STRATEGY STUDIO / PUBLIC DATA EXPLORER

BON SECOURS WARWICK HEALTH FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BON SECOURS WARWICK HEALTH FOUNDATION (EIN 14-1972807)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-07
IRS object ID
201441889349300244
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-07-07T14:12:31-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141972807EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Warwick Health FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone8453685151Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1
CitySuffernCity
StateNYState
ZIP Code109015620ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameStacey KirschenbaumName
TitleExecutive DirectorTitle
Phone8453685151Phone
Date Signed2014-07-07DateSigned
Authorize Third Party0AuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonStacey KirschenbaumNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1
CitySuffernCity
StateNYState
ZIP Code109015620ZIPCode
FieldValueIRS element (for citing)
Gross Receipts177237GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.stanthonycommunityhosp.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionFundraising events to support St. Anthony Community HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body33NbrVotingMembersGoverningBody
Nbr Independent Voting Members30NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers93TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year102491ContributionsGrantsPriorYear
Contributions Grants Current Year135762ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year70568InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year10268OtherRevenuePriorYear
Other Revenue Current Year-24367OtherRevenueCurrentYear
Total Revenue Prior Year183327TotalRevenuePriorYear
Total Revenue Current Year111395TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year629785GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY184303GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year116679SalariesEtcPriorYear
Salaries Etc Current Year78753SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year97430TotalFundrsngExpCurrentYear
Other Expense Prior Year58345OtherExpensePriorYear
Other Expenses Current Year60433OtherExpensesCurrentYear
Total Expenses Prior Year804809TotalExpensesPriorYear
Total Expenses Current Year323489TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-621482RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-212094RevenuesLessExpensesCY
Total Assets BOY1536866TotalAssetsBOY
Total Assets EOY1523422TotalAssetsEOY
Total Liabilities BOY146661TotalLiabilitiesBOY
Total Liabilities EOY345311TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1390205NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1178111NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense212140Expense
Grants184303Grants
DescriptionBon Secours Warwick Health Foundation is the fundraising arm of St. Anthony's Community Hospital, Mount Alverno Center and Schervier Pavilion. Funds may be raised annually via the annual campaign, major gifts/planned giving and special events. Special events general include a Spring Ball, a fall golf classic and other fundraising activities.Description
Total Program Service Expense212140TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members33NbrVotingGoverningBodyMembers
Number Independent Voting Members30NumberIndependentVotingMembers
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 Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid LarkinNamePerson
Telephone Number4433672204TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18990 Old Annapolis RoadAddressLine1
CityColumbiaCity
StateMDState
ZIP Code21045ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
Donna Applegate
Board Member0.500.00X000
Paul Berina
Board Member (Jan-Aug)0.500.00X000
Pamela Breeman
Board Member (Jan-Aug)0.500.00X000
Julie Cauda
Board Member0.500.00X000
Sister Madeline Cipriano RSM
Board Member (Jan-Aug)0.500.00X000
Stratos Colman
Board Member0.500.00X000
Sue DeVincenzo
Board Member0.500.00X000
Garrett Durland
Board Member (Jan-Aug)0.500.00X000
Tom Fitzgerald
Board Member0.500.00X000
Geoffrey Green
Board Member (Jan-Aug)0.500.00X000
Jane Gyulavary
Board Member (Jan-Aug)0.500.00X000
Caroline Hamling
Board Member0.500.00X000
Harold Hansen DC
Board Member0.500.00X000
Mary Juliano
Board Member0.500.00X000
Leo R Kaytes
Board Member0.500.00X000
Teresa Messineo
Board Member (Jan-Aug)0.500.00X000
Frank Petrucci
Board Member0.500.00X000
Tomi Prvulovic MD
Board Member0.500.00X000
Susan Ronga
Board Member (Jan-Aug)0.500.00X000
Douglas Stage Esq
Board Member0.500.00X000
Barbara Sullivan
Board Member0.500.00X000
Cindy Vander Plaat
Board Member0.500.00X000
Bruce Zaretsky
Board Member0.500.00X000
Helen Laskow
Board Member0.500.00X000
Steve Kent
Chairman (Sept-Dec)1.000.00X000X
Jeffrey Reilly
Board Member0.500.00X02575717703
Terry Quint
Treasurer (Sept-Dec)0.500.00X000X
Bonni Masi Oswald
Secretary (Sept-Dec)0.500.00X000X
Clare Brady
President1.0049.00X019351910737X
Philip A Patterson
CEO - BSCHS0.5049.50X079034890484X
Deirdre Hamling
Chairman (Jan-Aug)1.000.00X000X
Souzie Miller
Secretary (Jan-Aug)0.500.00X000X
Kevin Kern
Treasurer (Jan-Aug)0.500.00X000X
Stacey Kirschenbaum
Executive Director5.0020.00014494721804X
David Capone
Former CFO-BSCHS0.000.00042219220976X
Melinda Hancock
Former CFO-BSCHS0.000.00034394127968X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2152518TotalReportableCompFrmRltdOrgs
Total Other Compensation179672TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events90107FundraisingEvents
Related Organizations6000RelatedOrganizations
All Other Contributions39655AllOtherContributions
Total Contributions135762TotalContributions
Gross Income Fundraising Events41475GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events90107CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses65842FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-24367TotalRevenueColumn
Exclusion-$24,367ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column111395TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$24,367ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total184303Total
Program Services184303ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total72697Total
Program Services14539ProgramServices
Management And General7270ManagementAndGeneral
Fundraising50888Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total124Total
Program Services25ProgramServices
Management And General12ManagementAndGeneral
Fundraising87Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total572Total
Program Services114ProgramServices
Management And General57ManagementAndGeneral
Fundraising401Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5360Total
Program Services1072ProgramServices
Management And General536ManagementAndGeneral
Fundraising3752Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1854Total
Program Services371ProgramServices
Management And General185ManagementAndGeneral
Fundraising1298Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1020Total
Program Services204ProgramServices
Management And General102ManagementAndGeneral
Fundraising714Fundraising

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionPurchased ServicesDescription
Total57559Total
Program Services11512ProgramServices
Management And General5757ManagementAndGeneral
Fundraising40290Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total323489Total
Program Services212140ProgramServices
Management And General13919ManagementAndGeneral
Fundraising97430Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1504468BOY
EOY835432EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3595BOY
EOY2632EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY616059EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY28803BOY
EOY69299EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1536866BOY
EOY1523422EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6122BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY140539BOY
EOY345311EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY146661BOY
EOY345311EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY782010BOY
EOY559420EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY608195BOY
EOY618691EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1390205BOY
EOY1178111EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1536866BOY
EOY1523422EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-212094ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years2812CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years54078CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year102491CurrentTaxYearMinus1Year
Current Tax Year135762CurrentTaxYear
Total295143Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years2812CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years54078CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year102491CurrentTaxYearMinus1Year
Current Tax Year135762CurrentTaxYear
Total295143Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total220AmountsSubstContributorsTotal
Public Support Total170294923PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-36472CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years34163CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29673CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7995CurrentTaxYearMinus1Year
Total35359Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years138510CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years62616CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25885CurrentTaxYearMinus1Year
Current Tax Year41475CurrentTaxYear
Total268486Total
FieldValueIRS element (for citing)
Total Support598988TotalSupport
Gross Receipts From Admissions Etc797315GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.49240PublicSupportPertcentage170
Public Support Pertcent Prior Year0.37510PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSchedule A, Part II, Line 10, Explanation of Other Income: Special Event Revenue - 2008 Amount: $ 138,510. 2010 Amount: $ 25,470. 2011 Amount: $ 25,885. 2012 Amount: $ 41,475. Refund of grant money - 2010 Amount: $ 32,287. PV adj - 2010 Amount: $ 4,859.GeneralExplanation

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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to AffiliatesDescription
Amount$345,311Amount
FieldValueIRS element (for citing)
Total Of Amounts345311TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

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

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Tent PartyNameOfEvent1
Gross Receipts Event153010GrossReceiptsEvent1
Charitable Contributions Event131635CharitableContributionsEvent1
Gross Revenue Event121375GrossRevenueEvent1
Rent Facility Costs Event16072RentFacilityCostsEvent1
Food And Beverage Event17633FoodAndBeverageEvent1
Entertainment Event1300EntertainmentEvent1
Other Direct Expenses Event122667OtherDirectExpensesEvent1
Name Of Event2Garden Tea PartyNameOfEvent2
Gross Receipts Event278572GrossReceiptsEvent2
Charitable Contributions Event258472CharitableContributionsEvent2
Gross Revenue Event220100GrossRevenueEvent2
Rent Facility Costs Event23877RentFacilityCostsEvent2
Food And Beverage Event215929FoodAndBeverageEvent2
Entertainment Event2850EntertainmentEvent2
Other Direct Expenses Event28514OtherDirectExpensesEvent2
Gross Receipts Total131582GrossReceiptsTotal
Charitable Contributions Total90107CharitableContributionsTotal
Gross Revenue Total Events41475GrossRevenueTotalEvents
Rent Facility Costs Total Events9949RentFacilityCostsTotalEvents
Food And Beverage Total Events23562FoodAndBeverageTotalEvents
Entertainment Total Events1150EntertainmentTotalEvents
Other Direct Expenses Total Events31181OtherDirectExpensesTotalEvents
Direct Expense Summary Events65842DirectExpenseSummaryEvents
Net Income Summary-24367NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1St Anthony Community HospitalBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line115-19 Maple AvenueAddressLine1
CityWarwickCity
StateNYState
ZIP Code109901028ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient141340100EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant184303AmountOfCashGrant
Purpose Of GrantGeneral SupportPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (6 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
Jeffrey Reilly
Board Member01950040228960396710636001343026527400
Clare Brady
President01456610159410319170390006837020425600
Philip A Patterson
CEO - BSCHS04243050319079046964056213034271088083208750
Stacey Kirschenbaum
Executive Director01334110113720164010017011787016675100
David Capone
Former CFO-BSCHS024178400018040801838019138044316800
Melinda Hancock
Former CFO-BSCHS025190805336203867103924024044037190900

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Lines 4a-bBon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: David Capone, $103,846. The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Philip Patterson, $7,508.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section A, line 2Board members Caroline and Deirdre Hamling have a family relationship. The following board members have business relationships: Douglas Stage, Esq and Garrett Durland; Douglas Stage, Esq. and Leo R. Kaytes
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is one of two corporate members of Bon Secours Charity Health System along with the Sisters of Charity of Saint Elizabeth of Convent Station. Bon Secours Charity Health System, Inc. is the sole member of St. Anthony Community Hospital, which in turn is the sole member of Bon Secours Warwick Health Foundation.
Form 990, Part VI, Section A, line 7aThe governing body of Bon Secours Warwick Health Foundation is appointed by its Member, St. Anthony Community Hospital and subject to approval by Bon Secours Health System, Inc., one of two corporate members of Bon Secours Charity Health System along with the Sisters of Charity of Saint Elizabeth of Convent Station.
Form 990, Part VI, Section A, line 7bCertain authorities of Bon Secours Warwick Health Foundation are reserved to its member or is jointly reserved to Bon Secours Health System, Inc. and the Sisters of Charity of Saint Elizabeth of Convent Station, the two corporate members of Bon Secours Charity Health System, Inc.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section B, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization provides any documents open to public inspection upon request.
Form 990, Part VIIBoard Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. - Management ServicesMD501(c)(3)Line 11a, IBon Secours Inc0
Bon Secours Charity Health System Inc
255 Lafayette AvenueSuffernNY109015620912135195Local System Parent Org.NY501(c)(3)Line 11a, I0N/A
Good Samaritan Hospital
255 Lafayette AvenueSuffernNY109015620131740104HealthcareNY501(c)(3)Line 3Bon Secours Charity Health System0
Bon Secours Community Hospital
160 E Main StreetPort JervisNY127712253141347717HealthcareNY501(c)(3)Line 3Bon Secours Charity Health System0
St Francis Center at the Knolls (dba Mount Alverno Center)
20 Grand StreetWarwickNY109901028061370576Long-term CareNY501(c)(3)Line 9Bon Secours Charity Health System0
St Anthony Community Hospital
15-19 Maple AvenueWarwickNY109901028141340100HealthcareNY501(c)(3)Line 3Bon Secours Charity Health System0
Bon Secours Community Hospital Foundation
255 Lafayette AvenueSuffernNY109015620810667395Grant Making FoundationNY501(c)(3)Line 7Bon Secours Charity Health System0
Good Samaritan Foundation For Better Health
255 Lafayette AvenueSuffernNY109015620141972807Grant Making FoundationNY501(c)(3)Line 7Bon Secours Charity Health System0
Villa Francis at the Knolls (dba Schervier Pavilion)
20 Grand StreetWarwickNY109901028061381994Skilled Nursing FacilityNY501(c)(3)Line 9Bon Secours Charity Health System0
Bon Secours Charity Health System Medical Group PC
255 Lafayette AvenueSuffernNY109015620223636986Primary CareNY501(c)(3)Line 9Bon Secours Charity Health System0
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 Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg