2013-07-13T22:10:33-05:00 2012-08-31 861065772 DELOITTE TAX LLP 1750 TYSONS BLVD MCLEAN VA 221024219 990 2011-09-01 541744931 Memorial Regional Medical Center Inc MEMO 8046275400 8580 Magellan Parkway Building IV Richmond VA 23227 Melinda S Hancock 8046275400 2013-07-13 1 David A Craig P00542227 7032511000 2011 2016-02-24 21:20:13Z Melinda S Hancock 8580 Magellan Parkway Building IV Richmond VA 23227 354091127 0 X http://www.bonsecours.com/hospitals/memorial/ X 1994 VA Acute Care Hospital 19 15 2019 386 0 0 3704479 3199769 305489610 345165869 704751 547537 1413561 4197403 311312401 353110578 150075 79750 0 0 111976601 121303880 0 0 0 189794554 213094285 301921230 334477915 9391171 18632663 291584598 315887899 128746855 159557496 162837743 156330403 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 298857249 36868 345894699 Provide health and wellness for the surrounding community through a holistic approach. Services are provided to all regardless of their socio-economic status in various healthcare settings including a hospital, medical office, and at home. Please refer to the Community Benefit information on Schedule H. 5733710 42882 1291686 At Bon Secours Memorial College of Nursing, our students, faculty, staff and alumni are part of a nearly 200-year-old mission of providing compassionate care to those in need. Our College extends this mission by educating nurses in a spirit of academic and clinical excellence to serve our community with genuine compassion and the highest clinical standards. We are deeply committed to meeting the needs of our patients and adapting to the growing, changing needs of the world in which we serve. 304590959 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 128 0 1 2019 1 0 0 0 0 0 0 0 0 0 0 X 19 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 VA X Melinda S Hancock 8046275400 8580 Magellan Parkway Building IV Richmond VA 23227 X Nalia Townes Ahmed 4.00 X 0 0 0 Toni Ardabell 50.00 X 0 390990 68190 Jean Ann Bolling 4.00 X 0 0 0 John Bowman MD 4.00 X 0 0 0 Peter B Cleal 4.00 X 0 0 0 Robert J Cohen MD 4.00 X 0 0 0 Alexander J Corbett PhD 4.00 X 0 0 0 Mark Gordon 50.00 X 0 360340 72092 Richard Jackson MD 4.00 X 0 0 0 Kenneth J Jones 4.00 X 0 0 0 Sr Anne Marie Mack CBS 50.00 X 0 0 0 Joanne Nattrass 4.00 X 0 0 0 William Shewmake 4.00 X 0 0 0 Nancy Thomas 4.00 X 0 0 0 Jane Watkins 4.00 X 0 0 0 Michael Williams 4.00 X 0 0 0 Michael Robinson 50.00 X X 0 438084 105755 Sr Victoria Segura CBS MD 50.00 X X 0 0 0 Thomas Winfree 6.00 X X 0 0 0 Peter J Bernard 50.00 X 0 790976 236221 Peter F Gallagher 50.00 X 370109 0 61386 Allen Goolsby 6.00 X 0 0 0 Melinda S Hancock 50.00 X 0 292838 33668 Jill Kennedy 50.00 X 208420 0 33331 David J Dougherty 50.00 X 399516 0 35249 Amit N Gogia 50.00 X 356992 0 53671 Darius D Hollings 50.00 X 438560 0 57281 C Gregory Lockhard MD 50.00 X 635990 0 34888 Michael J MacDougall 50.00 X 482425 0 53123 Michael Kerner 50.00 X 0 492621 187822 Thomas Morris PhD 50.00 X 0 303520 67515 2892012 3069369 1100192 89 1 1 0 AthenaHealth Inc 311 Arsenal Ct Att Finance Dept Watertown MA 02472 Physician Business Services 2850305 Hanover Anesthesia Group Inc 5855 Bremo Rd Ste 100 North Richmond VA 232261926 Physicians 2559090 PrimeDoc of Richmond PC BBT Building Suite 300 Ashville NC 28801 Physicians 1866543 Sheltering Arms Hospital 8254 Atlee Road Mechanicsville VA 23116 Rehabilitation Clinicians 1551017 Chickahominy Family Practice 4630-B Laburnum Ave Richmond VA 