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BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP (EIN 45-2964467)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201333199349303223
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)
Timestamp2013-11-15T10:43:21-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

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 Line11750 TYSONS BLVDAddressLine1
CityMCLEANCity
StateVAState
ZIP Code221024219ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN452964467EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Charity Health System Affiliated GroupBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone8453685000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1
CitySuffernCity
StateNYState
ZIP Code10901ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary Leahy MDName
TitleChief Executive OfficerTitle
Phone8453685000Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDavid A CraigName
PTINP00542227PTIN
Phone7032511000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary Leahy MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1
CitySuffernCity
StateNYState
ZIP Code10901ZIPCode
FieldValueIRS element (for citing)
Gross Receipts458509986GrossReceipts
Group Return For Affiliates1GroupReturnForAffiliates
All Affiliates Included1AllAffiliatesIncluded
Group Exemption Number5747GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.GOODSAMHOSP.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Activity Or Mission DescriptionAcute care hospitals, physician services and long-term care facilitiesActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees3548TotalNbrEmployees
Total Nbr Volunteers523TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3734392ContributionsGrantsPriorYear
Contributions Grants Current Year10266805ContributionsGrantsCurrentYear
Program Service Revenue Prior Year430113011ProgramServiceRevenuePriorYear
Program Service Revenue CY444769571ProgramServiceRevenueCY
Investment Income Prior Year102207InvestmentIncomePriorYear
Investment Income Current Year-253847InvestmentIncomeCurrentYear
Other Revenue Prior Year1926861OtherRevenuePriorYear
Other Revenue Current Year3135778OtherRevenueCurrentYear
Total Revenue Prior Year435876471TotalRevenuePriorYear
Total Revenue Current Year457918307TotalRevenueCurrentYear
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 Year221857508SalariesEtcPriorYear
Salaries Etc Current Year253284803SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year231301691OtherExpensePriorYear
Other Expenses Current Year219549437OtherExpensesCurrentYear
Total Expenses Prior Year453159199TotalExpensesPriorYear
Total Expenses Current Year472834240TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-17282728RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-14915933RevenuesLessExpensesCY
Total Assets BOY251943636TotalAssetsBOY
Total Assets EOY251954297TotalAssetsEOY
Total Liabilities BOY266142156TotalLiabilitiesBOY
Total Liabilities EOY298567414TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-14198520NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-46613117NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense427280376Expense
Revenue446220028Revenue
DescriptionBon Secours Charity Health System Affiliated Group is composed of three acute care hospitals, primary and specialty medical care practices and two long-term care and residential facilities: Good Samaritan Hospital of Suffern, NY; Bon Secours Community Hospital; St. Anthony Community Hospital; Bon Secours Charity Health System Medical Group, PC; St. Francis Center at the Knolls (dba Mount Alverno Center); and Villas Francis at the Knolls (dba Schervier Pavilion).Good Samaritan Hospital, Suffern, New York, is a non-profit, 370-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute care services to residents of Rockland and Orange Counties in New York and northern Bergen County, New Jersey. The hospital also serves these communities as an Area Level II Trauma Center and Level II Neonatal Intensive Care Unit. Good Samaritan Hospital is home of the Active International Cardiovascular Institute providing open heart surgery and advanced cardiac services to the region.Bon Secours Community Hospital's primary program service is to provide inpatient and outpatient acute care hospital services. Additional community programs are provided to bring wellness to the community served.St. Anthony Community Hospital is an acute care facility with 78 licensed beds.Bon Secours Charity Health System Medical Group, PC provides medical services to Suffern, NY and surrounding communities. Their services include primary care and various specialty professional services. The organization seeks to locate its physician practice sites in areas that most effectively meet the needs of a community.Mt. Alverno Center is the adult home/assisted living complex serving approximately 79 residents.Villa Francis at the Knolls, Inc. is a 120-bed skilled nursing facility providing healthcare services to acute care patients.Description
Total Program Service Expense427280376TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
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 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 DQP0LoanToOfficerOrDQP
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 Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096280NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3548NumberOfEmployees
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 Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
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 LarkinBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4433672204TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18990 Old Annapolis RoadAddressLine1
CityColumbiaCity
StateMDState
ZIP Code21045ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Steve Albanese
Board Member1.00X000
Maureen Creegan
Board Member1.00X000
Stephen Dormer
Board Member1.00X000
Sr Mary Eillen O'Brien
Board Member1.00X000
Tamer El-Rayess
Board Member1.00X000
Sylvain Klein
Board Member1.00X000
Sr Roseann Mazzeo
Board Member1.00X000
Robert Porr
Board Member1.00X000
Jerome Quint MD
Board Member1.00X000
Dan Rifkin
Board Member1.00X000
Andrea Schmid-Mazzoccoli
Board Member1.00X06302996008449.00
Sr Rosemary Smith
Board Member1.00X000
Kenneth Steinglass MD
Board Member1.00X000
John Wallenhorst PhD
Board Member1.00X03041862343449.00
Sr Ellen Dauwer
Secretary - BSCHS1.00X000X
Martin Evers MD
President - BSCHS MedPC50.00X336750035094X
Fred Kelly
Chairman - BSCHS1.00X000X
Sr Anne Lutz
President - BSCHS1.00X00049.00X
Philip A Patterson
CEO - BSCHS50.00X079034890484X
David Capone Jan-Aug
CFO - BSCHS50.00422192020976X
William Ricco Jan-Oct
Executive Director50.00154908019882X
Toni Clark
EVP Sr Services - MA&SP50.00214331021080X
Eileen Dobbing
CNO - Acute Care50.00278970013380X
Gerry Durney Jan-July
COO - BSCHS50.00224526033395X
Mary Leahy MD
SVP Phy Serv50.00396303039590X
Judith Lindberg
VP PCS - SACH50.00154658016754X
Jeffrey Reilly
SVP Ops - CH & SACH50.0025757107703X
Pam Tarulli
SVP HR - BSCHS50.00288264033042X
Rodney Williams MD
CMO - Acute Care50.00406788027016X
Cary Hirsch MD
Physician50.00992821019889X
Seth Hurwitz MD
Cardiologist50.00887138037644X
Edward Lundy MD
Dir of Cardiac Surgery50.001242206039560X
Thomas L Facelle MD
Dir of Surgery50.00940392020653X
Andrew Najovits MD
Cardiologist50.00758920040695X
Melinda Hancock
Former Interim CFO0.0003439412796850.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7956738TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2068774TotalReportableCompFrmRltdOrgs
Total Other Compensation628323TotalOtherCompensation
Number Individuals GT100 K310NumberIndividualsGT100K
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
Holt Construction
50 East Washington AvenuePearl RiverNY10965Construction Capital Projects14402970
Crothall Services Group
13028 Collections CenterChicagoIL60693Engineering6491220
Morrison Management Specialists Inc
PO Box 102289AtlantaGA30368Dietary5435610
Rehabcare Group East Incorporated
PO Box 502096St LouisMO63150Rehab Services4379185
Hospital Attending Physicians
484 Temple Hill Rd Suite 102New WindsorNY12553Physician Fees3833318
FieldValueIRS element (for citing)
Number Of Contractors GT100 K248NumberOfContractorsGT100K
Related Organizations1185553RelatedOrganizations
Government Grants7543085GovernmentGrants
All Other Contributions1538167AllOtherContributions
Total Contributions10266805TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code623000BusinessCode
Total Revenue Column444769571TotalRevenueColumn
Related Or Exempt Function Income444769571RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue444769571TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column196236TotalRevenueColumn
Exclusion$196,236ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real415504Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real415504Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column415504TotalRevenueColumn
Exclusion$415,504ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities141596Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other591679Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities141596Securities
Other-591679Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-450083TotalRevenueColumn
Exclusion-$450,083ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Capitation Revenue900099678774678774
Medicare Incentive Pay900099418073418073
Medicaid Reimbursement900099353610353610

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1269817TotalRevenueColumn
Exclusion$1,269,817ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2720274TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column457918307TotalRevenueColumn
Related Or Exempt Function Income446220028RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,431,474ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3403176Total
Program Services3062859ProgramServices
Management And General340317ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total185300053Total
Program Services166770047ProgramServices
Management And General18530006ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8130286Total
Program Services7317258ProgramServices
Management And General813028ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total43443194Total
Program Services39098874ProgramServices
Management And General4344320ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13008094Total
Program Services11707285ProgramServices
Management And General1300809ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total932289Total
Program Services839060ProgramServices
Management And General93229ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total614096Total
Program Services552687ProgramServices
Management And General61409ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total101298Total
Program Services91168ProgramServices
Management And General10130ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total17128239Total
Program Services15415415ProgramServices
Management And General1712824ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1170867Total
Program Services1053780ProgramServices
Management And General117087ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8389911Total
Program Services7550920ProgramServices
Management And General838991ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total10187543Total
Program Services9168789ProgramServices
Management And General1018754ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total10425465Total
Program Services9382919ProgramServices
Management And General1042546ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total989786Total
Program Services890808ProgramServices
Management And General98978ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6340004Total
Program Services6340004ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17859516Total
Program Services16073564ProgramServices
Management And General1785952ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total7824020Total
Program Services7041618ProgramServices
Management And General782402ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies54943372494490355494337
Purchased Services52771024474939225277102
Bad Debt1095559210955592
BSHSI Mgmt Dues86054187744876860542

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total10310997Total
Program Services9279896ProgramServices
Management And General1031101ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total472834240Total
Program Services427280376ProgramServices
Management And General45553864ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY111180BOY
EOY395012EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY471686BOY
EOY306537EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY1500EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY62441733BOY
EOY60445243EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2580735BOY
EOY1262557EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6177611BOY
EOY6032302EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1372089BOY
EOY1819888EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis252077370LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec133249040LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY109212528BOY
EOY118828330EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY18929711BOY
EOY4786131EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY1285437EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY50646363BOY
EOY56791360EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY251943636BOY
EOY251954297EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY44518426BOY
EOY53730917EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY4903465EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY60710BOY
EOY103390EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY221563020BOY
EOY239829642EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY266142156BOY
EOY298567414EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-14966847BOY
EOY-47386207EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY768327BOY
EOY773090EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-14198520BOY
EOY-46613117EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY251943636BOY
EOY251954297EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-14915933ReconcilationRevenueExpenses
Reconciliation Unrealized Invest247603ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment4275ReconcilationPriorAdjustment
Reconcilation Other Changes-17750542ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$101,299OtherActivitiesAmount
Total Lobbying Expenditures IIB101299TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationAssociation dues were paid to the following organizations, a portion of which is used for lobbying activities: Leading Age 2.6% and 6.2% (National and State), Greater New York Hospital Association 25%, Health Association of New York 28.6%, North Metropolitan Hospital Association 14.61%, American Hospital Association 23.98% and Catholic Health Association 3.0%. Total lobbying as a portion of association dues: $101,299.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4639780OtherCostOrOtherBasis
Book Value4639780BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis123134531OtherCostOrOtherBasis
Depreciation56997744Depreciation
Book Value66136787BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1401361OtherCostOrOtherBasis
Depreciation240189Depreciation
Book Value1161172BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis102288081OtherCostOrOtherBasis
Depreciation76011107Depreciation
Book Value26276974BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20613617OtherCostOrOtherBasis
Book Value20613617BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings118828330TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
Assets Held in Trust for Others91852
Deposits125044
Medicare/Medicaid Settlements2347889
LT HPL/GL Assets50655821
HMO Settlement1358309
Accrued Revenue1249982
Other Hospital Bill Receivables478875
Other Org Costs183407
All other Assets300181
FieldValueIRS element (for citing)
Total Book Value Other Assets56791360TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
Other Debt Long Term Liability$84,403,533
Due to BSHSI$81,070,544
Capital Leases LT Investment$4,202,419
LT Building Development Liability$4,560,134
Medicare/Medicaid Settlements$4,594,420
Note Payable$974,969
LT HPL/GL Liab$50,655,821
LT State Healthcare Pool Liability$6,054,801
LT Pension Liability$3,313,001
FieldValueIRS element (for citing)
Total Of Amounts239829642TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
Return ReferencePart IV, Line 2b:ReturnReference
ExplanationCertain facilities hold, safeguard, manage and account for the personal funds of residents who have authorized the facility in writing to manage any personal funds. Fund requests less than $50 are available for immediate distribution to residents and written requests for $50 or more are honored, by check, within a reasonable time frame. Generally, all custodial funds in excess of $50 are held in interest bearing accounts separate from that of the organization.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
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 Expense2958919TotalCommunityBenefitExpense
Direct Offsetting Revenue748239DirectOffsettingRevenue
Net Community Benefit Expense2210680NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense66874825TotalCommunityBenefitExpense
Direct Offsetting Revenue44469975DirectOffsettingRevenue
Net Community Benefit Expense22404850NetCommunityBenefitExpense
Percent Of Total Expense0.04850PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense69833744TotalCommunityBenefitExpense
Direct Offsetting Revenue45218214DirectOffsettingRevenue
Net Community Benefit Expense24615530NetCommunityBenefitExpense
Percent Of Total Expense0.05330PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs44NumberOfActivitiesOrPrograms
Persons Served287231PersonsServed
Total Community Benefit Expense1247686TotalCommunityBenefitExpense
Direct Offsetting Revenue12000DirectOffsettingRevenue
Net Community Benefit Expense1235686NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served9982PersonsServed
Total Community Benefit Expense2025945TotalCommunityBenefitExpense
Net Community Benefit Expense2025945NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served9933PersonsServed
Total Community Benefit Expense62383TotalCommunityBenefitExpense
Net Community Benefit Expense62383NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs61NumberOfActivitiesOrPrograms
Persons Served307146PersonsServed
Total Community Benefit Expense3336014TotalCommunityBenefitExpense
Direct Offsetting Revenue12000DirectOffsettingRevenue
Net Community Benefit Expense3324014NetCommunityBenefitExpense
Percent Of Total Expense0.00720PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs61NumberOfActivitiesOrPrograms
Persons Served307146PersonsServed
Total Community Benefit Expense73169758TotalCommunityBenefitExpense
Direct Offsetting Revenue45230214DirectOffsettingRevenue
Net Community Benefit Expense27939544NetCommunityBenefitExpense
Percent Of Total Expense0.06050PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served1568PersonsServed
Total Community Building Expense425427TotalCommunityBuildingExpense
Net Community Building Expense425427NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served214PersonsServed
Total Community Building Expense2163TotalCommunityBuildingExpense
Net Community Building Expense2163NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served356PersonsServed
Total Community Building Expense6268TotalCommunityBuildingExpense
Net Community Building Expense6268NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served2138PersonsServed
Total Community Building Expense433858TotalCommunityBuildingExpense
Net Community Building Expense433858NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,873,575BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare135310277AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare147506627CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-12196350MedicareSurplusOrShortfall

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 Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
Good Samaritan Hospital of Suffern NY
1255 Lafayette AvenueSuffernNY10901XXX
St Anthony Community Hospital
215 Maple AvenueWarwickNY10990XXX
Bon Secours Community Hospital
3160 East Main StreetPort JervisNY12771XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelOther FactorsOtherFactorsExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
Good Samaritan Hospital
111200.0000000000001200.0000000000001XX11XX001X00
St Anthony Community Hospital
211200.0000000000001200.0000000000001XX11XX001X00
Bon Secours Community Hospital
311200.0000000000001200.0000000000001XX11XX001X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Regional Kidney Center
33-1 Route 17MHarrimanNY10926Output Dialysis Center
Women's Imaging Center
55 Ronald Regan BlvdWarwickNY10990Outpatient Women's Imaging Center
The Ambulatory Surgery Center
257 Lafayette AvenueSuffernNY10901Ambulatory Surgery Center
Monsignor Patrick J Frawley Mental Heal
3 Campbell AvenueSuffernNY10901Mental Health
Center for Physical Rehabilitation
153 South Route 94WarwickNY10990Out Patient Rehab
Good Samaritan Home Care
1 Crosfield Ave Ste 202West NyackNY10994Home Care
Good Samaritan Home Care
15 Matthew St Suite 302GoshenNY10924Home Care
Bon Secours Sleep Disorder Institute
74 North Main StreetFloridaNY10921Sleep Lab
St Anthony's Center For Physical Rehabil
153 State Route 94 SWarwickNY10990Outpatient Physical Therapy
Bon Secour Hlth Ctr - Lab & Radiology
510 Route 6 209MilfordPA183377615Lab & Radiology

Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, L7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $10,955,592.
Part II: Bon Secours is actively engaged in improving community health in the Port Jervis area through its Building Healthy Communities initiative. The BSCHS Director of Building Healthy Communities is focused on improving community health in the Port Jervis area. Building Healthy Communities has partnered with local residents, business owners, and government officials to bring fresh, local produce into the community and improve access to health screenings for low income residents. This initiative, along with related educational programs on healthy cooking and eating, are a step forward in addressing a major community-identified barrier to health.
Part III, Line 4: Part III, line 2: Bad debt expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospitals charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.Part III, line 4: In July 2011, the FASB issued Accounting Standards Update (ASU) No. 2011-07, Health Care Entities (Topic 954), Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities, which requires a healthcare entity to change the presentation of their statement of operations by reclassifying the provision for bad debts associated with patients service revenue from an operating expense to a deduction from patients service revenue (net of contractual allowances and discounts). Additionally, enhanced disclosures about an entity's policies for recognizing revenue, assessing bad debts, as well as qualitative and quantitative information about changes in the allowance for doubtful accounts are required. BSCHS adopted this guidance on January 1, 2012. Adoption of this guidance resulted in reclassification of $10,955,592 and $30,658,057 from operating expenses to operating revenue on the consolidated statements of operations and changes in net (deficit) assets for the years ended December 31, 2012 and 2011, respectively.
Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service.
Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending Financial Assistance Program (FAP) account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.
Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Good Samaritan Hospital
Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.St. Anthony Community Hospital
Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours Community Hospital
Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Good Samaritan Hospital
Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.St. Anthony Community Hospital
Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours Community Hospital
Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Good Samaritan Hospital
Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.St. Anthony Community Hospital
Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy.Bon Secours Community Hospital
Part VI, Line 2: Consistent with New York State Public Health Law 2803-L, Bon Secours Charity Health System participates in a Community Service Plan process on an annual basis. Working with the Rockland County Department of Health, the Orange County Department of Health, and other health care providers in the community, we gathered and analyzed the following information in selecting the public health priorities to be focused on in our community service plan: demographics of the population we serve, health status of the population, availability, accessibility, and acceptability of needed resources, and studies and surveys of local health issues. The framework/criteria we used in selecting the public health care priorities included: alignment with the health care priorities in the New York State Prevention Agenda, alignment with the local health priorities and concerns identified in interaction with key health care partners/providers, community leaders, organizations and interested residents in the communities we serve, and the opportunity to develop plans and programs to improve the health status of our community as well as access to care. Based on the above, in our Comprehensive Community Service Plan submitted in September 2009, Bon Secours Charity Health Care Systems identified two Prevention Agenda priorities as our focus from 2009-2012: Access to Quality Health Care and Chronic Disease and Cancer.
Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), as adjusted by the Medicare geographic wage index for each community served to reflect that community's relative cost of living ("Adjusted FPG"). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. A variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4: BSCHS facilities operate and serve populations of lower New York State, principally Rockland and Orange counties. Rockland County is located approximately 30 miles north of Manhattan on the West side of the Hudson River. The County is a popular residence for people who commute to work in nearby Westchester and Bergen Counties, as well as Manhattan. The County comprises approximately 115,000 acres and contains more than 35,000 acres of preserved open space and park land. Rockland continues to experience steady population growth in its 5 towns and 19 villages. The most recent Census Department estimates indicate that Rockland County grew 8.7% from 2000 to 2010, and now includes 311,687 residents.Orange County is located in the Hudson River Valley, bordering New Jersey. The County comprises approximately 816 square miles. Orange County continues to experience steady population growth, with the 2010 Census indicating that Orange County grew 9.2% from 2000 to 2010, and now includes 372,813 residents. In Rockland County, there was substantial growth in all age cohorts 65 and older, a consistent trend nationally. Gender among the age groups is roughly equal from the early age cohorts through the 40s, but after age 65, women continue to outnumber men. Population projections- Preliminary population projections through 2035 show that Rockland County's older population may double in size in the next three decades, while those ages 30 to 44 may shrink in size. While projections are based on historical data and do not always predict accurate trends, the dramatic possible increase in the elderly population is a trend that should be of importance to County service providers and planners. Based on 2010 U.S. Census population estimates, the median age in Orange County has increased by more than 2 years since 2007, to 36.6 years; the largest cohort of residents is age 45-49. The number of residents ages 65-69 is forecasted to more than double from 2000-2020 primarily due to the entry of 'baby boomers' into these age ranges.Twenty-one percent of Rockland County's population was estimated to be foreign-born in 2010. Among the 63,058 Rockland county residents estimated to be foreign born in 2007, the largest group was born in the Latin America and the Caribbean (48%). One quarter of foreign-born residents (25%) originated from Asia. Approximately another quarter (23%) came from Europe and 3% from Africa. Countywide, 32.9% of persons over age 5 speak a language other than English at home.According to the U.S. Census, 11.1% of residents in Orange County were foreign born, with 22.3% of persons over the age of five speaking a language other than English at home.Rockland County's rate of poverty for children under 18 increased to 16.9% in 2009 when compared to (15%) in 2000. Poverty rates in Orange County vary greatly based on municipality. Poverty rates exceeding 25% for families with related children under 18 are found in Orange County's three cities (Middletown, Newburgh, and Port Jervis), as well as in the town of Monroe, largely due to the impact of the village of Kiryas Joel, where the poverty rate is more than 4 times the county average.
Part VI, Line 5: All BSCHS facilities have an open medical staff with privileges available to all qualified physicians in the area and are governed by a System board of directors whose composition is representative of the community, with a majority being independent members of the community. BSCHS has a dedicated Community Outreach department responsible for planning, implementing and evaluating all community health and education programs. In 2012, over 30 support groups met monthly in our facilities. The Community Outreach department managed the BSCHS Speakers' Bureau which connected our medical professionals directly with the community on topics such as Cardiac, Orthopedics, Women's health, Obesity, Stroke, Diabetes, Wound Care, Safety, Asthma, Senior Services, etc. The Community Outreach department also managed 2 live radio interview broadcasts each month for a combined listening audience of 16,000/month. In addition to this, the Outreach department also managed service line specific programs such as Breast and Cervical Cancer screenings, Vein screenings, Sleep Disturbances seminars and others. Access to Care: Bon Secours Charity Health System is committed to responding to and participating in addressing the health care needs of the communities in its service area. This is accomplished through several means such as providing charity care; improving access to health care services especially for the underserved population; and offering various opportunities for community members to enroll in governmental and/or community health plans. All three BSCHS hospitals have partnered with local Federally Qualified Health Centers (FQHC) to increase public awareness of the available services that are either free of charge or based on a sliding scale payment. BSCHS also continues to increase the size of its employed Medical Group and, in accordance with our mission, these practitioners are required to accept Medicaid and to participate in programs to provide charity care. Chronic Disease:The goal of our Heart Disease strategies is to increase the public's awareness of the risk factors for heart disease and to give them information on how to diminish their risk. In 2012, BSCHS hosted 75 free cardiac awareness, screening and prevention programs that were attended by a total of 1,985 people. Specific programs focused on prevention, signs and symptoms, cholesterol, blood pressure screenings, obesity and women and heart disease. BSCHS also participated in the American Heart Walk which was attended by over 800 people. The Lower Hudson Valley Mended Hearts Chapter #368 meets monthly at Good Samaritan Hospital offering support and education for cardiac patients and their family members. Through the trained volunteer visitor program, both pre and post cardiac surgery patients are visited by a former heart surgery patient. The BSCHS cancer services provide the community with excellent cancer treatment and support opportunities as well as increase the public's awareness of risk factors and cancer prevention. BSCHS has two cancer treatment programs, one located at Good Samaritan Hospital and one at Bon Secours Community Hospital. Both programs are accredited by the Commission on Cancer by the American College of Surgeons and Good Samaritan Hospital's Radiation Oncology Services are accredited by the American College of Radiology. BSCHS leadership and cancer program staff work diligently to maintain these accreditations to ensure that the community is receiving the best care available. Additionally, partnerships with the American Cancer Society have helped to develop new community screening programs and to improve patient support offerings.In 2012, BSCHS hosted 92 cancer awareness, early detection, prevention and support programs that reached a total of 2,079 people. These programs focused on a wide variety of cancer related illnesses and many of them offered the community the opportunity to meet oncology specialists on a one-to-one basis. A partnership with the Cancer Services Program of Rockland County helped BSCHS to develop ongoing breast and cervical cancer screenings for uninsured and underinsured community members. Through this partnership, 9 free screenings were held in 2012 and 242 people received early detection services. Important to note is that, if a person has a positive finding from any of these free screenings, BSCHS works with the Cancer Services Program to provide all necessary follow up treatment including surgery, chemotherapy and radiation.BSCHS employs a board certified breast surgeon and a board certified colorectal surgeon. Additionally, BSCHS employs a Certified Genetics Counselor who provides patient and family consultations and speaks at free community education programs. A patient navigator assists breast cancer patients to coordinate their care and access available services. BSCHS continues to financially support the American Cancer Society's Making Strides Against Breast Cancer annual fundraising walk. Our restricted donation helps to produce prevention and early detection educational materials for the communities we serve.
Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2010-2012). One of those goals is to partner with communities to co-create a more humane world, improve health and model social justice. To accomplish this, two key strategies are to: - Engage communities to identify needs and assets and building partnerships to improve health and quality of life of a specific population.- Demonstrate sustainable stewardship for healing the earth as a way to improve health and life quality.As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), Bon Secours Charity Health System (BSCHS) is called to continue the healing ministry of Jesus. BSCHS exists to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." BSCHS shares the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world."Please see Schedule R for listings of the related organizations within BSCHS.
NYReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
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 (20 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
Andrea Schmid-Mazzoccoli
Board Member033283702376240598380407520193320690383019013
John Wallenhorst PhD
Board Member021081905073404263301386609568032762002402
Martin Evers MD
President - BSCHS MedPC152085018411805470166450184490371844000
Philip A Patterson
CEO - BSCHS04243050319079046964056213034271088083205000
David Capone Jan-Aug
CFO - BSCHS241784000180408018380191380443168000
William Ricco Jan-Oct
Executive Director12120403090030614083990114830174790000
Toni Clark
EVP Sr Services - MA&SP155684018911039736013591074890235411000
Eileen Dobbing
CNO - Acute Care21039302485104372605060083200292350000
Gerry Durney Jan-July
COO - BSCHS165125000594010159040174910257921000
Mary Leahy MD
SVP Phy Serv2640390764530558110202420193480435893000
Judith Lindberg
VP PCS - SACH14140501173101522043450124090171412000
Jeffrey Reilly
SVP Ops - CH & SACH19500402289603967106360013430265274000
Pam Tarulli
SVP HR - BSCHS2209730281310391600186910143510321306000
Rodney Williams MD
CMO - Acute Care37146003037504953018909081070433804000
Cary Hirsch MD
Physician97146500021356019197069201012710000
Seth Hurwitz MD
Cardiologist32676605422790180930175330201110924782000
Edward Lundy MD
Dir of Cardiac Surgery109372101430620542301919702036301281766000
Thomas L Facelle MD
Dir of Surgery5847790337177018436019197014560961045000
Andrew Najovits MD
Cardiologist3381970419666010570163890243060799615000
Melinda Hancock
Former Interim CFO025190805336203867103924024044037190900

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Part I, Lines 4a-bLine 4a: Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: David Capone, $103,846; William Ricco, $23,768. Line 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits are made into this plan. Individuals receiving payments in the current year included the following: Andrea Schmid-Mazzoccoli, $18,930; Philip A. Patterson, $7,508; John Wallenhorst, PhD, $2,843.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. ("BSHSI") is one of two corporate members of Bon Secours Charity Health System, Inc. ("BSCHSI") along with the Sisters of Charity of Saint Elizabeth of Convent Station. BSCHSI is in turn the sole member of each of the members within Bon Secours Charity Health System Affiliated Group ("Group"). Pursuant New York State Law, as an organization engaged in the profession of medicine, Bon Secours Charity Health System Medical Group, PC has a sole shareholder of the organization who is engaged in the practice of medicine and licensed to practice in the state of New York.
Form 990, Part VI, Section A, line 7aThe governing bodies of the members within the Group, but for Bon Secours Charity Healthy System Medical Group, PC, are appointed by its Member, BSCHSI, and subject to approval by BSHSI, one of two corporate members of BSCHSI along with the Sisters of Charity of Saint Elizabeth of Convent Station. The governing body of Bon Secours Charity Healthy System Medical Group, PC is appointed by its shareholder with the approval of Bon Secours Charity Health System. The board of directors is comprised of individuals, each of whom is a shareholder of the organization or engaged in the practice of medicine in the organization and licensed to practice medicine in the state of New York.
Form 990, Part VI, Section A, line 7bCertain authorities of the members of the Group, but for Bon Secours Charity Healthy System Medical Group, PC, are reserved to its member or to Bon Secours Health System, Inc. or are jointly reserved to Bon Secours Health System, Inc. and the Sisters of Charity of Saint Elizabeth of Convent Station. Certain authorities of Bon Secours Charity Healthy System Medical Group, PC are reserved to the shareholder, Bon Secours Charity Health System or to Bon Bon Secours Health System, Inc.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review and questions by both before the extended filing date. The local system's audit and compliance committee members review the Form 990, schedules time on their meeting agenda, and provide comments before the return is filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors' and compensation committee's minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the positions of other officers or key employees of the organization were compared to similar position market data in comparably situated organizations taking into consideration geographic location and organization size where appropriate. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The Group provides any documents open to public inspection upon request.
Form 990, Part VII:Hours worked are not tracked on an entity by entity basis. All officer's and director's hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Volunteer Board Members are not compensated for their time. Philip A. Patterson's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the CEO of Bon Secours Charity Health System, Inc., which includes direct management, monitoring and oversight over the System and its related organizations. John Wallenhorst, PhD's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the VP of Missions & Ethics of Bon Secours Health System, Inc. Andrea Schmid-Mazzoccoli's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the VP-Chief Nursing Officer of Bon Secours Health System, Inc. Sr. Anne Lutz does not receive payroll distributions as she has taken a vow of poverty.Avg hours devoted to related org(s) when related comp is reported:
Form 990, Part XI, line 9:Other 75,776. Additional Minimum Pension Liability -423,333. Addition of BOY Net assets for BSMPC -17,402,985.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Bon Secours Health System Inc (BSHSI)
1505 Marriottville RoadMarriottsvilleMD21104521301088Parent Org - Management ServicesMD501(c)(3)Line 11, Type II: 50N/A0
Good Samaritan Foundation for Better Health
255 Lafayette AvenueSuffernNY10901133400353FoundationNY501(c)(3)Line 7: 170(b)(1)(a)0BSCHSI
Bon Secours Community Hospital Foundation
255 Lafayette AvenueSuffernNY10901810667395FoundationNY501(c)(3)Line 7: 170(b)(1)(a)0BSCHSI
Bon Secours Warwick Health Foundation
255 Lafayette AvenueSuffernNY10901141972807FoundationNY501(c)(3)Line 7: 170(b)(1)(a)0BSCHSI
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg