Mary Immaculate Hospital: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: Mary Immaculate Hospital (EIN 54-0548200)
Tax period: 2011-09-01 to 2012-08-31
Filed: 2013-07-15
IRS object ID: 201311969349301531
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 G
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-07-15T18:38:34-05:00	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	540548200	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mary Immaculate Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MARY	NameControl
Phone	7576866000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7007 Harbour View Blvd No 108	AddressLine1
City	Suffolk	City
State	VA	State
ZIP Code	23435	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Michael K Kerner	Name
Title	CEO - BSHR	Title
Phone	7578895000	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	Michael K Kerner	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	7007 Harbour View Blvd No 108	AddressLine1
City	Suffolk	City
State	VA	State
ZIP Code	23435	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	185178965	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	www.bonsecourshamptonroads.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1956	YearFormation
State Legal Domicile	VA	StateLegalDomicile
Activity Or Mission Description	Acute Care Hospital	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	1077	TotalNbrEmployees
Total Nbr Volunteers	155	TotalNbrVolunteers
Total Gross UBI	298585	TotalGrossUBI
Net Unrelated Business Txbl Income	48003	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	314579	ContributionsGrantsPriorYear
Contributions Grants Current Year	2721787	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	177100093	ProgramServiceRevenuePriorYear
Program Service Revenue CY	179297332	ProgramServiceRevenueCY
Investment Income Prior Year	2206357	InvestmentIncomePriorYear
Investment Income Current Year	966129	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2279877	OtherRevenuePriorYear
Other Revenue Current Year	2170737	OtherRevenueCurrentYear
Total Revenue Prior Year	181900906	TotalRevenuePriorYear
Total Revenue Current Year	185155985	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	11928	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	29302	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	49881851	SalariesEtcPriorYear
Salaries Etc Current Year	51703452	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	113839736	OtherExpensePriorYear
Other Expenses Current Year	115925849	OtherExpensesCurrentYear
Total Expenses Prior Year	163733515	TotalExpensesPriorYear
Total Expenses Current Year	167658603	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	18167391	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	17497382	RevenuesLessExpensesCY
Total Assets BOY	154385895	TotalAssetsBOY
Total Assets EOY	179981353	TotalAssetsEOY
Total Liabilities BOY	30951982	TotalLiabilitiesBOY
Total Liabilities EOY	39468341	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	123433913	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	140513012	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
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	38594248	Expense
Revenue	42515992	Revenue
Description	Orthopedics is center of choice for orthopedic care in the Virginia Peninsula and beyond. It includes a continuum of care from pre-operative education through post-op recovery, and is supported by state-if-the-art technology and expert physicians, as well as a comprehensive rehab network.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	9171029	Expense
Revenue	10472961	Revenue
Description	Cardiovascular services - a comprehensive Early Detection Center, aimed at identifying cardiac disease early and referring patients to physicians as necessary for prompt and effective treatment, strong relationships with other Bon Secours hospitals for the delivery of advanced cardiac interventions, such as cardiac surgery, and a large community outreach program. A new state-of-the-art cardiac catheterization laboratory will be installed at Mary Immaculate in mid-2013, enhancing physicians' ability to better manage and treat cardiac disease in area patients.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	12806725	Expense
Revenue	9718927	Revenue
Description	Women and children services provided added capacity and resources so that the needs of the community for OB care would continue to be met. Mary Immaculate also offers advanced nursery services through a neonatal specialty care nursery. Bon Secours also offers the largest curriculum of family and parenting classes through its Love & Learn program. In the last year, Mary Immaculate expanded its gynecology offering by introducing gynecological oncology services (board certified and fellowship trained surgeon) and an infusion center for women suffering from such cancers.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	92242574	Expense
Grants	29302	Grants
Revenue	116345510	Revenue
Description	Major services offered by Mary Immaculate include the Hernia Center which is a comprehensive program dedicated to treating hernias. The program specializes in developing treatments based on each patient's individual needs. The program uses the latest innovations and performs many of it's procedurws using state-of-the-art, minimally invasive techniques. In addition, Mary Immaculate offers Neuroscience, Gastroenterology and Pulmonary services as well as a full service 24 hour Emergency Room. See Sch H for additional information.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	92242574	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	29302	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	116345510	TotalOfOtherProgramServiceRev
Total Program Service Expense	152814576	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	1	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	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	71	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1077	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	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
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	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	NumberIndependentVotingMembers
Family Or Business Relationship	0	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	1	InvestmentInJointVenture
Written Policy Or Procedure	0	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	VA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	James Pirtle	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7572152709	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	7007 Harbour View Blvd Suite 108	AddressLine1
City	Suffolk	City
State	VA	State
ZIP Code	23435	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
Susan B Anthony FNP
Board Member	4.00	X	0	0	0
Alejandra Arnold
Board Member	4.00	X	0	0	0
Sr Elaine Davia
Board Member	4.00	X	0	0	0
Timothy J Davis
Board Member	50.00	X	0	600441	184863
Pastor Ivan T Harris
Board Member	4.00	X	0	0	0
Sr Patricia Heath
Board Member	50.00	X	0	0	0
Steven B Hopson MD
Board Member	4.00	X	0	1375	0
Sr M Margaret Jackson
Board Member	4.00	X	0	0	0
Matthew James
Board Member	4.00	X	0	0	0
Sr Lynn Rachelle Pascoe
Board Member	4.00	X	0	0	0
William F Pile
Board Member	4.00	X	0	0	0
Sr Christen Shukwit
Board Member	4.00	X	0	0	0
Robert M Yacobi
Board Member	4.00	X	0	0	0
Paul W Garman
Secretary (Sept-Dec)	6.00	X	0	0	0	X
John H Garrett
Secretary (Jan-Aug)	4.00	X	0	0	0	X
Michael K Kerner
CEO-BSHR	50.00	X	0	492621	187822	X
Sr David Ann Niski
President	6.00	X	0	0	0	X
Jon A Nystrom
Chairman	6.00	X	0	0	0	X
Melinda Hancock
CFO-BSV (Aug)	50.00		0	292838	33668	X
Ernie Padden
Treas./Int. CFO (Sept-Jul)	50.00		0	195000	0	X
Patricia Robertson
CEO-MIH & Extended Care	50.00		0	327698	39138	X
Thomas J Hoffmier
Physician	50.00		332005	0	28628		X
Nauman Naseer
Physician	50.00		441397	0	63249		X
Allen B Nichols
Physician	50.00		505657	0	34259		X
James H Sammons
VP of Med Aff (Sep-Apr)	50.00		291205	0	46891		X
Anthony D Terracina
Physician	50.00		910191	0	61323		X
Joseph Buchheit
Former CFO - BSHR	50.00		0	268350	40227			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2480455	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2178323	TotalReportableCompFrmRltdOrgs
Total Other Compensation	720068	TotalOtherCompensation
Number Individuals GT100 K	28	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
Rehabcare Group Inc
PO Box 502096	St Louis	MO	631502096	Rehabilitation Services	2908592
Tidewater Physicians Multispecialty Grou
860 Omni Blvd 304	Newport News	VA	23606	Physician Services	1674043
Anesthesia Associates of Hampton
110 Three Point Ct	Yorktown	VA	23692	Physician Services	1500000
Origin Inc dba Shiftwise
PO Box 70870	St Paul	MN	551709705	Contract Nursing	1037071
Aramark CTS Inc
12483 Collections Ctr Dr	Chicago	IL	60693	Biomedical Engineering	962164

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	22	NumberOfContractorsGT100K
Fundraising Events	18766	FundraisingEvents
Related Organizations	54890	RelatedOrganizations
Government Grants	2523635	GovernmentGrants
All Other Contributions	124496	AllOtherContributions
Total Contributions	2721787	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Patient Service Rev.	Description
Business Code	622110	BusinessCode
Total Revenue Column	179297332	TotalRevenueColumn
Related Or Exempt Function Income	179053390	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	243942	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	179297332	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	575498	TotalRevenueColumn
Exclusion	$575,498	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	7028	TotalRevenueColumn
Exclusion	$7,028	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	77153	Real
Personal	3553	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	12098	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	65055	Real
Personal	3553	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	68608	TotalRevenueColumn
Unrelated Business Revenue	20345	UnrelatedBusinessRevenue
Exclusion	$48,263	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	357163	Securities
Other	26440	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	357163	Securities
Other	26440	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	383603	TotalRevenueColumn
Exclusion	$383,603	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	33239	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	18766	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	10882	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	22357	TotalRevenueColumn
Exclusion	$22,357	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
Joint Venture Income	900099	1351247	$1,351,247
Cafe/Vending/Dietary	900099	292737	$292,737
Managed Care/Rehab Svc	900099	212745	$212,745

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	223043	TotalRevenueColumn
Unrelated Business Revenue	34298	UnrelatedBusinessRevenue
Exclusion	$188,745	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	2079772	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	185155985	TotalRevenueColumn
Related Or Exempt Function Income	179053390	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	298585	UnrelatedBusinessRevenue
Exclusion	$3,082,223	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	17725	Total
Program Services	17725	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	11577	Total
Program Services	11577	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	181612	Total
Program Services	163588	ProgramServices
Management And General	18024	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	41227832	Total
Program Services	37105049	ProgramServices
Management And General	4122783	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1843083	Total
Program Services	1658775	ProgramServices
Management And General	184308	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	4758538	Total
Program Services	4282684	ProgramServices
Management And General	475854	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3692387	Total
Program Services	3323148	ProgramServices
Management And General	369239	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	185540	Total
Program Services	166986	ProgramServices
Management And General	18554	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	138333	Total
Program Services	124500	ProgramServices
Management And General	13833	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	32185	Total
Program Services	28967	ProgramServices
Management And General	3218	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	9409551	Total
Program Services	8468458	ProgramServices
Management And General	941093	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	201834	Total
Program Services	181651	ProgramServices
Management And General	20183	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1651899	Total
Program Services	1486709	ProgramServices
Management And General	165190	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	210758	Total
Program Services	189682	ProgramServices
Management And General	21076	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3145628	Total
Program Services	2831065	ProgramServices
Management And General	314563	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	78157	Total
Program Services	70341	ProgramServices
Management And General	7816	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	28321	Total
Program Services	25489	ProgramServices
Management And General	2832	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1561144	Total
Program Services	1561144	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2752233	Total
Program Services	2477010	ProgramServices
Management And General	275223	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1213591	Total
Program Services	1092232	ProgramServices
Management And General	121359	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Medical Supplies	46811408	42130267	4681141
Purchased Services	25884123	23295711	2588412
Bad Debt	17627891	17627891
BSHSI Allocation	2627136	2364422	262714

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2366117	Total
Program Services	2129505	ProgramServices
Management And General	236612	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	167658603	Total
Program Services	152814576	ProgramServices
Management And General	14844027	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2855	BOY
EOY	2955	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	70436974	BOY
EOY	79452701	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	95782	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	20081011	BOY
EOY	21741465	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3481390	BOY
EOY	3947664	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	279916	BOY
EOY	408341	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	85125505	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	51536218	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	29391652	BOY
EOY	33589287	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	26248865	BOY
EOY	26428069	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	1738260	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	81069	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	4463232	BOY
EOY	12495760	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	154385895	BOY
EOY	179981353	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	11181409	BOY
EOY	14035856	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	1479106	BOY
EOY	1471122	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	12213380	BOY
EOY	11361907	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	6078087	BOY
EOY	12599456	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	30951982	BOY
EOY	39468341	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	122861414	BOY
EOY	139822964	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	524352	BOY
EOY	645178	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	48147	BOY
EOY	44870	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	123433913	BOY
EOY	140513012	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	154385895	BOY
EOY	179981353	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	17497382	ReconcilationRevenueExpenses
Reconcilation Other Changes	-418283	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	1	Volunteers
Paid Staff Or Management	1	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$17,266	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$14,919	OtherActivitiesAmount
Total Lobbying Expenditures IIB	32185	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	Mary Immaculate Hospital paid dues to the American Hospital Association (AHA), the Virginia Hospital and Healthcare Association (VHHA) and the Catholic Health Association (CHA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities for each of these organizations is as follows: AHA $4,463 or 24.6%, VHHA $9,213 or 24.37% and CHA $1,243 or 4.68%. The filing organization also conducted advocacy relating to education of legislative body regarding hospital and healthcare reform and how it impacts communities.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	48147	BeginningOfYearBalance
Investment Earnings Or Losses	384	InvestmentEarningsOrLosses
Other Expenditures	3660	OtherExpenditures
End Of Year Balance	44871	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	50349	BeginningOfYearBalance
Other Expenditures	2202	OtherExpenditures
End Of Year Balance	48147	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	28574	BeginningOfYearBalance
Investment Earnings Or Losses	22025	InvestmentEarningsOrLosses
Other Expenditures	250	OtherExpenditures
End Of Year Balance	50349	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	112350	BeginningOfYearBalance
Investment Earnings Or Losses	-83276	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
End Of Year Balance	28574	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3352921	OtherCostOrOtherBasis
Book Value	3352921	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	33915772	OtherCostOrOtherBasis
Depreciation	17146100	Depreciation
Book Value	16769672	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	390703	OtherCostOrOtherBasis
Depreciation	134268	Depreciation
Book Value	256435	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	42703495	OtherCostOrOtherBasis
Depreciation	33341559	Depreciation
Book Value	9361936	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4762614	OtherCostOrOtherBasis
Depreciation	914291	Depreciation
Book Value	3848323	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	33589287	TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescription	Book ValueBookValue
Deferred Fin Costs	706247
Due from Affiliates	226323
3rd Party Payors	729366
Accrued Revenue	2422396
LT Rec - Mary Immaculate Medical Pavillion	2691432
LT Non-Cash Inv - HPL/GL	5719996

Field	Value	IRS element (for citing)
Total Book Value Other Assets	12495760	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescription	AmountAmount
LT Liab-Pension Liability	$4,347,969
Fin 47 LT Asbestos Liab	$1,675,062
Other Gen 3rd Party Rsvs LT	$412,169
Due to Affiliates	$76,273
Due to BSHSI	$19,864
HPL/GL Liability	$5,719,996
Other Liabilities	$348,123

Field	Value	IRS element (for citing)
Total Of Amounts	12599456	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	Earnings are to used to assist the needy.
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 FIN 48). ASC 740 (formerly FIN 48) 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 FIN 48) 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 FIN 48). 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.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	Gala	NameOfEvent1
Gross Receipts Event1	29558	GrossReceiptsEvent1
Charitable Contributions Event1	4766	CharitableContributionsEvent1
Gross Revenue Event1	24792	GrossRevenueEvent1
Food And Beverage Event1	1312	FoodAndBeverageEvent1
Name Of Event2	Golf	NameOfEvent2
Gross Receipts Event2	22447	GrossReceiptsEvent2
Charitable Contributions Event2	14000	CharitableContributionsEvent2
Gross Revenue Event2	8447	GrossRevenueEvent2
Rent Facility Costs Event2	6300	RentFacilityCostsEvent2
Other Direct Expenses Event2	3270	OtherDirectExpensesEvent2
Gross Receipts Total	52005	GrossReceiptsTotal
Charitable Contributions Total	18766	CharitableContributionsTotal
Gross Revenue Total Events	33239	GrossRevenueTotalEvents
Rent Facility Costs Total Events	6300	RentFacilityCostsTotalEvents
Food And Beverage Total Events	1312	FoodAndBeverageTotalEvents
Other Direct Expenses Total Events	3270	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	10882	DirectExpenseSummaryEvents
Net Income Summary	22357	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2169127	TotalCommunityBenefitExpense
Net Community Benefit Expense	2169127	NetCommunityBenefitExpense
Percent Of Total Expense	0.01450	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12939963	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9946290	DirectOffsettingRevenue
Net Community Benefit Expense	2993673	NetCommunityBenefitExpense
Percent Of Total Expense	0.02000	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1283923	TotalCommunityBenefitExpense
Direct Offsetting Revenue	958496	DirectOffsettingRevenue
Net Community Benefit Expense	325427	NetCommunityBenefitExpense
Percent Of Total Expense	0.00220	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	16393013	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10904786	DirectOffsettingRevenue
Net Community Benefit Expense	5488227	NetCommunityBenefitExpense
Percent Of Total Expense	0.03670	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	10	NumberOfActivitiesOrPrograms
Persons Served	5177	PersonsServed
Total Community Benefit Expense	288749	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5547	DirectOffsettingRevenue
Net Community Benefit Expense	283202	NetCommunityBenefitExpense
Percent Of Total Expense	0.00190	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	391	PersonsServed
Total Community Benefit Expense	74583	TotalCommunityBenefitExpense
Net Community Benefit Expense	74583	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	5758	PersonsServed
Total Community Benefit Expense	112522	TotalCommunityBenefitExpense
Net Community Benefit Expense	112522	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	21	NumberOfActivitiesOrPrograms
Persons Served	11326	PersonsServed
Total Community Benefit Expense	475854	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5547	DirectOffsettingRevenue
Net Community Benefit Expense	470307	NetCommunityBenefitExpense
Percent Of Total Expense	0.00310	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	21	NumberOfActivitiesOrPrograms
Persons Served	11326	PersonsServed
Total Community Benefit Expense	16868867	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10910333	DirectOffsettingRevenue
Net Community Benefit Expense	5958534	NetCommunityBenefitExpense
Percent Of Total Expense	0.03980	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	4758	TotalCommunityBuildingExpense
Net Community Building Expense	4758	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	35	PersonsServed
Total Community Building Expense	393	TotalCommunityBuildingExpense
Net Community Building Expense	393	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	23	PersonsServed
Total Community Building Expense	11495	TotalCommunityBuildingExpense
Net Community Building Expense	11495	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	58	PersonsServed
Total Community Building Expense	16646	TotalCommunityBuildingExpense
Net Community Building Expense	16646	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$4,012,167	BadDebtExpenseAmount
Amount Reimbursed By Medicare	46801661	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	50812674	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-4011013	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

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 Mary Immaculate ASC LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	Outpatient Surgery	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.34140	OrganizationProfitOrOwnership
Physicans Profit Or Ownership	0.49340	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
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	Mary Immaculate Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2 Bernardine Dr	AddressLine1
City	Newport News	City
State	VA	State
ZIP Code	23602	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
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	Mary Immaculate Hospital	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
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	7	NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
Mary Immaculate Phys Therapy Denbigh
14703 Warwick Blvd Suite B	Newport News	VA	23608	Physical Theraphy
In-Motion Boo Williams Sportsplex
5 Armistead Pointe Parkway	Hampton	VA	23666	Physical Theraphy
Mary Immaculate Phys Therapy Victory
101-A Long Green Blvd	Yorktown	VA	23693	Physical Theraphy
Cardiovascular Speciallists
12720 McManus Blvd Ste 201	Newport News	VA	23602	Physician Practice
Tidewater Surgical Specialists
12720 McManus Blvd Ste 311	Newport News	VA	23602	Physician Practice
Bon Secours Pulmonary Specialists
12720 McManus Blvd Ste 303	Newport News	VA	23602	Physician Practice
Bon Secours Occumed
14703 Warwick Blvd Suite A	Newport News	VA	23608	Occupational Medicine

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
Part I, Line 6a: Annually, Bon Secours Hampton Roads Health System (BSHRHS) publishes a report for the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report will available to the public each year at www.bshr.com on or about February 15, 2013.
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, L7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $17,627,891
Part II: Mary Immaculate Hospital provided facility space, dietary contributions and staff support to local community boards, coalitions, and civic groups to discuss and address health and social concerns across the community. These meetings enabled various community groups to plan programs and activities to improve the health of community residents across different health and social conditions.
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 publically 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 V,Line 11h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.
Part V, Line 13g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.
Part V, Line 19d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.
Part VI, Line 2: In partnership with Bon Secours Virginia Health System, Mary Immaculate Hospital uses multiple approaches to assess the health needs of the communities it serves. Health care needs of the community are assessed and updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to Mary Immaculate Hospital. National Research Corporation (NRC) is also utilized.
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: As of 2010, Hampton Roads is a very diverse community within an MSA of nearly 1.6 million people residing in 16 cities and counties, stretching from northeastern North Carolina to Williamsburg. The area is characterized by racial diversity, a significant military population and a growing elderly population. African Americans comprise 52.2% of the population in Portsmouth, 41.6% in Newport News, and 43.4% of Norfolk and 19.3% of Virginia Beach, which far exceeds the national average of 31.5%. Seniors currently account for 11.2% of the population, growing to 13% in the next five years.The population served by Mary Immaculate Hospital (MIH), Newport News, VA is estimated to change from 463,658 to 503,313, resulting in a growth of 8.6% between 2000 and the current year. Over the next five years, the population is projected to grow by 2.4%. Of this area's current year estimated population, 59.2% are White, 33.3% are Black or African American, and 4.5% are Hispanic or Latino and small percentages of other ethnicities. The current year median age for this area is 37.1, while the average age is 37.8. Five years from now, the median age is projected to be 38.0.The most prevalent chronic conditions among adults include high cholesterol (71,100 or 33.2%), high blood pressure (67,000 or 26.9%), arthritis (61,000 or 23.4%), asthma (29,800 or 11.9%), and diabetes (16,000 or 6.3%). Morbidity rates per 10,000: heart disease (92.0), cerebrovascular disease (25.3), chronic obstructive pulmonary disease (10.1), diabetes (12.0) and asthma (10.0). Mortality rates (age-adjusted per 100,000) for this area are cancer (166.4), ischemic heart disease (110.6), cerebrovascular disease (41.8) and chronic obstructive pulmonary disease (33.2).
Part VI, Line 5: MIH has an open medical staff with privileges available to all qualified physicians. Emergency departments at the three hospitals provide service 24 hours/day, 7days/week to ensure access for emergency care for all individuals in need of emergency care. Hospital board members are diverse, inclusive and representative of the broader community in which the facilities are located. MIH, through BSHR, offers CARE-A-VAN services to the community. The Care-A-Van (CAV), initiated on the peninsula in 2009 at two sites, has expanded in the past year to seven sites, two in Norfolk, two in Portsmouth and three in Newport News. This is a mobile health unit that provides healthcare services to those most in need-the uninsured. Services provided include urgent and primary care (including examination, diagnosis, lab, pharmacy, and follow-up), immunizations for school, pregnancy tests, blood pressure measurement, health education, referrals for specialty care, opportunity to enroll eligible children in children's health insurance. The Care-A-Van also offers sports physicals, children's health insurance enrollment, and health education services. While the CAV primarily serves adults, some sites do provide care and referral services for children aged 12 and older. Community partners include free clinics, local health agencies, and numerous Faith-based community organizations which collaborate with the Care-A-Van staff. The CAV has a staff of 10 FTEs and annual expenses of approximately $700,000.MIH, through BSHR, offers Bon Secours Senior Health Program which offers a free membership program to over 75,000 individuals 65 years and older. A key component is the Successful Aging Forum, which brings national speakers to the community to discuss the latest health and wellness topics for senior citizens. The annual HealthFest provides a seniors-focused health festival with health screenings, health information and social interaction for seniors of all socio-economic backgrounds. Friday Night Dinners, held at area hospitals, serve seniors who need low cost meals and socialization. A transportation program offers transportation to medical appointments, without charge to those who are financially challenged. A quarterly publication Good Health provides information to 75,000 members in Hampton Roads. Seniors play a vital role in BSHRHS' advocacy efforts against reductions in Medicaid payments and to support continued funding for the State Children Health Insurance Program (SCHIP). MIH supports and provides staffing for the BSHRHS Faith Community Health Ministry which builds on the skills of the registered nurse through additional, structured training in holistic (body, mind and spirit) health services; the faith community nurse partners with the congregational leadership to promote good health by serving as an educator, counselor, referral agent and advocate. Specialized training has also been developed to prepare non-licensed persons to serve in congregational health ministry. Additionally, the Influenza Vaccination Administration program provided 600 vaccines for select covenanted partners to host annual vaccine clinics. BSHRHS employs a sole Director to provide education, mentoring and support to more than 130 faith communities and 232 registered nurses and lay health promoters.MIH Family Focus is a child abuse prevention program of MIH, which targets at-risk families for child abuse and helps teach positive parenting skills. MIH employs the director for the program and provides operating funds for two locations. Family Focus, founded by BSHSI and the Bernardine Sisters of the Third Order of St. Francis, is a broad coalition of private and public organizations that provide a continuum of education, prevention and support programming for over 500 families to encourage healthy child development and nurturing environments in the home and community. In FY 11 the program was expanded to include services for Spanish-speaking families.BSHRHS' Community Sponsorship Committee reviews and financially sponsors community events that support our mission and values. Some of the contributions in FY 11 that support the work of MIH in addressing unmet need include:- H.E.L.P. Free Dental Clinic to partially subsidize the cost of dental supplies to provide services to uninsured adults- The Arc of the Virginia Peninsula to continue serving individuals with developmental and other disabilities and their families- American Heart Association heart healthy initiatives- American Cancer Society Relay for LifeMIH is dedicated to promoting the health and the quality of life for the women of Hampton Roads the women health service lines. We provide community health education seminars in cardiac, orthopedics, weight loss, acupuncture, sports performance, oncology, and stroke through the Bon Secours for Women program.MIH offers free Community Education programs open to the public throughout Hampton Roads on health topics such as heart disease, diabetes, bone and joint conditions, women's health and other chronic diseases. Several seminars on clinical ethics were also offered to professionals 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 it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world."Please see Schedule R for listings of the related organizations.
VA	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	Project Care of the Greater Virginia Peninsula Inc	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	416 J Clyde Morris Boulevard	AddressLine1
City	Newport News	City
State	VA	State
ZIP Code	23601	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	273518508	EINOfRecipient
IRC Section	501(c)(3)	IRCSection
Amount Of Cash Grant	8475	AmountOfCashGrant
Purpose Of Grant	General 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 III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	Benevolence Fund	TypeOfGrant
Number Of Recipients	71	NumberOfRecipients
Amount Of Cash Grant	11577	AmountOfCashGrant

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: Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement.	Explanation

Schedule J IRS990ScheduleJ

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 (11 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
Timothy J Davis
0	592854	0	0	0	7587	0	160480	0	24383	0	785304	0	0
Michael K Kerner
0	487110	0	0	0	5511	0	154116	0	33706	0	680443	0	0
Melinda Hancock
0	254357	0	5017	0	33464	0	4898	0	28770	0	326506	0	0
Ernie Padden
0	195000	0	0	0	0	0	0	0	0	0	195000	0	0
Patricia Robertson
0	292448	0	0	0	35250	0	25253	0	13885	0	366836	0	9750
Thomas J Hoffmier
269549	0	58750	0	3706	0	8314	0	20314	0	360633	0	0	0
Nauman Naseer
440688	0	0	0	709	0	30519	0	32730	0	504646	0	0	0
Allen B Nichols
443469	0	55800	0	6388	0	8314	0	25945	0	539916	0	0	0
James H Sammons
289670	0	0	0	1535	0	28250	0	18641	0	338096	0	0	0
Anthony D Terracina
468164	0	440983	0	1044	0	30990	0	30333	0	971514	0	0	0
Joseph Buchheit
0	232474	0	13123	0	22753	0	18475	0	21752	0	308577	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 Maryview Hospital, 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, Line4b: 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: Patricia Robertson, $9,923

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Form 990, Part VI, Section A, line 6	The General Minister and General Council of the Bernardine Sisters of the Third order of St. Francis and Bon Secours Health System, Inc. are the members of Mary Immaculate Hospital.
Form 990, Part VI, Section A, line 7a	The governing body of Mary Immaculate Hospital is appointed by both members, with Bon Secours Health System, Inc. having the majority vote.
Form 990, Part VI, Section A, line 7b	Certain authorities of Mary Immaculate Hospital are reserved to its members.
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 director's and compensation committee minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19	Mary Immaculate Hospital 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. Michael K. Kerner's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Executive Officer of Bon Secours Hampton Roads Health System which includes direct management, monitoring and oversight of Bon Secours Hampton Roads Health System and its related organizations. Melinda Hancock's compensation is paid by St. Mary's Hospital of Richmond, Inc., a related organization of Bon Secours Health System, Inc. The compensation she receives is for her role as the Chief Financial Officer of Bon Secours Virginia Health System which includes direct financial management, monitoring and oversight of Bon Secours Richmond Health System, Bon Secours Hampton Roads Health System and their related organizations. Ernie Padden's compensation was paid by Maryview Hospital, a related organization. The compensation he received was for his role as the Chief Financial Officer of Bon Secours Hampton Roads Health System which includes direct financial management, monitoring and oversight of Bon Secours Hampton Roads Health System and its related organizations. Timothy J. Davis' compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as Executive Vice President and Chief Administrative Officer of Bon Secours Health System, Inc. Patricia Robertson's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the Executive Vice President of Mary Immaculate Hospital and both nursing care facilities in the Hampton Roads Health System. Sr. Patricia Heath does not receive payroll distributions as she has taken a vow of poverty.
Form 990, Part XI, line 5:	Net unrealized gains on investments: 1,148,891. BSHSI - Debt/Principal Payment: -1,127,982. Add'l Minimun Pension Liability: -435,742. Error Suspense -3,450. Total to Form 990, Part XI, Line 5: -418,283.	Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
Mary Immaculate Hospital Auxiliary
2 Bernadine Drive	Newport News	VA	23602	546040266	Auxiliary	VA	501(c)(3)	11c-FI	N/A	0
Mary Immaculate Foundation
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	311644734	Fundraising	VA	501(c)(3)	11c-FI		1	Mary Immaculate Hospital
Mary Immaculate Nursing Center
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	541516476	Nursing Care Center	VA	501(c)(3)	9		1	Mary Immaculate Hospital
Bon Secours Hampton Roads Health System Inc
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	521538513	Local System Parent Org	VA	501(c)(3)	11b		0	Bon Secours Health System Inc
Bon Secours Maryview Nursing Care Center
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	521578169	Nursing Care Center	VA	501(c)(3)	9		0	Bon Secours Hampton Roads Health System
Bayley Properties
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	541424748	Rental	VA	501(c)(2)	N/A		1	Bon Secours DePaul Medical Center
Bon Secours Health System Inc
1505 Marriottsville Road	Marriottsville	MD	21104	521301088	Parent Org. Management Services	MD	501(c)(3)	1b		0	Bon Secours Inc
Bon Secours DePaul Health Foundation
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	541843876	Fundraising	VA	501(c)(3)	11c-FI		0	Bon Secours Hampton Roads Health System
Bon Secours Maryview Foundation
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	521694731	Fundraising	VA	501(c)(3)	11c-FI		0	Bon Secours Hampton Roads Health System
Bon Secours DePaul Medical Center Inc
7007 Harbour View Blvd Suite 108	Suffolk	VA	23435	541820093	Healthcare	VA	501(c)(3)	3		0	Bon Secours Hampton Roads Health System
Maryview Hospital
7007 Harbour View Blvd Suite 108	Suffolk	VA	23707	540506463	Healthcare	VA	501(c)(3)	3		0	Bon Secours Hampton Roads Health System

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner
Province Place of Maryview LLC
One Bon Secours Way	Portsmouth	VA	23703	541842697	Assisted Livivng	VA	Professional Health Care Mgmt	Related	0	0
Province Place of DePaul LLC
6403 Granby Street	Norfolk	VA	23505	541950880	Assisted Livivng	VA	Professional Health Care Mgmt	Related	0	0

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Percentage OwnershipPercentageOwnership
Professional Health Care Mgmt Inc
7007 Harbourview Blvd Suite 108	Suffolk	VA	23435	541241031	Administrative	VA	Hampton Roads Health System Inc	C
Tidewater Diversified Inc
7007 Harbourview Blvd Suite 108	Suffolk	VA	23435	541431826	Pharmacy	VA	Bon Secours DePaul Medical Center Inc	C
OSF Inc
7007 Harbourview Blvd Suite 108	Suffolk	VA	23435	541369919	Rental	VA	Mary Immaculate Hospital Inc	C	1.00000

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	0	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	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg