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GRACE MEDICAL CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
GRACE MEDICAL CENTER INC (EIN 52-0591555)
Tax period
2011-09-01 to 2012-08-31
Filed
2013-07-15
IRS object ID
201301969349300100
Schema version
2011v1.5
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)
Timestamp2013-07-15T00:09:58-05:00Timestamp
Tax Period End Date2012-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11750 Tysons BlvdAddressLine1
CityMcLeanCity
StateVAState
ZIP Code221024219ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN520591555EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Hospital Baltimore IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone4103623000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 West Baltimore StreetAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212231558ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRichard JonesName
TitleChief Financial OfficerTitle
Phone4103624477Phone
Date Signed2013-07-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDavid A CraigName
PTINP00542227PTIN
Phone7032511000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRichard JonesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12000 West Baltimore StreetAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212231558ZIPCode
FieldValueIRS element (for citing)
Gross Receipts138792340GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bonsecoursbaltimore.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileMDStateLegalDomicile
Activity Or Mission DescriptionAcute Care HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1158TotalNbrEmployees
Total Nbr Volunteers91TotalNbrVolunteers
Total Gross UBI16741TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7992836ContributionsGrantsPriorYear
Contributions Grants Current Year1017085ContributionsGrantsCurrentYear
Program Service Revenue Prior Year132055347ProgramServiceRevenuePriorYear
Program Service Revenue CY136083583ProgramServiceRevenueCY
Investment Income Prior Year-770937InvestmentIncomePriorYear
Investment Income Current Year904165InvestmentIncomeCurrentYear
Other Revenue Prior Year866227OtherRevenuePriorYear
Other Revenue Current Year787507OtherRevenueCurrentYear
Total Revenue Prior Year140143473TotalRevenuePriorYear
Total Revenue Current Year138792340TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year58575GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY197872GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year64595492SalariesEtcPriorYear
Salaries Etc Current Year61919999SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year72460871OtherExpensePriorYear
Other Expenses Current Year76163514OtherExpensesCurrentYear
Total Expenses Prior Year137114938TotalExpensesPriorYear
Total Expenses Current Year138281385TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3028535RevenuesLessExpensesPriorYear
Revenues Less Expenses CY510955RevenuesLessExpensesCY
Total Assets BOY83049970TotalAssetsBOY
Total Assets EOY72332787TotalAssetsEOY
Total Liabilities BOY142266042TotalLiabilitiesBOY
Total Liabilities EOY157340732TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-59216072NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-85007945NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense126249133Expense
Grants197872Grants
Revenue136083583Revenue
DescriptionBon Secours Baltimore Hospital provides both inpatient and outpatient services. Such services include:Inpatient Services - 151 licensed beds for critical care, medical, psychiatric and surgical needs. BSBHS provides a full range of services & programs in response to community needs & interests including: Acute Care; Cardiology; Case Management; Wound Care Community Health Screenings; Critical Care; Emergency Care; Diagnostic Services; Employment Services; Family Support Center; Financial Education; Infectious Disease Care; Lab Services; Mammography; Neurology; Nuclear Medicine; Ophthalmology; Orthopedics; Faith Community Nurse Services; Pastoral Care; Pharmacy; Physical Therapy; Podiatry; Psychiatry; Pulmonary Services; Primary Care; Senior & Family Housing; Smoking Cessation; Social Work; Substance Abuse Treatment; Surgery; a Wellness & Fitness Center; Vascular Services; & the Women's Resource Center. Outpatient Services - including renal dialysis, HIV/AIDS services, mental health, substance abuse treatment, health education, cardiac rehabilitation and wellness programs and tele-health program for patients with congestive heart disease. BSBHS operates an emergency room that is open 24 hours per day, seven days per week, serving persons regardless of their ability to pay. See Sch H for additional information.Description
Total Program Service Expense126249133TotalProgramServiceExpense
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 Endowments0TermOrPermanentEndowments
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 Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096183NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1158NumberOfEmployees
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 FiledMDStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Richard JonesBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4103623000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12000 W Baltimore StAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212231558ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Mary Lenore Beachley
Board Member4.00X000
Matthew Hemelt
Board Member4.00X000
J Howard Henderson
Board Member4.00X000
Keshia Pollack
Board Member (May-Aug)4.00X000
Martha Riva
Board Member50.00X0342569128325
Sr Mary Shimo
Board Member50.00X000
Alan Siegfried
Board Member4.00X000
Anthony Stanowski
Board Member4.00X000
Lisa Williams
Board Member4.00X000
Theodore Wimberly
Board Member4.00X000
Patricia Scipio
Board Member (Jan-Aug)4.00X000
Bro Art Caliman
President50.00X000X
Glendora Hughes Esq
Chairman6.00X000X
Ackneil Muldrow
Secretary6.00X000X
Samuel L Ross MD
CEO-BSBHS50.00X059206377713X
Richard Jones
Treasurer/CFO50.00333070022593X
Fabienne Larkins
CNO50.00278096019581X
Rosita R Cruz MD
Physician50.00203379018429X
Usha Jain MD
Chief Pathologist50.00306576037503X
Kwang Kim MD
Physician50.00203221014660X
Shivani Myer MD
Physician50.00204088015465X
Donovan Parkes MD
Physician50.00409898057660X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1938328TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs934632TotalReportableCompFrmRltdOrgs
Total Other Compensation391929TotalOtherCompensation
Number Individuals GT100 K74NumberIndividualsGT100K
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
Cardinal Health
1330 Enclave ParkwayHoustonTX77077Pharmacy Mgmt Services2319104
Shiftwise
PO Box 70870St PaulMN55170Nursing Services2088010
University of Maryland
110 South Paca StBaltimoreMD21201Physician Services1907409
West Baltimore Anesthesia LLC
2000 W Baltimore StBaltimoreMD21223Anesthesiologists1623520
Broadway Services Inc
3709 E Monument StBaltimoreMD21205Security1221252
FieldValueIRS element (for citing)
Number Of Contractors GT100 K78NumberOfContractorsGT100K
Related Organizations30590RelatedOrganizations
Government Grants973843GovernmentGrants
All Other Contributions12652AllOtherContributions
Total Contributions1017085TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Rev.Description
Business Code621110BusinessCode
Total Revenue Column136083583TotalRevenueColumn
Related Or Exempt Function Income136083583RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue136083583TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column200047TotalRevenueColumn
Exclusion$200,047ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column1646TotalRevenueColumn
Exclusion$1,646ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real199937Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real199937Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column199937TotalRevenueColumn
Exclusion$199,937ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities137867Securities
Other564605Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities137867Securities
Other564605Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column702472TotalRevenueColumn
Exclusion$702,472ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Cafe and Vending722212403597$403,597
Parking812930149109$149,109
Purchase Discounts90009918123$18,123

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column16741TotalRevenueColumn
Unrelated Business Revenue16741UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue587570TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column138792340TotalRevenueColumn
Related Or Exempt Function Income136083583RelatedOrExemptFunctionIncome
Unrelated Business Revenue16741UnrelatedBusinessRevenue
Exclusion$1,674,931ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total175706Total
Program Services175706ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total22166Total
Program Services22166ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total678506Total
Program Services610655ProgramServices
Management And General67851ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total47200329Total
Program Services42480296ProgramServices
Management And General4720033ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2267044Total
Program Services2040340ProgramServices
Management And General226704ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8270453Total
Program Services7443408ProgramServices
Management And General827045ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3503667Total
Program Services3153300ProgramServices
Management And General350367ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total320210Total
Program Services288189ProgramServices
Management And General32021ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total277276Total
Program Services249548ProgramServices
Management And General27728ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total14491Total
Program Services13042ProgramServices
Management And General1449ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12273726Total
Program Services11046353ProgramServices
Management And General1227373ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total501996Total
Program Services451796ProgramServices
Management And General50200ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total913087Total
Program Services821778ProgramServices
Management And General91309ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total173418Total
Program Services156076ProgramServices
Management And General17342ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5127967Total
Program Services4615170ProgramServices
Management And General512797ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total128627Total
Program Services115764ProgramServices
Management And General12863ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2045010Total
Program Services2045010ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3331597Total
Program Services2998437ProgramServices
Management And General333160ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1711918Total
Program Services1540726ProgramServices
Management And General171192ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad Debt Expense157159831571598300
Purchased Services141511311273601814151130
Medical Supplies128480811156327312848080
BSHSI Mgmt Allocation542137648792385421380

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1207620Total
Program Services1086861ProgramServices
Management And General120759ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total138281385Total
Program Services126249133ProgramServices
Management And General12032252ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY532485BOY
EOY362260EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1795634BOY
EOY464881EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY19775321BOY
EOY19426325EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1179262BOY
EOY1344093EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY14854BOY
EOY1384077EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis91234260LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec61749453LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28472159BOY
EOY29484807EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9608249BOY
EOY10352296EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY21672006BOY
EOY9514048EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY83049970BOY
EOY72332787EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14404431BOY
EOY14196890EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1452192BOY
EOY2822759EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5007955BOY
EOY4737030EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY121401464BOY
EOY135584053EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY142266042BOY
EOY157340732EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-59815241BOY
EOY-84867001EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY599169BOY
EOY-140944EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-59216072BOY
EOY-85007945EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY83049970BOY
EOY72332787EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses510955ReconcilationRevenueExpenses
Reconcilation Other Changes-26302828ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$14,491OtherActivitiesAmount
Total Lobbying Expenditures IIB14491TotalLobbyingExpendituresIIB
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
ExplanationBon Secours Hospital Baltimore, Inc. paid dues to the American Hospital Association (AHA), the Maryland Hospital Association (MHA) and the Catholic Hospital Association (CHA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities for each of these organizations is as follows: Lobbying activity for AHA ($4,623 or 24.6%), MHA ($8,731 or 8.65%), CHA ($1,137 or 5.15%) for a total of $14,491.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis600000OtherCostOrOtherBasis
Book Value600000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis29936934OtherCostOrOtherBasis
Depreciation17345943Depreciation
Book Value12590991BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis18163178OtherCostOrOtherBasis
Depreciation12514718Depreciation
Book Value5648460BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis30771788OtherCostOrOtherBasis
Depreciation24036083Depreciation
Book Value6735705BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11762360OtherCostOrOtherBasis
Depreciation7852709Depreciation
Book Value3909651BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29484807TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Due from Afilliates1859157
Due from HSO20
HPL/GL Asset7602179
Other LT Investments13150
Social Security Assets39542
FieldValueIRS element (for citing)
Total Book Value Other Assets9514048TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
Due to BSHSI$92,062,921
Pension Liability$28,094,654
Capital Leases$412,339
Advances from Medicaid$4,503,795
Advances from Carefirst$639,862
HPL/GL Liability$7,602,179
Due to Affiliates$919,351
FIN 47 Liability$1,348,952
FieldValueIRS element (for citing)
Total Of Amounts135584053TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X: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 (formerly FIN48). Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $95,733 and $89,500 of net operating loss carryforwards as of August 31, 2012 and 2011, respectively, which expire in varying periods through 2032 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2012 and 2011. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5925739TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5925739NetCommunityBenefitExpense
Percent Of Total Expense0.04830PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense5925739TotalCommunityBenefitExpense
Net Community Benefit Expense5925739NetCommunityBenefitExpense
Percent Of Total Expense0.04830PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served2892PersonsServed
Total Community Benefit Expense2362457TotalCommunityBenefitExpense
Net Community Benefit Expense2362457NetCommunityBenefitExpense
Percent Of Total Expense0.01930PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served224PersonsServed
Total Community Benefit Expense108862TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense108862NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served26983PersonsServed
Total Community Benefit Expense15108674TotalCommunityBenefitExpense
Direct Offsetting Revenue111889DirectOffsettingRevenue
Net Community Benefit Expense14996785NetCommunityBenefitExpense
Percent Of Total Expense0.12240PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served30099PersonsServed
Total Community Benefit Expense17579993TotalCommunityBenefitExpense
Direct Offsetting Revenue111889DirectOffsettingRevenue
Net Community Benefit Expense17468104NetCommunityBenefitExpense
Percent Of Total Expense0.14260PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served30099PersonsServed
Total Community Benefit Expense23505732TotalCommunityBenefitExpense
Direct Offsetting Revenue111889DirectOffsettingRevenue
Net Community Benefit Expense23393843NetCommunityBenefitExpense
Percent Of Total Expense0.19090PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served2193PersonsServed
Total Community Building Expense4686952TotalCommunityBuildingExpense
Direct Offsetting Revenue2779792DirectOffsettingRevenue
Net Community Building Expense1907160NetCommunityBuildingExpense
Percent Of Total Expense0.01560PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served1788PersonsServed
Total Community Building Expense1484931TotalCommunityBuildingExpense
Net Community Building Expense1484931NetCommunityBuildingExpense
Percent Of Total Expense0.01210PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served26923PersonsServed
Total Community Building Expense940851TotalCommunityBuildingExpense
Net Community Building Expense940851NetCommunityBuildingExpense
Percent Of Total Expense0.00770PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs18NumberOfActivitiesOrPrograms
Persons Served30904PersonsServed
Total Community Building Expense7112734TotalCommunityBuildingExpense
Direct Offsetting Revenue2779792DirectOffsettingRevenue
Net Community Building Expense4332942NetCommunityBuildingExpense
Percent Of Total Expense0.03540PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$8,860,170BadDebtExpenseAmount
Amount Reimbursed By Medicare33066259AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare29220251CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall3846008MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Hospital Baltimore IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12000 W Baltimore StAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code212231558ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Hospital Baltimore IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Other PublicityXOtherPublicity
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Bon Secours CIBS
3101 Towanda AveBaltimoreMD212150000Behavioral Health Services
New Hope
2401 W Baltimore StreetBaltimoreMD212231558Behavioral Health Services
Druid Park Facility
2901 Druid Park Drive Suite A103BaltimoreMD212150000Behavioral Health Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: Part I, Lines 7a-7c: 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 payors rates, which does not enable Maryland hospitals to breakout any offsetting revenue related to Uncompensated Care.For Part I, Lines 7a-7c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, Line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, Line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, L7 Col(f): Current year bad debt expense not included in the calculation for line 7, column f: $15,715,983
Part II: Bon Secours Baltimore Health System works closely with the community it serves to create projects, programs and services that are leading to the realization of a vision towards making southwest Baltimore a healthier community of choice for current and new residents.Bon Secours offered the following Community Building programs and services in FY 2012:Our Money Place (OMP) Financial Services offers group and individual financial education, debt remediation, free and low-cost tax preparation and retirement planning to help residents reduce non-asset building debt and increase personal wealth. Residents can also be screened for and access public and private benefits through Earn Benefits. Over 2,260 persons utilized these services in FY 12. Youth Employment and Entrepreneurship Program (YEEP) helps high school age youth learn job readiness, financial literacy and leadership skills and then access part time and summer jobs. YEEP also helps youth develop career plans and get into post-secondary education. The program follows alumni who attend college. Over 340 area youth participated in YEEP activities in FY 12.Clean & Green turns vacant lots into attractive green spaces and consistently maintains them at a community-wide scale. Also provides paid internships in landscaping and other job skills. The program maintained over 400 lots in FY 12. In addition eight individuals completed a six month training program.Career Development Program offers job readiness, GED instruction, placement and retention services where, after a five-week intensive classroom experience, clients are followed for three years and helped to move up the company ladder, obtain more education as needed, get out of debt and learn basic money management skills. The ultimate goal is financial self-sufficiency. A total of 21 individuals completed our job readiness training and 53 community residents were placed in employment in FY 2012. Family Support Center helps young parents obtain a GED and get into college while providing developmental childcare and parenting classes. Children (birth to age 4) receive developmental childcare while their parents are in class or in training. In addition, the Family Support Center staff provides In-Home-Intervention services. One-thousand two hundred thirty four parents and children were served during FY 12.Women's Resource Center is a drop-in center that provides crisis intervention, hospitality services and domestic violence counseling for homeless women or women at risk for becoming homeless. Over 510 women were served in FY 12.Housing: BSBHS also renovates row houses and constructs apartment buildings where low-income families and seniors can find safe and affordable housing. Over 648 families and seniors were housed in FY 12.
Part III, Line 4: Part III, Line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, Line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.
Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.
Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending Financial Assistance Program (FAP) account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.Part V, Section B, line 11h:Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Part V, Section B, line 13g:Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Part V, Section B, line 19d:Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.
Part VI, Line 2: In FY13 BSBHS will complete its current Community Health Needs Assessment which began in November 2009 with a community health engagement process with an objective to develop:- An agreed-upon vision of an improved healthcare system which would lead to a healthier community and would be financially sustainable- A plan to achieve our visionWe hosted meetings involving 9 community associations, churches - such as Central Baptist Church and Greater Church of the Risen Savior - schools, service providers and seniors, gathering input from more than 100 community members. We also consulted other hospitals, our local health department, federally qualified health centers, physicians, and philanthropic organizations, institutions of higher education, and elected officials.This planning process led to recommendations and strategies under three major areas of focus: Healthy People, Healthy Environment and Healthy Economy.The next step taken in our current effort was a West Baltimore Health Care Summit which brought together 100 participants representing various stakeholders - hospitals, federally qualified health centers, physicians, philanthropic organizations, institutions of higher education, community members, and elected officials - to focus on improving access to primary care in Central and Southwest Baltimore City.Following the 2010 West Baltimore Health Care Summit, three workgroups were formed to focus on various aspects of improving access to primary care: Prevention, Education, and Outreach; Healthcare Workforce and Service Delivery. Understanding that central and southwest Baltimore exhibit some of the poorest health status indicators in the state, and understanding that the passage of the Patient Protection and Affordable Care Act now provides us with a unique opportunity to create new models of care that better meet the needs of our community, Bon Secours and the Mid Atlantic Association of Community Health Centers then launched a West Baltimore Primary Care Access Assessment and Strategic Planning project. A primary goal of that project is to ensure that our community members have access to quality primary care. We also now have a New Vision and corresponding strategic plan designed to expand our role as a trusted resource for healthcare, education, community, social and housing services. As we look to implement a new patient-centered "Medical Neighborhood," we are sharpening our focus on creating even more programs to address the needs of our community.
Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), as adjusted by the Medicare geographic wage index for each community served to reflect that community's relative cost of living ("Adjusted FPG"). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are also eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4: Bon Secours Baltimore Health System's Community Benefit Service Area is southwest Baltimore, which has a population of more than 17,885 (2010 Census) people, many of whom are medically and economically underserved. The socioeconomic status, ethnic diversity and health status of residents, according to the Baltimore City Health Department, indicates that 27% of the population is between 0-17 years; 76% are African American; 33% have a high school diploma equivalent; 43% of those ages 16-64 are not employed; 44% of households make less than $25,000; and the leading causes of health-related deaths are heart disease, HIV/AIDS, substance abuse and diabetes. In fact, in the neighborhoods served by BSBHS, residents die from heart disease at a rate that is 26% higher than the city as a whole. Deaths from diabetes and HIV/AIDS are also substantially higher than in the entire city. And residents of certain areas along the West Baltimore Street corridor have a life expectancy of 64.2 years, compared to almost 71 years for the entire city. Health problems in the community are exacerbated by inadequate insurance coverage. Approximately 11% of neighborhood residents are covered by Medicare, and 31% receive Medicaid. Seventeen percent are without any form of health insurance.
Part VI, Line 5: BSB has an open medical staff with privileges available to all qualified physicians in the area. BSB is governed by a board of directors whose composition is representative of the community it serves.
Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2010-2012). One of those goals was to partner with communities to co-create a more humane world, improve health and model social justice. To accomplish this, two key strategies are to: - Engage communities to identify needs and assets and building partnerships to improve health and quality of life of a specific population.- Demonstrate sustainable stewardship for healing the earth as a way to improve health and life quality.As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations.
MDReports Filed With StatesPart VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Baltimore Health System Foundation IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12000 W Baltimore StreetAddressLine1
CityBaltimoreCity
StateMDState
ZIP Code21223ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient383843816EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant175706AmountOfCashGrant
Purpose Of GrantGeneral Support to start up organizationPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEmergency Assistance Funds for Patients, Volunteers & EmployeesTypeOfGrant
Number Of Recipients22NumberOfRecipients
Amount Of Cash Grant22166AmountOfCashGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (9 entries)

Base 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
Martha Riva
031850500024064089783038542047089400
Samuel L Ross MD
0491059045844055160053709024004066977600
Richard Jones
260932035000037138051370174560355663000
Fabienne Larkins
239637015462022997064350131460297677000
Rosita R Cruz MD
17276800030611011610068190221808000
Usha Jain MD
286741000198350233650141380344079000
Kwang Kim MD
17030000032921012470134130217881000
Shivani Myer MD
203541000547034000120650219553000
Donovan Parkes MD
371175000387230233260343340467558000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationPart IIIPart I, Line 3: Bon Secours Health System, Inc., a related organization of Bon Secours Hospital Baltimore, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Supplemental InformationPart IIIPart I, Line 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Baltimore Health Systems, Inc., which in turn is the sole member of Bon Secours Hospital Baltimore, Inc.
Form 990, Part VI, Section A, line 7aThe governing body of Bon Secours Hospital Baltimore, Inc. is appointed by its member Bon Secours Baltimore Health System, Inc. and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Bon Secours Hospital Baltimore, Inc. are reserved to its member or to Bon Secours 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's 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 director's 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 19Bon Secours Hospital Baltimore, Inc. provides any documents open to public inspection upon request.
Form 990, Part VII:Hours worked are not tracked on an entity by entity basis. All officer's and director's hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Voluntary Board Members are not compensated for their time. Dr. Samuel Ross' compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the CEO of Bon Secours Baltimore Health System which includes direct management, monitoring and oversight of Bon Secours Baltimore Health System and its related organizations. Martha Riva's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the SPV of Governance of Bon Secours Health System, Inc. Brother Art Caliman and Sr. Mary Shimo do not receive payroll distributions as they have taken vows of poverty.Avg hours devoted to related org(s) when related comp is reported:
Form 990, Part XI, line 5:Net unrealized gains on investments: 437,624. Amounts released from restriction -115,253. Transfers to BSHSI - Reimbursement and Swap/Principal -1,337,422. Add'l Minimum Pension Liability -8,246,070. Forgiveness of debt to LMC and UMI -16,900,826. Other Changes -140,881. Total to Form 990, Part XI, Line 5: -26,302,828.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD211041301521301088Parent Org. Management ServicesMD501(c)(3)11bBon Secours Inc0
Bon Secours Community Health Services Inc
2600 Liberty Heights AvenueBaltimoreMD212157804521909599Medical Services CenterMD501(c)(3)9Bon Secours Baltimore Health System Inc0
The Bon Secours of Maryland Foundation Inc dba Community Works
26 N Fulton AvenueBaltimoreMD212231624521732800Community FoundationMD501(c)(3)11bBon Secours Baltimore Health System Inc0
Unity Properties Inc
26 N Fulton AvenueBaltimoreMD212231624521857768Low Income HousingMD501(c)(3)7Bon Secours of Maryland Foundation0
Urban Medical Institute Inc
2600 Liberty Heights AvenueBaltimoreMD212157804521905869Medical Services CenterMD501(c)(3)3Liberty Medical Center Inc0
Bon Secours Baltimore Development Inc
26 N Fulton AvenueBaltimoreMD212231624760785344Low Income HousingMD501(c)(3)7Unity Properties Inc0
Washington Village Community Medical Center Inc
700 Washington BlvdBaltimoreMD212231624520591555HealthcareMD501(c)(3)9Bon Secours Baltimore Health System Inc0
Bon Secours Baltimore Health System Foundation Inc
2000 W Baltimore StreetBaltimoreMD21223383843816Grant Making FoundationMD501(c)(3)11aBon Secours Baltimore Health System Inc0
Bon Secours Housing
26 N Fulton AvenueBaltimoreMD212231624521442707Low Income HousingMD501(c)(3)9Bon Secours of Maryland Foundation0
Bon Secours Housing II
26 N Fulton AvenueBaltimoreMD212231624521543174Low Income HousingMD501(c)(3)9Bon Secours of Maryland Foundation0
Bon Secours Baltimore Health Corps (dba Bon Secours Baltimore Health System
2000 W Baltimore StreetBaltimoreMD212231558800728893Local System Parent OrgMD501(c)(3)11bBon Secours Health System Inc0

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Bon Secours Apartments LP
1800 W Baltimore StBaltimoreMD21223521952505Low Income HousingMDUnity Housing IncRelated00
Bon Secours Apartments II LP
1800 W Baltimore StBaltimoreMD21223522063512Low Income HousingMDUnity Housing IncRelated00
Liberty Senior Housing LP
1800 W Baltimore StBaltimoreMD21223522134447Low Income HousingMDUnity Housing IncRelated00
Bon Secours Apartments III LP
1800 W Baltimore StBaltimoreMD21223522134444Low Income HousingMDUnity Housing IncRelated00
Bon Secours Smallwood Summit
26 N Fulton AvenueBaltimoreMD212231624522280175Low Income HousingMDUnity Housing IncRelated00
Bon Secours Chesapeake Apartments LP
26 N Fulton AvenueBaltimoreMD212231624200107034Low Income HousingMDChesapeake Housing LLCRelated00
Bon Secours Shiloh LP
26 N Fulton AvenueBaltimoreMD212231624203965243Low Income HousingMDBon Secours Shiloh LLCRelated00
Bon Secours Wayland LP
26 N Fulton AvenueBaltimoreMD212231624270468688Low Income HousingMDBon Secours Wayland LLCRelated00

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Unity Housing Inc
26 N Fulton AvenueBaltimoreMD212231624521952507Low Income HousingMDUnity Properties IncC
Bon Secours Wayland LLC
26 N Fulton AvenueBaltimoreMD212231624270468561Low Income HousingMDUnity Properties IncC
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
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