Our Lady of Bellefonte Hospital Inc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Our Lady of Bellefonte Hospital Inc (EIN 61-1356023)
- Tax period
- 2011-09-01 to 2012-08-31
- Filed
- 2013-07-15
- IRS object ID
- 201311969349300301
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-15T01:12:25-05:00 | Timestamp |
| Tax Period End Date | 2012-08-31 | 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 | 1750 TYSONS BLVD | AddressLine1 |
| City | MCLEAN | City |
| State | VA | State |
| ZIP Code | 221024219 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611356023 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Our Lady of Bellefonte Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OURL | NameControl |
| Phone | 6068333333 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joe Buchheit | Name |
| Title | Chief Financial Officer | Title |
| Phone | 6068333600 | Phone |
| Date Signed | 2013-07-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | David A Craig | Name |
| PTIN | P00542227 | PTIN |
| Phone | 7032511000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Kevin Halter | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 157292756 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.olbh.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | Acute Care Hospital | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1545 | TotalNbrEmployees |
| Total Nbr Volunteers | 125 | TotalNbrVolunteers |
| Total Gross UBI | 2050400 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 941431 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2728884 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 150022362 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 149745567 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 426499 | InvestmentIncomePriorYear |
| Investment Income Current Year | 352056 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4064403 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4457326 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 155454695 | TotalRevenuePriorYear |
| Total Revenue Current Year | 157283833 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 372800 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 375315 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 59461273 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 58130093 | 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 | 87228960 | OtherExpensePriorYear |
| Other Expenses Current Year | 90399736 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 147063033 | TotalExpensesPriorYear |
| Total Expenses Current Year | 148905144 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8391662 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8378689 | RevenuesLessExpensesCY |
| Total Assets BOY | 98205634 | TotalAssetsBOY |
| Total Assets EOY | 114048363 | TotalAssetsEOY |
| Total Liabilities BOY | 50715835 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 77870120 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47489799 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 36178243 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 135355908 | Expense |
| Grants | 375315 | Grants |
| Revenue | 148858673 | Revenue |
| Description | To bring compassion to healthcare and to be good help to those in need by providing healthcare services. Please see community benefit disclosures in Sch H. | Description |
| Total Program Service Expense | 135355908 | 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 | 0 | 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 | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | 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 | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 105 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1545 | 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 |
| 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 | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Aaron Akers | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6068333333 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | OLBH St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Gregory Bausch Pharm D | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Mary Carolyn Carter | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| William Dickens | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Larry Fields MD | ||||||||
| Board Member (Sept-Dec) | 4.00 | X | 0 | 0 | 0 | |||
| Mary Catherine Flath PhD | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| John Gross III | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Lawrence Hubbard CHCIO | ||||||||
| Board Member | 50.00 | X | 0 | 588946 | 92858 | |||
| Connie Johnson | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Larry Jones | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Elizabeth Keith | ||||||||
| Board Member | 50.00 | X | 0 | 184254 | 36729 | |||
| Phillip Bruce Leslie Esq | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| James Martin MD | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| EW Unnikrishnan MD | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| William Willan | ||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | |||
| Carol Allen | ||||||||
| Board Member (Jan-Aug) | 4.00 | X | 0 | 0 | 0 | X | ||
| Kevin Halter FACHE | ||||||||
| CEO - BSKY | 50.00 | X | 0 | 362079 | 58560 | X | ||
| Daniel Huffman | ||||||||
| Board Member | 6.00 | X | 0 | 0 | 0 | X | ||
| John Wallenhorst PhD | ||||||||
| President | 50.00 | X | 0 | 250446 | 33699 | X | ||
| Frank Warnock Esq | ||||||||
| Chairman (Sept-Dec) | 6.00 | X | 0 | 0 | 0 | X | ||
| Joe Buchheit | ||||||||
| CFO-BSKY/Treasurer | 50.00 | 0 | 268350 | 40227 | X | |||
| Jennifer Moore | ||||||||
| Secretary | 50.00 | 0 | 230682 | 22073 | X | |||
| Michele Friday MD | ||||||||
| Physician | 50.00 | 750159 | 0 | 47497 | X | |||
| Daniel T Goulson MD | ||||||||
| CMO | 50.00 | 376508 | 0 | 27854 | X | |||
| Kurt F Jaenicke MD | ||||||||
| Physician | 50.00 | 619074 | 0 | 31845 | X | |||
| Phillip L Lackey MD | ||||||||
| Physician | 50.00 | 384541 | 0 | 40650 | X | |||
| Yogendra Prasad MD | ||||||||
| Physician | 50.00 | 568194 | 0 | 50483 | X | |||
| Mark Gordon | ||||||||
| Former CEO | 50.00 | 0 | 360340 | 72092 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2698476 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2245097 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 554567 | TotalOtherCompensation |
| Number Individuals GT100 K | 41 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| Morrison Management Specialists Inc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Cafeteria/Food Services | 3577426 |
| Ashland Anesthesia PSC | |||||
| PO Box 1377 | Ashland | KY | 411051377 | Medical Services | 2717108 |
| Aramark CTS Inc | |||||
| 12483 Collections Center Dr | Chicago | IL | 60693 | Equipment Maintenance | 1788542 |
| Aramark Healthcare | |||||
| 24863 Network PL | Chicago | IL | 60693 | Lift Team | 1342123 |
| Allied Barton | |||||
| PO Box 828854 | Philadelphia | PA | 191828854 | Security Services | 1027202 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 31 | NumberOfContractorsGT100K |
| Related Organizations | 226162 | RelatedOrganizations |
| Government Grants | 2482722 | GovernmentGrants |
| All Other Contributions | 20000 | AllOtherContributions |
| Noncash Contributions | 19694 | NoncashContributions |
| Total Contributions | 2728884 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Service Rev. | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 149745567 | TotalRevenueColumn |
| Related Or Exempt Function Income | 148858673 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 886894 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 149745567 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 252292 | TotalRevenueColumn |
| Exclusion | $252,292 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 405092 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 405092 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 405092 | TotalRevenueColumn |
| Exclusion | $405,092 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 107187 | Securities |
| Other | 1500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 8923 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 107187 | Securities |
| Other | -7423 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 99764 | TotalRevenueColumn |
| Exclusion | $99,764 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| Retail Pharmacy Rev. | 446110 | 2587419 | 1163506 | $1,423,913 |
| Cafeteria/Vending | 531120 | 846038 | $846,038 | |
| Comm. Health & Fitness | 621610 | 316126 | $316,126 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 302651 | TotalRevenueColumn |
| Exclusion | $302,651 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4052234 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 157283833 | TotalRevenueColumn |
| Related Or Exempt Function Income | 148858673 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2050400 | UnrelatedBusinessRevenue |
| Exclusion | $3,645,876 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 375315 | Total |
| Program Services | 375315 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 558706 | Total |
| Program Services | 502835 | ProgramServices |
| Management And General | 55871 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43011862 | Total |
| Program Services | 38710676 | ProgramServices |
| Management And General | 4301186 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3870869 | Total |
| Program Services | 3483782 | ProgramServices |
| Management And General | 387087 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7610158 | Total |
| Program Services | 6849142 | ProgramServices |
| Management And General | 761016 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3078498 | Total |
| Program Services | 2770648 | ProgramServices |
| Management And General | 307850 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 640092 | Total |
| Program Services | 576083 | ProgramServices |
| Management And General | 64009 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179160 | Total |
| Program Services | 161244 | ProgramServices |
| Management And General | 17916 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15667 | Total |
| Program Services | 14100 | ProgramServices |
| Management And General | 1567 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4225101 | Total |
| Program Services | 3802591 | ProgramServices |
| Management And General | 422510 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1490557 | Total |
| Program Services | 1341501 | ProgramServices |
