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SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK (EIN 16-0743187)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201333169349303158
Schema version
2012v2.1
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)
Timestamp2013-11-12T09:17:31-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN160743187EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sisters of Charity HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSISTNameControl
Phone7168282993Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 Abbott Road No 500AddressLine1
CityBuffaloCity
StateNYState
ZIP Code142202039ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid P MacholzName
TitleVP Finance/Corp ControllerTitle
Phone7168282993Phone
Date Signed2013-11-12DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJoseph D McDonaldNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12121 Main Street Suite 300AddressLine1
CityBuffaloCity
StateNYState
ZIP Code14214ZIPCode
FieldValueIRS element (for citing)
Gross Receipts317393807GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.chsbuffalo.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1849YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionThe Catholic Health System (CHS) Mission is to provide quality healthcare services in an acute care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2012 Community Service Plan can be found at www.chsbuffalo.org.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees2686TotalNbrEmployees
Total Nbr Volunteers396TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5495911ContributionsGrantsPriorYear
Contributions Grants Current Year845482ContributionsGrantsCurrentYear
Program Service Revenue Prior Year299301494ProgramServiceRevenuePriorYear
Program Service Revenue CY307729834ProgramServiceRevenueCY
Investment Income Prior Year339283InvestmentIncomePriorYear
Investment Income Current Year221051InvestmentIncomeCurrentYear
Other Revenue Prior Year7757548OtherRevenuePriorYear
Other Revenue Current Year8597440OtherRevenueCurrentYear
Total Revenue Prior Year312894236TotalRevenuePriorYear
Total Revenue Current Year317393807TotalRevenueCurrentYear
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 Year139998941SalariesEtcPriorYear
Salaries Etc Current Year148629651SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year155903530OtherExpensePriorYear
Other Expenses Current Year159270636OtherExpensesCurrentYear
Total Expenses Prior Year295902471TotalExpensesPriorYear
Total Expenses Current Year307900287TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16991765RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9493520RevenuesLessExpensesCY
Total Assets BOY263524760TotalAssetsBOY
Total Assets EOY282864096TotalAssetsEOY
Total Liabilities BOY190770849TotalLiabilitiesBOY
Total Liabilities EOY211568358TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY72753911NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY71295738NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Catholic Health System (CHS) Mission is to provide quality healthcare services in an acute care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2012 Community Service Plan can be found at www.chsbuffalo.org.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense153857621Expense
Revenue205765424Revenue
DescriptionInpatient Services:78,834 Acute Care Patient Days18,317 Newborn Patient Days28,229 Skilled Nursing Patient Days6,586 I/P Ambulatory SurgeriesDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense70207245Expense
Revenue94037280Revenue
DescriptionOutpatient Services:58,269 ED Visits286,561 Referred Ambulatory Visits19,720 O/P Ambulatory VisitsDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6073688Expense
Revenue7927130Revenue
DescriptionPrimary Care Clinics:24,387 Clinic/Primary Care Service Visits278,760 Substance VisitsDescription
FieldValueIRS element (for citing)
Total Program Service Expense230138554TotalProgramServiceExpense
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 Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
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 Bonds1TaxExemptBonds
Invest Tax Exempt Bonds1InvestTaxExemptBonds
Escrow Account1EscrowAccount
On Behalf Of Issuer1OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096257NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2686NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
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
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1David MacholzController Catholic Health System FinanceBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7168282974TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1515 Abbott Road Suite 500AddressLine1
CityBuffaloCity
StateNYState
ZIP Code142202039ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Joseph McDonald
President and CEO, CHS0.0037.50XX0147125738697
Mark Sullivan
Executive VP / COO0.0037.50XX083761331269
Peter Bergmann
President, and CEO Sisters37.500.00XX433289033126
David Macholz
Treasurer0.0037.50XX023223334122
Dr Michael Albert
Director5.000.00X3262300
Dr Paul Anain
Director0.0037.50X022426512894
Brian Beitz
Director0.001.00X000
Frances Crosby RN PhD
Director0.001.00X000
Richard Curran MD
Director0.001.00X000
Dennis Dombek
Director0.001.00X000
Dr Michael Edbauer
Director0.0025.00X028279826400
Dr Craig Fetterman
Director0.001.00X000
Christine Kluckhohn
Pres. & CEO Continuing Care0.0037.50X0317921122567
Mr William Lawley Jr
Director0.001.00X000
Judith Maness
Director0.001.00X000
James Manzella
Director0.001.00X000
James Millard
Director0.0037.50X0322272146102
Michael Montante
Director0.001.00X000
Charles J Urlaub
Officer/Director0.0037.50XX047715636336
Cynthia Zane EdD
Director0.001.00X000
Monsignor Robert E Zapfel
Director0.001.00X000
James A Dunlop Jr
Executive VP, Finance / CFO0.0037.50X0672603115267
Dr Brian D'Arcy
Senior VP, Medical Affairs0.0037.50X057858837824
Matthew Hamp
COO, Sisters37.500.00X2177400111003
Michael Moley
Sr.VP, Human Resources0.0037.50061487136811X
John Stavros
Sr.VP Marketing / P.R.0.0037.50028345336599X
Dr Michael Galang
Chief Information Officer0.0037.50039310925395X
Nancy Sheehan
SVP Legal Service, General Counsel0.0037.50024944526369X
Richard J Ruh MD
Sr. VP, Service Lines0.0037.50036137132599X
Dr Nady Shehata
VP, Medical Affairs37.500.00300161040933X
Dr Bruce Rodgers
Physician37.500.00356449019843X
Dr Jack R Lawler
Physician37.500.00324111021357X
Dr Margaret McDonnell
Physician37.500.00321754039897X
Dr Anthony Pivarunus
Physician37.500.003302960145779X
Dr Paul Updike
Physician37.500.00241950032207X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2558373TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7318955TotalReportableCompFrmRltdOrgs
Total Other Compensation1203396TotalOtherCompensation
Number Individuals GT100 K61NumberIndividualsGT100K
Formers Listed0FormersListed
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
Sodexho Inc & Affiliates
PO Box 81049WoburnMA018131049Environmental Services3431298
Quest Diagnostic (Chicago)
2178 Collection Center DriveChicagoIL60693Laboratory Services1690099
Siemens Medical Solutions
PO Box 120001 Dept 0733DallasTX753120733Maintenance Services934226
Endion Hospitalist Services
PO Box 645037CincinnatiOH452645037Physician Services718750
IR Mueller Corporation
789 Colvin BLVDKenmoreNY14217Secruity Services570901
FieldValueIRS element (for citing)
Number Of Contractors GT100 K61NumberOfContractorsGT100K
All Other Contributions845482AllOtherContributions
Total Contributions845482TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicaid/Medicare900099156759399156759399
Patient Service900099150970435150970435
FieldValueIRS element (for citing)
Total Program Service Revenue307729834TotalProgramServiceRevenue

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column221051TotalRevenueColumn
Exclusion$221,051ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real825995Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real825995Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column825995TotalRevenueColumn
Exclusion$825,995ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Meaningful Use Money9000993432711$3,432,711
Shared Service90009924150372415037
Cafeteria9000991056131$1,056,131

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column867566TotalRevenueColumn
Exclusion$867,566ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7771445TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column317393807TotalRevenueColumn
Related Or Exempt Function Income310144871RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6,403,454ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total116196664Total
Program Services106175950ProgramServices
Management And General10020714ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8688566Total
Program Services8019377ProgramServices
Management And General669189ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16092330Total
Program Services14678182ProgramServices
Management And General1414148ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7652091Total
Program Services6990440ProgramServices
Management And General661651ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total580673Total
Program Services4264ProgramServices
Management And General576409ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11182170Total
Program Services7685238ProgramServices
Management And General3496932ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total14097Total
Program Services13153ProgramServices
Management And General944ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8344220Total
Program Services4387994ProgramServices
Management And General3956226ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total426991Total
Program Services98401ProgramServices
Management And General328590ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3663970Total
Program Services1104619ProgramServices
Management And General2559351ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total154479Total
Program Services138529ProgramServices
Management And General15950ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total79164Total
Program Services75552ProgramServices
Management And General3612ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2049601Total
Program Services2049601ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11150199Total
Program Services11150199ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2904578Total
Program Services2679463ProgramServices
Management And General225115ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies5284416853625187-781019
Shared Service4905261849052618
Purchased Services1435019092446195105571
Non-Medical Supplies24735182017786455732

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total307900287Total
Program Services230138554ProgramServices
Management And General77761733ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY276916BOY
EOY178626EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY100212303BOY
EOY115701231EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY151469BOY
EOY136332EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY42614351BOY
EOY44346176EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3980469BOY
EOY5285870EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1585152BOY
EOY1572324EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis133864602LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec58374942LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY75049615BOY
EOY75489660EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY39654485BOY
EOY40153877EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY263524760BOY
EOY282864096EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY40818653BOY
EOY43269356EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY398060BOY
EOY272110EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30288115BOY
EOY28648948EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY7808694BOY
EOY7648399EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY111457327BOY
EOY131729545EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY190770849BOY
EOY211568358EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY70680654BOY
EOY69184523EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1950734BOY
EOY1988692EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY122523BOY
EOY122523EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY72753911BOY
EOY71295738EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY263524760BOY
EOY282864096EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9493520ReconcilationRevenueExpenses
Reconcilation Other Changes-10951692ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

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 Basis1958968OtherCostOrOtherBasis
Book Value1958968BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis26802820OtherCostOrOtherBasis
Depreciation15398114Depreciation
Book Value11404706BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis39369390OtherCostOrOtherBasis
Depreciation5760435Depreciation
Book Value33608955BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis61348704OtherCostOrOtherBasis
Depreciation37216393Depreciation
Book Value24132311BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4384720OtherCostOrOtherBasis
Book Value4384720BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings75489660TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Other Receivables2666600
Due from Affiliates10817629
Workers Comp Funding Surplus729951
Insurance Recoveries18902583
Investment in Net Assets of the SOC Foundation6936354
Investment in Caritas Medical Arts Building100760
FieldValueIRS element (for citing)
Total Book Value Other Assets40153877TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$19,487,288
Interest Rate Swap$5,071,179
Pension Obligation$75,703,302
Asset Retirement Obligation$2,231,290
L/T Disposables$185,455
L/T General Liability IBNR$14,412,118
L/T Workers Comp IBNR$14,638,913
FieldValueIRS element (for citing)
Total Of Amounts131729545TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt318230525TotRevenueEtcAuditedFinclStmt
Other Revenues1682200OtherRevenues
Revenue Not Rptd F9901682200RevenueNotRptdF990
Revenue Subtotal316548325RevenueSubtotal
Other Revenues Not Included845482OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt845482RevenueNotRptdOnFinStmt
Total Revenue Per Form990317393807TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt308997230TotExpensesEtcAuditedFinclStmt
Other Expenses Included1096943OtherExpensesIncluded
Expenses Not Rptd F9901096943ExpensesNotRptdF990
Expenses Subtotal307900287ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990307900287TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 2d - Other Adjustments:SOC Foundation Inc Revenue
Part XI, Line 4b - Other Adjustments:Contributions from Sisters Hospital Foundation
Part XII, Line 2d - Other Adjustments:Foundation Expenses less the SOC Foundation Contributions to the Hospital

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage110.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage500.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3570615TotalCommunityBenefitExpense
Direct Offsetting Revenue236935DirectOffsettingRevenue
Net Community Benefit Expense3333680NetCommunityBenefitExpense
Percent Of Total Expense0.01080PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense62348411TotalCommunityBenefitExpense
Direct Offsetting Revenue46725242DirectOffsettingRevenue
Net Community Benefit Expense15623169NetCommunityBenefitExpense
Percent Of Total Expense0.05070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense65919026TotalCommunityBenefitExpense
Direct Offsetting Revenue46962177DirectOffsettingRevenue
Net Community Benefit Expense18956849NetCommunityBenefitExpense
Percent Of Total Expense0.06150PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1811956TotalCommunityBenefitExpense
Net Community Benefit Expense1811956NetCommunityBenefitExpense
Percent Of Total Expense0.00590PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense6553778TotalCommunityBenefitExpense
Direct Offsetting Revenue2529340DirectOffsettingRevenue
Net Community Benefit Expense4024438NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense510086TotalCommunityBenefitExpense
Net Community Benefit Expense510086NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8875820TotalCommunityBenefitExpense
Direct Offsetting Revenue2529340DirectOffsettingRevenue
Net Community Benefit Expense6346480NetCommunityBenefitExpense
Percent Of Total Expense0.02070PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense74794846TotalCommunityBenefitExpense
Direct Offsetting Revenue49491517DirectOffsettingRevenue
Net Community Benefit Expense25303329NetCommunityBenefitExpense
Percent Of Total Expense0.08220PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense2538TotalCommunityBuildingExpense
Net Community Building Expense2538NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2538TotalCommunityBuildingExpense
Net Community Building Expense2538NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,553,397BadDebtExpenseAmount
Amount Attributable To2211243AmountAttributableTo
Amount Reimbursed By Medicare46537926AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47143686CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-605760MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityEr24 HoursEr24HoursOtherOther
Sisters of Charity Hospital
12157 Main StreetBuffaloNY14214XXXXXAmbulatory Surgery - Multi Speciality
Sisters of Charity Hospital-St Jospeh Ca
22605 Harlem RDCheektowagaNY14225XXXXXAmbulatory Surgery - Multi Speciality

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Sisters Of Charity HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent110.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent500.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities12NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Harvey Austin School #97
1405 Sycamore StBuffaloNY14211Extension Clinic:Medical Social Services O/P, Well Child Care OP,Health ED
Pathways Methadone
158 Holden AvenueBuffaloNY14214Extension Clinic: Methadone Maintenance O/P
Rochester Pathways
79 Howell StreetRochesterNY14614Extension Clinic: Methadone Maintenance O/P
St Vincent Health Center
1595 Bailey AveBuffaloNY14212Extension Clinic:Primary Med Care O/P, Chemical Dependency Rehab O/P,
Sisters Ambulatory Surgery Center
45 Spindrift DrWilliamsvilleNY14221Extension Clinic: Ambulatory Surgery - Multi Speciality
Sisters Athleticare
100 Corporate PkyAmherstNY14226Extension Clinic: Therapy - Physical O/P
Sisters Hospital Star Program
3730 Sheridan DrAmherstNY14226Extension Clinic:Methadone Maintenance O/P Chemical Dependence - Rehabilitat
West Hertel Academy
489 Hertel AveBuffaloNY14212Extension Clinic:Medical Social Services O/P, Well Child Care OP,Health ED
Southside Elementary School #93
430 Southside PkwyBuffaloNY14210Extension Clinic:Medical Social Services O/P, Well Child Care OP,Health ED
St Catherine Laboure Health Care Center
2157 Main StreetBuffaloNY14214Long Term Care,Adult Day Healthcare, Clinical Laboratory Service O/P,Radiolo
CHS Partners in Rehab
6199 Transit RdDepewNY14043Extension Clinic:Therapy - Occupational O/P, Therapy - Physical O/P
Sisters Central Pk Diagnostic Center
34 Benwood AveBuffaloNY14214Clinical Laboratory Service O/P,Radiology - Diagnostic O/P

Form990 Schedule H Part VI Form990ScheduleHPartVI (24 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 3c: n/a
Part I, Line 6a: The Sisters of Charity Hospital/Sisters of Charity Hospital, St. Joseph Campus Community Benefit Report is contained in a report prepared by the Catholic Health System.Part 1, line 6 b. Yes, the report is made available to the public by posting on the Catholic Health website, www.chsbuffalo.org, as well as the annual submission to NYS for the Community Service Plan.
Part I, Line 7: Costing is a full step down methodology of cost from non-revenue producing departments to revenue producing departments', with assignment of cost to individual charge items based on volume and charge amount. All patient accounts are cost with the same methodology regardless of patient type (inpatient, outpatient, emergency room, etc.) or insurance coverage (Medicare, Medicaid, private insurance, uninsured, etc.).
Part I, Line 7g: N/A
Part I, L7 Col(f): Bad debt expenses of $10,255,398 are included in Part IX, line 25, column (A) but subtracted when calculating the percentage in column (f).
Part II: Sisters Hospital provided Community Building in various ways, including the Environmental Improvements were noted in the form of Pharmaceutical Waste Disposal that was provided for the community throughout the year.
Part III, Line 4: The amount in Part III line 2 is the actual bad debt expenses of $10,255,398 written down to cost, utilizing the Uninsured Ratio of Cost to Charges (RCC) obtained from the full step down methodology of cost described in Part 1, line 7. The amount in Part III line 3 is the estimate of bad debt from uninsured balance which is developed as follows: as policy is to write accounts to bad debt 120 days after discharge, the discharge date period of 10/1/2011 to 9/30/2012 was used to determine the population of uninsured accounts. The balance of these accounts was determined and the RCC was applied to develop the estimate in Schedule H Part III Line 3.As our determination of eligibility for the Healthcare Assistance Program (HAP) (Charity Care) is based solely on the presentation for care without insurance, which is now for each account, and use of a sophisticated estimator (PARO) of each guarantor's ability to pay an estimate of "the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy if sufficient information had been available to make a determination of their eligibility" is not relevant. The organizations financial statements do not include a footnote that describes bad debt expense, but the financial statements account for bad debt expenses in the statement of operations as actual expenses written off and an estimate of future write-offs less any recoveries.
Part III, Line 8: The costing methodology used to determine the Medicare Allowable costs is Cost to Charge. The shortfall is not treated as a community benefit.
Part III, Line 9b: n/a
Part V, Section A: Audiology O/P Chemical Dependence - Rehabilitation O/P Clinical Laboratory Service Clinic Part Time Services Coronary Care CT Scanner Dental O/P Emergency Department Health Fairs O/P Intensive Care Magnetic Resonance Imaging Maternity Medical Social Services Medical/Surgical Neonatal Continuing Care Neonatal Intensive Care Neonatal Intermediate Care Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Pediatric O/P Pharmaceutical Service Physical Medical Rehabilitation Physical Medicine and Rehabilitation O/P Podiatry O/P Prenatal O/P Primary Medical Care O/P Psychology O/P Radiology - Diagnostic Renal Dialysis - Acute Therapy - Occupational O/P Therapy - Physical O/P Therapy - Speech Language Pathology Therapy - Vocational Rehabilitation O/P
Part V, Section B, Line 10: N/ASisters Of Charity Hospital
Part V, Section B, Line 11: N/ASisters Of Charity Hospital
Part V, Section B, Line 12h: N/ASisters Of Charity Hospital
Part V, Section B, Line 14g: Includes information in both English and Spanish on all signage and brochures for financial assistance.Sisters Of Charity Hospital
Part V, Section B, Line 19c: N/ASisters Of Charity Hospital
Part V, Section B, Line 20d: Highest volume commercial payor rateSisters Of Charity Hospital
Part V, Section B, Line 21: N/ASisters Of Charity Hospital
Part V, Section B, Line 22: There are instances where the full charges on the account are equal to or less than the highest volume commercial payor rate.Sisters Of Charity Hospital
Part VI, Line 2: The Catholic Health System has recently conducted a Community Health Needs Assessment in 2013, which will be reported on the 12/31/2013 990 returns. For the 12/31/2012 990, the assessment conducted in previous years is being reported. In 2009, Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus, as part of Catholic Health, involved many participants in assessing community health needs including: 1. New York State Department of Health Prevention Agenda for the Healthiest State Erie County Department of Health Catholic Health Kaleida Health Erie County Medical Center Sheehan Memorial Hospital 2. Health Consumers 3. Patients/residents/clients A. Hospital Inpatients and OutpatientsB. Nursing Home Residents and Families C. Rehabilitation Patients D. Primary Care Center Patients E. Home Care Clients 4. Physicians 5. External Organizations, such as Academia, Community-based organizations, elected officials, employers and business, Faith based organizations, governmental organizations, media, philanthropists and schools.6. Statistical Resources1. New York State Department of Health Prevention Agenda for the Healthiest State Catholic Health worked in collaboration with the Erie County Department of Health, Kaleida Health, ECMC and Sheehan Memorial on the Erie Co. DOH Prevention Agenda for the Healthiest State. In February 2009, an Erie County Joint Planning Committee formed to identify prevention priorities and strategies to focus on collaboratively over the next 3 years, , which included: Chronic Disease, Healthy Mothers, Healthy Babies, Healthy Children, Physical Activity and Nutrition and Tobacco Use. 2. Health Consumers In creating the Catholic Health and Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus strategic plan, input was sought from a variety of constituents including consumers. In August 2008, eight (8) consumer focus groups were conducted asking consumers what they wanted from their patient care experience. These focus groups were created by reaching out to 8,000 area residents who were asked to contact friends/families/neighbors to participate. 3. Patients/residents/clients A. Hospital Inpatients and Outpatients At the time of the assessment, Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus participated in a regional patient satisfaction survey through a cooperative effort with the Buffalo Niagara Health Quality Coalition and area hospitals. Patient participation was voluntary. This survey took place twice per year. Through hospital admission and outpatient ancillary sites, surveys were distributed to individuals to gain an understanding about their healthcare needs and how well their needs were being met. Currently, Hospital Care Quality Information (HCHAPS) is publicly reported. 4. Physicians Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus surveys its medical staff annually. Physicians are surveyed on issues relating to the quality and efficiency of services offered throughout Catholic Health including at Sisters Hospital. 5. External OrganizationsCatholic Health and Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus also engaged in the P2 Collaborative (Pursuing Perfection) dedicated to improving the health of people across the region. There are more than 200 participant organizations including the provider community, payers, community based organizations, religious organizations, local business, colleges & universities, and governmental agencies. Areas of focus include working with physicians and organizations to enhance access to care and improve efficiency of care and empowering all of the Western New York community to take responsibility for and act on their own wellness.In an effort to engage health care needs at the grass roots level, Catholic Health and Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus work closely with the following organizations to assess community health need:Niagara Health Quality Coalition Community Cancer CoalitionAmerican Heart Association Near East & West Side Task ForceBaker Victory Services Community Health Center of BuffaloWNY Osteoporosis Resource Ctr. WNY Health Equity Work GroupLiving Healthy Task Force of Erie Co. Minority Health CoalitionBuffalo Public Schools Worksite Wellness Flu CoalitionEvery Parent Influences Children (EPIC) Tobacco CoalitionWNY Coalition for Diabetes Community Health FoundationErie Co. Coalition for Diabetes WNED Public TelevisionCatholic Charities Niagara University6. Statistical ResourcesCatholic Health and Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus used PQI (Preventable Quality Indicators) to map specific areas by zip code to better understand needs and target for need. We mapped specifically for Congestive Heart Failure, Hypertension, Angina & Diabetes to identify target areas for community education & screening initiatives. Other statistical resources used to assess the needs of the communities served included: "Buffalo Public Schools: Student Body Mass Index", "Erie County Health Assessment Indicators", and "Erie County Health Indicators Profile". Goals/Objectives for the priorities identified for Catholic Health and Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus include: Increase consumer knowledge and adoption of healthy lifestyle behaviors by encouraging frequent physical activity and healthy nutrition, leading to improved health status and reduced chronic disease prevalence for residents of Buffalo and Erie County. Increase participants ability to identify risk factors for cardiovascular disease. Lower body mass index (BMI) in youth; early identification of adolescents and adults with high blood pressure, high blood cholesterol and high blood glucose through screening and prevention interventions. Implement a social marketing campaign to positively influence voluntary behavior of target population to take action to maximize health. Restrict the availability of less healthy foods and beverages in public service venues in Buffalo and Erie County, such as schools, community centers and hospitals.
Part VI, Line 3: Sisters Hospital informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the Catholic Health System Healthcare Assistance Program (HAP) policy. For example, Sisters Hospital has posters and brochures available which include contact information for the Financial Clearance staff in admissions areas, emergency rooms, primary care and outpatient rehabilitation clinics, Revenue Management Center (RMC) and other areas of the organizations facilities where eligible patients are likely to be present; provides information about financial assistance and HAP contact information to patients as part of the intake process; provides financial assistance and HAP contact information to inpatients either during or within 90 days of discharge of their hospital stay; patient bills include the following language: "The Catholic Health System has a Healthcare Assistance Program to assist those in need of financial assistance for qualified patients. If you would like to obtain additional information on the Healthcare Assistance Program, please call (716) 601-3600. Thank you.Our Customer Service area is our front end team to assist all patients in this process". Additionally, we discuss with the patient the availability of various government benefits, such as Medicaid or state programs, and assist the patient with qualification for such programs, where applicable, and there is information about financial aid posted on the Catholic Health System website.
Part VI, Line 4: Sisters of Charity Hospital including Sisters of Charity Hospital/St. Joseph Campus serves a mixed suburban and urban service area which is comprised of 72.5% white (non-Hispanic) and 17.5% African-American (non-Hispanic) households. The service area is more elderly than most with 16.5% of the population over the age of 65 compared to a national average of 12.9%. The community is also poorer than the national average with 16.7% of the households with annual incomes below $15,000/year compared to a national average of 13%.
Part VI, Line 5: Catholic Health Systems community service activities at the acute facilities include benefits to the broader community, which include non-billed services and provided services paid below costs. Charity care and benefits to the community are provided through long term care facilities, home care programs and Catholic Health system-wide community programs. These programs touch more than 40,000 Western New York residents through community health education programs, health screenings (including: glucose, blood pressure, and cholesterol screenings; and cardiac, stroke, vascular, diabetes, nutrition, stress management, and womens community programming) clinical and support services, clerkships, internships, scholarships, in-kind donations and community support activities. Additionally, thousands of people make unique visits to the Catholic Health website seeking information about an individual or family healthcare issue, follow Catholic Health on Facebook and Twitter (where daily posts talk to education and prevention of the priority areas) and receive relevant health information through the Catholic Health wellness blog and monthly email newsletter.The governing Board of Directors of Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus is comprised of community representatives from universities, legal communities, & business leaders. Religious orders are represented, as well as active and retired medical staff members.The Sisters Hospital medical staff can be considered an "open" medical staff, as any physician can apply for privileges. Each application is reviewed by a vigorous credentialing verification process.
Part VI, Line 6: Sisters of Charity Hospital/Sisters of Charity Hospital St. Joseph Campus is affiliated with the Catholic Health System, Inc., a New York State licensed corporation. Catholic Health System, located in Buffalo, New York exempt from taxation and a charitable organization described in Section 501(c) (3) of the Internal Revenue Code of 1986. Catholic Health is also the parent company of the following New York State corporations: Kenmore Mercy Hospital, and Mercy Hospital of Buffalo, Its outpatient and post-acute facilities (and services) include Mercy Ambulatory Care Center, Mercy Diagnostic and Treatment Center, Mercy Diagnostic Center, Sheridan Health Care Center, Sisters Central Park Diagnostic Center, Williamsville Diagnostic Center, Kenmore Specialty Center, Ken-Ton Family Care Center, Lovejoy/St. Vincent Health Center, Mercy Comprehensive Care Center, Mercy OB/GYN Center, OLV Family Care Center, Sisters OB/GYN Center, Springville Primary Care Center, Williamsville Primary Care Center, Catholic Health Home Care, St. Elizabeths Home, St. Vincents Home, Father Baker Manor, McAuley Residence, Mercy Nursing Facility at OLV, St. Catherine Laboure Health Care Center, and St. Francis of Williamsville.
NYReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitleBase 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
Joseph McDonald
President and CEO, CHS0691688043681503427540230550156420150995400
Mark Sullivan
Executive VP / COO042001902530930164501017302013967086888200
Peter Bergmann
President, and CEO Sisters3558180325830448880145450185810466415000
David Macholz
Treasurer0177154029346025733015747018375026635500
Dr Paul Anain
Director02239950002700126310263023715900
Dr Michael Edbauer
Director0207109043465032224013275013125030919800
Christine Kluckhohn
Pres. & CEO Continuing Care02494370292770392070103254019313044048800
James Millard
Director022304106018603904501457690333046837400
Charles J Urlaub
Officer/Director0332714087875056567021316015020051349200
James A Dunlop Jr
Executive VP, Finance / CFO037261002313590686340101350013917078787000
Dr Brian D'Arcy
Senior VP, Medical Affairs02729870291150276486019190018634061641200
Matthew Hamp
COO, Sisters1541770147340488290953040156990328743000
Michael Moley
Sr.VP, Human Resources028770501451640182002022381014430065168200
John Stavros
Sr.VP Marketing / P.R.0193171050332039950020253016346032005200
Dr Michael Galang
Chief Information Officer029513705906203891002039704998041850400
Nancy Sheehan
SVP Legal Service, General Counsel020629101606802708601989606473027581400
Richard J Ruh MD
Sr. VP, Service Lines031190800049463017374015225039397000
Dr Nady Shehata
VP, Medical Affairs2665160105000231450232650176680341094000
Dr Bruce Rodgers
Physician34942506250077401922306200376292000
Dr Jack R Lawler
Physician3229230001188019240021170345468000
Dr Margaret McDonnell
Physician3209800007740223960175010361651000
Dr Anthony Pivarunus
Physician28658402734801636401294250163540476075000
Dr Paul Updike
Physician23709000048600186030136040274157000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 4bCertain Officers and Key employees participated in a supplemental nonqualified retirement plan per the terms and conditions of their employment arrangement. Pension CHS & Acutes Pension GAP Joseph McDonald $26,000.00 Mark Sullivan $39,000.00 Dr. Brian D'Arcy $ 9,800.00 Michael Moley $20,697.00 Peter Bergmann $ 7,334.00 CHE SERP Joseph McDonald $150,012.00 Dr. Brian D'Arcy $142,750.00
Part I, Line 6The 2012 Incentive payments were dependent upon achieving the Catholic Health System Operating Income target for Catholic Health System participants or the Ministry Operating Income target for Ministry participants. Joseph McDonald $436,814.82 Mark Sullivan $253,093.07 James A Dunlop Jr $231,359.41 Dr. Brian D'Arcy $ 29,115.18 Nancy Sheehan $ 16,068.24 Michael Moley $145,164.42 John Stravos $ 50,331.57 Christine Kluckhohn $ 29,277.18 Maria Foti $ 11,344.26 Bartholomew Rodriques$ 32,085.26 Dr. Michael Galang $ 59,062.48 Dr. Michael Edbauer $ 43,464.85 Dave Macholz $ 29,345.53 Peter Bergmann $ 32,583.13 Matthew Hamp $ 14,733.82 Dr. Bruce Rodgers $ 6,250.00 Dr. Anthony Pivarunus$ 27,348.01 Charles Urlaub $ 87,875.19 James Millard $ 60,186.07 Dr. Nady Shehata $ 10 499.67

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Dormitory Authority of the State of NY
A14600029364983Q5S42006-11-2930295000Part VI000
Dormitory Authority of the State of NY
B14600029364983Q5U92006-11-298435000Part VI000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A3029500011209111792862899480219941011
B843500034158149919804350020051011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0000000
B0000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2
HSBC Bank NA
A00001118.50000000000010000
JP Morgan Chase
B00001118.50000000000010000NA

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A0
B0

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

ExplanationExplanation
Part I A (f) Description of Purpose: To refund Sisters Of Charity Of Buffalo Insured Revenue Bonds, Series 2003, which were bonds issued for the purpose of refunding a series of bonds issued in 1991, the proceeds of which were applied to finance the construction and renovation of the Sisters of Charity facilities and to refinance outstanding indebtedness.
Part I B (f) Description of Pupose: To finance the cost of the St. Joseph Campus emergency room expansion project.
Part IV (1) The bonds were issued by the Dormitory Authority of the State of New York on November 29,2006. On or around December 1, 2011, DASNY performed a rebate analysis that indicated no rebate liability had accrued. An analysis completed by the Bond Trustee in October 2012 indicated that DASNY mistakenly excluded from their analysis bond proceeds that had been deposited into the current refunding escrow for the Refunded Bonds. Sisters of Charity was first made aware of this error on October 24, 2012. Payment of the rebate, plus interest, was made to the IRS on March 29, 2013, within 180 days of the discovery.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Karen Hamp
Wife of COO, Matt Hamp39703RN, Kenmore0
Susan Urlaub
Wife of Mercy CEO, C.J. Urlaub76847Corporate Nurse Educator0
James Manzella
Acute Care Board Member204991Key Employee of Manzella Marketing0
David Zapfel
Brother of BOD, Msgr. Robert Zapfel66713HR Employee of CHS0
Kathleen Zapfel
Sister-in-law of BOD, Msgr. Robert Zapfel57335HR Employee of CHS0
Susan Gallagher-Stavros
Wife of Key Employee, John Stavros21753Nurse, McAuley Seton Home Care0
Marie Packard
Daughter of BOD, Dennis Dombek55983Mercy Physical Therapist0
Dr Craig Fetterman
Partner of Buffalo Niagara Hospitalists448438Acute Care Board Member0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6CHS has three members: Ascension Health, Catholic Health East, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws.
Form 990, Part VI, Section A, line 7aAccording to the CHS Bylaws, each member is equally allowed to appoint up to three individuals to act as its representatives on the Corporate Member Board, and in undertaking any action in its capacity as a Member. The Corporate Member Board oversees the governance of the Catholic Health System.
Form 990, Part VI, Section A, line 7bEach member is entitled to one vote on each matter properly submitted at any membership meeting, and the members also have reserve powers which allow approval for certain business events and ratification of certain business transactions.
Form 990, Part VI, Section B, line 11Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6.Schedule J: Compensation Information 7.Schedule L: Transactions with Interested Persons 8.Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information
Form 990, Part VI, Section B, line 12cAll associates on the Merit program; all Physicians and Non Physician Practitioners as well as Physician groups who are independent contractors or employees of CHS; and all board members must complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner.
Form 990, Part VI, Section B, line 15In 2012, the Catholic Health System utilized a Compensation Committee of the Board of Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO; COO; CFO; CEO's for each Ministry; and all Senior Vice Presidents. The Compensation Committee provides oversight to management decisions which are based on outlines approved by the committee, and performs a review of data. The outcome of these meetings is documented.
Form 990, Part VI, Section C, line 19We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws.
Form 990, Part XI, line 9:Pension Liability Adjustments -8,680,685. Equity Transfer to Affiliates -2,102,854. Change in Unrestricted Interest in net assets of Sisters Foundation 9,825. Interest Rate Swap Adjustment -215,936. Change in Temporary Restricted Interest in net assets of Sisters Foundation 37,958.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (18 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Catholic Health System Inc
515 Abbott RoadBuffaloNY14220222565278Health Care Delivery SystemNY501c3Schedule A Line 9N/A0
Mercy Hospital of Buffalo
565 Abbott RoadBuffaloNY14220160756336Acute Care HospitalNY501c3Schedule A Line 30Catholic Health System Inc
Kenmore Mercy Hospital
2950 Elmwood AvenueKenmoreNY14217160762843Acute Care HospitalNY501c3Schedule A Line 30Catholic Health System Inc
Nazareth Home of the Franciscan Sisters
291 North StreetBuffaloNY14201160813142Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Clare Manor
543 Locust StreetLockportNY14094160782647Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Elizabeth Home for the Aged
5539 BroadwayLancasterNY14086160743154Adult HomeNY501c3Schedule A Line 90Catholic Health System Inc
St Francis Home of Williamsville
147 Reist StreetWilliamsvilleNY14221160743153Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Francis of Buffalo
34 Benwood AvenueBuffaloNY14214161523535Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Joseph Manor
2211 West State StreetOleanNY14760160796400Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Luke Manor for the Chronically Ill
17 Wiard StreetBataviaNY14020160794811Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Mary's Manor
515 6th StreetNiagara FallsNY14301160924139Skilled Nursing FacilityNY501c3Schedule A Line 90Catholic Health System Inc
St Vincent Manor
319 Washington AvenueDunkirkNY14048160743167Adult HomeNY501c3Schedule A Line 90Catholic Health System Inc
WNY Catholic Long Term Care Inc
6400 Powers RoadOrchard ParkNY14127161434368Skilled Nursing FacilityNY501c3schedule A Line 90Catholic Health System Inc
Niagara Homemaker Services (Mercy Home Care)
Appletree Business Park 2875 UnionCheektowagaNY14227161317960Home Care ProviderNY501c3Schedule A Line 90Catholic Health System Inc
McAuley Seton Home Care
Appletree Business Park 2875 UnionCheektowagaNY14227161310062Home Care ProviderNY501c3Schedule A Line 90Catholic Health System Inc
Catholic Health System Infusion Pharmacy Inc
2875 Union Rd Suite 14CheektowagaNY14227200198518Home Care Infusion ServicesNY501c3Schedule A Line 90Catholic Health System Inc
CHS Program of All-Inclusive Care for the Elderly Inc
55 Melroy AvenueLancasterNY14218261252884All-inclusive Care for the ElderlyNY501c3Schedule A Line 30Catholic Health System Inc
Sisters Hospital Foundation
2130 Main StreetBuffaloNY14214222283077FoundationNY501c3Schedule A Line 70Sisters of Charity Hospital

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Caritas Medical Arts Building LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1350 Essjay Road Suite 101AddressLine1
CityWilliamsvilleCity
StateNYState
ZIP Code14221ZIPCode
FieldValueIRS element (for citing)
EIN161521486EIN
Primary ActivityRental Real EstatePrimaryActivity
Legal Domicile StateNYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRelated to exempt puPredominantIncomeType
Share Of Total Income42305ShareOfTotalIncome
Share Of EOY Assets106731ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg