2013-07-15T14:24:06-05:00 2012-08-31 861065772 Deloitte Tax LLP 1750 Tysons Blvd McLean VA 221024219 990 2011-09-01 521301088 Bon Secours Health System Inc BONS 4104425511 1505 Marriottsville Road Marriottsville MD 21104 Janice E Burnett 4104425511 2013-07-15 1 David A Craig P00542227 7032511000 2011 2016-02-24 21:20:13Z Janice E Burnett 1505 Marriottsville Road Marriottsville MD 21104 214545798 0 0928 X www.bshsi.com X 1983 MD Provide admin/mgmt services to hospitals, nursing homes & other related healthcare orgs. 18 16 856 16 410960 0 19049 29434 134428586 165204936 26041591 19486120 30253342 29825308 190742568 214545798 1833331 1605030 0 0 95001172 101216300 0 0 0 115948053 114107717 212782556 216929047 -22039988 -2383249 1104949244 1140476498 1202859447 1245642024 -97910203 -105165526 X 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. 0 0 196683441 1605030 175279466 The Bon Secours Health System provides a wide range of corporate support services to the facilities it owns or has affiliations. The system's mission services ensure that all Bon Secours facilities support the ministry of the Sisters of Bon Secours and the Catholic Church, and are driven by the system's mission and values. The system's financial, operational and business development services provide essential centralized support to improve operations, financial performance, and the delivery of patient care. With expertise in all areas of acute, long-term care and assisted living facility and home care management and operations, the corporate staff also serves as an invaluable corporate consulting resource.See Schedule O. Mission Services:-Direction, support and consultation for the local and corporate staff and boards of directors-Policy development in areas such as sponsorship, business relationships, moral investments, bioethics, organizational ethics, social justice and community commitment services-Education to promote the Bon Secours mission, philosophy and values to key staff-Coordination of teams charged with addressing health care issues and ethical concernsFinancial & Treasury Services:-Negotiation of access to capital-Oversight, coordination and control of external audits-Coordination of and assistance in maximizing third-party reimbursement and filing related appeals-Monitoring of federal health care policy-Monitoring of System's master pension trust encompassing the pooled investment of all defined benefit pension plan assets of System members, including the selection of master pension trust investment advisor and managers and evaluation of their performance-Management of System members' trustee-held funds and System-wide investment program encompassing the vast majority of System members' investments, including funded depreciation accounts and centralized cash management program, in accordance with uniform System investment guidelines-Management of centralized cash management program-Maintenance of System-wide common financial data base providing statusof key financial indicators and operating statistics-Long range capital and financial planning and annual operating and capital budgeting support-Preparation of monthly and year-end consolidating System-wide financial statements, including budget variation reporting and statistical analysis-Development, implementation and monitoring of standardized accounting policies and educates senior leaders on financial literacy and contemporary financial practices.-Development of external financial disclosures to investors and the public at large-Primary contact with rating agencies, bond insurers and for investors questions Oversight of System consulting in the areas of tax returns,cost reporting, A-133 filings, CDM compliance and third party appeals-Organization of meetings of Chief Financial Officers to better coordinate implementation of System-wide goals, strategies, tactics and objectives and to monitor facility operations and corporate compliance Operational Services:-Actuarial, accounting and investment functions for self insurance funding of System members' general and professional liability and workers compensation claims and for a System-wide self-funded plan for employee health benefits-Coordination of functions for a System-wide standard hospital information system and other systems for use throughout the System and support functions for implementing and maintaining the information system-Standardized purchasing function, material management, Lawson ERP system, and other standard IS-Knowledge Transfer of best practices and successes on revenue enhancement and cost reduction initiatives.Strategic Planning, Marketing, and Business Development Services:-Coordination of System strategic planning including coordination of development of the System's vision, goals, and 3-year strategic plan and annual planning processes.-Market assessment and strategy development for improved local market positioning-Strategic planning support for acute, long-term and home care operations-New product/service research and development-Emerging technology research & assessment; knowledge transfer of technology and implications for system-Coordination and consultative assistance in service line planning & profitability analyses-Implementation of strategic growth initiatives in new and existing communities-Coordination of Planning & Business Development leaders, Customer Satisfaction, and Marketing & Communications leaders networksOther Corporate Services:-Corporate Communications and Public Relations-Internal auditing-Corporate Responsibility-Risk management-Governance-Coordination and control of System-wide benefit testing-Administration of System-wide health benefit plans-Placement and renewal of various System-wide welfare benefit plans-Coordination and management of legal services provided to System members-Regulatory compliance and insurance functions-System-wide employee, patient, resident and physician satisfactionProgram 196683441 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 282 0 1 856 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X Laura Ellison 4104425511 8990M Old Annapolis Road Columbia MD 21045 X Chris Allen 6.00 X 0 0 0 Richard Blair 6.00 X 0 0 0 Michael Carey 4.00 X 0 0 0 Marcia Dush 4.00 X 0 0 0 Sister Elaine Davia 4.00 X 0 0 0 Elder Granger MD 4.00 X 0 0 0 Roger Huang 4.00 X 0 0 0 David Jimenez 6.00 X 0 0 0 Gerard Kells 4.00 X 0 0 0 Laurie Lafontaine 6.00 X 0 0 0 Lucretia McClenney 4.00 X 0 0 0 Susan Sandlund 6.00 X 0 0 0 Richard Serafini 4.00 X 0 0 0 Rev Myles Sheehan MD 4.00 X 0 0 0 Sister Mary Shimo 4.00 X 0 0 0 Sister Alice Talone 4.00 X 0 0 0 Donald G Seitz MD 12.00 X X 65000 0 0 Richard Statuto 50.00 X X 1119455 0 260809 Katherine Arbuckle 50.00 X 578621 0 125210 Janice E Burnett 50.00 X 304192 0 63510 Martha Riva 50.00 X 342569 0 128325 Timothy Davis 50.00 X 600441 0 184863 Lawrence Skip Hubbard 50.00 X 588946 0 92858 Marlon Priest MD 50.00 X 573597 0 134079 Peter Bernard 50.00 X 790976 0 236221 Daniel Duggan 50.00 X 568242 0 47305 Mark Nantz 50.00 X 580131 0 107975 Samuel Ross MD 50.00 X 592063 0 77713 Matthew Toddy 50.00 X 557965 0 136632 7262198 0 1595500 232 0 1 0 Towers Watson PO Box 8500 Philadelphia PA 19178 Pension Consulting 3868017 JDA Health Systems Inc 1717 Park St Ste 250 Naperville IL 60563 Bus Office Claims Mgmt 3194485 Gallup PO Box 30111 Omaha NE 68103 Engagement Survery Services 2772971 Quadramed Corp PO Box 1915 Merrifield VA 22116 Software Consulting 2734097 Benefit Focus 100 Benefitfocus Way Charleston SC 29492 Benefits Consulting 2309436 128 29434 29434 Corp Mgmt & IS Fees 900099 165204936 165204936 165204936 10968523 10968523 1302239 1302239 182604 0 182604 182604 182604 7215358 0 7215358 7215358 7215358 Rebate 900099 13404667 13404667 Premier & Other Pships 900099 7056879 6837235 219644 Billings, Townley, Oth 900099 5943863 191316 5752547 3237295 3237295 29642704 214545798 175279466 410960 38825938 1567430 1567430 37600 37600 4874341 4386907 487434 74491507 66932217 7559290 8453493 7608144 845349 9000777 8087668 913109 4396182 3956564 439618 523190 470871 52319 163154 146839 16315 125314 112783 12531 807675 720145 87530 31244278 28119850 3124428 6553436 5898092 655344 3786634 3407971 378663 1046226 941603 104623 17243410 17242447 963 34927814 31298935 3628879 94474 85027 9447 Purchased services 14100272 12648294 1451978 Recruitment/Relocation 741583 667425 74158 Loss-Defeasance of Debt 601798 541618 60180 Dues and Subscriptions 346292 311664 34628 1802167 1493347 308820 216929047 196683441 20245606 0 42944241 34156512 3653326 3560094 12386956 17543453 296866159 117656121 177007427 179210038 203878373 214946643 42033298 42089841 11084421 13968310 611961202 635001607 1104949244 1140476498 46130409 54180118 15234030 16570284 869586571 854473162 5387911 2753885 266520526 317664575 1202859447 1245642024 X -105170203 -112425526 7260000 7260000 -97910203 -105165526 1104949244 1140476498 X -2383249 -4872074 X 0 1 1 X 1 1 X X X 0 0 0 United States Province of the Sisters of Bon Secours of Paris 520715237 1 1 1 0 6622826 Listed on supplemental information-Bon Secours Health System Inc is forme 521301088 9 1 1 1 0 2 6622826 Schedule A, Part IV, Supplemental Information: Part I, Line 11 H (i) - Supported Organizations: Bon Secours Health System, Inc. is formed exclusively for the benefit of, to perform the functions of, and to carry out the purposes of the Sisters of Bon Secours in the United States, Inc. and all other publicly supported organizations (within the meaning of section 509(a)(1) or 509(a)(2) of the Internal Revenue Code of 1986) in, or operating for the benefit of, the Bon Secours Health System, Inc. Additionally, Bon Secours Health System, Inc. is formed: (1) To participate in the charitable health care system sponsored by Bon Secours Ministries throughout the United States, and globally, through which the health care mission of The Sisters of Bon Secours in the United States, Incorporated (the "Congregation"), the founding participating entity of Bon Secours Ministries, is furthered; (2) To fulfill and to participate in, the charitable health care mission sponsored by Bon Secours Ministries throughout the United States, and globally, as it carries out its health care mission in accordance with the philosophy, mission and policies of Bon Secours Ministries and the directives and teachings of the Roman Catholic Church; (3) To participate in the activities and implement the operational policies and procedures pertaining to health care facilities and other enterprises sponsored by Bon Secours Ministries, or associated or affiliated with, BSHSI, a Maryland nonstock, nonprofit corporation; (4) To benefit the Congregation and