23231 Physicians 1048828 69 368673 2804484 26612 3199769 Patient Service Rev. 622110 343874184 343874184 Col of Nursing Tuition 611600 1291685 1291685 345165869 473922 473922 841570 38108 905278 38108 -63708 0 -63708 -63708 110778 0 37163 110778 -37163 73615 73615 Sheltering Arms 622110 2020516 2020516 Cafe and Vending Rev. 722210 1317714 1317714 Physician Billing Rev. 514200 301415 301415 621466 621466 4261111 353110578 347186385 0 2724424 75000 75000 4750 4750 638957 575061 63896 94677821 85210039 9467782 6591815 5932633 659182 13007867 11707080 1300787 6387420 5748678 638742 311052 279947 31105 704037 633633 70404 46140 41526 4614 25917 23325 2592 10605977 9545379 1060598 231130 208017 23113 1346823 1212141 134682 513323 461991 51332 7984374 7185937 798437 388232 349409 38823 368132 331319 36813 6613977 6613977 8179999 7361999 818000 1789479 1610531 178948 Purchased Services 79533353 71580018 7953335 Medical Supplies 49250500 44325450 4925050 Bad Debt 28914621 28914621 BSHSI Corp Mgmt Alloc. 7931537 7138383 793154 8355682 7520115 835567 334477915 304590959 29886956 0 4414 5837 144535894 162293119 0 130668 32247596 33328966 0 123214 4978837 5313529 2122215 2440788 178331294 93525972 88472021 84805322 0 4819742 12086726 7862737 0 50251 7136895 14713726 291584598 315887899 15616912 14613448 1932152 3116946 25730000 22700000 0 2600 153485 0 85314306 119124502 128746855 159557496 X 162713283 156116341 4460 94062 120000 120000 162837743 156330403 291584598 315887899 X 18632663 -25140003 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 25917 25917 0 Explanation of Lobbying Activities: Part II-B, Line 1: Memorial Regional Medical Center, Inc. paid dues to the American Hospital Association (AHA), the Virginia Hospital and Healthcare Association (VHHA) and the Catholic Hospital Association (CHA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities for each of these organizations is as follows: AHA 24.60% or $6,483, VHHA 24.37% or $16,837 and CHA 5.15% or $2,597 for a total of $25,917. 0 1 120000 120000 120000 120000 117232 2768 120000 101825 15407 117232 1.00000 0 0 5377333 5377333 91264942 33090214 58174728 4477119 1861157 2615962 68364088 52766931 15597157 8847812 5807670 3040142 84805322 Pension Liability 63461809 Due to Affiliates 41880103 HPL/GL Liability 9216341 Medicare Settlement 2813783 Long Term Deferred Rent 715628 Loan Guarantee 439292 College of Nursing Student Deposits 272292 Real Estate and Sales & Use Tax Liability 176054 Scholarship Liabilities 24468 All Other Liabilities 124732 119124502 Description of Intended Use of Endowment Funds: Part V, Line 4: The Frank E. Brown trust is administered by Wachovia/Well Fargo and was never booked on MRMC ledger until fiscal year 2009. The trust has been in existence FBO MRMC since August 6, 1962 and provides for income to be used for operating purposes. 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 1 1 X 1 X 1 1 0 1 1 7539677 7539677 0.02470 26659805 17565793 9094012 0.02980 0.00000 34199482 17565793 16633689 0.05450 702353 702353 0.00230 8340574 4565499 3775075 0.01240 0.00000 0.00000 76372 76372 0.00020 9119299 4565499 4553800 0.01490 43318781 22131292 21187489 0.06940 0.00000 0.00000 2 221992 221992 0.00070 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 2 221992 221992 0.00070 1 6551188 84584782 89964307 -5379525 X 1 1 1 Memorial Ambulatory Surgery Center LLC Ambulatory Surgery 0.45800 0.04000 1 1 Memorial Regional Medical Center

