ST MARYS HEALTHCARE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HEALTHCARE (EIN 14-1347719)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201303169349305255
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-12T15:36:05-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141347719 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STMA | NameControl |
| Phone | 5188421900 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joan Ehlinger | Name |
| Title | VP of Finance & CFO | Title |
| Phone | 5188421900 | Phone |
| Date Signed | 2013-11-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew A Montgomery | Name |
| PTIN | P00492843 | PTIN |
| Phone | 5137847100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Victor Giulianelli | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 149354962 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.smha.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1903 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | To serve all persons with compassion and excellence, especially those who are vulnerable. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1828 | TotalNbrEmployees |
| Total Nbr Volunteers | 298 | TotalNbrVolunteers |
| Total Gross UBI | 1355666 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3645338 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5422689 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 132217947 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 137514057 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2620025 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4865697 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5083483 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1248874 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 143566793 | TotalRevenuePriorYear |
| Total Revenue Current Year | 149051317 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 79584 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50325 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 83611619 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 89256871 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 52527392 | OtherExpensePriorYear |
| Other Expenses Current Year | 48185270 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 136218595 | TotalExpensesPriorYear |
| Total Expenses Current Year | 137492466 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7348198 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 11558851 | RevenuesLessExpensesCY |
| Total Assets BOY | 148447908 | TotalAssetsBOY |
| Total Assets EOY | 158992703 | TotalAssetsEOY |
| Total Liabilities BOY | 33638340 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 40866069 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 114809568 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 118126634 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Rooted in the healing ministry of Jesus, we dedicate ourselves to serve all persons with compassion and excellence, especially those who are vulnerable. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 116399927 | Expense |
| Grants | 50325 | Grants |
| Revenue | 136301161 | Revenue |
| Description | St. Mary's Healthcare provides a substantial portion of its services to the elderly and poor. During the fiscal year ending December 31, 2012, approximately 35% of the value of services rendered were to elderly patients under the Medicare program and approximately 23% of the services were provided to patients who were deemed indigent under state, county or hospital guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending December 31, 2012, the estimated cost of providing care of persons living in poverty totaled $11.6 million, including $572,000 cost of charity care, $4.7 million in programs for persons living in poverty, and $6.3 million in the unpaid cost of public programs. These amounts vary from Schedule H due to different methods of calculation.In 2012, St. Mary's Healthcare provided health care services to 6,595 inpatients and 405,613 outpatients, and 56,565 days of care to residents of the skilled nursing facility. The inpatient care covered medical/surgical, psychiatric, alcohol rehabilitation, physical rehabilitation, maternity and newborn patients. The outpatient visits included 28,846 emergency visits; 8,626 outpatient surgeries; 161,131 referred visits (including imaging, laboratory, therapies, and cardiac rehab), total other outpatient visits of 26,500 including 3,265 visits to nursing home patients, 8,331 adult day care visits, 10,107 urgent care visits, 3,940 occupational medicine visits and 857 visits to the diabetes center; 61,135 family health center visits; total specialty visits of 21,556 including 4,783 urology health center visits, 2,964 cancer treatment center visits and 1,216 specialty surgical visits; 1,363 prenatal visits; and total mental health and alcohol visits of 95,400 including , 15,376 alcohol clinic visits, and 81,080 mental health clinic visits. St. Mary's Healthcare administers one of the most comprehensive mental health outpatient programs in New York State. In 2012, the Hospital provided a variety of services through various grant-funded programs including psych-social clubs, prevocational/employment assistance programs, mobile geriatric/senior citizen programs, and alcohol intervention service programs. In addition, caring families provided family care services and hospital personnel provided case management counseling under various grant-funded programs. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2206000 | Expense |
| Description | Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, St. Mary's Healthcare has made available the following programs to the community: reduced cost programs providing senior citizens with Lifeline equipment enabling them to solicit help should the need arise; community continuing education programs providing information on a variety of subjects including child abuse, day-to-day parenting, seat belt use and safety, smoking cessation, weight loss, and other wellness programs; help and support groups for victims and their family members; and providing meeting facilities for victims of alcohol abuse. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 938709 | Expense |
| Revenue | 1212896 | Revenue |
| Description | St. Mary's Healthcare's other program service revenue includes continuing education programs, psychological services provided to Montgomery county, medical director services, cafeteria sales to visitors and employees, and rebates/refunds of expenses. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 119544636 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 130 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1828 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joan Ehlinger | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5188417434 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 12010 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Victor Giulianelli | |||||||||
| President & CEO | 40.00 | 1.00 | X | X | 808087 | 0 | 26808 | ||
| Ronald Marsh MD | |||||||||
| Chairperson | 2.00 | 1.00 | X | 78825 | 0 | 0 | |||
| Michael J Pepe | |||||||||
| Treasurer | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Sister Lauren VanDermark | |||||||||
| Secretary | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Thomas F Cichy | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Sister Charla Commins CSJ | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| John Daly | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Emily T Etzkorn MD | |||||||||
| Director | 2.00 | 0.00 | X | 3692 | 0 | 0 | |||
| Mohammad R Ghazi-Moghadam MD | |||||||||
| Director | 40.00 | 1.00 | X | 222736 | 0 | 5915 | |||
| Vito L Greco | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Sister Nancy Gregg | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Sr Joan Mary Hartigan | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Andrew Heck | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Joan R Pipito | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Brent E Phetteplace | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Michael M Sheridan DO | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Ronald Limoncelli | |||||||||
| Director | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| John Sagan | |||||||||
| VP of Finance / CFO | 40.00 | 1.00 | X | 328064 | 0 | 22959 | |||
| Scott Bruce | |||||||||
| VP of Operations | 40.00 | 1.00 | 315992 | 0 | 44846 | X | |||
| John Kelley | |||||||||
| VP of Mental Health | 40.00 | 0.00 | 238009 | 0 | 24321 | X | |||
| Timothy Shoen | |||||||||
| VP of Medical Affairs | 40.00 | 0.00 | 396808 | 0 | 19948 | X | |||
| Michelle Walsh | |||||||||
| VP of Nursing | 40.00 | 0.00 | 224568 | 0 | 15601 | X | |||
| James Charland MD | |||||||||
| Physician | 40.00 | 0.00 | 592182 | 0 | 14417 | X | |||
| Hamid Aziz Rehman MD | |||||||||
| Physician | 40.00 | 0.00 | 525899 | 0 | 0 | X | |||
| David Lehr MD | |||||||||
| Physician | 40.00 | 0.00 | 424812 | 0 | 23892 | X | |||
| Deborah Sculco | |||||||||
| Physician | 40.00 | 0.00 | 414652 | 0 | 8340 | X | |||
| Kendy Verpile | |||||||||
| Physician | 40.00 | 0.00 | 339134 | 0 | 9353 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4913460 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 216400 | TotalOtherCompensation |
| Number Individuals GT100 K | 75 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Touchpoint Support Services | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Food, Nutritional, & Environmental Svcs | 1708501 |
| Atlantic Prof Svcs of Rhode Island Inc | |||||
| PO Box 635998 | Cincinnati | OH | 45263 | Medical Services | 1681991 |
| Assoc Regional and University Pathololo | |||||
| ARUP Laboratories 500 Chipete Way | Salt Lake City | UT | 84108 | Medical Services | 699352 |
| Medical Staffing Network | |||||
| PO Box 202996 | Dallas | TX | 753202996 | Medical Services | 392271 |
| Acute Dialysis Equipment Inc | |||||
| 1288 Simons Road | Castleton | NY | 12033 | Medical Services | 260550 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Related Organizations | 459665 | RelatedOrganizations |
| Government Grants | 4961250 | GovernmentGrants |
| All Other Contributions | 1774 | AllOtherContributions |
| Total Contributions | 5422689 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Revenue | 621990 | 136301161 | 136301161 |
| Other Program Service | 621990 | 1212896 | 1212896 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 137514057 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4978368 | TotalRevenueColumn |
| Exclusion | $4,978,368 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 81326 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 188118 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -106792 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -106792 | TotalRevenueColumn |
| Exclusion | -$106,792 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2856 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 115527 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -112671 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -112671 | TotalRevenueColumn |
| Exclusion | -$112,671 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|
| Laboratory Services | 621500 | 945878 | 945878 |
| Occupational Medicine | 621400 | 269642 | 269642 |
| Medical Director Servi | 623990 | 102698 | 102698 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37448 | TotalRevenueColumn |
| Unrelated Business Revenue | 37448 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1355666 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 149051317 | TotalRevenueColumn |
| Related Or Exempt Function Income | 137514057 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1355666 | UnrelatedBusinessRevenue |
| Exclusion | $4,758,905 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50325 | Total |
| Program Services | 50325 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2777209 | Total |
| Program Services | 344847 | ProgramServices |
| Management And General | 2432362 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73674538 | Total |
| Program Services | 67684028 | ProgramServices |
| Management And General | 5990510 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1626228 | Total |
| Program Services | 1495642 | ProgramServices |
| Management And General | 130586 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6034497 | Total |
| Program Services | 5549927 | ProgramServices |
| Management And General | 484570 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5144399 | Total |
| Program Services | 4731304 | ProgramServices |
| Management And General | 413095 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 335800 | Total |
| Program Services | 6918 | ProgramServices |
