avenues, and has a populationof 75,243, with a growing proportion of seniors. Thetraditionally blue collar community is part of the AnneArundel County Health Jurisdiction. Baltimore WashingtonMedical Center is the primary hospital provider best positionedto address the specific health needs of this community.Pasadena (Zip Code 21122):Pasadena is a suburban community, located southeast of Catonand Wilkens Avenues, and has a population of 58,941, with agrowing proportion of seniors. The growing community is primarilyserved by Baltimore Washington Medical Center and is part of the AnneArundel County Health Jurisdiction. Baltimore WashingtonMedical Center and Anne Arundel Medical Center are theprimary hospital providers best positioned to addressthe specific health needs of this community.South Baltimore City (Zip Code 21223, 21230):South Baltimore City is an older urban community, locatedeast/southeast of Caton and Wilkens Avenues, and has apopulation of 62,268. The urban community is projectedto experience population declines. South Baltimore Cityis part of the Baltimore City Health Jurisdiction. BaltimoreWashington Medical Center is the primary hospital providerbest positioned to address the specific health needs of thiscommunity.South Carroll (Zip Codes 21104, 21163, 21784):South Carroll is a suburban community, located northwest ofCaton and Wilkens Avenues, and has a population of 52,287,with a growing proportion of seniors. The traditionally ruralcommunity has transitioned to a growing suburb of the MetroBaltimore Region. South Carroll is part of Carroll CountyHealth Jurisdiction. Carroll County General Hospital andNorthwest Hospital are the primary hospital providers bestpositioned to address the specific health needs of thiscommunity.Southwest Baltimore City (Zip Code 21229):Southwest Baltimore City is an older urban community, located atCaton and Wilkens Avenues, and has a population of 46,881. Similar to other urban areas, Southwest Baltimore is projected to experience population declines. Southwest Baltimore City is part of the Baltimore City Health Jurisdiction. Saint Agnes Hospital is the primary hospital provider best positioned to address the specific health needs of this community.West Baltimore City (Zip Code 21215, 21216, 21217):West Baltimore City is an older urban community, located north ofCaton and Wilkens Avenues, and has a population of134,531. Similar to other urban areas, West Baltimore is projectedto experience population declines. West Baltimore City ispart of the Baltimore City Health Jurisdiction. Sinai Hospital,University of Maryland and Bon Secours Hospital are theprimary hospital providers best positioned to addressthe specific healths needs of this community.Woodlawn (Zip Code 21207, 21244):Woodlawn is a suburban community, located northwest of Catonand Wilkens Avenues, and has a population of 83,180, witha growing proportion of seniors. Woodlawn is part of theBaltimore County Health Jurisdiction. Northwest Hospitalis the primary hospital provider best positioned to addressthe specific health needs of this community.
Part VI, Line 6: St. Agnes Healthcare is a member of Ascension Health, a national health care system. Ascension Health is the sole corporate member of St. Agnes Healthcare. St. Agnes Healthcare is the sole corporate member of Seton Medical Group Inc., which provides Primary Care, Gynecology and Obstetrics care for patients in St. Agnes Healthcare's service area. St. Agnes Healthcare is also the sole corporate member of St. Agnes Foundation, the philanthropic arm of St. Agnes Healthcare.
St. Agnes Healthcare files a community benefits reportwith the Health Services Cost Review Commission (HSCRC),the regulatory agency in the state of Maryland. The reportis then made public by the HSCRC. Additionally, communitybenefit information is available in the St. Agnes HealthcareAnnual Report and the St. Agnes Healthcare Fact Sheet.Both documents are available on the hospital website.Part VI, Line 7, Supplement Information

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
Cal Ripken Sr Foundation
1427 Clarkview RoadBaltimoreMD21209522310500501(c)(3)150000FMVSponsorship
MHEI Who Will Care
6820 Deerpath RoadElkridgeMD21075520901664501(c)(3)109500FMVNursing
Greater Baltimore Committee
111 South Calvert StreetBaltimoreMD21202520645650501(c)(4)7000FMVSponsorship
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantStudent Internship Recruitment ScholarshipTypeOfGrant
Number Of Recipients2NumberOfRecipients
Amount Of Cash Grant5485AmountOfCashGrant
Method Of ValuationFMVMethodOfValuation

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Discretionary grants or assistance to other organizations are approved by either the Chief Executive Officer or the Chief Finanical Officer.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Carole B Miller MD
Board Director3217520122141025110305000195400496444000
Bonnie Phipps
President5861480395784068124901062701532301689131000
Carlos S Ince Jr MD
Secretary39616000011300112500198700428410000
Scott Furniss
Senior VP/CFO2874660469580899085000191890363012000
Adrian Long MD
Executive VP/CMO3495090606430559940135000210580500704000
George T Grace MD
Medical Director Plastic/Hand7503580133295041440282500225240938571000
Howard S Hessan MD
Medical Director Otolaryngology79693000042990282500145770844056000
Lawrence Shin MD
Orthopedic Surgeon68565401072000500066920225240822570000
Michel A Zatina MD
Surgical Director-Cardiovascular569609057998032090282500167410675807000
Kerry E Owens
Plastic Surgeon35222602237100863028250020140607063000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aClub dues are available to senior leadership and are shown as a taxable fringe benefit. Average hours per week; all persons listed at Part VII and Schedule J as working 50 hours are full-time employees of the organization. The use of 50 hours on this return is intended to denote that such persons may work significantly more hours during the week on average. St. Agnes Healthcare is a member of Ascension Health. Bonnie Phipps, President and CEO of St. Agnes Healthcare, also serves in an oversight role to other Ascension Health facilities as a ministry market leader. The compensation earned as a ministry market leader is paid through St. Agnes Healthcare, and therefore, reported on this form 990. The compensation has not been allocated back to the entities deriving the benefit.
