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Holy Cross Hospital Inc: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Holy Cross Hospital Inc (EIN 86-0575938)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201331359349305488
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T14:39:24-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1250 East Fifth Street Suite 1900AddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860575938EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Cross Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLYNameControl
Phone5202853000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAlan StraussName
TitleCFO - CHNTitle
Phone5202853000Phone
Date Signed2013-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRebecca LyonsName
PTINP01487105PTIN
Phone5137847100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDebra KnapheideNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode
FieldValueIRS element (for citing)
Gross Receipts22507236GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.carondelet.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionProviding various types of advanced medical/surgical services to our patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees238TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI166753TotalGrossUBI
Net Unrelated Business Txbl Income7282NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year189747ContributionsGrantsPriorYear
Contributions Grants Current Year70562ContributionsGrantsCurrentYear
Program Service Revenue Prior Year23975118ProgramServiceRevenuePriorYear
Program Service Revenue CY20959667ProgramServiceRevenueCY
Investment Income Prior Year262148InvestmentIncomePriorYear
Investment Income Current Year37218InvestmentIncomeCurrentYear
Other Revenue Prior Year665797OtherRevenuePriorYear
Other Revenue Current Year1431944OtherRevenueCurrentYear
Total Revenue Prior Year25092810TotalRevenuePriorYear
Total Revenue Current Year22499391TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12309577SalariesEtcPriorYear
Salaries Etc Current Year10622179SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year15663621OtherExpensePriorYear
Other Expenses Current Year15219445OtherExpensesCurrentYear
Total Expenses Prior Year27973198TotalExpensesPriorYear
Total Expenses Current Year25841624TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2880388RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3342233RevenuesLessExpensesCY
Total Assets BOY9883434TotalAssetsBOY
Total Assets EOY8873873TotalAssetsEOY
Total Liabilities BOY8830791TotalLiabilitiesBOY
Total Liabilities EOY11203387TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1052643NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-2329514NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionProvide for the healthcare needs of the community; to embrace the person in mind, body and spirit; and to serve all people with dignity.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense16210853Expense
Revenue21902053Revenue
DescriptionHoly Cross Hospital is a 25-bed facility that provides general medical/surgical services, 24-hour emergency care, rehabilitation, mammography, ultrasound, chemotherapy, home health, and long-term care. We also offer advanced technology such as renal dialysis, teleradiology, and lithotripsy programs. Holy Cross Hospital's community benefit information is included in the community benefit report for Carondelet Health Network.Description
Total Program Service Expense16210853TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees238NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Alan StraussBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5208727520TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12202 N Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Mark Valenzuela
Chairman0.50XX000
Eladio Pereira MD end 1111
Chairman0.50XX000
Jose Duran MD
Director0.50X000
Jorge Mera MD end 1111
Director0.50X000
Anita Moreno
Director0.50X000
William Neubauer start 112
Director0.50X000
Sr Irma Odabashian
Director0.50X000
James Ross
Director0.50X000
Wlliam Stout
Director0.50X000
Ruth Brinkley end 1011
CEO-CHN40.00XX0116714632277
James Beckmann Ex-Officio
President/CEO - CHN (start 12/11)40.00XX058310
Wanona Fritz Sch O
CEO-CSM/HCH40.00X045606542147
Dorothy Sawyer start 1111
CEO-CSM/HCH40.00X5992400
Deb Mohesky
CFO-CHN40.00X051417733475
Alan Strauss start 412
CFO-CHN40.00X000
Odette Bolano Sch O
COO-CHN40.00X053814138220
Debra Knapheide
CNO/COO-HCH40.00X153436023198
Daisy Jenkins Sch O
Sr. V.P. Human Resources40.00032034345986X
Patricia Martinez Sch O
V.P. Chief Quality Officer40.00032880035609X
Roy Farrell
CMO-HCH40.00198342025639X
Carolyn Kenngott
RN-CRNA40.0015680108110X
Amos Wilkinson
RN-CRNA40.00152075027997X
Kerry Donn Smith
RN-CRNA40.00150702017089X
Celia Torres
Director-Pharmacy40.00141158021725X
Eric Padilla
RN40.00119287020316X
Wesley Colvin
Former COO - CHN (end 7/09)0.0002602850X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1131725TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3590788TotalReportableCompFrmRltdOrgs
Total Other Compensation371788TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Morrisons Management Specialists
5801 Peachtree Dunwoody RdAtlantaGA30342Nutritional Services1020416
Crothall Healthcare Inc
13028 Corrections Center DrChicagoIL60693Housekeeping653551
TriMedx LLC
PO Box 636129CincinnatiOH452636129Equipment Maintenance485688
Quantum Plus Inc
PO Box 634850CincinnatiOH452634850Emergency Room Physicians434554
Alliance Healthcare Services
FILE 55826Los AngelesCA900745826Radiology289266
FieldValueIRS element (for citing)
Number Of Contractors GT100 K20NumberOfContractorsGT100K
Related Organizations70562RelatedOrganizations
Total Contributions70562TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service RevDescription
Business Code621400BusinessCode
Total Revenue Column20959667TotalRevenueColumn
Related Or Exempt Function Income20959667RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue20959667TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11904TotalRevenueColumn
Exclusion$11,904ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real173069Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real5733Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real167336Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column167336TotalRevenueColumn
Exclusion$167,336ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other27426Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2112Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other25314Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column25314TotalRevenueColumn
Exclusion$25,314ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
EHR Incentive Payment900099859528859528
Reference Lab621500166753166753
Cafeteria Revenue722210155469$155,469

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column82858TotalRevenueColumn
Related Or Exempt Function Income82858RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1264608TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column22499391TotalRevenueColumn
Related Or Exempt Function Income21902053RelatedOrExemptFunctionIncome
Unrelated Business Revenue166753UnrelatedBusinessRevenue
Exclusion$360,023ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total376186Total
Program Services376186ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8637925Total
Program Services7316745ProgramServices
Management And General1321180ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total272517Total
Program Services206813ProgramServices
Management And General65704ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total631958Total
Program Services479593ProgramServices
Management And General152365ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total703593Total
Program Services533957ProgramServices
Management And General169636ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total9121Total
Management And General9121ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3644441Total
Program Services2609753ProgramServices
Management And General1034688ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total16502Total
Management And General16502ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total338740Total
Program Services243126ProgramServices
Management And General95614ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total25477Total
Program Services19386ProgramServices
Management And General6091ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total408473Total
Program Services196067ProgramServices
Management And General212406ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total47158Total
Program Services36526ProgramServices
Management And General10632ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total195885Total
Program Services94025ProgramServices
Management And General101860ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total696092Total
Program Services334124ProgramServices
Management And General361968ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total446609Total
Program Services338932ProgramServices
Management And General107677ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
Shared Services56628295662829
Bad Debt15813841581384
Supplies1509034284411480593
Repairs and Maintenance699163575334163

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total567784Total
Program Services329480ProgramServices
Management And General238304ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25841624Total
Program Services16210853ProgramServices
Management And General9630771ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2362BOY
EOY875EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3107513BOY
EOY2830992EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY78263BOY
EOY71174EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY92740BOY
EOY62075EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY364322BOY
EOY339217EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY42671BOY
EOY75350EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11909210LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6679457LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5692682BOY
EOY5229753EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY502881BOY
EOY264437EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9883434BOY
EOY8873873EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1006452BOY
EOY1102793EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7824339BOY
EOY10100594EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8830791BOY
EOY11203387EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1034591BOY
EOY-2339221EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY18052BOY
EOY9707EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1052643BOY
EOY-2329514EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9883434BOY
EOY8873873EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3342233ReconcilationRevenueExpenses
Reconcilation Other Changes-39924ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis815007OtherCostOrOtherBasis
Book Value815007BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6946601OtherCostOrOtherBasis
Depreciation3315734Depreciation
Book Value3630867BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3887OtherCostOrOtherBasis
Depreciation1798Depreciation
Book Value2089BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3960694OtherCostOrOtherBasis
Depreciation3213669Depreciation
Book Value747025BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis183021OtherCostOrOtherBasis
Depreciation148256Depreciation
Book Value34765BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5229753TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$9,444,582
Estimated Settlements to Third Party Payors$223,532
Other Current Liabilities$96,922
Self Insurance Liability$231,848
Other Non-Current Liabilities$103,710
FieldValueIRS element (for citing)
Total Of Amounts10100594TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage400.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense383708TotalCommunityBenefitExpense
Net Community Benefit Expense383708NetCommunityBenefitExpense
Percent Of Total Expense0.01580PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense9003257TotalCommunityBenefitExpense
Direct Offsetting Revenue6269314DirectOffsettingRevenue
Net Community Benefit Expense2733943NetCommunityBenefitExpense
Percent Of Total Expense0.11270PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense9386965TotalCommunityBenefitExpense
Direct Offsetting Revenue6269314DirectOffsettingRevenue
Net Community Benefit Expense3117651NetCommunityBenefitExpense
Percent Of Total Expense0.12850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served420PersonsServed
Total Community Benefit Expense77818TotalCommunityBenefitExpense
Net Community Benefit Expense77818NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served29PersonsServed
Total Community Benefit Expense354699TotalCommunityBenefitExpense
Net Community Benefit Expense354699NetCommunityBenefitExpense
Percent Of Total Expense0.01460PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served731PersonsServed
Total Community Benefit Expense2021864TotalCommunityBenefitExpense
Direct Offsetting Revenue1314305DirectOffsettingRevenue
Net Community Benefit Expense707559NetCommunityBenefitExpense
Percent Of Total Expense0.02920PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Benefit Expense6122TotalCommunityBenefitExpense
Net Community Benefit Expense6122NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served1180PersonsServed
Total Community Benefit Expense2460503TotalCommunityBenefitExpense
Direct Offsetting Revenue1314305DirectOffsettingRevenue
Net Community Benefit Expense1146198NetCommunityBenefitExpense
Percent Of Total Expense0.04730PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served1180PersonsServed
Total Community Benefit Expense11847468TotalCommunityBenefitExpense
Direct Offsetting Revenue7583619DirectOffsettingRevenue
Net Community Benefit Expense4263849NetCommunityBenefitExpense
Percent Of Total Expense0.17580PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense2650TotalCommunityBuildingExpense
Net Community Building Expense2650NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense15845TotalCommunityBuildingExpense
Net Community Building Expense15845NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense662TotalCommunityBuildingExpense
Net Community Building Expense662NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense119TotalCommunityBuildingExpense
Net Community Building Expense119NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Total Community Building Expense19276TotalCommunityBuildingExpense
Net Community Building Expense19276NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,581,384BadDebtExpenseAmount
Amount Attributable To660648AmountAttributableTo
Amount Reimbursed By Medicare4965426AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6365766CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1400340MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Cross Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12202 North Forbes BlvdAddressLine1
CityTucsonCity
StateAZState
ZIP Code857451412ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Holy Cross Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent400.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 6a: The organization prepares and files an annual Community Benefit Plan Report. This report is prepared on a consolidated basis and includes data for Carondelet Health Network, Holy Cross Hospital, Carondelet Foundation, and Carondelet Heart & Vascular Institute.
Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table.
Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services.
Part I, L7 Col(f): The Bad Debt expense included in Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $1,581,384.
Part III, Line 4: From the audited consolidated financial statements of Ascension Health Alliance (which includes the activity of Holy Cross Hospital):The provision for bad debt expense is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debt expense to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.
Part III, Line 8: Holy Cross Hospital follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. Patients who are cooperating in good faith to resolve their hospital bills will not receive from Holy Cross Hospital liens on primary residences or wage garnishments and unpaid bills will not be sent to collection agencies.
Part V, Section B, Line 13g: In addition to providing the financial assistance policy upon request, it is also referenced in the Emergency Rooms and admissions.Holy Cross Hospital, Inc.
Part V, Section B, Line 19d: Per the Carondelet Health Network Financial Assistance Policy:Charges for emergency or other medically necessary care provided to persons who are eligible for financial assitance under this policy shall not exceed the amounts generally billed to individuals who have insurance coverage for such care.Holy Cross Hospital, Inc.
Part VI, Line 2: Holy Cross Hospital follows the Catholic Healthcare Association Guidelines which state that a Community Needs Assessment ("CHNA") should be completed every three years. The last Community Needs Assessment was commissioned in 2012 and will be delivered in June 2013 from an outside research center affiliated with Arizona State University. The research center worked with an internal committee for guidance of the needs assessment. Other internal strategic documents are used to identify community needs and hospital data support the work community outreach programs do in Tucson.
Part VI, Line 3: Upon admission, patients are encouraged to apply for the state medicaid program if they are uninsured as well as other public benefits such as TANF or SNAP if the patient has a need. If patients prove they meet at least one (1) of eight (8) criteria outlined in the policy, they will be eligible for charity care. The patient will be placed in pre-emptive charity care status and after all bills are finalized a request for the total amount with be made on the patient's behalf by their financial counselor. Trained financial counselors will work with patients if it is not easily determined that a patient qualifies for charity care or to what level of financial assistance a patient may qualify for. The Pre-emptive Charity Care Policy is posted in the Emergency Department, Admitting, hospital lobbies, other public areas as well as summarized on the Carondelet website and is to be included in a patient's financial statements when sent. The Network participates in "Tu Salud", a Southern AZ community Collaboration CHIPRA funded outreach program which provides a community outreach worker/financial counselor at community events to facilitate enrollment into government and community assistance programs. CHN led a Southern Arizona "Phonathon", which was a one day event, to increase awareness of state Medicaid eligibility requirements and other public funding resources as well as to facilitate enrollment of qualifying individuals and families.
Part VI, Line 4: The primary and secondary service area includes Pima, Santa Cruz and Cochise Counties. The population is 1.21 million individuals based on 2010 census data. This growth is 2.05% from 2000. The average household size is 2.53. The median age is 37.4 which is at the national average. 51.7% of the population earns less than $50,000 with the median household income at $48,208 and the per capita income at $24,171. 27.2% of the population is over the age of 55. The demographics of the area with regard to ethnicity is as follows: 36% of Hispanic Origin, 3.8% two or more races, 15.6% some other race alone, 0.2% Pacific Islander alone, 2.2% Asian American, 2.8% American Indian Alone, 3.5% black and 36% white alone. Santa Cruz County has been growing at a percentage of 2.14% between 2000 and 2014, the national average is 0.76%. Current population, based on the 2010 census reveals a total of 47,420 in Santa Cruz County. There are a total number of households of 15,437 which represents a 2.72% growth since 2000. 81% of the population are households with 2+ members, and 77.7% are family households. Husband-Wife families comprise 55.7% of this and 26.7% with children. The average household size is 3.1 members
Part VI, Line 6: Carondelet Health Network ("CHN")is a member of Ascension Health. Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 21 of the United States and the District of Columbia. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province. Holy Cross Hospital is part of CHN. CHN is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health are related to providing health care services.Mission: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with The System's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs:1. Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. 2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.3. Cost of other programs for the persons living in poverty and other vulnerable persons includes programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community including substance abusers, the homeless, victims of child abuse and persons with acquired immune deficiency syndrome. 4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, including health promotion and education, health clinics and screenings and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with the guidelines established by both the Catholic Health Associations (CHA) and the Internal Revenue Service (IRS).

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ruth Brinkley end 1011
0116714600000186150136620119942300
Wanona Fritz Sch O
0455632000433020328021819049821200
Deb Mohesky
05141770000022000011475054765200
Odette Bolano Sch O
053814100000220000162200576361037316
Debra Knapheide
1534360000014278089200176634000
Daisy Jenkins Sch O
03180080002335021639024347036632900
Patricia Martinez Sch O
03288000000016500019109036440900
Roy Farrell
1983420000069230187160223981000
Carolyn Kenngott
156801000006184019260164911000
Amos Wilkinson
15207500000108210171760180072000
Kerry Donn Smith
1507020000061740109150167791000
Celia Torres
140810000348040090177160162883000
Wesley Colvin
0260285000000000260285013540

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationPart IIIPart I, Line 3: Carondelet Health Network, a related organization of Holy Cross Hospital, Inc., uses the following to establish the compensation of the organization's CEO: -Compensation Committee, -Independent Compensation Committee, -Written Employment Contract, -Compensation Survey or Study, and -Approval by the Board or Compensation Committee.
Supplemental InformationPart IIIPart I, Line 4b: Eligible Executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. A related organization made distributions from the supplemental nonqualified retirement plan in the amounts as noted: Irma Ramirez - $30,406 Odette Bolano - $37,316 Neil Carolan - $35,640

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Alfredo Guevara MD
To purchase medical office buildingX$296,76662075011
Jose Duran MD
To purchase medical office buildingX$245,73571174011
FieldValueIRS element (for citing)
Total Balance Due133249TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (17 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Changes in Program ServicesForm 990, Part III, line 3Both the Holy Cross Hospital and Carondelet Health Network boards have agreed to close the hospice program. After in-depth financial analysis, the board has concluded that the financial losses of the hospice program are no longer sustainable due to the cuts made to Arizona's Medicaid program that will result in lower reimbursements.
Number of Forms 1099 Filed:Form 990, Part V, Line 1a:Carondelet Health Network, a related organization of Holy Cross Hospital, uses a common paymaster to compensate all independent contractors used within the Health System. The number attributable to each hospital is not easily distinguishable. The total amount of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of Carondelet Health Network's Form 990.
Form 990, Part VI, Section A, line 6Holy Cross Hospital, Inc. has a single corporate member, Carondelet Health Network.
Form 990, Part VI, Section A, line 7aHoly Cross Hospital, Inc. has a single corporate member, Carondelet Health Network, who has the ability to elect members to the governing body of Holy Cross Hospital, Inc.
Form 990, Part VI, Section A, line 7bAll decisions that have a material impact to Holy Cross Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Carondelet Health Network.
Form 990, Part VI, Section B, line 11Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Section B, line 15In determining compensation of the organization's CEO, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individuals were not present when their compensation was decided. In determining compensation of other officers or key employees of the organization, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
Form 990, Part VI, Section C, line 19The organization will provide any documents open to public inspection upon request.
Explanation of Average Hours Worked for Organization:Form 990, Part VII, Section A:Officers and Key Employees for Holy Cross Hospital, Inc. provide services to Carondelet Health Network and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore where noted with a "Sch O" reference, all hours are 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 for all entities.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 5:Net unrealized losses on investments: -514. Transfers to Sponsor - Ascension Health -35,853. Net Assets Released from Restriction -8,346. Interest Rate Swap 4,789. Total to Form 990, Part XI, Line 5: -39,924.
Form 990, Part XII, Line 2:The financial statements of Carondelet Health Network (which include the activity of Holy Cross Hospital) fall under the limited scope audit of Ascension Heatlh Alliance. The activity of Carondelet Health Network and other members of the Carondelet Health Network are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit report of Carondelet Health Network is completed.
Form 990, Part III, Line 4a:Carondelet Health Network Community Benefit Report Fiscal Year 2012 Post-Hospital Program for Those Who Are Homeless: Jose C., aged 73, was in a tough spot. He had been homeless for many years, had no financial resources and had recently been hospitalized for heart failure. Jose needed a place to stay while he recuperated. He also needed meals and follow-up medical care. His only family member was a brother who lived out of state and was unable to provide assistance. Fortunately, Jose was able to enroll in the Homeless Post-Hospital Program. The Homeless Post-Hospital Program is part of the Southern Arizona Health Village for the Homeless Program, which also includes the Van of Hope. The Van of Hope is a mobile clinic providing medical, social and behavioral health services for people who are homeless. Partners in the Health Village collaborative are: Carondelet Health Network, El Rio Community Health Center, Primavera Foundation, Interfaith Coalition for the Homeless, Pima Community Access Program, Salvation Army, Dependable Home Health, St. Elizabeth's Health Center and the Veterans Administration. While in the Homeless Post-Hospital Program, Jose stayed at the Primavera Men's Shelter and also received his meals there. Dependable Home Health sent in skilled nurses to provide the follow-up care he needed, and an El Rio Community Health Center Nurse Practitioner checked in with Jose every week. A Carondelet Heart Failure Team nurse also visited Jose to help monitor his progress. Members of the Van of Hope staff rounded out Jose's post-hospital support team, visiting him twice a week to ensure that all his needs (medical, social and behavioral health) were being met. When Jose first arrived at the Primavera Men's Shelter, he had been in and out of hospitals and was very weak. After a couple of weeks, he began to feel better. Before the end of his three-month stay, he began to thrive. Case managers at the shelter worked closely with Jose to find a home for him to transition into once he had recuperated. Ultimately they suggested St. Luke's Home; Jose visited there and thought it was a great fit. He made great strides and his life improved drastically once he was healthier and living at St. Luke's. Behavioral Health Patients Who Are Homeless Get Vital Care: Behavioral health issues, including psychiatric illnesses and substance abuse problems, are often factors that prevent people from holding a job. All too often, this ultimately causes them to become homeless. Unfortunately, having a serious psychiatric illness - such as schizophrenia, post-traumatic stress disorder (PTSD), panic attacks or addiction - can make homelessness even more terrifying and overwhelming. Some homeless individuals also have serious medical issues that make their lives that much more difficult. These issues commonly include heart attacks, strokes, chronic obstructive pulmonary disease (COPD), back injuries and diabetes, among many others. With the past several years of our country's economic downturn, many more people have become homeless. The behavioral health services offered via Carondelet Health Network's Van of Hope are often a lifesaver for those in great need. The van, with its medical and behavioral health staff, routinely travels to 21 locations where the homeless congregate - primarily shelters and meal sites. One man, who had lost his job, house, wife and children, tried to walk from Mesa to Tucson in the summertime and had been hospitalized for dehydration. When he encountered staff on the Van of Hope, he was disoriented and suicidal. After counseling, he was willing to return to Phoenix, where he had the most support, and was connected with behavioral health services there. Carondelet's follow-up efforts indicate that he is now doing well. Another man had significant psychiatric symptoms resulting from severe abuse by his mother and grandmother throughout childhood. He had grown tall, but could not defend himself from the intrusion of horrible memories and nightmares because of his PTSD. He found relief only by cutting and burning himself, and he had thoughts of both suicide and homicide. He knew he needed to control these thoughts, but could not do it alone. He had no healthcare and no money. This patient was connected to the Crisis Response Center/SAMHC for emergency assessment and then referred to a behavioral health network center. After therapeutic encounters, he reported that his anxiety and anger were diminished. With the regular treatment and medication he now receives, he is doing much better. The Van of Hope has provided an ever-increasing number of services to people like these. In fiscal year 2011, the Van assisted 54 behavioral health patients with 74 therapeutic encounters. In fiscal year 2012 those numbers increased to 245 behavioral health patients receiving 373 therapeutic encounters. Van staffers work hard to ensure that patients go to their follow-up appointments to get the best and most thorough care. Carondelet's Van of Hope serves a community of people in great need, most of whom have no other options or behavioral health services available to them. Over the past two years, the Van of Hope has worked with 33 individuals with serious mental illness. Not only are these patients getting the help they desperately need, they also report being very happy with their care and grateful for the services. "It means a lot to me to have someone professional to talk to." A behavioral health patient who is homeless explained what getting help means to him.
Heart Failure Transitional Care Team Celebrates Two Years of Successful, Challenging Care: Patients who have been diagnosed with heart failure are on a precarious journey - one that frequently leads right back to the hospital. To improve their health and help avoid repeat hospitalizations, Carondelet Health Network created a special Heart Failure Transitional Care team made up of experienced cardiac nurses. The first year of the program's existence was challenging but successful. Patients with heart failure definitely benefited from the education, medication, understanding and coordination of care that the nurses in Carondelet's program provide. Heart Failure Transitional Care begins when patients are released from the hospital. A nurse follows up with each patient at home, working to develop a plan of care that will help patients become independent in managing their care. Care plans include the following elements: -Home visits to provide self-management education -Education to increase patients' understanding of their condition and medications -Care coordination for follow-up medical appointments -Other community or social services care coordination as needed The nurses work with heart failure patients for two months, providing consistent and ongoing care and education. During this critical time, nurses are able to monitor patients' weight via tele-monitoring, while educating patients about the significance and potential dangers posed by weight gains. With significant help from Dependable Home Health, Pima Council on Aging and other community partners, team nurses care for a number of patients with complex health needs. Some are homeless, without insurance and lack money and food. They often have many other needs as well. This program helps people understand that heart failure need not be a death sentence. One patient said, "I gave up all hope and just wanted to die. Then you came and showed me how I can still live a good life with just a few adjustments in my daily living." Carondelet's exceptional nurses are able to keep these patients from going back into the hospital. The hospital re-admission rate for patients with heart failure who are in the program is significantly lower than for similar patients who do not participate in the program. Thanks to the Heart Failure Transitional Care Program, the future is a lot brighter for many Tucson residents with heart failure. Faith through Good Health and Wellness: Reaching out to engage an entire community in the pursuit of good health and wellness can be an overwhelming task. One way to do this is by partnering with religious groups, which have already established ties to their members: ties of faith, trust and fellowship. To take advantage of an excellent opportunity to help more people in Southern Arizona, Carondelet Health Network has teamed up with local religious congregations to train their leaders on how best to provide health and wellness outreach to church members. "Basic Training for Congregational Health Leaders" (CHL training) was created to teach the essentials of starting or improving an existing health ministry program, with a focus on promoting whole-person health within religious organizations. A health ministry can include such elements as prayer groups, visiting the sick, nutrition classes, health screenings and evaluations and other wellness initiatives. By March 2012, Carondelet - in partnership with Interfaith Community Services - had completed its sixth session of CHL training. Thus far, 83 individuals, representing faith communities that reach over 61,000 members, have participated in the training. Putting Health Ministries into Action: One example of the faith community spreading the message of good health is Rising Star Missionary Baptist Church. It has used CHL training, along with technical assistance from Carondelet's Parish Nurse Program, to implement a health ministry program. Their first initiative was in February 2011, when 65 Rising Star members were screened to assess their risk for diabetes and high blood pressure. The church used the results from the health screenings as a guide for further activities. Blue Cross and Blue Shield of Arizona is continuing to fund health screenings in the community. Next, the church kicked off its "Biggest Winner" challenge to lose pounds, exercise more and reduce the risk of developing diabetes, heart disease, stroke and certain cancers. More than 100 church members signed up to participate in this program. Each member was assigned to one of eight teams that encourage one another to eat healthy diets, exercise and attend Bible study and prayer services. Nogales Diabetes Support Group Helps Kids and Families Stay Healthy: Children diagnosed with type 1 diabetes face an extra challenge in their daily lives. But sometimes the diagnosis is even harder on their parents. To help families manage this condition, Carondelet Holy Cross Hospital offers a Diabetes Support Group in Nogales. Gwen Gallegos, FNP, MSN, CDE, started the group more than 20 years ago and still conducts the monthly meetings for kids (most of whom have type 1 diabetes) and their parents. Within this supportive environment, Gallegos educates families about healthy lifestyle habits for optimal diabetes management. Beginning with just seven young people referred by their pediatricians, the group now has a roster of about 25 regulars. The first children in the group are grown and in college or working now. These alumni often refer other families to the support group. According to Gallegos, the support parents get from other parents who face the same diagnosis is especially valuable. Diabetes is a growing problem in the U.S., where Hispanics and Native Americans have a particularly high risk of developing type 2 diabetes. Thanks to the longtime efforts of Gwen Gallegos, the next generation of Southern Arizonans has a better chance of staying healthy.
Young Parents Helped by Corazon de Maria Program: At Holy Cross Hospital in Nogales, Arizona, young women facing the realities of a teenage pregnancy participated in a unique program to teach them about the role and responsibility of becoming a mother. This community outreach and education project, called Corazon de Maria, was made possible by a grant from the Sisters of St. Joseph of Carondelet. The effort focused on educating teenagers about the need to protect and ensure human dignity - both their own and their child's. It also promoted the Sisters' values: respect, integrity, wisdom and leadership. The program helped young people appreciate the importance of a good quality of life for everyone. In collaboration with a number of community organizations, the Corazon de Maria team created a curriculum focused on teenaged mothers and their infants, although young fathers and others who play supporting roles in raising the child were also encouraged to attend. Class topics included the following: -What to Expect When You Turn 18 -Infant CPR -Shaken Baby Syndrome -Identifying and Building Healthy Relationships -Personal Identity -The Happiest Baby on the Block The curriculum included hands-on activities, medical and social educational presentations, a guide to available community resources, lots of conversation and a tremendous amount of compassion. Teenagers feeling the pressure of parenthood found a sense of value and empowerment. One young girl who participated in the program explained, "You realize that you are not alone in your fear, confusion and thoughts about what to do now. Corazon de Maria helps teen mothers learn to take care of a baby, from changing diapers to giving CPR." Corazon de Maria classes were held at Carondelet Holy Cross Hospital and Cima Vista High School in Rio Rico, Arizona. Many thanks to the following organizations whose collaboration make the Corazon de Maria program possible: -Mariposa Community Health Center -Child & Family Resources -Arizona Cooperative Extension -Catholic Community Services -Community Intervention Associates -Nuestra Casa -Santa Cruz Valley Unified School District Carondelet Community Outreach to the Rescue: At 20 years old, Sislynne Langbata had to grow up fast. She moved to Arizona from Colorado in June 2010 with her daughter. As a new mother, Langbata knew she needed an education to be able to have a good career. Her parents, who live in Phoenix, were happy to care for their two-year-old granddaughter while Langbata attended the Fred Giacosta Job Corps Center in Tucson. She was working hard to earn a medical receptionist certificate when she discovered she was pregnant again. Without health insurance, she felt lost and afraid. "I didn't tell anyone I was pregnant. I was so stressed and depressed because I didn't have the means to see a doctor," Langbata said. The next three months were torture. "I went to see a doctor in one office, but he couldn't do anything to help me with my pregnancy since I had no health insurance." In America today, approximately 13 percent of pregnant women do not have health insurance. The percentages are higher for minorities, and the consequences can be severe. Unfortunately, without health insurance, pregnant women are at greatly increased risk for miscarriage, birth defects, infant mortality and maternal death. But Langbata's story is happier than most in a similar situation. Renee Perez, Community Health Outreach Coordinator for Carondelet Health Network, visited the Job Corps Center and met Langbata. Perez assisted her in taking the necessary steps to apply electronically for AHCCCS coverage, Arizona's Medicaid program. Within weeks of Perez's intervention, Langbata was insured through the Mercy Care Plan. "It is such a huge weight off my shoulders. This means everything to me." Perez also helped Langbata make her first appointment at Carondelet Health Network's Primeros Pasos Prenatal Clinic. Langbata was able to get regular checkups and the prenatal care and vitamins she needed to ensure that her second child was born healthy. With health insurance coverage, Langbata had the peace of mind to focus on her future. She was able to concentrate on school, getting her employment certificate, finding a job and building a life for herself and her children.
Brain Academy Offers Students a Glimpse into the Future: All parents ponder the possibilities of what our children may become. Scientists...doctors...brain surgeons? Consider actually providing them a firsthand look at the realities of those possibilities. Over the past two years, students from all over Tucson participated in a special event called the Brain Academy, sponsored by Carondelet Health Network. The two-day event was held in tandem with Carondelet Neurological Institute's annual Neurosciences Conference. On the first day of the Brain Academy, students tour the Carondelet Neurological Institute at St. Joseph's Hospital. They get to see the neurosurgical operating room suites-the first of their kind in North America. They also visit the biplane angiography suite, where aneurysms are treated, and the Stereotactic Radiosurgery Suite, used for targeted radiation treatment of brain and spinal tumors. The second day, students have the unique opportunity to meet with top neurologists and neurosurgeons at the Neurosciences Conference. Conference leaders discuss the latest developments in the treatment of Alzheimer's disease, stroke, movement disorders, disorders of the spine and brain concussions. Brain Academy was conceived in an effort to spark interest in the medical sciences among Tucson's youth. Robert P. Goldfarb, M.D., Chairman of Carondelet Neurological Institute noted, "The Brain Academy is a valuable next effort to invest in and strengthen this region's future through the students we encourage to pursue careers in our field." Carondelet Health Network began the program in 2011 with a dozen students from Tucson Unified School District. In 2012, 20 high school juniors participated from a number of local school systems. Students must apply for the program and write an essay; participants are selected by a panel of top neurosurgeons. One lucky student is selected for a $2,500 scholarship toward the college of his/her choice. Scholarship funds are provided by the Carondelet Foundation. Plans are already underway for the 2013 Brain Academy. As one school administrator commented, "Carondelet Neurological Institute's outreach to our students is a wonderful gift that allows students to see the possibilities that exist in their futures through science and medicine." "The discussion groups and activities were fun - such a fantastic opportunity." Student comment "It was great to learn about conditions applicable to teenage lives, like concussions in sports." Student comment Carondelet Offers Shadowing, Hiring Events to Boost Workforce: Carondelet Health Network engages in a variety of professional outreach efforts to find people considering a career in healthcare and those who want to return to a career in the hospital environment. Events are organized by Carondelet's Student Services, Management Development and Human Resources teams. One great opportunity for those who want an up-close look at the hospital environment is called "shadowing." This allows individuals considering a healthcare career to follow a physician or nurse around during a typical day in the hospital. Similarly, "RN refreshers" are opportunities for nurses to become reacquainted with the intricacies of hospital care. Four-hour shadowing periods help train nurses in the most up-to-date care practices. Carondelet Volunteer Services also gets involved by coordinating unique visits and volunteer experiences at Carondelet hospitals or other facilities that span Southern Arizona. Maria Sandra Marshall is a great example of the value of the RN refresher program in the community. A registered nurse with a PhD, Marshall stopped working when her children were young. After many years out of the workforce, she was ready to restart her career. She enrolled at Pima Community College for an RN refresher course, where she learned about the opportunity to shadow a Carondelet nurse. "I was lucky to have a wonderful and knowledgeable mentor, Maria Valenzuela," Marshall said. After her refresher program, Marshall landed a job as an RN with Carondelet's Faith Community Nursing Program. "I truly enjoy my job," she noted. "It's such a meaningful role for me to advocate and educate in the community to improve health, while using my clinical, research and Spanish language skills to truly understand and help people." As the healthcare industry experiences dynamic fluctuations in hiring, coupled with an ongoing need for specialized clinicians, Carondelet also hosts career fairs and hiring events. Even as the industry changes and evolves, healthcare recruiting for those with specialized skills and experienced caregivers will likely remain a constant. Hiring events held in FY 2011 and 2012 saw tremendous turnout with long lines of interested job applicants. Openings ranged from experienced RNs, therapists and patient care technicians. Some attendees scored interviews on the spot and job offers shortly thereafter to join the Carondelet family. Carondelet is one of the main trainers for Pima County's One Stop Program. This workforce development program helps people seeking employment with job training and employment assistance.
Hospice & Palliative Care Program Uses Family-Centered Care To Enhance Patients' Comfort and Well-Being: Carondelet Hospice and Palliative Care was blessed to receive its largest donation ever in FY 2011. A gift of $4.5 million was gratefully accepted from the estate of Winifred Q. Witt, a longtime Tucsonan who passed away in September 2010 at age 94. This gift allows the program to continue its vital ministry in the Tucson community. Carondelet St. Mary's Hospital's Hospice and Palliative Care Program aligned with the mission and ministry of Carondelet Health Network, is a model of care that is patient- and family-centered for those who suffer from chronic disease or who may be at the end of their life. This care optimizes patients' quality of life by anticipating, preventing and treating suffering, while also addressing the physical, emotional and spiritual needs of each patient. Palliative care can be provided in the hospital setting at any time during a serious illness in conjunction with curative or life-prolonging medical care. The Palliative Program team consists of a registered nurse, physicians and other interdisciplinary team members, such as hospital chaplains, social workers and case managers. As a faith-based organization, Carondelet Health Network's mission is to provide compassionate medical and spiritual care for patients and families as they navigate their life's journeys. One example of a collaborative effort by the Palliative care team and the Spiritual Care department is the prayer blanket ministry. Prayer blankets are created by volunteers, associates and community partners as a gift of love for patients who may be at the end of life. The thought of losing a life is heartbreaking for everyone involved-patients, family and friends, and even the medical team, hospital associates and volunteers who have served the patient. But sometimes a kind gesture can make a difference. Thus, the Prayer Blanket Ministry was born. This collaborative effort began back in 2008 at St. Mary's Hospital in an effort to ease a stressful time for patients and their families. Volunteers and associates began to crochet and knit blankets as gifts for patients at the end of their lives. The project began with a single knitter and has since expanded to dozens of volunteers and staff members who create the blankets. The blankets are lovingly presented, along with special blessings for both the patient and family, by the Hospital's Spiritual Care chaplains, Palliative nurse and sometimes even the volunteer who created the blanket. The impact has been significant. The daughter of a patient commented, "Words cannot convey our gratitude for your gift of love. The blanket, your gentle kindness and thoughtful counsel were so wonderful as we went through a remarkable farewell journey with our mom. We will forever cherish the beautiful blanket that warmed our mother during our last days together. It warms us still. Thank you, and bless you." Habitat for Humanity and Carondelet Build a Dream: Carondelet Health Network is always actively working to improve the lives of those in Southern Arizona. In addition to providing excellent medical care and a broad spectrum of health resources, Carondelet also works with Habitat for Humanity to build homes for those in need. In the fall of 2010, Carondelet associates volunteered to help build a house for a deserving Tucson family. As it happened, they were building for one of their own. Gina Beltran, an office coordinator in the Carondelet Diabetes Center, was the joyful recipient of the new home, located in Southeast Tucson. Beltran has four children: Jessica, 24, and Pedro, 20, who have left the nest, and Cassandra, 18, and Angela, 15, who live with Beltran in their new Habitat home. Carondelet clinical workers, physicians and executives pounded nails and raised the first walls at the home's groundbreaking. Volunteers from Carondelet continued to lend time and muscle on weekends for several months. Beltran and her children joined in to contribute the many required "sweat equity" hours during construction. "I am just so happy about this opportunity," Beltran said. "This means so much to me and my children." Postpartum Depression Prevention and Awareness: Postpartum depression has far-reaching consequences for a woman, her family and the community. Unfortunately it affects 10 to 25 percent of new mothers. Carondelet's Postpartum Depression Program at St. Joseph's Hospital began in 2003, offering free support groups open to the public. The Postpartum depression group meets the second and fourth Tuesdays of each month at 10:00 a.m. at St.Joseph's Hospital in the Childbirth Education Room on the first floor in the Women's Care Pavilion.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

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Ascension Health
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Carondelet Health Network
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Carondelet Heart & Vascular Institute
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Carondelet Foundation Inc
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Southwest Catholic Health Network (dba Mercy Care Plan)
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Chalon Living Inc
8553 E San Alberto DriveScottsdaleAZ85258860805615Elderly/Disabled HousingAZSection 501(c)(3)Schedule A, Line 7Holy Cross Hospital Inc1
The Centurions
2202 N Forbes BlvdTucsonAZ85745854088322FoundationAZSection 501(c)(3)Schedule A, Line 11aCarondelet Foundation Inc1

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

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Carondelet Medical Group PC
2202 N Forbes BlvdTucsonAZ85745860836126Medical GroupAZN/AC
Carondelet Specialist Group Inc
2202 N Forbes BlvdTucsonAZ85745281558773Physician PracticeAZN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
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Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
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Other Transfer To Other Org1OtherTransferToOtherOrg
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Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Carondelet Foundation Inc
C70562Actual Amount Transferred
Carondelet Health Network
Q2063345Actual Amount Transferred