8260 Atlee Road Mechanicsville VA 231161844

X X X X Memorial Regional Medical Center Inc 1 1 1 200.000000000000 1 200.000000000000 1 X X 1 1 X X 0 0 1 X 0 0 27 Laburnum Medical Center

4620 S Laburnum Ave Richmond VA 23231

Physician Practices Lee Davis Pediatrics

6372 Mechanicsville Turnpike Mechanicsville VA 23111

Physician Practices Memorial Medical Center

8220 Meadowbridge Road Ste 203 Mechanicsville VA 23116

Physician Practices Surgical Specialists of Richmond

8262 Atlee Road MOB III Ste 205 Mechanicsville VA 23116

Physician Practices Surgical Specialists of Richmond

1850 Pocahontas Trail Quinton VA 23141

Physician Practices Surgical Specialists of Richmond

1396 - B Tappahannock Blvd Tappahannock VA 22560

Physician Practices Theresa Thomas Medical Center

635 N Washington Highway Ashland VA 23005

Physician Practices Aylett Medical Center

7864 Richmond - Tappahannock Highway Aylett VA 23009

Physician Practices Bon Secours Behavioral Health Services

1510 North 28th Ste Hosp 3rd FL Richmond VA 23223

Physician Practices Crossridge Internal Med and Pediatrics

10150 Staples Mill Road Glen Allen VA 23060

Physician Practices Thoracic Surgery Associates

8220 Meadowbridge Road Suite 306 Mechanicsville VA 23116

Physician Practices Thoracic Surgery Associates

14051 St Francis Blvd Suite 2205 Midlothian VA 23114

Physician Practices Richmond Diabetes and Endocrinology

8220 Meadowbridge Road Suite 308 Mechanicsville VA 23116

Physician Practices Hanover Pediatrics

9113 Dickey Drive Mechanicsville VA 23116

Physician Practices MRMC - Inpatient Surgical Specialists

8262 Atlee Road MOB III Ste 205 Mechanicsville VA 23116

Physician Practices Diabetes Treatment Center

8201 Atlee Road Suite A Mechanicsville VA 23116

Outpatient diabetes clinic Women's Specialty Ctr - Female Pelvic Me

8266 Atlee Road MOB II Ste 219 Mechanicsville VA 23116

Physician Practices Women's Specialty Ctr - Female Pelvic Me

13700 St Francis Blvd Midlothian VA 23114

Physician Practices Bon Secours Behavioral Health Group

1510 North 28th Street MOB Suite 101 Richmond VA 232235332

Physician Practices Capitol OBGYN

1510 North 28th Ste 305 Richmond VA 232235332

Physician Practices Arleeta M Diggs MD

304 East Leigh Street Richmond VA 23219

Physician Practices Bon Secours Oncology Associates

8266 Atlee Road MOB II Ste 225 Mechanicsville VA 23116

Physician Practices Memorial Regional Medical Center

8243 Meadowb8262 Atlee Road MOB Mechanicsville VA 23116

Ambulatory Surgery Center Richmond Cardiology Associates

8243 Meadowbridge Road Mechanicsville VA 23116

Physician Practices Richmond Cardiology Associates

1850 Pocahontas Trail Suite 202 Quinton VA 23141

Physician Practices Richmond Cardiology Associates

430 Clairmont Court Suite 211 Colonial Heights VA 23525

Physician Practices Bon Secours Wound Care Clinic

8237 Meadowbridge Road Mechanicsville VA 23116

Physician Practices Part I, Line 6a: Annually, Bon Secours Richmond Health System (BSRHS) 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 is available to the public each year on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours. 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): The Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $29,189,078. Part II: Advancing the Bon Secours mission "to bring people and communities to health and wholeness," the Bon Secours Richmond Health System and MRMC leadership in collaboration with Dunany Plater Zyberk & Company (DPZ) a leading proponent of traditional town planning and New Urbanism sponsored a weeklong charrette in fiscal year 2012. The purpose of the charrette was to engage hospital staff, administration and supporters along with neighbors, municipal officials and a team of design consultants to develop a vision for the next 40 years. The Healthy Communities Liaison was instrumental in planning and executing the event. The HCL also guided the installation and development of a new software program, Social Solutions, which will enhance the health system's ability to measure and evaluate outcomes. 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 Patient 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 FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility. Part VI, Line 2: In partnership with Bon Secours Richmond Health System, MRMC uses multiple approaches to assess the health needs of the communities it serves. In October 2009, the Central Virginia Health Planning Agency released an Immigrant Needs Assessment commissioned by Bon Secours Richmond Health System in collaboration with MRMC. This work documented the growth of the immigrant population in the metropolitan Richmond area and made multiple recommendations including the need for interpretation and translation services, health resource information in other languages, preventive services, health screenings including vision and dental, affordable health insurance for immigrants and their families and access to behavioral health services. Bon Secours Richmond has initiated many of the recommendations. 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: MRMC serves the greater Richmond, Virginia area. Projections indicate that the population will grow by 5.2% from 1,089,918 in 2012 to 1,146,394 in 2017, with 11.8% of the service area having a household income of less than $15,000 per year, compared to the national average of 13.0%. Similarly, 21.8% of the service area's populace maintains a household income less than $25,000 per year, compared to the national average of 23.8%. Demographic data shows that 52.8% of the population is white and 35.0% is black, compared to the national averages of 62.8% and 12.3% respectively. Demographics of the service area indicate that the age cohort of 64 to 75 will increase by 20.7% between 2012 and 2017. MRMC is a disproportionate share hospital (DSH). In fiscal year 2012, it served 14,785 inpatients and provided outpatient services for 63,826 visits. Additionally, MRMC provided 76,572 emergency room visits. The Emergency Department is open 24 hours a day and available to all persons regardless of ability to er government sponsored health care programs such as the State/Local Hospitalization program and the SCHIP/FAMIS program for children. Bon Secours MRMC owns fifteen physician practices. They provided free or reduced fee services to patients in FY 12 at a cost of $618,918.At Bon Secours Memorial College of Nursing, our students, faculty, staff and alumni are part of a nearly 200-year-old mission of providing compassionate care to those in need. Beginning in the 1800s, the Sisters of Bon Secours provided care to the sick and dying in Paris, France. From those humble beginnings, the mission has grown into an international health care organization. Our College extends this mission by educating nurses in a spirit of academic and clinical excellence to serve our community with genuine compassion and the highest clinical standards. We are deeply committed to meeting the needs of our patients and adapting to the growing, changing needs of the world in which we serve. The Bon Secours Memorial College of Nursing had 245 enrolled students in fiscal year 2012. Part VI, Line 5: MRMC has an open medical staff with privileges available to all qualified physicians in the area. MRMC, through the BSRHS is governed by a board of directors whose composition is representative of the community. MRMC also engages in medical research. Inpatient and outpatient research-related activities are conducted by MRMC with oversight from the BSRHS Institutional Review Board. 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." BSRHS shares 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. Reports Filed With States Part VI, Line 7 VA 1 Bon Secours Richmond Healthcare Foundation 8580 Magellan Parkway Richmond VA 23227 541201346 501(c)(3) 75000 General Support 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Memorial Regional Medical Center complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. 0 1 0 0 0 0 0 0 0 Toni Ardabell 0 368180 0 0 0 22810 0 64266 0 3924 0 459180 0 0 Mark Gordon 0 338075 0 0 0 22265 0 38340 0 33752 0 432432 0 0 Michael Robinson 0 410571 0 0 0 27513 0 91606 0 14149 0 543839 0 0 Peter J Bernard 0 761416 0 0 0 29560 0 201853 0 34368 0 1027197 0 0 Peter F Gallagher 366724 0 0 0 3385 0 27022 0 34364 0 431495 0 0 0 Melinda S Hancock 0 254357 0 5017 0 33464 0 4898 0 28770 0 326506 0 0 Jill Kennedy 207870 0 0 0 550 0 5796 0 27535 0 241751 0 0 0 David J Dougherty 243155 0 155844 0 517 0 3372 0 31877 0 434765 0 0 0 Amit N Gogia 315701 0 40798 0 493 0 19848 0 33823 0 410663 0 0 0 Darius D Hollings 389969 0 48098 0 493 0 25164 0 32117 0 495841 0 0 0 C Gregory Lockhard MD 507529 0 126600 0 1861 0 3552 0 31336 0 670878 0 0 0 Michael J MacDougall 366143 0 115645 0 637 0 19250 0 33873 0 535548 0 0 0 Michael Kerner 0 487110 0 0 0 5511 0 154116 0 33706 0 680443 0 0 Thomas Morris PhD 0 277485 0 0 0 26035 0 49847 0 17668 0 371035 0 0 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. Supplemental Information Part III Part I, Line 3: Bon Secours Health System, Inc., a related organization of Memorial Regional Medical Center, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Neurological Associates BD Member R. Cohen has more than 5% ptnrship in Neurological Assoc. 168448 Independent Contractor 0 Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours - Richmond Health Corp, which in turn holds the majority interest in Bon Secours - Richmond Health System, which in turn is the sole member of Memorial Regional Medical Center, Inc. Form 990, Part VI, Section A, line 7a The governing body of Memorial Regional Medical Center is appointed by its member, Bon Secours Richmond Health System, and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of Memorial Regional Medical Center are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15 The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS's rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of 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 Memorial Regional Medical Center provides any documents open to public inspection upon request. Form 990, Part VII: Hours worked are not tracked on an entity by entity basis. All officer's and director's hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Voluntary Board Members are not compensated for their time. Peter J. Bernard's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the CEO of Bon Secours Virginia Health System which includes direct management, monitoring and oversight of Bon Secours Richmond Health System, Bon Secours Hampton Roads Health System and their related organizations. Melinda Hancock's compensation is paid by St. Mary's Hospital of Richmond, Inc., a related organization. The compensation she receives is for her role as the CFO 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. Toni Ardabell'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 St. Mary's Hospital of Richmond, Inc., a related organization. Mark Gordon'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 St. Francis Medical Center, a related organization. Michael Robinson'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 Memorial Regional Medical Center and Richmond Community Hospital. Sr. Anne Marie Mack and Sr. Victoria Segura do not receive payroll distributions as they have taken vows of poverty. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 361,262. Minimum pension liability adjustment -21,042,502. Transfers from HSO for Debt Service -4,458,762. Rounding -1. Total to Form 990, Part XI, Line 5: -25,140,003. Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. Management Services MD 501(c)(3) 11b Bon Secours Inc 0 Bon Secours Richmond Health Corporation 8580 Magellan Parkway Richmond VA 23227 541356155 Management Services VA 501(c)(3) 11b Bon Secours Health System Inc 0 Bon Secours Richmond Health System 8580 Magellan Parkway Richmond VA 23227 521988421 Local System Parent Org. VA 501(c)(3) 11b Bon Secours Richmond Health Corporation 0 St Mary's Hospital of Richmond Inc 8580 Magellan Parkway Richmond VA 23227 540793767 Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System 0 Bon Secours Richmond Community Hospital 8580 Magellan Parkway Richmond VA 23227 540647482 Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System 0 Bon Secours St Francis Medical Center 8580 Magellan Parkway Richmond VA 23227 311716973 Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System 0 Laburnum Properties 8580 Magellan Parkway Richmond VA 23227 521260700 Title Holding Company VA 501(c)(2) Bon Secours Richmond Health System 0 Bon Secours Stuart Circle Hospital 8580 Magellan Parkway Richmond VA 23227 541740128 Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System 0 Bon Secours Richmond Healthcare Foundation 8580 Magellan Parkway Richmond VA 23227 541201346 Grant Making Foundation VA 501(c)(3) 7 Bon Secours Richmond Health Corporation 0 St Mary's MRI LP 8580 Magellan Parkway Richmond VA 23227 541568022 Imaging Services VA Virginia Healthsource Inc Related 0 0 RI LP 8580 Magellan Parkway Richmond VA 23227 541708835 Imaging Services VA Virginia Healthsource Inc Related 0 0 Broad64 Imaging LLC 8580 Magellan Parkway Richmond VA 23227 205886018 Imaging Services VA Virginia Healthsource Inc Related 0 0 Richmond Radiation Oncology Center I LLC 8580 Magellan Parkway Richmond VA 23227 208444551 Radiation Oncology Services VA Radiation Oncology Center Inc Related 0 0 Chesterfield Community Healthcare Center MOB I LLC 435 Southlake Blvd Richmond VA 23236 541745670 Rental - Medical Office Building VA Virginia Healthsource Inc Related 0 0 Chesterfield Community Healthcare Center Inc 8580 Magellan Parkway Richmond VA 23227 541812738 Ambulatory Healthcare Services VA Richmond Health System Inc C RHS Management Corporation 8580 Magellan Parkway Richmond VA 23227 541313425 Independent Living Facility VA Richmond Health System Inc C Bon Secours - Virginia Healthsource Inc 8580 Magellan Parkway Richmond VA 23227 541417686 Ambulatory Healthcare Services VA Richmond Health System Inc C Richmond MRI Inc 8580 Magellan Parkway Richmond VA 23227 541568452 Imaging Services VA Virginia Healthsource Inc C 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0