Part I, Line 3The compensation for the Chief Executive Officer (CEO) of St. Agnes Healthcare is determined by Ascension Health, the parent company of St. Agnes Healthcare. Ascension Health uses independent compensation consultants, who use compensation surveys and studies, to establish the pay range for the CEO of St. Agnes Healthcare. The Ascension Health Executive Compensation Committee approves the recommended salary for the CEO of St. Agnes Healthcare. The Ascension Health Executive Compensation Committee provides the local St. Agnes Healthcare compensation committee the analysis performed by the independent consultant for review and approval.
Part I, Line 4bCarole Miller, Howard Hessan, George Grace, Michael Zatina and Kerry Owens participated in 457F supplemental non-qualified retirement plans. Carole Miller's non-vested plan value was $277,389.81. Howard Hessan's non-vested plan value was $94,931.56. George Grace's non-vested value was $63,646.22. Michael Zatina's non-vested value was $47,890.73. Kerry Owen's non-vested value was $25,507.27 at June 30, 2013.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Certain persons reported on Part VII are employed by and/or serve as officer, director, trustee, or key employee at a related tax exempt organization.
Form 990, Part VI, Section A, line 6St. Agnes Healthcare has a sole corporate member, Ascension Health.
Form 990, Part VI, Section A, line 7aSt. Agnes Healthcare has a sole corporate member, Ascension Health, who has the ability to elect members to the governing body of St. Agnes Healthcare.
Form 990, Part VI, Section A, line 7bAscension Health has designed a System Authority Matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; system policies and procedures. These areas are subject to certain levels of approval by Ascension Health per the System Authority Matrix.
Form 990, Part VI, Section B, line 11Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the form to the Finance Committee and certain members of the Audit Committee and addresses any questions that arise. Once the Finance Committee and Audit Committee review is completed, the Form 990 is then made available to the full Board of Directors via a secure website. Management team members are available to respond to any Board member questions. After the Board of Directors' review is complete, management files the Form 990 with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12cAnnually, a conflicts of interest disclosure form is distributed to board members, the executive team, board committees, purchasing agents, legal counsel, medical leadership, and certain members of management. Officers, directors and key employees are required to complete the annual disclosure. Any conflicts, or potential conflicts that are identified are examined by the Corporate Responsibility Officer and appropriate measures are taken.
Form 990, Part VI, Section B, line 15The compensation for the Chief Executive Officer (CEO) of St. Agnes Healthcare is determined by Ascension Health, the parent company of St. Agnes Healthcare. Ascension Health uses independent compensation consultants, who use compensation surveys and studies, to establish the pay range for the CEO of St. Agnes Healthcare. The Ascension Health Executive Compensation Committee approves the recommended salary for the CEO of St. Agnes Healthcare. The Ascension Health Executive Compensation Committee provides the local St. Agnes Healthcare Compensation Committee the analysis performed by the independent consultant for review and approval. The annual compensation review for officer level staff is performed by an outside compensation consulting firm, which specializes in executive compensation. On an annual basis, the Compensation Committee of the Board of Directors sends an engagement letter outlining the positions requiring compensation analysis, and seeks analysis and recommendations. The consulting firm then performs a market analysis of compensation and benefits for the executives with recommended salary ranges by executive position, and those are reviewed and approved by the compensation committee. The senior VP/Chief Financial Officer, Executive VP/Chief Medical Officer, VP Operations & Capital Projects, Senior VP Patient Care Services are included in the group of persons whose compensation is reviewed by an outside consulting firm.
Form 990, Part VI, Section C, line 19The organization will provide any documents open to public inspection upon written request.
Form 990, Part XI, line 9:Transfers to Ascension Health -6,969,520. Transfer to Sponsor -420,903. Deferred Pension Costs 424,477. Capital Transfer to Seton Medical Group -7,823,276. Lab Outreach Expenses -4,133,498. Lab Outreach Utilization -385,087. Donated Equipment 8,063,081. Net Change in Interest in Foundation Assets -554,083. Special Purpose Funds Unrealized Gains 157,713. Special Purpose Funds Restricted Contributions 867,441. Net Assets Released From Restriction -7,369,241. Special Purpose Funds Investment Income -130,177. Rounding -1.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Ascension Health
PO Box 45998St LouisMO63145311662309National Health OfficeMOSection 501(c)(3)Box 11aAHA0
Seton Medical Group
900 Caton AvenueBaltimoreMD21229392064992Provides Health Care Services to the CommunityMDsection 501(c)(3)Box 3 - HospitalSt Agnes Hospital1
St Agnes Foundation
900 Caton AvenueBaltimoreMD21229521415083provides funding to the hospital and to the CommunityMDsection 501(c)(3)Box 11-509(a)(3)-Typst Agnes Hospital1
St Agnes Auxiliary
900 Caton AvenueBaltimoreMD21229520643673FundraisingMDsection 501(c)(3)Box 9st Agnes Hospital1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1St Agnes Health Ventures IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 Caton AvenueAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code21229ZIPCode
FieldValueIRS element (for citing)
EIN521733632EIN
Primary ActivityHolding CompanyPrimaryActivity
Legal Domicile StateMDLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income32716ShareOfTotalIncome
Share Of EOY Assets1208332ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Seton Medical Group
B7823276Fair Market Value
St Agnes Foundation
C2255400Fair Market Value
St agnes Foundation
M454404Fair Market Value
St Agnes Foundation
Q1090304Fair Market Value