| Management And General | 328882 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43448 | Total |
| Management And General | 43448 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60564 | Total |
| Management And General | 60564 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6745154 | Total |
| Program Services | 5960713 | ProgramServices |
| Management And General | 784441 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 755423 | Total |
| Program Services | 162140 | ProgramServices |
| Management And General | 593283 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17468924 | Total |
| Program Services | 17177347 | ProgramServices |
| Management And General | 291577 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4652027 | Total |
| Program Services | 3044414 | ProgramServices |
| Management And General | 1607613 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2650147 | Total |
| Program Services | 2221346 | ProgramServices |
| Management And General | 428801 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142016 | Total |
| Program Services | 134345 | ProgramServices |
| Management And General | 7671 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 263899 | Total |
| Program Services | 196806 | ProgramServices |
| Management And General | 67093 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 184567 | Total |
| Management And General | 184567 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2872607 | Total |
| Management And General | 2872607 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4543148 | Total |
| Program Services | 4338706 | ProgramServices |
| Management And General | 204442 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 383575 | Total |
| Management And General | 383575 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Repairs & Maintenance | 2143894 | 2054199 | 89695 | 0 |
| Provider Tax | 1153898 | 1153898 | 0 | 0 |
| Dues & Subscriptions | 303753 | 146650 | 157103 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3482426 | Total |
| Program Services | 3091081 | ProgramServices |
| Management And General | 391345 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137492466 | Total |
| Program Services | 119544636 | ProgramServices |
| Management And General | 17947830 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3527827 | BOY |
| EOY | 6491836 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17188135 | BOY |
| EOY | 19222063 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1165569 | BOY |
| EOY | 1419014 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1417491 | BOY |
| EOY | 1561718 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 73354311 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 28037077 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46355499 | BOY |
| EOY | 45317234 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1099771 | BOY |
| EOY | 1407833 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77693616 | BOY |
| EOY | 83573005 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 148447908 | BOY |
| EOY | 158992703 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10758638 | BOY |
| EOY | 13107454 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 259158 | BOY |
| EOY | 493539 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71735 | BOY |
| EOY | 82221 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22548809 | BOY |
| EOY | 27182855 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33638340 | BOY |
| EOY | 40866069 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105417179 | BOY |
| EOY | 108075551 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2918337 | BOY |
| EOY | 3570648 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6474052 | BOY |
| EOY | 6480435 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 114809568 | BOY |
| EOY | 118126634 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 148447908 | BOY |
| EOY | 158992703 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 11558851 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -239599 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -8002186 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $60,564 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 60564 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Lobbying expenses include the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. St. Mary's Healthcare does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Beginning Balance | 71735 | BeginningBalance |
| Additions During Year | 10486 | AdditionsDuringYear |
| Ending Balance | 82221 | EndingBalance |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7591798 | OtherCostOrOtherBasis |
| Book Value | 7591798 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 49407141 | OtherCostOrOtherBasis |
| Depreciation | 18529181 | Depreciation |
| Book Value | 30877960 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34892 | OtherCostOrOtherBasis |
| Depreciation | 15260 | Depreciation |
| Book Value | 19632 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15108613 | OtherCostOrOtherBasis |
| Depreciation | 8432169 | Depreciation |
| Book Value | 6676444 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1211867 | OtherCostOrOtherBasis |
| Depreciation | 1060467 | Depreciation |
| Book Value | 151400 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45317234 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Health System Depository Account | 71235376 |
| Interest in Net Assets of Foundation | 10051084 |
| Other Receivables | 945560 |
| Intangible Pension Asset | 826563 |
| Third Party Receivable | 514422 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 83573005 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (9 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Pension Costs | $10,627,378 |
| Intercompany Debt to Ascension Health | $8,799,147 |
| Third Party Liability | $2,821,526 |
| Asset Retirement Obligation | $1,500,000 |
| Patient Credit Liabilities | $1,389,656 |
| Deferred Revenue - Meaningful Use | $1,338,989 |
| IBNR Liability | $325,260 |
| Third Party Advance | $272,000 |
| Other Advances | $108,899 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 27182855 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part IV, Line 2b: | ReturnReference |
| Explanation | The Hospital maintains custodial accounts for residents of the skilled nursing facility which totaled $82,221 at 12/31/2012. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 768721 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 108406 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 660315 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38234324 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 31934551 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6299773 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04580 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39003045 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 32042957 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6960088 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05060 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2754803 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 163167 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2591636 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01880 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 693903 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 693903 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14443406 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11199430 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3243976 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02360 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 441207 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 441207 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18333319 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11362597 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6970722 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05060 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 57336364 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43405554 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13930810 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10120 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15461 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15461 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15461 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15461 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $6,918,436 | BadDebtExpenseAmount |
| Amount Attributable To | 1775198 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 50516120 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 51098825 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -582705 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 Guy Park Avenue | AddressLine1 |
| City | Amsterdam | City |
| State | NY | State |
| ZIP Code | 120101054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.smha.org | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 17 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (17 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| St Mary's Healthcare | ||||
| 4988 State Highway 30 | Amsterdam | NY | 12010 | Diagnostic Care, Primary Care, Cancer Medicine, and Inpatient Physical Rehab |
| Wilkinson Residential Health Care | ||||
| Facility 4988 State Highway 30 | Amsterdam | NY | 12010 | Residential Health Care Facility |
| Johnstown Family Health Center | ||||
| 700 S Perry Street | Johnstown | NY | 12095 | Family Health Center |
| Canajoharie Family Health Center | ||||
| 48 Erie Boulevard | Canajoharie | NY | 13317 | Family Health Center |
| Carondelet Family Health Center | ||||
| 380 Guy Park Ave | Amsterdam | NY | 12010 | Family Health Center |
| Gloversville Family Health Center | ||||
| 84 E State Street | Gloversville | NY | 12078 | Family Health Center |
| St Johnsville Family Health Center | ||||
| 7 Timmerman Ave | St Johnsville | NY | 13452 | Family Health Center |
| Northville Family Health Center | ||||
| 331 Bridge Street | Northville | NY | 12134 | Family Health Center |
| Amsterdam OBGYN Center | ||||
| 446A Guy Park Ave | Amsterdam | NY | 12010 | OB/GYN Center |
| Montgomery County Addiction Services | ||||
| 76 Guy Park Ave | Amsterdam | NY | 12010 | Addiction Services |
| Fulton County Day Rehab Addiction Svcs | ||||
| 57 E Fulton Street | Gloversville | NY | 12078 | Addiction Rehabilitation Center |
| Children's Mental Health Clinic | ||||
| 8 Northhampton Road | Amsterdam | NY | 12010 | Children's Mental Health Center |
| Diagnostic Service Center | ||||
| 110 Holland Circle Drive | Amsterdam | NY | 12010 | Diagnostic Care Center |
| Riverfront Diagnostic Service Center | ||||
| 1340 Riverfront Center | Amsterdam | NY | 12010 | Diagnostic Care Center |
| Children's Day Treatment Program | ||||
| 234 Lincoln Street | Gloversville | NY | 12078 | Children's Treatment Center |
| Social Club North | ||||
| 73 North Main Street | Gloversville | NY | 12078 | Human Services |
| Social Club West | ||||
| 17 River Street | Nelliston | NY | 13410 | Human Services |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data and is calculated in compliance with Catholic Health Association (CHA) guidelines. The organization uses a cost accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For charity care, a specific cost-to-charge ratio was applied; for other categories in the table, a cost accounting system was used. | ||
| Part I, Line 7g: The organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I. | ||
| Part II: St. Mary's Healthcare provided the following community building activities in 2012:-Donated the use of a "safe house" for victims of domestic violence and provided maintenance and upkeep of the property. -Community health improvement advocacy through brain injury helmet contest. This program partners with local law enforcement to reach out to young students to teach them the importance of wearing helmets to prevent head injury. St. Mary's has been the driver and sponsor of this program for the last 13 years.-In September and March 2012, hosted the Victim Impact Panel in partnership with the Montgomery County District Attorney's office and the Hamilton-Fulton-Montgomery Prevention Council. This is an awareness program for offenders convicted of misdemeanor driving under the influence of alcohol or other drugs. The goal is to help offenders become more aware of the possible consequences of driving while impaired so they may think to make different choices in the future.-In 2012 St. Mary's Healthcare brought together leaders of local community agencies and the Department of Social Services to address the homeless issues in Amsterdam. Through their continued collaboration, funds were raised to purchase a house to be used as a shelter and temporary housing for men, women and families.-Donated appointed staff and funding to the local Habitat for Humanity Chapter. | ||
| Part III, Line 4: The provision for doubtful accounts is based upon management's assessment of historical and expected net collections considering economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payer category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted the Hospital may place past due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the hospital's policies.The organization's share of bad debt expense in 2012 was $6,918,436 of charges. | ||
| Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as a community benefit. | ||
| Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance, certain collection practices do not apply. | ||
| Part V: St. Mary's Healthcare consists of two licensed facilities, namely, the Hospital and the Wilkinson Residential Health Care Facility, which is a skilled nursing facility. The Hospital has several locations, including two outpatient alcohol rehabilitation clinics, one diagnostic service center, and seven primary care centers. | ||
| Part V, Line 14a: Individual letters are mailed to all uninsured patients informing them of the financial assistance programs available. | ||
| Part V, Line 20d: The maximum amount charged to FAP-eligible individuals is based on the uninsured discount, which is reviewed and updated annually, as applicable. Uninsured patients with the ability to pay will be provided a discount based on the discount provided to the highest-paying payer that accounts for at least three percent of the Hospital's volume or gross patient revenues. In 2012, the Hospital provided discounts to the uninsured equal to 28% of charges for inpatients and 36% of charges for outpatients. | ||
| Part VI, Line 2: In 2012, the Hospital contracted with Professional Research Consultants, Inc. (PRC) to conduct St. Mary's Healthcare's Community Health Needs Assessment (CHNA). The assessment, made available to the public in March 2013, incorporated data from both quantitative and qualitative sources including random sampling of community members, key informant focus groups and secondary data sources. The focus groups consisted of input from persons who represent the community we serve, including business leaders, community-based and social service agencies, school districts and those with a special knowledge or expertise in public health. The data from this assessment was made available to the public via the hospital's website, http://smha.healthforecast.net and upon request. The hospital also used data from our county health departments' community needs surveys.Additionally, the Hospital sought input from its Board of Trustees, Medical Executive Committee, leadership staff and community partners when completing its annual Integrated Strategic, Operational, and Financial Plan (ISOFP). The ISOFP uses pertinent data and comprehensive feedback to outline current and future critical healthcare needs for the Hospital's service area, as well as the resources needed to address the identified issues. | ||
| Part VI, Line 3: St. Mary's Healthcare, in keeping with the mission and policies of Ascension Health, strives to maintain a balance between providing care of the poor with the ability of the Hospital to maintain quality health care for the community it serves. As part of its financial assistance policies, the Hospital offers a self pay discount to all uninsured patients as a percentage off the standard charge; the discounts were set at 28% for inpatient services and 36% for outpatient services. In 2012, the discounts provided to the uninsured were approximately $2.6 million. The Carondelet Care assistance program is the next level of financial assistance available to the Hospital's patients. This program is available to all patients who can demonstrate a financial burden associated with their patient responsibility. Financial assistance is provided through collaboration between the health insurance enrollment and financial assistance staff. Although the two departments offer different financial assistance services, the enrollment staff is trained to help those individuals who do not qualify for any government sponsored programs to access the Carondelet Care assistance program. Similarly, the Financial Counselors often refer patients in need of insurance to our Enrollment Specialist. The enrollment staff is available to meet with community members at the main hospital, at our Memorial campus and at all seven of our off-site family health centers. Staff is also trained to refer individuals to free or low cost health care programs within the community if no other options are immediately available. In 2012, 750 individuals were enrolled in health insurance programs as a direct result of these efforts. The Hospital enroller works collaboratively with Fidelis Care, the Cancer Services Program and community agencies to further expand its outreach. Large posters describing the Hospital's willingness to help patients with financial assistance are displayed in all main entrances to the Hospital and the off-site locations, as well as in our multiple registration sites and waiting rooms. The informational posters are in English and Spanish and urge patients to call if they are concerned about bill payment. Translation services are also available as needed via language line telephones and iPad video application.Brochures in English and Spanish are available at all service sites and offer detailed information about the various levels of assistance. In addition to offering discounts, St. Mary's offers options for payment plans and payment schedules. The English and Spanish brochures are also available on the Hospital web site. Information on financial assistance is also contained in the Patient Information Guide given to all inpatients at St. Mary's Healthcare. | ||
| Part VI, Line 4: St. Mary's Healthcare serves a rural community consisting of Montgomery and Fulton counties in New York State as its primary service area (PSA), and is the only acute care hospital in Montgomery County. On average, 65% of hospital admissions come from Montgomery County, and 26% come from Fulton County. The main hospital campus is located in the city of Amsterdam, though a number of vital services are available on the Memorial campus in the town of Amsterdam. The Hospital operates seven primary care centers; four sites in Montgomery County (two located in Amsterdam, one in Canajoharie and one in St. Johnsville) and three sites in Fulton County (Johnstown, Gloversville and Northville), in addition to a cancer medicine center and specialty practices in general surgery, urology, gastroenterology, obstetrics/gynecology, ophthalmology and pain management. The Hospital's comprehensive behavioral health programs provide extensive mental health and addiction services, including inpatient and outpatient treatment in Montgomery and Fulton Counties. The PSA represents one of the oldest regions in NYS. Estimates indicate that the 65 and older population will continue to grow. According to Thomson Reuters, the only segment of our population showing growth is the 65+, with a growth rate of 9.8%. In fact, within this segment, 85+ shows a 6.7% increase. The unemployment rate in Fulton and Montgomery Counties continues to be among the highest in NYS, exceeding the State average by 1.0%. There are many factors that contribute to the community's poverty levels, including the high school dropout rate in both counties. Reports indicate that 30% of ninth graders entering school will not complete high school in four years in our PSA. The lack of education affects the workforce, contributes to higher unemployment and greater risk of working without health insurance. Forty-five percent of all families in poverty are headed by a single parent with children.Research indicates a decline in the Caucasian population, which is a consistent trend over several years. The Hispanic community is our largest minority community, with the largest concentration within the city of Amsterdam. The 2010 Census indicates that 26.2% of the residents of Amsterdam are identified as Hispanic and according to the estimates this segment of our population will grow by 12.7% in the next five years. The Hospital employs bilingual and bicultural healthcare professionals to meet the needs of the Hispanic community.Health statistics relevant to the community's health status are as follows: Over 70% of the St. Mary's Healthcare Service Area is overweight. Especially alarming is that 38% of our children are overweight. The relationship of being overweight with other health issues such as high blood pressure, chronic depression, arthritis and diabetes are significant. Poor nutritional habits and lack of physical activity are significant contributing factors to the overweight status of our community.Access to quality health care services is important for increasing the quality of life for everyone. It impacts overall physical, social and mental health status; the prevention of disease and disability; quality of life; preventable death and life expectancy. Uninsured individuals comprise 13% of the population in Fulton and Montgomery Counties. Nearly 8% of the population in St. Mary's Healthcare's service area went without any type of healthcare insurance coverage at some point in the past year. Disproportionately, over 16% of those with low-income went without some type of coverage the past year. These numbers are significantly less favorable than the US average of 4.8%. Additionally, nearly 40% of respondents reported some type of difficulty or delays in receiving needed health care in the past year, with those who are uninsured much more likely to report barriers when compared to the insured population. The Hospital serves a disproportionate share of the Medicaid population, and approximately 23% of the total inpatient discharges are Medicaid. | ||
| Part VI, Line 5: St. Mary's Healthcare promotes the health of its community through various activities, including the following:- St. Mary's made a financial donation to the City of Amsterdam's Bacon Recreational Center. The Center provides year-round recreational facilities for youth and family focusing on health and wellness, physical activity and community pride. Many programs there are no cost, allowing lower-income families to be able to participate without a financial burden. Additionally, the hospital also provides health education programs for the community at the Center.- More than 1,400 people attended free educational programs offered by the Hospital on various topics including Alzheimer's Disease, Childbirth Education, Colon Cancer, Breast Cancer, Bladder Health, Bone and Joint Health, Women's Safety, Brain Injury Awareness, Infant CPR, Lactation Support, Physical Activity and Nutrition, Concussions in Athletes and Designer Drugs.- St. Mary's partnered with our local school districts hosting five school tours in 2012, providing children first-hand knowledge and experience of the operations of a hospital. Our Registered Dieticians participated in school wellness days to teach children about the importance of healthy eating and physical activity. - St. Mary's associates gave back to their community serving on various boards including The Amsterdam Homeless Coalition, Liberty ARC Board, Montgomery County Office for the Aging, The Sanford Home, Montgomery County Habitat for Humanity, the Minority Health Task Force, the Suicide Prevention Task Force, Sexual Assault Task Force, United Way, Regional Chamber of Commerce, Glove City and Amsterdam Rotary, Children's Aid Society, Community Health Center and Fulton County Long-term Care Council Boards. - In 2012, St. Mary's associates gave their time to better the community by participating in walks for Alzheimer's Disease, American Cancer Society's Relay for Life and other awareness walks as well as taking part in clean-up projects in both Fulton and Montgomery Counties.- St. Mary's providers are able to refer uninsured or underinsured patients with medication needs to the Dispensary of Hope program at the Hospital. This program provides free prescription medications to those who lack prescription drug coverage.- Continued to lead the work of the Fullmont Community Health Improvement Coalition, a group of committed partners from local health care entities and community agencies whose mission is to improve the health status for all we serve. During 2012, this group readjusted their focus to respond to the changes of the Affordable Care Law. This group continues to collaborate on a plan to address the needs identified in our 2012 CHNA.- In 2012, we continued our ninth year of distributing educational information on insurance eligibility for children through the school system, public service announcements, advertising and appearances at "back to school" events such as PTA meetings and open houses.- Enrolled 750 persons in State-sponsored insurance programs. - Provided 3,381 life-saving cancer screenings to 863 uninsured individuals through the Cancer Services Program. - Expanded the "Promotora de Salud" program that provides for outreach, education, referral, follow-up, case management and advocacy services to our Latino and migrant community. The goal of the program is to promote needed primary health services and prevention efforts in a culturally appropriate manner. In 2012, nearly 80 migrant clients were provided health care services through this program, most of whom had never seen a healthcare provider before. The Promotora has an average of 250 client contacts/communications per month. Additionally, there are countless other communications, educational trainings, community events, individual and family visits, and service navigation that has been made available by the program. - Maintained the importance of culturally sensitive and accurate communication with Latino patients and patients with limited English proficiency through the use of translation services which include professional phone and video translation services and the translation of key documents. English and Spanish are the most prominent languages spoken in the community, so all signage is posted in both English and Spanish throughout the organization. The iPad video services also serve those who are in need of sign language services.- Developed and distributed 30,000 free copies of a Breast Cancer Awareness/Health Facts Book to the community. - Provided free screenings at various health fairs and community events throughout the year.- Participated in the Fulton and Montgomery County Office for Aging picnics to educate seniors on a variety of wellness topics.- Hosted eight different support groups including the Women's Cancer, Brain Injury, Behavioral/Mental Health, Ostomy, Diabetes, Survivors of a Loved One's Suicide (SOLOS) and Alzheimer's Caregiver Support Groups supporting nearly 250 community members who receive peer support and educational opportunities to manage their concerns. This year we partnered with Community Hospice to add a Grief Support Group.- The Medical Explorers, a group for young adults, meets monthly for education and socialization with the goal of assisting youth to explore the various options in healthcare careers.- Club 60, an educational and social group for seniors aged 60 and above, meets monthly for updates on health-related issues such as the flu vaccine and specialized primary care services. Each event includes the opportunity to ask questions and spend time with the President/CEO or other members of the senior management team.- A majority of the Hospital's Board of Trustees is comprised of persons who reside in the organization's primary service area and are neither employees nor independent contractors of the Hospital, nor family members thereof.- The Hospital established the Carondelet Community Fund, which provides modest assistance to local programs and agencies whose values and mission align with the values of St. Mary's Healthcare. Grants from the fund are made to eligible non-profit community agencies which are located within the service area of St. Mary's Healthcare and which share the values of St. Mary's with an emphasis on service to the poor and vulnerable, and holistic care. The total amount awarded from this fund in 2012 was $10,800. | ||
| Part VI, Line 6: St. Mary's Healthcare (the Hospital) is a member of Ascension Health. In December 2011, Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 21 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health Alliance, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province American Province. The Hospital, located in Amsterdam, New York, is a nonprofit acute care hospital. The consolidated financial statements include the Hospital, Medical Services Enhancement, Inc. (MSE), and The Foundation of St. Mary's Hospital at Amsterdam, Inc. (Foundation). MSE operates a medical office building to retain and attract physician specialists to better serve the healthcare needs of the community. The Foundation's primary purpose is to assist the Hospital to develop and expand its services to the community by providing a focal point as the recipient for philanthropic support and by transferring funds to the Hospital. The Hospital provides acute inpatient, inpatient physical rehabilitation, outpatient, and emergency care services for the residents of Montgomery, Fulton, and Hamilton counties. The Hospital also provides an array of Behavioral Health services including inpatient mental health and alcohol rehabilitation plus outpatient mental health and alcohol related services. Admitting physicians are primarily practitioners in the local area. Additionally, the Hospital operates a 160 bed skilled nursing facility which provides housing, healthcare and other related services to residents who are severely limited in their ability to care for themselves due to illness and/or disability, and a medical adult day care program. The Hospital is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. Inaccordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources used for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed cost of programs intentionally designed to serve persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings.Discounts are provided to all uninsured patients in the acute care facility, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliancewith guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS).The amount of traditional charity care provided, determined on the basis of cost, excluding the provision for bad debt expense, was approximately $572 and $563 for the years ended December 31, 2012 and 2011, respectively. The amount of unpaid cost of public programs, cost of otherprograms for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying supplementary information. | ||
| NY | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| Total Nbr Of501 C3 And Govt Grants | 0 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance |
|---|---|---|---|
| Family Care - Entitlement Provider | 4 | 17452 | 0 |
| Family Care - Entitlement Resident | 11 | 10568 | 0 |
| ICM - Patient Service Dollars | 156 | 14481 | 0 |
| SCM - Patient Service Dollars | 92 | 7824 | 0 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The grant funds awarded are to clients of the family care, intensive case management, and supportive case management programs which are administered through the Hospital's behavioral health services division. The amounts are determined based on evaluation of client needs as determined by their individual case managers. All amounts are processed in accordance with the Hospital's disbursements practices which require evidence of supporting documentation for all expenditures, and required approvals. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Victor Giulianelli | ||||||||||||||
| President & CEO | 332365 | 0 | 357250 | 0 | 118472 | 0 | 5000 | 0 | 21808 | 0 | 834895 | 0 | 0 | 0 |
| Mohammad R Ghazi-Moghadam MD | ||||||||||||||
| Director | 205353 | 0 | 0 | 0 | 17383 | 0 | 0 | 0 | 5915 | 0 | 228651 | 0 | 0 | 0 |
| John Sagan | ||||||||||||||
| VP of Finance / CFO | 227822 | 0 | 36768 | 0 | 63474 | 0 | 3880 | 0 | 19079 | 0 | 351023 | 0 | 0 | 0 |
| Scott Bruce | ||||||||||||||
| VP of Operations | 247873 | 0 | 37150 | 0 | 30969 | 0 | 23746 | 0 | 21100 | 0 | 360838 | 0 | 0 | 0 |
| John Kelley | ||||||||||||||
| VP of Mental Health | 155778 | 0 | 29631 | 0 | 52600 | 0 | 3933 | 0 | 20388 | 0 | 262330 | 0 | 0 | 0 |
| Timothy Shoen | ||||||||||||||
| VP of Medical Affairs | 309846 | 0 | 36979 | 0 | 49983 | 0 | 5000 | 0 | 14948 | 0 | 416756 | 0 | 0 | 0 |
| Michelle Walsh | ||||||||||||||
| VP of Nursing | 187352 | 0 | 28785 | 0 | 8431 | 0 | 9034 | 0 | 6567 | 0 | 240169 | 0 | 0 | 0 |
| James Charland MD | ||||||||||||||
| Physician | 579260 | 0 | 0 | 0 | 12922 | 0 | 0 | 0 | 14417 | 0 | 606599 | 0 | 0 | 0 |
| Hamid Aziz Rehman MD | ||||||||||||||
| Physician | 525899 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 525899 | 0 | 0 | 0 |
| David Lehr MD | ||||||||||||||
| Physician | 404482 | 0 | 0 | 0 | 20330 | 0 | 5000 | 0 | 18892 | 0 | 448704 | 0 | 0 | 0 |
| Deborah Sculco | ||||||||||||||
| Physician | 399106 | 0 | 10000 | 0 | 5546 | 0 | 2461 | 0 | 5879 | 0 | 422992 | 0 | 0 | 0 |
| Kendy Verpile | ||||||||||||||
| Physician | 250804 | 0 | 33528 | 0 | 54802 | 0 | 1278 | 0 | 8075 | 0 | 348487 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Per St. Mary's Healthcare's accountability plan, spousal travel is reimbursed if there is a business purpose, however the amount reimbursed is also included as income on the individual's W-2. Certain St. Mary's Healthcare employees are reimbursed for cell phone/PDA expense, which is included on the respective employee's W-2. These payments are grossed up to include tax related obligations paid. St. Mary's Healthcare offers a fitness club membership credit to all employees to reimburse half of the cost of a yearly fitness club membership up to $150 per year. |
| Part I, Line 4b | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The filing organization contributed to the supplemental nonqualified retirement plan in the amount as noted: Victor Giulianelli - $64,408 John Sagan - $32,354 John Kelly - $26,528 Timothy Shoen - $26,528 Scott Bruce - $10,629 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related St. Mary's Healthcare entity boards. | |
| Form 990, Part VI, Section A, line 6 | St. Mary's Healthcare has a single corporate member, Ascension Health. | |
| Form 990, Part VI, Section A, line 7a | St. Mary's Healthcare has a single corporate member, Ascension Health, which has the ability to elect members to the governing body of the Hospital. | |
| Form 990, Part VI, Section A, line 7b | Ascension Health has designed a system of authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organization & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. The Board of Trustees has delegated the review of the Form 990 to its Finance Committee. Management presents the Form 990 to Finance Committee Members to review and answer any Committee member's questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. | |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. | |
| Form 990, Part VI, Section B, line 15 | In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive compensation committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to CEOs at other hospitals who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. | |
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. | |
| Form 990, Part XI, line 9: | Change in Temporary and permanently restricted interest in Foundation 658,694. FAS 158 Pension Adjustment -8,871,091. Other 210,211. | Changes in Net Assets or Fund Balances: |
| Form 990, Part VII, Section A: | During 2012 and 2011, the Hospital paid Ronald Marsh, M.D. for services rendered in his role as surgeon of the Hospital, not for his duties as a board member. | Explanation of Compensation for Ronald Marsh, M.D.: |
| Form 990, Part VII, Section A: | During 2012 and 2011, the Hospital paid Emily Etzkorn, M.D. for services rendered in her role as surgeon of the Hospital, not for her duties as a board member. | Explanation of Compensation for Emily Etzkorn, M.D.: |
| Form 990, Part VII, Section A: | During 2012, the Hospital paid Mohammad R. Ghazi-Moghadam, M.D. for services rendered in his role as a physician of the Hospital, not for his duties as a board member. | Explanation of Compensation for Mohammad Ghazi-Moghadam, M.D.: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health | |||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | 501(c)(3) | Line 11, Type I: 509 | Ascension Health Alliance | 0 | |
| Medical Services Enhancement Inc | |||||||||||
| 425 Guy Park Avenue | Amsterdam | NY | 12010 | 141776546 | Rental of Medical and Office Space | NY | 501(c)(25) | N/A | St Mary's Healthcare | 1 | |
| The Foundation of St Mary's Hospital at Amsterdam Inc | |||||||||||
| 427 Guy Park Avenue | Amsterdam | NY | 12010 | 133254655 | Supporting Organization | NY | 501(c)(3) | Line 11, Type III-FI | 1 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Medical Services Enhancement Inc | ||
| J | 281290 | Actual amount paid or transferred |
| Medical Services Enhancement Inc | ||
| D | 202735 | Actual amount paid or transferred |
| The Foundation of St Mary's Hospital at Amsterdam Inc | ||
| C | 459665 | Actual amount paid or transferred |
| The Foundation of St Mary's Hospital at Amsterdam Inc | ||
| P | 171884 | Actual amount paid or transferred |
| Ascension Health | ||
| O | 5512809 | Actual amount paid or transferred |
| Ascension Health | ||
| D | 69363 | Actual amount paid or transferred |
| Ascension Health | ||
| Q | 3010368 | Actual amount paid or transferred |