all other publicly supported organizations (within the meaning of Section 509(a)(1) or 509(a)(2) of the Code) in, or operating for the benefit of, the Bon Secours Health System in the United States by carrying out the health care mission of the Congregation in accordance with the philosophy, mission and policies of the Congregation, and in accordance with, and subject to, the directives and teachings of the Roman Catholic Church or in concert with one or more other publicly supported organizations which provide health care services in a manner that is consistent with the teachings of the Roman Catholic Church; (5) To perform all activities permitted corporations under the laws of the State of Maryland, to the extent such activities are permitted by organizations which are exempt from Federal income tax under Section 501(c)(3) of the Code and contributions to which are deductible under Sections 170(c)(2), 2055(a)(2) and 2522(a)(2) of the Code and to the extent such activities are not inconsistent with the Corporation's non-private foundation status under Section 509(a) of the Code, including the making of distributions for charitable, religious, educational, and scientific purposes to organizations which are exempt from Federal income tax under Section 501(c)(3) of the Code and contributions to which are deductible under Sections 170(c)(2), 2055(a)(2) and 2522(a)(2) of the Code (a "Charity"). 11566082 11566082 8620951 2978944 5642007 1522091 1195760 326331 3945112 2030655 1914457 271211923 111450762 159761161 179210038 Other Assets (Misc and Exec Assets - Cap accum, Insurance policies) 12071655 Due from Affiliates 496512043 Investment in Joint Ventures 112132038 Assets Held in Trust 14285871 635001607 Worker's Comp Liability 45050949 Health Plan Liability 18707305 Pension Liability 153350978 Discontinued Operations Liability 5308781 Swaps 94259543 Other Liabilities 987019 317664575 Description of Uncertain Tax Positions Under FIN 48: Part X: 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. 1 Central America & the Caribbean 0 1 Program services Off Shore Captive Management 27628304 Sub-Saharan Africa 0 0 Grant making N/A 22000 South America 0 0 Grant-making N/A 15600 0 1 0 0 0 1 27665904 0 27665904 X Sub-Saharan Africa Boys Shelter in Louis Trichard 22000 Electronic Fund/Wire Book South America Cholera Test Kits 15600 Electronic Fund/Wire Book 2 1 0 1 0 0 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: Grantees submit progress reports on the anniversary date on which the grant was received. Includes status of goals and objectives and progress towards achievement of desired outcomes. An accurate accounting of revenues and expenses must be submitted. 1 Bon Secours Depaul Health Foundation 5818 Harbourview Blvd Suffolk VA 23435 541843876 501(c)(3) 92000 East Ocean View Bon Secours Community Works 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 10000 Working Families Initiative Bon Secours Community Works 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 40000 Open Space Management Bon Secours Community Works 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 47000 Youth Employment & Entrepreneurship Bon Secours Richmond Health System Foundation 5875 Bremo Road Richmond VA 23226 131740104 501(c)(3) 97000 MRMC - A Community Maps Its Future Bon Secours Maria Manor Nursing Care Center 10300 4th Street North St Petersburg FL 33716 650051820 501(c)(3) 97000 HCI Collaboration Grants Good Samaritan Foundation for Better Health Inc 255 Lafayette Avenue Suffern NY 10901 133400353 501(c)(3) 91000 Community Gardens, Phase 3 Frances Schervier Home and Hospital 2975 Independence Avenue Bronx NY 10463 131740397 501(c)(3) 97000 Response to Community Food Assessment Bon Secours OLBH Foundation 1000 Ashland Drive Ashland KY 41101 611381952 501(c)(3) 47000 Healthy Community Programs Bon Secours OLBH Foundation 1000 Ashland Drive Ashland KY 41101 611381952 501(c)(3) 50000 Community Services BS St Francis Health System Foundation One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 10000 Mobile Dental Unit Soft Tissue Laser BS St Francis Health System Foundation One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 15000 Sterling Trail BS St Francis Health System Foundation One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 25000 Good Help for San Sebastian Community BS St Francis Health System Foundation One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 47000 Faith Ministries Social Worker Roper - St Francis Health System 69-B Barre Street Charleston SC 29401 571068509 501(c)(3) 35000 Services to HIV Homeless Persons Mercy Housing 1999 Broadway Denver CO 80202 470646706 501(c)(3) 125000 Strategic Healthcare Partnership Pledge Midwives for Haiti 7130 Glen Forest Drive Richmond VA 23226 272368581 501(c)(3) 50000 Midwives for Haiti Pledge Sisters Academy of Baltimore 139 First Avenue Baltimore MD 21227 341975939 501(c)(3) 25000 Class Sponorship; annual pledge Sisters of Bon Secours USA Inc 1505 Marriottsville Road Marriottsville MD 21104 520715237 501(c)(3) 143097 Volunteer Ministry FY12 Program College of Saint Elizabeth 2 Convent Road Morristown NJ 07960 221529785 501(c)(3) 5000 Support of Service Learning Mission Trip Sisters of Mercy Northeast Community 2715 Bainbridge Avenue Bronx NY 10458 861164387 501(c)(3) 10000 All African Conference - Srs to Srs The Health Wagon Inc 119 Number Ten Street Clinchco VA 24226 043739083 501(c)(3) 25000 Annual Pledge for Lung Clinic Catholic Relief Service 228 W Lexington Street Baltimore MD 21201 135563422 501(c)(3) 83333 Haiti Project; Rebuilding of St.Francis de Sales Hospital & Hospital Network Strengthening Catholic Diocese of Lexington 1310 West Main Street Lexinton KY 40508 611132894 501(c)(3) 5000 West Liberty Tornado Relief Fund Catholic Medical Mission Board 1129 20th Street NW Washington DC 20036 135602319 501(c)(3) 232500 General Support The Cross-Over Ministry Inc 108 Cowardin Avenue Richmond VA 23224 541371067 501(c)(3) 10000 Compassionate Care Awards Archdiocese of Baltimore 320 Cathedral Street Baltimore MD 21201 520591535 501(c)(3) 5000 Annual Pledge for Gala Basilica of the Assumption Historic Trust Inc 408 N Charles Street Baltimore MD 21201 521065433 501(c)(3) 20000 Pope John Paul II Prayer Garden The Rose Foundation 6008 College Avenue Oakland CA 94618 943179772 501(c)(3) 5000 Environmental Health Network Bread for the World Institute 425 3rd Street SW Washington DC 20024 510175510 501(c)(3) 8000 Support US Food and Farm Policy Roper St Francis Foundation 316 Calhoun Street Charleston SC 29401 571068509 501(c)(3) 5000 Spirit of Caring Golf Tournament Ubuntu Africa NFP PO Box 7906 Greenwich CT 06836 205952356 501(c)(3) 5000 General Support Bon Secours OLBH Foundation 1000 Ashland Drive Ashland KY 41101 611381952 501(c)(3) 5000 OLBH Auxiliary Golf Benefit 26 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grantees submit progress reports on the anniversary date on which the grant was received. The evaluation report includes: 1) progress toward the deployment of the stated goals and objectives, 2) progress towards the achievement of desired outcome as demonstrated by Project Work Plan, 3) an accurate accounting of the revenue and expenses and the amount of the mission fund award expensed, and 4) a summary past, current and future funding sources and efforts to secure sustaining sources of funding. Description of the Bon Secours Health System Mission Fund: Bon Secours Health System, Inc. performs its philanthropic work through its mission department. This initiative, called the Bon Secours Health System Mission Fund ("Mission Fund"), was developed to promote the Catholic Health Ministry and the BSHSI Mission. This purpose is realized through the funding of initiatives that improve the health and well being of communities, particularly for disenfranchised and marginalized people, served by BSHSI Local Systems ("Local Systems"), Cosponsors and the Congregation of the Sisters of Bon Secours. The scope of its purpose and use of funds would be to: -promote healthy community coalition initiatives in conjunction with local system efforts, -develop local system and community excellence for a specific health condition and preventive need, and -improve access for uninsured populations and reduce health disparities among populations in the community. The Strategic Quality Plan of the health system calls for focused efforts to Build Healthier Communities. The health system understands "health" to include social and communal dimensions and has adopted the following articulation of a healthy community. The conditions of communities and individuals served by BSHSI reflect the interaction of significant factors and complex behaviors at the individual, communal, and societal level. It is not likely that interventions by any one organization will result in substantial improvement or benefit to the community. Rather, increased participation by stakeholders and greater cooperation among entities with appropriate skills and resources is necessary for systemic change and improved outcomes. Mission Fund grants place emphasis on increased collaboration among community based members (Healthy Community Initiative), public health officials and other providers of services. The Mission Fund anticipates that most endeavors that seek to bring meaningful improvement require time and commitment. Consequently, local system grant recipients may expect continuity of support (several years) to establish and track outcomes. At the same time, grant applicants need to cultivate and achieve a wide array of financial resources necessary to sustain promising projects and service programs. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Richard Statuto 1090248 0 0 0 29207 0 221141 0 39668 0 1380264 0 0 0 Katherine Arbuckle 553871 0 0 0 24750 0 98459 0 26751 0 703831 0 0 0 Janice E Burnett 301621 0 0 0 2571 0 40831 0 22679 0 367702 0 0 0 Martha Riva 318505 0 0 0 24064 0 89783 0 38542 0 470894 0 0 0 Timothy Davis 592854 0 0 0 7587 0 160480 0 24383 0 785304 0 0 0 Lawrence Skip Hubbard 384617 0 0 0 204329 0 68458 0 24400 0 681804 0 159679 0 Marlon Priest MD 545803 0 0 0 27794 0 98330 0 35749 0 707676 0 0 0 Peter Bernard 761416 0 0 0 29560 0 201853 0 34368 0 1027197 0 0 0 Daniel Duggan 306712 0 34835 0 226695 0 22741 0 24564 0 615547 0 0 0 Mark Nantz 487395 0 69645 0 23091 0 80079 0 27896 0 688106 0 0 0 Samuel Ross MD 491059 0 45844 0 55160 0 53709 0 24004 0 669776 0 0 0 Matthew Toddy 533470 0 0 0 24495 0 102878 0 33754 0 694597 0 0 0 Part I, Line 1a Bon Secours Health System, Inc. has from time to time used gross-ups as a tool to cover relocating expenses when hiring and relocating executives. Executive positions eligible throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. 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. South Carolina Jobs-Economic Development Authority 576000286 837031QH9 2008-01-15 69925000 Construct and equip facility 0 0 0 Economic Development Authority of Henrico County VA 541197472 42605PBV6 2010-10-19 80412256 Refund bonds issued by Econ. Dev. Auth. of Henrico Co. VA on 1/15/08 0 0 0 Economic Development Authority of the County of Chesterfield 521279622 16639EAY0 2010-10-19 93627897 Refund bonds issued by Econ Dev Auth of the Co of Chesterfield on 1/15/08 0 0 0 South Carolina Jobs-Economic Development Authority 570960018 837031RA3 2008-10-17 30365000 Refund bonds issued by SC Jobs Econ. Dev. Auth. On 12/30/02 0 0 0 69973023 729108 1694518 67549397 2008 0 0 1 1 80412256 80412256 1 0 1 1 93627897 967897 92660000 1 0 1 1 5355000 30365000 255675 7500 30101825 1 0 1 1 0 1 1 1 1 1 0.43000 0.01000 0.44000 1 0 1 1 1 1 1 0.00000 0.01000 0.01000 1 0 0 1 1 1 1 0.00000 0.00000 0.00000 1 0 1 1 PNC Bank 33.000000000000 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 Part I, Line D, Column(f), (Entity 2): 2011 Norfolk description of purpose - to refund bonds issued by the Economic Development Authority of the City of Norfolk on 10/17/08. Schedule K, Supplemental Information: Differences between the Issue Price (Part I) and total proceeds (Part III, line 3) are due to investment earnings. The Henrico, Chesterfield and Virginia bonds issued on 10/19/2010 constitute a single issue for federal tax reporting purposes. Part III has not been completed with respect to bonds that refinanced projects where the original debt was issued prior to 2003. Bon Secours is revising its existing tax exempt bond compliance policy to include reference to VCAP. Economic Development Authority of Henrico County VA 541197472 42605PBK0 2008-10-17 53890000 Refund bonds issued by Econ Dev Auth Of Henrico County, VA on 12/30/02 0 0 0 Economic Development Authority of Hanover County VA 541228097 41077RAC6 2008-10-17 124715000 2008D-1 Refund bonds issued by the Econ Dev Auth Of Hanover Co on 09/28/05 0 0 0 Virginia Small Business Financing Authority 541300845 928105AY1 2010-10-19 40740000 Terminate swap agreements 0 0 0 Economic Development Authority of the City of Norfolk 521375010 noCUSIPno 2011-12-08 72460000 Refund 2008D Norfolk bonds (see Part VI below) 0 0 0 23925000 53890000 449479 7500 53433021 1 0 1 1 10190000 124715000 1131056 157532 123426412 1 0 1 1 40740000 489597 24322 40226081 2010 0 0 1 1 72460000 480000 1100000 70880000 2011 1 0 1 1 0 1 1 1 1 1 0.00000 0.00000 1 0 0 1 1 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 1 Goldman Sachs 13.000000000000 0 0 0 0 0 Dr Leta Herring See Part V 184450 See Part V 0 (a) Name of Person: Dr. Leta Herring(b) Relationship Between Interested Person and Organization: Wife of Dr. Marlon Priest(d) Description of Transaction: Independent Contractor. This contract was terminated as of March 30, 2012. Form 990, Part VI, Section A, line 6 Bon Secours, Inc. is the sole member of Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7a The governing body of Bon Secours Health System, Inc. is appointed by its member Bon Secours, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of Bon Secours Health System, Inc. are reserved to its Member, Bon Secours, 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 an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section B, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 BSHSI provides any documents open to public inspection upon request. Form 990, Part VII: As the parent organization of nine local systems, Bon Secours Health System, Inc.'s officers, directors, key employees and highly compensated employees have duties and responsibilities which encompass the activities of many of the related organizations within those local systems. Part VII, Section B: Five Highest Paid Independent Contractors Providing Services: Independent contractors and vendors paid/invoiced to Bon Secours Health System, Inc. are generally for services covering a majority of the related organizations, if not all. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 3,917,943. Other changes in Unrest NA - Joint Venture 4,300,304. Transfers to/from affiliates 27,160,365. Add'l Minimum Pension Liability -41,685,654. Investment in Partnership 1,544,712. Loss from partnerships on tax return not in financial stmts -109,744. Total to Form 990, Part XI, Line 5: -4,872,074. Bon Secours Associates Services LLC 1505 Marriottsville Road Marriottsville MD 211041301 522321591 Healthcare MD 0 1720287 Bon Secours Health System Inc Townley IV Farm LLC 1402 Stapleton Road Gladstone VA 245533138 541833386 Farm VA -486056 6393074 Bon Secours Health System Inc Bon Secours Good Helpcare LLC 1505 Marriottsville Road Marriottsville MD 211041301 Accountable Care Organization MD 0 0 Bon Secours Health System Inc Bon Secours St Petersburg Home Care Services Inc 10300 Fourth Street North St Petersburg FL 33716 134334363 Home Care Services FL 501(c)3 Line 9 Maria Manor Nursing Care Center 1 Bon Secours Maria Manor Nursing Care Center 10300 Fourth Street North St Petersburg FL 33716 134334363 Nursing Home FL 501(c)3 Line 9 Bon Secours Health System Inc 1 Our Lady of Bellefonte Hospital Inc 1000 St Christopher Dr Ashland KY 41101 611356023 Acute Care Hospital KY 501(c)3 Line 3 Bon Secours Kentucky Health System 1 Bon Secours Kentucky Health System Inc St Christopher Dr Ashland KY 41101 611356024 Local System Parent Org. KY 501(c)3 Line 11b, Type 2 Bon Secours Health System Inc 1 Our Lady of Bellefonte Hospital Foundation St Christopher Dr Ashland KY 41101 611381952 Grant Making Foundation KY 501(c)3 Line 7 Bon Secours Kentucky Health System 1 Bellefonte Physician Services Inc St Christopher Dr Ashland KY 41101 352320780 Physician Practices KY 501(c)3 Line 9 Bon Secours Kentucky Health System 1 Bon Secours Baltimore Hospital 2000 West Baltimore Street Baltimore MD 21223 521909599 Health Care MD 501(c)3 Line 3 Bon Secours Baltimore Health System 1 Washington Village Community Medical Center Inc 2600 Liberty Heights Avenue Baltimore MD 21223 521138191 Health Care MD 501(c)3 Line 9 Bon Secours Community Health Services Inc 1 Urban Medical Institute Inc 2600 Liberty Heights Avenue Baltimore MD 21215 521905869 Health Care MD 501(c)3 Line 3 Liberty Medical Center Inc 1 Bon Secours Baltimore Development 26 North Fulton Avenue Baltimore MD 21223 760785344 Community Housing MD 501(c)3 Line 7 Unity Properties Inc 1 Bon Secours Baltimore Health System Foundation Inc 26 North Fulton Avenue Baltimore MD 21223 383843816 Grant Making Foundation MD 501(c)3 Line 11b, Type 3 Bon Secours Baltimore Health System 1 Bon Secours Community Health Services Inc 2600 Liberty Heights Avenue Baltimore MD 21215 521909599 Health Care MD 501(c)3 Line 9 Bon Secours Baltimore Health System 1 The Bon Secours of Maryland Foundation Inc (dba Bon Secours Community Work 26 North Fulton Avenue Baltimore MD 21223 521732800 Grant Making Foundation MD 501(c)3 Line 11b, Type 3 Bon Secours Baltimore Health System 1 Unity Properties Inc 26 North Fulton Avenue Baltimore MD 21223 521857768 Low Income Housing MD 501(c)3 Line 7 Bon Secours of Maryland Foundation 1 Bon Secours Housing 26 North Fulton Avenue Baltimore MD 21223 521442707 Low Income Housing MD 501(c)3 Line 9 Bon Secours of Maryland Foundation 1 Bon Secours Housing II 26 North Fulton Avenue Baltimore MD 21223 521543174 Low Income Housing MD 501(c)3 Line 9 Bon Secours of Maryland Foundation 1 Bon Secours Baltimore Health System 2000 West Baltimore Street Baltimore MD 21223 800728893 Local System Parent Org. MD 501(c)3 Line 11b, Type 2 Bon Secours Health System Inc 1 Bon Secours Inc 1505 Marriottsville Road Marriottsville MD 21104 521301091 Supporting Org. to Bon Secours Health System, Inc. MD 501(c)3 Line 11a, Type 1 N/A 0 Bon Secours New York Health System 2975 Independence Avenue Bronx NY 10463 912135196 Local System Parent Org. NY 501(c)3 Line 11b, Type 1 Bon Secours Health System Inc 1 Frances Schervier Home and Hospital 2975 Independence Avenue Bronx NY 10463 131740397 Long term nursing care NY 501(c)3 Line 3 Bon Secours NY Health System 1 Schervier Housing Development Fund Corporation 2975 Independence Avenue Bronx NY 10463 133098867 Housing NY 501(c)3 Line 9 Bon Secours NY Health System 1 Bon Secours Community Hospital 160 E Main Street Port Jervis NY 12771 141347717 Health Care NY 501(c)3 Line 3 Bon Secours Charity Health System 1 Bon Secours Community Hospital Foundation 160 E Main Street Port Jervis NY 12771 810667395 Grant Making Foundation NY 501(c)3 Line 7 Bon Secours Community Hospital 1 Good Samaritan Hospital of Suffern NY 255 Lafayette Avenue Suffern NY 10901 131740104 Acute Care Hospital NY 501(c)3 Line 3 Bon Secours Charity Health System 1 Good Samaritan Foundation for Better Health Inc 255 Lafayette Avenue Suffern NY 10901 133400353 Grant Making Foundation NY 501(c)3 Line 7 Bon Secours Charity Health System 1 Bon Secours Charity Health System Inc 255 Lafayette Avenue Suffern NY 10901 912135195 Local System Parent Org. NY 501(c)3 Line 11b, Type 1 Bon Secours Health System Inc 1 St Francis Center at the Knolls Inc (dba Mount Alverno Center) 20 Grand Street Warwick NY 10990 061370576 Long term Care NY 501(c)3 Line 9 Bon Secours Charity Health System 1 Villa Francis at the Knolls (dba Schervier Pavilion) 20 Grand Street Warwick NY 10990 061381994 Skilled Nursing NY 501(c)3 Line 9 Bon Secours Charity Health System 1 St Anthony Community Hospital 15-19 Maple Ave Warwick NY 10990 141340100 Hospital NY 501(c)3 Line 3 Bon Secours Charity Health System 1 The Bon Secours Warwick Health Foundation 20 Grand Street Warwick NY 10990 141972807 Grant Making Foundation NY 501(c)3 Line 7 St Anthony Community Hospital 1 Bon Secours Charity Health System Medical Group PC 255 Lafayette Avenue Suffern NY 10901 223636986 Physician Practices NY 501(c)3 Line 9 Bon Secours Charity Health System 1 Bon Secours St Francis Health System Foundation One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)3 Line 7 SFH Inc 1 SFH Inc One St Francis Drive Greenville SC 29601 582504530 Health Care SC 501(c)3 Line 3 St Francis Health System Inc 1 Bon Secours St Francis Health System Inc 1 St Francis Drive Greenville SC 29601 582504528 Local System Parent Org. SC 501(c)3 Line 11b, Type 2 Bon Secours Health System Inc 1 St Francis Physician Services Inc One St Francis Drive Greenville SC 29601 134290167 Physician Services SC 501(c)3 Line 9 St Francis Health System Inc 1 Mary Immaculate Hospital Inc 7007 Harbour View Blvd Suffolk VA 23435 540548200 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System 1 Mary Immaculate Nursing Center Inc 7007 Harbour View Blvd Suffolk VA 23435 541516476 Nursing Care Center VA 501(c)3 Line 9 Mary Immaculate Hospital 1 Mary Immaculate Foundation 7007 Harbour View Blvd Suffolk VA 23435 311644734 Fundraising VA 501(c)3 Line 11b, Type 3- FI Mary Immaculate Hospital 1 Bon Secours - Maryview Nursing Care Center 7007 Harbour View Blvd Suffolk VA 23435 521578169 Nursing Care Center VA 501(c)3 Line 9 Bon Secours Hampton Roads Health System 1 Bon Secours Maryview Foundation 7007 Harbour View Blvd Suffolk VA 23435 521694731 Fundraising VA 501(c)3 Line 11b, Type 3-FI Bon Secours Hampton Roads Health System 1 Bayley Properties 7007 Harbour View Blvd Suffolk VA 23435 541424748 Title Holding Company VA 501(c)2 N/A Bon Secours DePaul Medical Center 1 Bon Secours DePaul Medical Center Inc 7007 Harbour View Blvd Suffolk VA 23435 541820093 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System 1 Bon Secours DePaul Health Foundation 7007 Harbour View Blvd Suffolk VA 23435 541843876 Fundraising VA 501(c)3 Line 11b, Type 3- FI Bon Secours Hampton Roads Health System 1 Bon Secours Hampton Roads Health System 7007 Harbour View Blvd Portsmouth VA 23435 521538513 Local System Parent Org. VA 501(c)3 Line 11b, Type 2 Bon Secours Health System Inc 1 Maryview Hospital 7007 Harbour View Blvd Portsmouth VA 23707 540506463 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System 1 Bon Secours Richmond Health Care Foundation 8580 Magellan Parkway Richmond VA 23227 541201346 Grant Making Foundation VA 501(c)3 Line 7 Bon Secours Richmond Health Corp 1 Bon Secours Richmond Health Corporation 8580 Magellan Parkway Richmond VA 23227 541356155 Supporting Org. to Bon Secours Richmond Health System VA 501(c)3 Line 11, Type 2 Bon Secours Health System Inc 1 Bon Secours Stuart Circle Hospital 8580 Magellan Parkway Richmond VA 23227 541740128 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System 1 Bon Secours Memorial Regional Medical Center Inc 8580 Magellan Parkway Richmond VA 23227 541744931 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System 1 Bon Secours Richmond Health System 8580 Magellan Parkway Richmond VA 23227 521988421 Supporting Org. to Bon Secours Richmond Health System VA 501(c)3 Line 11, Type 2 Bon Secours Richmond Health Corp 1 Bon Secours St Mary's Hospital 8580 Magellan Parkway Richmond VA 23227 540793767 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System 1 Bon Secours Richmond Community Hospital 8580 Magellan Parkway Richmond VA 23227 540647482 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System 1 Bon Secours St Francis Medical Center 8580 Magellan Parkway Richmond VA 23227 311716973 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System 1 Laburnum Properties 8580 Magellan Parkway Richmond VA 23227 521260700 Title Holding Company VA 501(c)2 N/A Bon Secours Richmond Health System 1 Bon Secours Place at St Petersburg LLP 10300 Fourth Street North St Petersburg FL 33716 593589729 Assisted Living/Senior Care FL Bon Secours Florida Integrated Services Related 0 0 Bon Secours Apartments LP 1800 West Baltimore St Baltimore MD 21223 521952505 Low Income Housing MD Unity Housing Inc Related 0 1 Bon Secours Apartments II LP 1800 West Baltimore St Baltimore MD 21223 522063512 Low Income Housing MD Unity Housing Inc Related 0 1 Liberty Senior Housing LP 1800 West Baltimore St Baltimore MD 21223 522134447 Low Income Housing MD Unity Housing Inc Related 0 1 Bon Secours Apartments III LP 1800 West Baltimore St Baltimore MD 21223 522134444 Low Income Housing MD Unity Housing Inc Related 0 1 Bon Secours Smallwood Summit 26 North Fulton Ave Baltimore MD 21223 522280175 Low Income Housing MD Unity Housing Inc Related 0 1 Bon Secours Chesapeake Apartments LP 26 North Fulton Ave Baltimore MD 21223 200107034 Low Income Housing MD Chesapeake Housing LLC Related 0 1 Bon Secours Shiloh LP 26 North Fulton Ave Baltimore MD 21223 203965243 Low Income Housing MD Bon Secours Baltimore Development Inc Related 0 1 Bon Secours Wayland LP 26 North Fulton Ave Baltimore MD 21223 270468688 Low Income Housing MD Unity Properties Inc Related 0 1 Upstate Surgery Center LLC One St Francis Drive Greenville SC 29601 562186977 Ambulatory Surgery Center SC SFH Inc Related 0 0 Province Place of DePaul LLC 6403 Granby Street Norfolk VA 23505 541950880 Assisted Living Facilities VA Professional Health Care Management Inc Related 0 0 Province Place of Maryview LLC One Bon Secours Way Portsmouth VA 23703 541842697 Assisted Living VA Professional Health Care Management Inc Related 0 0 Broad64 Imaging LLC 8580 Magellan Parkway Richmond VA 23227 205886018 Imaging Services VA Bon Secours Virginia Health Source Inc Related 0 0 Richmond Radiation Oncology Center I LLC 8580 Magellan Parkway Richmond VA 23227 208444551 Radiation Oncology Services VA Richmond Radiation Oncology Center Inc Related 0 0 RI LP 8580 Magellan Parkway Richmond VA 23227 541708835 Imaging Services VA Bon Secours Virginia Health Source Inc Related 0 0 RI LP 8581 Magellan Parkway Richmond VA 23228 541708835 Imaging Services VA Richmond MRI Inc Related 0 1 Chesterfield Community Healthcare Center MOB 1 LLC 435 Southlake Blvd Richmond VA 23236 541745670 Rental - Medical Office Building VA Bon Secours Virginia Health Source Inc Related 0 0 Bon Secours Assurance Company Ltd PO Box 69 CJ KY1-1102 980152147 Offshore Captive Management CJ Bon Secours Health System Inc C 27623048 113582747 1.00000 Bon Secours-Florida Integrated Health Services Inc 10300 Fourth Street North St Petersburg FL 33716 650779777 Holding Company/Assisted Living FL Bon Secours Maria Manor Nursing Care C 180514 1873600 1.00000 Unity Housing Inc 26 North Fulton Avenue Baltimore MD 21223 521952507 Low Income Housing MD Unity Properties Inc C -111 350100 1.00000 Bon Secours Wayland LLC 26 North Fulton Avenue Baltimore MD 21223 270468561 Low Income Housing MD Unity Properties Inc C -39 1.00000 HealthCare Enterprises Inc & Subs One St Francis Drive Greenville SC 29601 571012852 Holding Company SC St Francis Health System Inc C 70702 1.00000 Professional Health Care Management Inc & Subs 150 Kingsley Lane Norfolk VA 23505 541241031 Administrative VA Bon Secours Hampton Roads Health System Inc C -308729 4450589 1.00000 OSF Inc 2 Bernadine Drive Newport News VA 23602 541369919 Rental VA Mary Immaculate Hospital Inc C -143240 1300957 1.00000 Bon Secours Tidewater Diversified Inc 160 Kingsley Lane Norfolk VA 23505 541431826 Pharmacy VA Bon Secours DePaul Medical Center Inc C 153275 2263317 1.00000 Chesterfield Community Healthcare Center Inc 8580 Magellan Parkway Richmond VA 23227 541812738 Ambulatory Healthcare Services VA Bon Secours Richmond Health System Inc C 12293 139674 0.83000 Bon Secours-Virginia Healthsource Inc & Subs 8580 Magellan Parkway Richmond VA 23227 541417686 Ambulatory Healthcare Services VA Bon Secours Richmond Health System Inc C -6248746 30594803 0.83000 RHS Management Corp 8580 Magellan Parkway Richmond VA 23227 541313425 Independent Living Facility VA Bon Secours Richmond Health System Inc C 80325 0.83000 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 BS Maryview Foundation B 92000 Fair Market Value BS of MD Foundation Inc B 97000 Fair Market Value BS OLBH Foundation B 97000 Fair Market Value BS Richmond Healthcare Foundation B 97000 Fair Market Value Good Samaritan Foundation for Better health B 91000 Fair Market Value Maria Manor Nursing Care Center B 97000 Fair Market Value Schervier Pavilion B 97000 Fair Market Value St Francis Foundation B 132000 Fair Market Value D Bellefonte Physician Services D 9558443 Fair Market Value Bon Secours Baltimore Hospital D 3465456 Fair Market Value Bon Secours Community Hospital D 4165277 Fair Market Value Bon Secours Richmond Healthcare Foundation D 2044500 Fair Market Value BS Community Health Services D 142562 Fair Market Value BS Depaul Medical Center D 19396922 Fair Market Value BS Maryview Foundation D 130878 Fair Market Value BS of MD Foundation Inc D 709111 Fair Market Value DePaul Medical Center Foundation D 63557 Fair Market Value Good Samaritan Hospital of Suffern D 10562664 Fair Market Value GSH Medical Care PC D 17153396 Fair Market Value Laburnum Properties Inc D 310915 Fair Market Value Maryview Medical Center D 18900477 Fair Market Value Mt Alverno Assisted Living Facility D 947646 Fair Market Value Schervier Pavilion D 3041956 Fair Market Value St Anthony Community Foundation D 125157 Fair Market Value St Francis Physician Services D 35275381 Fair Market Value Bon Secours St Petersburg Home Care Services D 1143302 Fair Market Value Bon Secours Place at St Petersburg D 5764241 Fair Market Value Province Place at Maryview D 266600 Fair Market Value Province Place at DePaul D 376801 Fair Market Value Bon Secours Community Hospital K 2326342 Cost Bon Secours Hospital Baltimore K 3151345 Cost Bon Secours Maria Manor Nursing Center K 258710 Cost Good Samaritan Hospital of Suffern K 6538104 Cost Hampton Roads Shared Services K 15664223 Cost Our Lady of Bellefonte Hospital K 7427506 Cost Schervier Housing Development K 492657 Cost Schervier Long Term K 119791 Cost St Anthony Community Hospital K 3157531 Cost St Francis Hospital K 14698396 Cost St Mary's Hospital K 35475251 Cost Good Samaritan Home Care P 48197 Fair Market Value Bon Secours St Petersburg Home Care Services P 71667 Fair Market Value RHS Ent P 74098 Fair Market Value Broad64 Imaging P 134562 Fair Market Value St Mary's MRI Center P 137497 Fair Market Value Upstate Surgery Center P 150316 Fair Market Value Bon Secours of MD Foundation P 202960 Fair Market Value St Francis Nursing P 896818 Fair Market Value St Francis Imaging P 236772 Fair Market Value Richmond Radiation Oncology Center P 175459 Fair Market Value Mt Alverno Assisted Living Facility P 438908 Fair Market Value Bon Secours Community Shared Services P 1273249 Fair Market Value Hampton Roads Shared Services P 2504630 Fair Market Value Millenium P 433561 Fair Market Value Bon Secours Place at St Petersburg P 513544 Fair Market Value Province Place of Maryview P 579555 Fair Market Value Schervier Pavilion P 1967389 Fair Market Value Province Place of DePaul P 704228 Fair 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of Bellefonte Hospital P 20268679 Fair Market Value Bon Secours St Francis Medical Center P 23168129 Fair Market Value Bon Secours Memorial Regional Medical Center P 31836984 Fair Market Value Bon Secours St Mary's Hospital P 45066564 Fair Market Value Good Samaritan Hospital of Suffern P 42081236 Fair Market Value St Francis Hospital P 48264403 Fair Market Value