| Management And General | 149056 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286793 | Total |
| Program Services | 258114 | ProgramServices |
| Management And General | 28679 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4123412 | Total |
| Program Services | 3711071 | ProgramServices |
| Management And General | 412341 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5957300 | Total |
| Program Services | 5361570 | ProgramServices |
| Management And General | 595730 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419796 | Total |
| Program Services | 377816 | ProgramServices |
| Management And General | 41980 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2893069 | Total |
| Program Services | 2893069 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10525714 | Total |
| Program Services | 9473143 | ProgramServices |
| Management And General | 1052571 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1546785 | Total |
| Program Services | 1392107 | ProgramServices |
| Management And General | 154678 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 21674449 | 19507004 | 2167445 |
| Purchased Services | 15556951 | 14001256 | 1555695 |
| Bad Debt | 10144394 | 10144394 | |
| BSHSI Corporate Dues | 5031548 | 4528393 | 503155 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5688948 | Total |
| Program Services | 5120054 | ProgramServices |
| Management And General | 568894 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148905144 | Total |
| Program Services | 135355908 | ProgramServices |
| Management And General | 13549236 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9071874 | BOY |
| EOY | 18210455 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17698609 | BOY |
| EOY | 18635012 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1290667 | BOY |
| EOY | 876804 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3669259 | BOY |
| EOY | 3495278 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 453826 | BOY |
| EOY | 1008536 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 125034786 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 70826555 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55370063 | BOY |
| EOY | 54208231 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7030076 | BOY |
| EOY | 7607838 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388320 | BOY |
| EOY | 449980 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3232940 | BOY |
| EOY | 9556229 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98205634 | BOY |
| EOY | 114048363 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14344504 | BOY |
| EOY | 12938926 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3999967 | BOY |
| EOY | 3865059 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32371364 | BOY |
| EOY | 61066135 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50715835 | BOY |
| EOY | 77870120 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47489799 | BOY |
| EOY | 36177683 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 560 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47489799 | BOY |
| EOY | 36178243 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98205634 | BOY |
| EOY | 114048363 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8378689 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -19690245 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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 | $15,667 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 15667 | 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 | Our Lady of Bellefonte Hospital paid dues to the Kentucky Hospital Association (KHA), Catholic Health Association (CHA), and American Hospital Association (AHA) 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: 18% ($8,858) to the KHA, 5.2% ($1,360) CHA, and 25.1% ($5,449) AHA for a total of $15,667. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4533456 | OtherCostOrOtherBasis |
| Book Value | 4533456 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 57145204 | OtherCostOrOtherBasis |
| Depreciation | 23476256 | Depreciation |
| Book Value | 33668948 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2532517 | OtherCostOrOtherBasis |
| Depreciation | 1560480 | Depreciation |
| Book Value | 972037 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 56851180 | OtherCostOrOtherBasis |
| Depreciation | 42601168 | Depreciation |
| Book Value | 14250012 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3972429 | OtherCostOrOtherBasis |
| Depreciation | 3188651 | Depreciation |
| Book Value | 783778 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 54208231 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| HPL/GL | 7884204 |
| Other Pat and 3rd Party Payors | 635916 |
| Goodwill | 265985 |
| Miscellaneous Receivables | 707762 |
| Accrued Interest Receivables | 14124 |
| Due from Affiliate | 48238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9556229 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Mcare Settlements | $4,053,068 |
| LT Liability Pension | $48,774,204 |
| HPL/GL | $7,884,204 |
| Other LT Liability | $354,445 |
| Unclaimed Property Accrual | $214 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 61066135 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X: | ReturnReference |
| Explanation | Schedule 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 derecognition 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| 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 | 2004386 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 492033 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1512353 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01090 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19708539 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14916157 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4792382 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03450 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21712925 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15408190 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6304735 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04540 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 998706 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 33985 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 964721 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00700 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1577618 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 162470 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1415148 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 770710 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 770710 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 174660 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 174660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3521694 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 196455 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3325239 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02410 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25234619 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15604645 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9629974 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06950 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 2028 | PersonsServed |
| Total Community Building Expense | 10650 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10650 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 145 | PersonsServed |
| Total Community Building Expense | 5990 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5990 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 1874 | PersonsServed |
| Total Community Building Expense | 8293 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8293 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 18 | NumberOfActivitiesOrPrograms |
| Persons Served | 6245 | PersonsServed |
| Total Community Building Expense | 41222 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 41222 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 6166 | PersonsServed |
| Total Community Building Expense | 47817 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 47817 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 898 | PersonsServed |
| Total Community Building Expense | 4011 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4011 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 17356 | PersonsServed |
| Total Community Building Expense | 117983 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 117983 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,566,330 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 39789296 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 51022483 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -11233187 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| 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 | Our Lady of Bellefonte Hospital Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Our Lady of Bellefonte Hospital Inc | 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 | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| 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 | 10 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (10 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Med Plaza Pharmacy | ||||
| 700 St Christopher Drive | Ashland | KY | 41101 | Pharmacy |
| Ashland Sleep Lab | ||||
| 2920 Winchester Avenue | Ashland | KY | 41101 | Sleep Lab |
| Bellefonte Sleep Lab | ||||
| 118 St Christopher Drive | Ashland | KY | 41101 | Sleep Lab |
| Ironton MRI | ||||
| 1015 East Ring Road | Ironton | OH | 45638 | Imaging Center |
| Vitality Center | ||||
| St Christopher Drive | Ashland | KY | 41101 | Cardio/Vascular Rehab |
| Same Day Surgery Center | ||||
| 1101 St Christopher Drive | Ashland | KY | 41101 | Surgery Center |
| Bellefonte Home Health Care Agency | ||||
| 1819 Ashland Road | Greenup | KY | 41144 | Home Health |
| OLBH Pediatric Rehabilitation Clinic | ||||
| 1629 Ashland Road Unit 2 | Greenup | KY | 41144 | Pediatric Rehab |
| Bellefonte Behavioral Health | ||||
| St Christopher Drive | Ashland | KY | 41101 | Behavioral Health |
| Bellefonte Center | ||||
| 1000 Ashland Drive | Ashland | KY | 41101 | Womens Health, Pre-testing, Various physician offices |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c 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, Line 7g: Primary Care Clinic subsidy: Bellefonte Physician Services, Inc., ("BPS") in conjunction with OLBH employs 70 providers in order to offer quality health care to the residents of Eastern Kentucky and Southeastern Ohio, more specifically Boyd, Greenup, Carter Counties in Kentucky and Lawrence County Ohio. BPS providers offer healthcare services to patients who are either uninsured or are covered by Medicaid, which equals approximately 12% and 23% of our overall patient population. | ||
| Part I, L7 Col(f): The bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $10,144,349. | ||
| Part II: Healthy Community Initiative: BSKHS' commitment to social and economic justice is integrated into the fabric of the organization through its Strategic Quality Plan and its common vision of a healthy community. Our vision of a healthy community is embodied in the following statements. "A healthy community is a good place to live for all residents. The rich diversity of cultures and capacities of the community are celebrated and mobilized, with a particular concern for the poor, marginalized and dying, to create physical and social environments that promote families, nurture youth and support senior citizens. Individuals have the opportunity to fully participate in defining holistic well-being and assuming responsibility for the development of their innate potential."BSKHS is working to engage and empower the members of the Argillite community located in Greenup County to support them in improving their quality of life and holistic health. The Director of Healthy Community Initiatives is coordinating efforts to unite the communities and aid in health and social issues. The Director is assessing the needs and assets of the communities through resident interviews, community forums, surveys and focus groups. With this data, the community members will choose the priority improvement initiatives that residents and supporting organizations want to address. Argillite is a rural community with approximately 1,000 residents. Single-family homes and trailers prevail. 47% of the households make less than $25,000 per year with 17% of that number making less than $15,000 annually. 43% of residents have no high school diploma; 16% of that number have less than a 9th grade education. Argillite Elementary has 68% of students receiving free and reduced lunch. Community projects include distribution of free books to students and a back pack program to assist low income students with school supplies and clothes and funding for a weekend snack sack program that provides students most at risk of going hungry with food during the weekend. A walking track was built in the community to provide a safe area for residents to exercise in close proximity to where they live, along with school and community gardens for students and residents.The Ironton, Ohio community is a small urban area of approximately 25,000 residents. The once thriving city with abundant jobs in the steel and industrial areas is now in a situation of high unemployment, low job opportunities and a strapped city budget with an aging infrastructure. The 9th street community is home to subsidize housing for seniors and families; high crime rates and drug abuse are taking a toll on the residents. One of the first initiatives was the purchase of computers for senior housing recreation rooms and a community center used by students and families. Financial support for a cash strapped after school program allowed services to be provided three days a week to low income students needing assistance with homework and providing a safe environment for students. Students participating in summer youth activities at the community center provides the opportunity to go on fieldtrips, safe summer day camp activities and mentors to work with on the various topics. Community garden is in the final stages of completion and will be available in the spring of 2013. The garden will provide community residents with space to grow fresh vegetables, support through master gardeners will assist residents in learning how to grow vegetables to use in family meals. Work on a local farmers market will provide fresh fruit and vegetables in an area that is labeled a food dessert. In FY12, Healthy Community Services conducted 100 health fairs providing a total of approximately 6,000 health screening tests. All participants in our health fairs received personal health counseling and those with abnormal results received appropriate educational materials and the offer of assistance in finding a health care provider if they had none. Information about the Northeast Kentucky Care Center, our local "free" clinic was also given to participants who were uninsured or couldn't afford a health care provider. We currently partner with 51 local churches with 21 additional congregations on our mailing list. We offered our area's first basic faith ministery education program during the summer of 2012. Six nurses completed the course. Our Healthy Community Services Van Ministry provides free non-emergency medical transportation to patients who are receiving outpatient services or appointments with affiliated physicians. We have two vans one is equipped with a wheelchair lift. In FY12, the number of "round trips" we provided increased from 2,013 in FY11 to 2,131 and we traveled slightly over 4,000 more miles in FY12 than in FY11.Healthy Community Services provides our community CPR classes. In FY12 we provided 20 classes and certified 133 individuals in CPR. We provided one Safe Sitter class in FY12 resulting in 8 certified Safe Sitters. BSKHS provides a Women's Services mobile clinic that offers mammography screening, monthly bone density screening In FY2012, we served 7,718 in the pre-osteoporosis or osteoporosis range. Two primary care physicians volunteered four times a month at Northeast Kentucky Care Center, our local free clinic, throughout FY2012, our medical students are also involved in the clinic. 14th Annual Bicycle Safety Camp in FY 2012 served 55 children. We also provided educational programs at both end-of-school activities | ||
| 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's 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 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publicly insured patients where reimbursement is less than cost of providing the service. | ||
| 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 VI, Line 2: Our Lady of Bellefonte Hospital (OLBH) uses multiple approaches to assess the health needs of the communities it serves. We have a community based board of directors that provides the hospital with guidance and input on services needed in the local community through contacts with local business and government leaders. Community health screening data is gathered through the year and analyzed for use in planning. OLBH conducted a community needs assessment in 2012. The survey was distributed to local community organizations, and residents. OLBH is also working with local health departments on a community assessment (MAPP) and has participated in meetings and community forums with local organizations and residents to assess the needs of the community. Community needs are also determined and updated with information from Kentucky Health Information for state based performance data, Kentucky Hospital Association info site for market and geographic data bases, third party data bases, US census Bureau data and Thomson-Reuters market expert, is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to OLBH. We have also developed regional alignment plans using this data to target our underserved areas to plan for future growth in the communities we serve by providing more access points for patients in our service areas. Our Primary service area consists of Boyd, Greenup and Carter Counties in Kentucky and Lawrence County in Ohio. Our Secondary service area consists of Lewis County Kentucky and Scioto County Ohio. We continually update our information for our market share and physician planning to offer services in underserved areas of our region utilizing hospital data including emergency department visits. | ||
| 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 Kentucky Health System (BSKHS), Our Lady of Bellefonte Hospital (OLBH) serves a region of approximately to 400,000 people in northeastern Kentucky, southern Ohio, and western West Virginia, The service areas includes six counties in northern Kentucky (Greenup, Boyd, Lawrence, Carter, and Elliott) which comprises the FIVCO Area Development District as well as Lewis County, two counties in southern Ohio (Lawrence, Scioto) and Wayne and Cabell counties in western West Virginia. Due to our growing aging population services for our community residents aged 55 and older are needed, particularly women's health, orthopedics, diabetes, cardiopulmonary services, cancer, drug rehab and wound care.Major trends in the service area include a stable population that is aging. The 55 and older population is expected to increase by 14% over the next five years. The younger population tends to leave the area to find jobs. The high poverty and high unemployment rate in the area result in a low social economic status. It is a very industrialized region which creates carcinogens and unhealthy life styles especially in eastern Kentucky which has some of the highest incidence in the country of smoking, diabetes, obesity and carcinogens. These demographic characteristics create a high demand for chronic disease health care including diabetes, cancer and heart disease among others. | ||
| Part VI, Line 5: BSKHS' Our Lady of Bellefonte Hospital, operates an emergency room that is open 24 hours 7 days a week to all persons regardless of ability to pay. Our Lady of Bellefonte Hospital has an open medical staff with privileges available to all qualified physicians in the area. | ||
| 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 its 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. | ||
| KY | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLBH Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 521301088 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 375315 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Purpose Of Grant | General and Administrative Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
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: These funds are for General and Administrative Support and are tracked through a specific accounting unit (cost center) in the General ledger. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lawrence Hubbard CHCIO | |||||||||||||
| 0 | 384617 | 0 | 0 | 0 | 204329 | 0 | 68458 | 0 | 24400 | 0 | 681804 | 0 | 159679 |
| Elizabeth Keith | |||||||||||||
| 0 | 164126 | 0 | 18679 | 0 | 1449 | 0 | 17763 | 0 | 18966 | 0 | 220983 | 0 | 0 |
| Kevin Halter FACHE | |||||||||||||
| 0 | 309929 | 0 | 29358 | 0 | 22792 | 0 | 26205 | 0 | 32355 | 0 | 420639 | 0 | 0 |
| John Wallenhorst PhD | |||||||||||||
| 0 | 227839 | 0 | 0 | 0 | 22607 | 0 | 21913 | 0 | 11786 | 0 | 284145 | 0 | 0 |
| Joe Buchheit | |||||||||||||
| 0 | 232474 | 0 | 13123 | 0 | 22753 | 0 | 18475 | 0 | 21752 | 0 | 308577 | 0 | 0 |
| Jennifer Moore | |||||||||||||
| 0 | 193239 | 0 | 14204 | 0 | 23239 | 0 | 11294 | 0 | 10779 | 0 | 252755 | 0 | 0 |
| Michele Friday MD | |||||||||||||
| 494362 | 0 | 254710 | 0 | 1087 | 0 | 19344 | 0 | 28153 | 0 | 797656 | 0 | 0 | 0 |
| Daniel T Goulson MD | |||||||||||||
| 269465 | 0 | 106410 | 0 | 633 | 0 | 2730 | 0 | 25124 | 0 | 404362 | 0 | 0 | 0 |
| Kurt F Jaenicke MD | |||||||||||||
| 344364 | 0 | 273157 | 0 | 1553 | 0 | 3972 | 0 | 27873 | 0 | 650919 | 0 | 0 | 0 |
| Phillip L Lackey MD | |||||||||||||
| 364341 | 0 | 1650 | 0 | 18550 | 0 | 12653 | 0 | 27997 | 0 | 425191 | 0 | 0 | 0 |
| Yogendra Prasad MD | |||||||||||||
| 406250 | 0 | 161017 | 0 | 927 | 0 | 20280 | 0 | 30203 | 0 | 618677 | 0 | 0 | 0 |
| Mark Gordon | |||||||||||||
| 0 | 338075 | 0 | 0 | 0 | 22265 | 0 | 38340 | 0 | 33752 | 0 | 432432 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Supplemental Information | Part III | Part I, Line 3: Bon Secours Health System, Inc., a related organization of Our Lady of Bellefonte Hospital, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent compensation consultant Written employment contracts Compensation survey or study Approval by the board/compensation committee |
| Supplemental Information | Part III | Part 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. Individuals that received a distribution include: Lawrence "Skip" Hubbard, $162,275 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LawFirm McBrayer McGinnis Leslie | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Phillip B. Leslie, Esq. (Board Member) is a partner at this firm | Relationship |
| Amount Of Transaction | 231219 | AmountOfTransaction |
| Description Of Transaction | Consulting Services | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Board members Philip B. Leslie and Frank Warnock have a business relationship. | |
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc. is the sole member of Bon Secours Kentucky Health System, which in turn is the sole member of Our Lady of Bellefonte Hospital, Inc. | |
| Form 990, Part VI, Section A, line 7a | The governing body of Our Lady of Bellefonte Hospital, Inc. is appointed by its Member, Bon Secours Kentucky Health System, Inc. and subject to approval by Bon Secours Health System, Inc. | |
| Form 990, Part VI, Section A, line 7b | Certain authorities of Our Lady of Bellefonte Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc. | |
| Form 990, Part VI, Section B, line 11 | The 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 12c | The 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 15 | The 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 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 directors and compensation committee minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. | |
| Form 990, Part VI, Section C, line 19 | Our Lady of Bellefonte Hospital, 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. Volunteer Board Members are not compensated for their time. Kevin Halter's 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 Kentucky Health System, which includes direct management, monitoring and oversight of Bon Secours Kentucky Health System and its related organizations. John Wallenhorst's compensation is paid by Bon Secours Health Systems, Inc., a related organization. The compensation he receives is for his role as the VP of Mission & Ethics at Bon Secours Health Systems, Inc. Elizabeth Keith's compensation is paid by SFH, Inc., a related organization of Bon Secours Health System, Inc. The compensation she receives is for her role as the SVP, Mission Services at SFH, Inc. Lawrence "Skip" Hubbard's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Information Officer of Bon Secours Health System, Inc. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 339,102. Minimum Pension Liability -17,914,416. Transfers to affiliates -2,114,931. Total to Form 990, Part XI, Line 5: -19,690,245. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Bon Secours Health Systems Inc | |||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org. Management Services | MD | 501(c)(3) | 11b | Bon Secours Inc | 0 | |
| Bellefonte Physician Services Inc | |||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 352320780 | Physician Practices | KY | 501(c)(3) | 3 | Bon Secours Kentucky Health System | 0 | |
| Our Lady of Bellefonte Hospital Foundation | |||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 611381952 | Grant Making Foundation | KY | 501(c)(3) | 9 | Bon Secours Kentucky Health System | 0 | |
| Bon Secours Kentucky Health System | |||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 611356024 | Local System Parent Org. | KY | 501(c)(3) | 11b | Bon Secours Health System Inc | 0 | |
| Our Lady of Bellefonte Hospital Auxiliary | |||||||||||
| 1000 St Christopher Drive | Ashland | KY | 41101 | 610488859 | Fundraising for Our Lady of Bellefonte Hospital | KY | 501(c)(3) | 0 | N/A | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |