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ST JAMES HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST JAMES HOSPITAL (EIN 16-0743310)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201203209349303075
Schema version
2011v1.2
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)
Timestamp2012-11-15T10:30:29-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Line11700 Market Street 25th FloorAddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code191033984ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN160743310EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1St James Mercy HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTJANameControl
Phone6073248000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1411 Canisteo StreetAddressLine1
CityHornellCity
StateNYState
ZIP Code148432104ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary LaRoweName
TitlePresident/CEOTitle
Phone6073248113Phone
Date Signed2012-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam J HomerName
PTINP00994519PTIN
Phone2152462300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary LaRoweNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1411 Canisteo StreetAddressLine1
CityHornellCity
StateNYState
ZIP Code148432104ZIPCode
FieldValueIRS element (for citing)
Gross Receipts57196856GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.stjamesmercy.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionFaithful to our sponsor, the Sisters of Mercy, St. James Mercy Hospital is a part of St. James Mercy Health System,Inc. ("SJMHS") a community of persons committed to being a transforming, healing presence within the rural communities we serve, particularly addressing the needs of the poor, underserved and disadvantaged. St. James Mercy Health System, Inc. is a member of Catholic Health East ("CHE").ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees986TotalNbrEmployees
Total Nbr Volunteers70TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year528389ContributionsGrantsPriorYear
Contributions Grants Current Year291041ContributionsGrantsCurrentYear
Program Service Revenue Prior Year60330070ProgramServiceRevenuePriorYear
Program Service Revenue CY56411098ProgramServiceRevenueCY
Investment Income Prior Year441912InvestmentIncomePriorYear
Investment Income Current Year332585InvestmentIncomeCurrentYear
Other Revenue Prior Year218936OtherRevenuePriorYear
Other Revenue Current Year162132OtherRevenueCurrentYear
Total Revenue Prior Year61519307TotalRevenuePriorYear
Total Revenue Current Year57196856TotalRevenueCurrentYear
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 Year35549603SalariesEtcPriorYear
Salaries Etc Current Year34404161SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year26823174OtherExpensePriorYear
Other Expenses Current Year26829901OtherExpensesCurrentYear
Total Expenses Prior Year62372777TotalExpensesPriorYear
Total Expenses Current Year61234062TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-853470RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4037206RevenuesLessExpensesCY
Total Assets BOY41591897TotalAssetsBOY
Total Assets EOY39269196TotalAssetsEOY
Total Liabilities BOY25115729TotalLiabilitiesBOY
Total Liabilities EOY27791110TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16476168NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11478086NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionFaithful to our sponsor, the Sisters of Mercy, St. James Mercy Health System, a member of Catholic Health East, is a community of persons committed to being a transforming, healing presence within the rural communities we serve, particularly addressing the needs of the poor, underserved and disadvantaged.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense43168873Expense
Revenue56060862Revenue
DescriptionSt. James Mercy Hospital is an acute healthcare facility providing routine, Ambulatory and Ancillary services. Major services include Medical, Surgical, X-ray, Laboratory and Maternity. The Aquinas Center Psychiatric Day Care Center provides Behavioral Health Programs for resocialization and recreation of the mentally handicapped. Total Acute discharges for the Hospital were 2,427. Outpatient registrations for the Hospital were 140,456 and Behavioral Health (Adult and Adolescent psychiatric care and addiction) days were 12,128. St. James Mercy Hospital operates a 120 bed Long-Term Care skilled nursing facility. The Long-Term Care Facility specializes in skilled nursing, assisted living and rehabilitation services. Total patient days for the Long-Term Facility were 42,209. St. James Mercy Hospital operates several physician practices. Total office visits were 47,405.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense177573Expense
Revenue378258Revenue
DescriptionLife Line Service - Revenue generated from rental of Life Line units to the elderly for medical alert.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense104206Expense
Revenue123911Revenue
DescriptionSchool of Radiography - Tuition and fee revenue for school.Description
FieldValueIRS element (for citing)
Total Program Service Expense43450652TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
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 Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096105NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees986NumberOfEmployees
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
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Jennifer L Sullivan Sr VP FinanceCFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6073248110TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1411 Canisteo StreetAddressLine1
CityHornellCity
StateNYState
ZIP Code148432104ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Mary LaRowe
President/CEO35.00XX043346622022
Mary Fran Wegman RSM
Chair1.00X000
John Weyand DC
Treasurer1.00X000
Rhonda Peterson MD
Board Member1.00X000
Brenda Copeland
Vice Chair1.00X000
Philip Loree
Secretary1.00X000
Pasquale A Picco
MD40.00X48699309800
Robert Donius
Board Member1.00X000
Mary Ann Schimscheiner RSM
Board Member1.00X000
Joyce McGinn RSM
Board Member1.00X000
Maninder Virdee
Board Member1.00X000
Nancy Hoff RSM
Board Member1.00X000
Robert J Whelpley MD
Board Member40.00X197583025733
Jennifer Sullivan
Sr. Vice President/CFO40.00X164019015891
Dr Bradley T Truax
CMO20.00X15197902524
Patricia A Uldrich
CNO40.00X12886908150
Patricia Dagon
CCO/VP Continuing Care40.00X88726020833
Sylvia Bryant
VP Mission/ExecDir Foun20.00X6052607738
Raja V Rao
MD40.00317483018825X
M Tariq Randhawa
MD40.00190596026602X
Irvin C Oh
MD40.00464719021672X
Anthony F Yacona
MD40.0031681508562X
Andres I Rubert
MD40.00258536021761X
Robert W Whelpley
MD40.00280444023339X
Adrian Ashdown
MD40.00229411024829X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3336699TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs433466TotalReportableCompFrmRltdOrgs
Total Other Compensation258281TotalOtherCompensation
Number Individuals GT100 K12NumberIndividualsGT100K
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
Cardinal Health
6012 Molloy RoadSyracuseNY13211Pharmaceuticals1857079
Exigence Medical of Hornell
1 John James Audubon PkwyAmherstNY14228Hospitalists and ED Physicians1542498
Sodexho Inc & Affiliates
PO Box 95374CharlotteNC28290Food & Related Services1134309
Cardinal Health Medical Products and Ser
PO Box 13862NewarkNJ07188Medical Products895945
Health Facility Assessment Fund
PO Box 4757SyracuseNY13221Cash Assessments850434
FieldValueIRS element (for citing)
Number Of Contractors GT100 K50NumberOfContractorsGT100K
Government Grants50997GovernmentGrants
All Other Contributions240044AllOtherContributions
Total Contributions291041TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Service Re6221105590892955908929
Life Line Services621610378258378258
School of Radiography611519123911123911
FieldValueIRS element (for citing)
Total Program Service Revenue56411098TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column332585TotalRevenueColumn
Exclusion$332,585ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real34715Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real34715Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column34715TotalRevenueColumn
Related Or Exempt Function Income24516RelatedOrExemptFunctionIncome
Exclusion$10,199ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Specialty Clinic9000994523345233
Drugs Sold to Employee9000991962519625
Mgt/Building Service F9000991538215382

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column47177TotalRevenueColumn
Related Or Exempt Function Income47177RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue127417TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column57196856TotalRevenueColumn
Related Or Exempt Function Income56563031RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$342,784ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4047727Total
Program Services3018795ProgramServices
Management And General1028932ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23964353Total
Program Services17873392ProgramServices
Management And General6090961ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total531000Total
Program Services396034ProgramServices
Management And General134966ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3956521Total
Program Services2950883ProgramServices
Management And General1005638ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1904560Total
Program Services1420474ProgramServices
Management And General484086ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total190321Total
Program Services117647ProgramServices
Management And General72674ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total105897Total
Program Services65460ProgramServices
Management And General40437ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1760405Total
Program Services1094807ProgramServices
Management And General665598ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total73878Total
Program Services45668ProgramServices
Management And General28210ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total59280Total
Program Services36644ProgramServices
Management And General22636ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total332130Total
Program Services206554ProgramServices
Management And General125576ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2357447Total
Program Services1466111ProgramServices
Management And General891336ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total776752Total
Program Services483067ProgramServices
Management And General293685ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Supplies6367658393618224314760
Purchased Services5689538351700021725380
Physician Fees3375786337578600
Bad Debt Expense20371292444816-4076870

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3703680Total
Program Services1001332ProgramServices
Management And General2702348ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total61234062Total
Program Services43450652ProgramServices
Management And General17783410ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY459647BOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6495988BOY
EOY4549473EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5804162BOY
EOY5799063EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY8000BOY
EOY8000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1580446BOY
EOY1480107EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY467922BOY
EOY336864EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis77798272LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec64181420LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14376019BOY
EOY13616852EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9790541BOY
EOY5297588EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2609172BOY
EOY8181249EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY41591897BOY
EOY39269196EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5099053BOY
EOY5860033EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY13297767BOY
EOY8106250EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6718909BOY
EOY13824827EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25115729BOY
EOY27791110EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16269186BOY
EOY11250219EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY206982BOY
EOY227867EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16476168BOY
EOY11478086EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41591897BOY
EOY39269196EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4037206ReconcilationRevenueExpenses
Reconcilation Other Changes-960876ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
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$11,527OtherActivitiesAmount
Total Lobbying Expenditures IIB11527TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart IV, Supplemental Information:Identifier
ExplanationPart II-B, Line 1i: As part of our membership fees paid to The Health Care Association of New York State, a portion of the fee is allocated for lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Beginning Balance0BeginningBalance
Ending Balance0EndingBalance

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1652526OtherCostOrOtherBasis
Book Value1652526BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis41321769OtherCostOrOtherBasis
Depreciation38643348Depreciation
Book Value2678421BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis932383OtherCostOrOtherBasis
Depreciation837267Depreciation
Book Value95116BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32219466OtherCostOrOtherBasis
Depreciation24700805Depreciation
Book Value7518661BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1672128OtherCostOrOtherBasis
Book Value1672128BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13616852TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Est Third Party Payors Net976827
Due From Related Parties951792
Assets Held for Resale26630
Other Long-term Assets6226000
FieldValueIRS element (for citing)
Total Book Value Other Assets8181249TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Est 3rd party Payors net$4,073,099
Other Liabilities$651,427
Insurance Liabilities$9,100,301
FieldValueIRS element (for citing)
Total Of Amounts13824827TotalOfAmounts
Total Revenue57196856TotalRevenue
Total Expenses61234062TotalExpenses
Excess Or Deficit For Year-4037206ExcessOrDeficitForYear
Net Unrealized GL On Investments-115335NetUnrealizedGLOnInvestments
Other-$845,541OtherAmount
Total Adjustments-960876TotalAdjustments
Excess Or Deficit Per FS-4998082ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt56215096TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-115335NetUnrealizedGainsInvestments
Other Revenues-866425OtherRevenues
Revenue Not Rptd F990-981760RevenueNotRptdF990
Revenue Subtotal57196856RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99057196856TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt61234062TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal61234062ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99061234062TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:Intercompany Transactions 16,518. Grant Funded Capital Additions 352,116. Contribution and Investment Income Allocation 20,885. Loss on Extinguishment of Debt -539,402. Discontinued Operations -695,658. Total to Schedule D, Part XI, Line 8: -845,541.
Part XII, Line 2d - Other Adjustments:Intercompany transfers 16,518. Loss on Extinguishment of Debt -539,402. Discontinuted Operations -695,657. Grant Funded Capital Additions 352,116.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1745720TotalCommunityBenefitExpense
Direct Offsetting Revenue432232DirectOffsettingRevenue
Net Community Benefit Expense1313488NetCommunityBenefitExpense
Percent Of Total Expense0.02220PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense23516027TotalCommunityBenefitExpense
Direct Offsetting Revenue18082094DirectOffsettingRevenue
Net Community Benefit Expense5433933NetCommunityBenefitExpense
Percent Of Total Expense0.09180PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense25261747TotalCommunityBenefitExpense
Direct Offsetting Revenue18514326DirectOffsettingRevenue
Net Community Benefit Expense6747421NetCommunityBenefitExpense
Percent Of Total Expense0.11400PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense37134TotalCommunityBenefitExpense
Direct Offsetting Revenue987DirectOffsettingRevenue
Net Community Benefit Expense36147NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense129098TotalCommunityBenefitExpense
Direct Offsetting Revenue212821DirectOffsettingRevenue
Net Community Benefit Expense-83723NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense7811182TotalCommunityBenefitExpense
Direct Offsetting Revenue6205728DirectOffsettingRevenue
Net Community Benefit Expense1605454NetCommunityBenefitExpense
Percent Of Total Expense0.02710PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense70111TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense70111NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8047525TotalCommunityBenefitExpense
Direct Offsetting Revenue6419536DirectOffsettingRevenue
Net Community Benefit Expense1627989NetCommunityBenefitExpense
Percent Of Total Expense0.02890PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense33309272TotalCommunityBenefitExpense
Direct Offsetting Revenue24933862DirectOffsettingRevenue
Net Community Benefit Expense8375410NetCommunityBenefitExpense
Percent Of Total Expense0.14290PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense606TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense606NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense239019TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense239019NetCommunityBuildingExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense239625TotalCommunityBuildingExpense
Net Community Building Expense239625NetCommunityBuildingExpense
Percent Of Total Expense0.00400PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,218,155BadDebtExpenseAmount
Amount Attributable To168535AmountAttributableTo
Amount Reimbursed By Medicare14329671AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare11527391CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall2802280MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St James Mercy HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1411 Canisteo StreetAddressLine1
CityHornellCity
StateNYState
ZIP Code148432104ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St James Mercy HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: A cost-to-charge ratio is used for lines 7a and 7b computed by taking total expenses less bad debt divided by total gross patient revenue.
Part I, Line 7g: Subsidized health care costs include the costs attributable to two outpatient clinics:1. Dental clinic - $932,8292. Rural health clinic - $145,344
Part I, L7 Col(f): The amount of bad debt the organization included on Form 990, Part IX, line 25, column (a), subtracted for purposes of calculating the percentage of Schedule H, Part 1, line 7, column (f) is $2,037,129.
Part II: St. James Mercy Hospital actively recruits physicians and other health professionals to provide services in areas with a medical shortage or are underserved.
Part III, Line 4: The Hospital provides an allowance for uncollectibles for estimated losses resulting from the unwillingness of patients to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are charged off against the allowance for uncollectibles when management determines that recovery is unlikely and the Hospital ceases collection efforts. The amount reported in Part III, Section A, line 3 is determined by estimating the amount of bad debt expense that would be attributed to patients who would likely qualify for financial assistance but for whom sufficient information was not obtained to make that determination.
Part III, Line 8: To determine Medicare allowable costs reportable in the Medicare cost report, the cost-to-charge ratio is applied to gross patient revenue associated with services performed for patients who are eligible for Medicare. Although shortfall is not reported on Part I, Line 7, Community Benefit, it evidences the fact that the organization significantly subsidizes the cost of treating Medicare patients.
Part III, Line 9b: A bad debt results from a patient account balance from which payment was anticipated from the patient, credit extended and the account later deemed to be uncollectible. A bad debt does not meet the criteria for Charity Care, that is, bad debt patients are considered to have the financial capacity and ability to pay, but are unwilling to pay. Collection activities are only pursued with respect to amounts that patients are able to pay as determined by the organization's charity care policy. No collection activities take place with respect to amounts that patients are not expected to pay under this policy. A separate Charity Care Policy is in place and would be exhausted before a patient balance would be deemed self pay. Under the Charity Care policy, Charity Care/Financial Assistance is provided to a patient with a demonstrated inability to pay. A patient is eligible for Charity Care/Financial Assistance consideration based upon meeting certain income eligibility criteria as established by the Federal Poverty Income Guideline Sliding Scale, Per NYS PHL 2807-K, this considers patients whose household income is up to 300% of the most recent Federal Poverty Guidelines.All uninsured, low-income patients within St. James Mercy Hospital's primary service area who can demonstrate an inability to pay charges may apply for Charity Care/Financial Assistance for adjustments to their balances for all medically necessary healthcare services, provided that a member, in good standing, of St. James Mercy Hospital's medical staff determines the need for such medical care treatment.
Part V, Section B, Line 19d: A patient whose household income is between 201% and 250% of the most recent Federal Poverty Level qualifies for a Partial Charity Care discount. The patient liability is 40% of the rate of reimbursement SJMH would have received from its "highest volume payor" (Excellus Blue Cross) for like services (Inpatient, Outpatient, ED). The patient is eligible for a charity care discount equal to the difference between charges and 40% of the Excellus Blue Cross rate. A patient whose household income is between 251% and 300% of the most recent Federal Poverty Level qualifies for a Partial Charity Care discount. The patient is responsible for paying the Excellus Blue Cross rate. The Charity Care discount would equal the difference between charges and the Excellus Blue Cross rate. SJMH determined that Excellus Blue Cross is the "highest volume" payor as referenced in the NYS statue 2807-K. Therefore, for uninsured patients with household incomes below 300% of the most recent Federal Poverty Level, the patient responsibility will not exceed the rate of reimbursement SJMH would have received from Excellus Blue Cross.St. James Mercy Hospital
Part VI, Line 2: St. James Mercy Hospital conducts a community needs assessment every three years in conjunction with Steuben County Public Health. Based on residents' feedback, the county's health care priorities, strategies, and programs are determined. St. James Mercy Hospital creates an annual plan based on this assessment, and the progress of these initiatives is reported annually to NYS Department of Health. Local health care priorities are also identified through surveying participants at St. James Mercy's Community Health Fair and its public health education programs.
Part VI, Line 3: At the time of registration, all self-pay individuals receive an information sheet describing the types of Federal, state and local government programs available, including St. James Mercy Hospital's Charity Care Policy. The eligibility process is coordinated by a Financial Counselor, who contacts the patient or patient family member by phone and/or letter. Patients who qualify for Medicaid are also directed to an in-house facilitated enroller, who coordinates the Medicaid application process on behalf of the patient.
Part VI, Line 4: The primary service area for St. James Mercy Hospital (SJMH) is the 15-mile radius extending from Hornell (Steuben County), New York, and includes the towns of Wayland to the northeast and Troupsburg to the southeast (just outside of the 15-mile radius). The secondary service area is the 30-mile radius extending from Hornell. Per the 2010 Census, the population for the primary service area (Steuben County) remained relatively flat, increasing 0.3% from 2000 to 2010 to 98,990 and is projected to remain flat through 2014. The population aged 65 and over comprises 16% of the primary service area compared to 13% for New York State population. The population is racially and ethnically homogenous with 95.3% White, 1.6% Black, 1.4% Hispanic/Latino, and 1.2% Asian. Persons over the age of 65 represent 15.6% of the county, a two percentage points higher than the state. Median household income is $42,764 compared to $54,554 for the state. Approximately 20% of the county population have a bachelor's degree or higher compared to 32% of state residents.
Part VI, Line 5: St. James Mercy Hospital (SJMH) is the lead agency for the Cancer Services Program (CSP) of Steuben County. A community-based, grant-funded program of New York State Department of Health, the CSP serves uninsured men and women with comprehensive, age-appropriate, no-cost screenings for breast, cervical and colorectal cancer. As an extension of CSP activities, SJMH has partnered with Corning Hospital to increase access to cancer screening services for uninsured women who utilize local food pantries. In addition to the Community Health Fair, St. James Mercy Hospital participates in coordinating a similar annual event for children called the Pediatric Health Fair. This event is directed to parents and community youth and is held in conjunction with a longstanding community kids "fun run" to promote exercise and healthy lifestyles. SJMH staff members throughout the organization participate in community initiatives and hold seats on boards including the Steuben Rural Health Network, Catholic Charities, YMCA, United Way of the Southern Tier, Steuben Co. Health Priorities Team, and other non-profit organizations whose primary mission is to assess and address community needs. SJMH has also collaborated in a pilot program in collaboration with the Hornell City School District and is designed to address the issue of students without health insurance in pre-K through grade 6, through educational materials to parents and Medicaid enrollment assistance.
Part VI, Line 6: St. James Mercy Hospital furthers its exempt status through participation of its senior leadership team on various community boards including Hornell Children's Home; Home and Health, Inc.; United Way; BOCES Nursing Advisory Committee; Faith in Action; Allegany Western Steuben Rural Health Network; and Kinship. In addition, St. James Mercy Hospital recruits community members to serve on its own Board of Directors, Foundation Board, and Properties Board. St. James Mercy Hospital physicians and providers enhance community building through participation in the Hospital's annual Health Fair, and through educational programs such as "Sharing the Health" and "Working with Wegmans". The Hospital furthers its community reach through holiday sponsorships of needy families, and corporate sponsorships such as the local "Relay for Life" event. In addition, St. James Mercy Hospital's Emergency Department is open 24 hours a day and all persons needing care are treated, regardless of ability to pay.
NYReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
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 (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mary LaRowe
0260100094449078917010065011957045548800
Pasquale A Picco
4485040372280126109800000496793000
Robert J Whelpley MD
1862380967401671083710173620223316000
Jennifer Sullivan
163678000341042340116570179910000
Dr Bradley T Truax
149999000198002524000154503000
Raja V Rao
3121150125004118041710146540336308000
M Tariq Randhawa
1854910005105071400194620217198000
Irvin C Oh
463784000935049000167720486391000
Anthony F Yacona
310782000603302782057800325377000
Andres I Rubert
2562140002322046840170770280297000
Robert W Whelpley
279993000451045090188300303783000
Adrian Ashdown
2056030231330675056990191300254240000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 5ReturnReference
ExplanationSubject to incentive compensation limitations, primary care incentive compensation is based on the amount by which the number of Relative Value Units (RVU's) performed by Physician during any full calendar year exceeds targeted RVU's. Subject to incentive compensation limitations, specialist incentive compensation is based on a percentage of the amount by which adjusted gross revenues of the practice exceed expenses for the practice. Executive performance-based variable compensation is based on performance indicators established annually by the Administrative Team and approved by the Executive Compensation Committee.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonWilliam VeazeyNamePerson
Loan From OrganizationXLoanFromOrganization
Original Principal$20,000OriginalPrincipalAmount
Balance Due8000BalanceDue
Default1Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due8000TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Changes in Program ServicesForm 990, Part III, line 3The organization is in the process of discontinuing the operation of its Psychiatric Day Treatment Program and Dental Clinic Program.
Form 990, Part VI, Section A, line 2Patricia Dagon, CCO/VP of Continuing Care is the mother-in-law of Pasquale A. Picco, MD who is an employed physician of St. James Mercy Hospital and a Board Member.
Form 990, Part VI, Section A, line 6Yes, St. James Mercy Health System is the sole member.
Form 990, Part VI, Section A, line 7aYes, governance decisions are made by the board of St. James Mercy Hospital and then forwarded for final approval to St. James Mercy Health System Board.
Form 990, Part VI, Section A, line 7bYes, all decisions are made by the Board of St. James Mercy Hosptial and then forwarded for approval by St. James Mercy Health System Board.
Form 990, Part VI, Section B, line 11A copy of the Form 990 was made available to each board member before it was filed. St. James Mercy Health System Board has designated the Audit and Compliance Committee as the group to be educated and to review each entity return. The Audit and Compliance committee reviewed the 2011 Forms 990's for St. James Heath System, St. James Foundation and St. James Hospital on September 25, 2012.
Form 990, Part VI, Section B, line 12cSt. James Mercy Hospital has adopted CHE's Policy 103 setting forth the organization's conflict-of-interest policy and processes. Annually, all those serving St. James Mercy Hospital in a fiduciary capacity, including directors, officers, Sponsors Council representatives, and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's CEO and Board Chair. Summary information is reported to the entire board and available to the board throughout the year as business comes before the board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the board or an appropriate committee thereof comprised of disinterested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request.
Form 990, Part VI, Section B, line 15St. James Mercy Hospital has adopted CHE's process for determining compensation includes the following: The board has an independent committee review and approves all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing CHE roles to similarly sized health systems utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative program and establishes the detailed performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes.
Form 990, Part VI, Section C, line 19Organizational Articles of Incorporation, Corporate Bylaws, governance policies believed to be of interest to the public, conflict-of-interest policy, audited financial statements; annual community benefit report and IRS Form 990 are available to the public upon request.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 5:Net unrealized losses on investments: -115,335. Intercompany Transactions 16,518. Grant Funded Capital Additions 352,116. Contribution and Investment Income Allocation 20,885. Loss on Extinguishment of Debt -539,402. Discontinued Operations -695,658. Total to Form 990, Part XI, Line 5: -960,876.
Disclosure Statement Related to Form 5471 Filed by Catholic Health East and Saint Michael's Medical Center Under the constructive ownership rule of Internal Revenue Code Sections 318(a) and 958(b), the organization is required to file Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 4 and/or Category 5 filer with respect to Stella Maris Insurance Company Limited and Chestnut Risk Services, LTD (collectively, the "foreign corporations"). This filing requirement is, or will be, satisfied through the filing of Forms 5471 with respect to the foreign corporations on the organization's behalf by the U.S. organizations identified below. Foreign Corporation: Stella Maris Insurance Company U.S. Organization: Catholic Health East Address: 3805 West Chester Pike, Suite 100, Newtown Square, Pennsylvania 19073 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 23-2929748 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Foreign Corporation: Chestnut Risk Services, LTD U.S. Organization: Saint Michael's Medical Center Address: 111 Central Avenue, Newark, New Jersey 07102 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 26-2616046 IRS Service Center Where U.S. Return Was Filed: Ogden, UT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (139 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Catholic Health East
3805 West Chester Pike Suite 100Newtown SquarePA19073232929748Management ServicesPA501(c)(3)Line 11a, IN/A1
Continuing Care Management Services Network
3805 West Chester Pike Suite 100Newtown SquarePA19073352336834Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
Mercy Health System of Maine
144 State StreetPortlandMA04101010484074Management & Support ServicesME501(c)(3)Line 11c, III-FI1Catholic Health East
Mercy Hospital
144 State StreetPortlandMA04101010211534HospitalME501(c)(3)Line 31Mercy Health System of Maine
St Peter's Health Partners
315 South Manning BlvdAlbanyNY12208453570715Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
St Peter's Health Care Services
315 South Manning BlvdAlbanyNY12208222702507Management & Support ServicesNY501(c)(3)Line 91St Peter's Health Partners
St Peter's Hospital
315 South Manning BlvdAlbanyNY12208141348692HospitalNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Hospital Foundation Inc
319 South Manning Blvd Suite 309AlbanyNY12208222262982Fundraising & Public RelationsNY501(c)(3)Line 71St Peter's Health Care Services
Eddy Licensed Home Care Agency
433 River St Suite 3000TroyNY12180141818568Home HealthNY501(c)(3)Line 31LTC(Eddy) Inc
The Community Hospice Foundation Inc
295 Valley View BlvdRensselaerNY12144222692940Fundraising & Public RelationsNY501(c)(3)Line 71The Community Hospice Inc
The Community Hospice Inc
295 Valley View BlvdRensselaerNY12144141608921Serving seriously ill people & their familiesNY501(c)(3)Line 31St Peter's Health Care Services
Villa Mary Immaculate
301 Hackett BlvdAlbanyNY12208141438749Nursing Home & Physical RehabNY501(c)(3)Line 31St Peter's Hospital
Warde Service Corporation Inc
159 Wolf Road 3rd FloorAlbanyNY12205141732097Supporting & strengthing the ministries of rel. sr. mercyNY501(c)(3)Line 91St Peter's Health Care Services
Mercy Care for Kids Inc
310 South Manning BlvdAlbanyNY12208141717564Day care centerNY501(c)(3)Line 91St Peter's Health Care Services
Our Lady of Mercy Life Center
2 Mercycare LaneGuilderlandNY12084141743506Nursing Home FacilityNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Auxiliary
315 South Manning BlvdAlbanyNY01228222843206AuxiliaryNY501(c)(3)Line 11a, I1St Peter's Health Care Services
Memorial Hospital Albany NY
600 Northern BlvdAlbanyNY12204141338457General HospitalNY501(c)(3)Line 31Northeast Health Inc
Beechwood Inc
2212 Burdett AveTroyNY12180141651563Real estate holdingNY501(c)(2)N/A1LTC (Eddy) Inc
Beverwyck Inc
40 Autumn DriveSlingerlandsNY12159141717028Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Capital Region Geriatric Center Inc
421 West Columbia StCohoesNY12047141701597Nursing HomeNY501(c)(3)Line 91LTC (Eddy) Inc
Senior Care Connection Inc
504 State StSchenectadyNY12305141708754PACE ProgramNY501(c)(3)Line 91LTC (Eddy) Inc
Glen Eddy Inc
One Glen Eddy DriveNiskayunaNY12309141794150Independent/Assisted Living CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Hawthorne Ridge Inc
30 Community WayEast GreenbushNY12061800102840Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Heritage House Nursing Center Inc
2920 Tibbits AveTroyNY12180141725101Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
Home Aid Service of Eastern New York Inc
433 River St Suite 3000TroyNY12180141514867Home careNY501(c)(3)Line 91LTC (Eddy) Inc
James A Eddy Memorial Geriatric Center Inc
2256 Burdett AveTroyNY12180222570478Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
LTC (Eddy) Inc
2212 Burdett AveTroyNY12180222564710Elderly health/housing supporting orgNY501(c)(3)Line 11a, I1Northeast Health Inc
The Marjorie Doyle Rockwell Center Inc
421 West Columbia StCohoesNY12047141793885Adult Home/AlzheimersNY501(c)(3)Line 91LTC (Eddy) Inc
Samaritan Hospital of Troy New York
2215 Burdett AveTroyNY12180141338544General hospitalNY501(c)(3)Line 31Northeast Health Inc
Shaker Properties Inc
2212 Burdett AveTroyNY12180223119822Real Estate holdingNY501(c)(2)N/A1Northeast Health Inc
Sunnyview Hospital & Rehabilitation Ctr
1270 Belmont AveSchenectadyNY12308141338386Rehabilitation hospitalNY501(c)(3)Line 31LTC (Eddy) Inc
Empire Home Infusion Service Inc
10 Blacksmith DriveMaltaNY12020141795732Home careNY501(c)(3)Line 91Home Aid Service of Eastern New York Inc
Samaritan Child Care Center Inc
2213 Burdett AveTroyNY12180141710225Child day careNY501(c)(3)Line 91Northeast Health Inc
The Northeast Health Foundation Inc
2224 Burdett AveTroyNY12180222743478Supporting foundationNY501(c)(3)Line 71Northeast Health Inc
Northeast Health Inc
2212 Burdett AveTroyNY12180042450756Supporting OrganizationNY501(c)(3)Line 11b, II1St Peter's Health Partners
Seton Health System Inc
1300 Massachusetts AvenueTroyNY12180141776186HospitalNY501(c)(3)Line 31St Peter's Health Partners
Seton Auxiliary Inc
1300 Massachusetts AvenueTroyNY12180141505031Supporting OrganizationNY501(c)(3)Line 91Seton Health System Inc
Seton Health at Schuyler Ridge Residential Healthcare
1 Abele BlvdClifton ParkNY12065141756230Skilled NursingNY501(c)(3)Line 91Seton Health System Inc
Seton Health Foundation
1300 Massachusetts AvenueTroyNY12180222345416Supporting OrganizationNY501(c)(3)Line 11a, I1Seton Health System Inc
Seton Licensed Home Care Inc
1300 Massachusetts AvenueTroyNY12180141809134Licensed Home Health AgencyNY501(c)(3)Line 31Seton Health System Inc
Vincentian Health Services
1300 Massachusetts AvenueTroyNY12180141685163Discontinued OperationsNY501(c)(3)Line 11a, I1Seton Health System Inc
St Mary's Woodland Village Inc
1300 Massachusetts AvenueTroyNY12180141675183Discontinued OperationsNY501(c)(3)Line 91Seton Health System Inc
Brightside Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040042182395Behavioral CareMA501(c)(3)Line 91Sisters of Providence Health System Inc
Farren Care Center Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040042501711Long Term CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Mercy Hospital Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398280Acute CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Mercy Specialist Physicians Inc
c/o SPHS 1221 Main Street No 108HolyokeMA01040264033168Neurosurgery Medical ServicesMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Care Centers Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040222541103Long Term CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Health System Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398374Management & Support ServicesMA501(c)(3)Line 11a, I1Catholic Health East
McAuley Center Inc
275 Steele RoadWest HartfordCT06117061058086Independent LivingCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Community Health Inc
2021 Albany AvenueWest HartfordCT06117061492707Management & Support ServicesCT501(c)(3)Line 11a, I1Catholic Health East
Mercy Community HomeCare Services
2021 Albany AvenueWest HartfordCT06117061488137In Home Health CareCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Services
2021 Albany AvenueWest HartfordCT06117061453323Support ServicesCT501(c)(3)Line 11Mercy Community Health Inc
Mercyknoll Inc
2021 Albany AvenueWest HartfordCT06117060757380Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Saint Mary Home II Inc
2021 Albany AvenueWest HartfordCT06117061164104Elderly CareCT501(c)(3)Line 31Mercy Community Health Inc
St Mary Home Incorporated
2021 Albany AvenueWest HartfordCT06117060646843Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Mercy Healthcare Center
114 Wawbeek AvenueTupper LakeNY12986150532211HospitalNY501(c)(3)Line 31Catholic Health East
Mercy Uihlein Health Corporation
185 Old Military RoadLake PlacidNY12946161535133HospitalNY501(c)(3)Line 11b, II1Mercy Healthcare Center
Uihlein Mercy Center
185 Old Military RoadLake PlacidNY12946150532190HospitalNY501(c)(3)Line 31Mercy Healthcare Center
St James Mercy Foundation Inc
411 Canisteo StreetHornellNY14843161486437FoundationNY501(c)(3)Line 71St James Mercy Health System Inc
St James Mercy Health System Inc
411 Canisteo StreetHornellNY14843223127184Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
Marian Community Hospital
100 Lincoln AvenueCarbondalePA18407240711230HospitalPA501(c)(3)Line 31Maxis Health System
Marian Community Hospital Auxiliary
100 Lincoln AvenueCarbondalePA18407251874733FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Foundation
100 Lincoln AvenueCarbondalePA18407232330090FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Health System
100 Lincoln AvenueCarbondalePA18407911940902Health Care SystemPA501(c)(3)Line 11b, II1Catholic Health East
Maxis Medical Services
100 Lincoln AvenueCarbondalePA18407232577185Physician PracticesPA501(c)(3)Line 31Maxis Health System
Tri-County Human Services Center Inc
PO Box 517CarbondalePA18407231938528Behavioral Health OrganizationPA501(c)(3)Line 71Maxis Health System
Columbus Acquisition Corp
1160 Raymond BoulevardNewarkNJ07102262616342Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
Saint Michaels Medical Center
111 Central AvenueNewarkNJ07102262616046HospitalNJ501(c)(3)Line 31Catholic Health East
St James Care Inc
1160 Raymond BoulevardNewarkNJ07102262616230Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
St Michaels Medical Center Foundation
1160 Raymond BoulevardNewarkNJ07102223311976FoundationNJ501(c)(3)Line 11a, I1Saint Michaels Medical Center
University Heights Property Company Inc
1160 Raymond BoulevardNewarkNJ07102223100162Medical Property Holding CompanyNJ501(c)(2)N/A1Saint Michaels Medical Center
Life St Francis Corporation
601 Hamilton AvenueTrentonNJ08629222797282Health ServicesNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Foundation NJ
601 Hamilton AvenueTrentonNJ08629521025476FoundationNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Trenton NJ
601 Hamilton AvenueTrentonNJ08629223431049HospitalNJ501(c)(3)Line 31Catholic Health East
Langhorne MRI Inc
1201 Langhorne-Newtown RoadLanghornePA19047232519529Inactive EntityPA501(c)(3)Line 91St Mary Medical Center
Langhorne Physician Services Inc
1201 Langhorne-Newtown RoadLanghornePA19047232571699Physician ServicesPA501(c)(3)Line 91St Mary Medical Center
LIFE St Mary
1201 Langhorne-Newtown RoadLanghornePA19047262976184Elderly CarePA501(c)(3)Line 91St Mary Medical Center
St Mary Medical Center
1201 Langhorne-Newtown RoadLanghornePA19047231913910HospitalPA501(c)(3)Line 31Catholic Health East
St Mary Medical Center Foundation Inc
1201 Langhorne-Newtown RoadLanghornePA19047232567468FoundationPA501(c)(3)Line 71St Mary Medical Center
East Norriton Physician Services
c/o One West Elm StreetConshohockenPA19428232515999Physician ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Catholic Medical Center of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428231352191Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Family Support
1001 Baltimore Pike Suite 301SpringfieldPA19064232325059Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Health Foundation of Southeastern Pennsylvania
c/o MHS One West Elm StreetConshohockenPA19428232829864FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health Plan
c/o One West Elm StreetConshohockenPA19428222483605Health PlansPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health System of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232212638Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
Mercy Home Health
1001 Baltimore Pike Suite 310SpringfieldPA19064231352099Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Home Health Services
1001 Baltimore Pike Suite 301SpringfieldPA19064232325058Home HealthPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Management of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232627944Physician PracticesPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Suburban Hospital
One West Elm StreetConshohockenPA19428231396763Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Health Care Foundation
2701 Holme AvenuePhiladelphiaPA19152232300951FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Nazareth Hospital
2601 Holme AvenuePhiladelphiaPA19152232794121Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Physician Services Inc
2601 Holme AvenuePhiladelphiaPA19152203261266Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
NE Physician Services
2601 Holme AvenuePhiladelphiaPA19152232497355Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center
1900 S Broad StreetPhiladelphiaPA19145232840137Continuing Care ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center Foundation
1900 S Broad StreetPhiladelphiaPA19145232415137FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Life at Lourdes Inc
1600 Haddon AvenueCamdenNJ08108261854750Elderly CareNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Ancillary Services
1600 Haddon AvenueCamdenNJ08103222568525Supporting OrganizationNJ501(c)(3)Line 11b, II1Our Lady of Lourdes Health Care Services
Lourdes Dialysis at Innova Inc
1600 Haddon AvenueCamdenNJ08108263237625HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Medical Center Burlington County
218 Sunset RoadWillingboroNJ08046223612265HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Health Care Services
1600 Haddon AvenueCamdenNJ08103222568528Management & Support ServicesNJ501(c)(3)Line 11b, II1Catholic Health East
Our Lady of Lourdes Health Foundation Inc
1600 Haddon AvenueCamdenNJ08103222351960FoundationNJ501(c)(3)Line 71Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Medical Center
1600 Haddon AvenueCamdenNJ08103210635001HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Franciscan Eldercare Corporation
PO Box 2500WilmingtonDE19805223008680EldercareDE501(c)(3)Line 91St Francis Hospital
St Francis Foundation
PO Box 2500WilmingtonDE19805510374158FoundationDE501(c)(3)Line 11b, II1St Francis Hospital
St Francis Hospital
PO Box 2500WilmingtonDE19805510064326HospitalDE501(c)(3)Line 31Catholic Health East
LIFE at St Francis Healthcare Inc
7th Clayton StreetsWilmingtonDE19805452569214Elderly CareDE501(c)(3)Line 31St Francis Hospital
McAuley Ministries
McAuley Hall 3333 Fifth AvenuePittsburghPA15213943436142Management & Support ServicesPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Jeannette Hospital
3805 West Chester PikeNewtown SquarePA19073251310602Inactive EntityPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Life Center Corporation
1200 Reedsdale StreetPittsburghPA15233251604115Community TreatmentPA501(c)(3)Line 91Pittsburgh Mercy Health System
Pittsburgh Mercy Health System
3333 5th AvenuePittsburghPA15213251464211Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
St Joseph's of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387560694200HospitalNC501(c)(3)Line 31Catholic Health East
Life St Joseph of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387272159847Healthcare ServicesNC501(c)(3)Line 31St Joseph's of the Pines Inc
Mercy Senior Care Inc
212 West Third Street PO Box 866RomeGA30162581366508Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Good Samaritan HospitalInc
1201 Siloam RoadGreensboroGA30462261720984HospitalGA501(c)(3)Line 31Saint Joseph's Health System Inc
Saint Joseph's Health System Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581744848Management & Support ServicesGA501(c)(3)Line 11b, II1Catholic Health East
Saint Joseph's Mercy Care Services Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581752700Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Saint Joseph's Mercy Foundation Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581448522FundraisingGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
Mercy Services Downtown Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342272046353Real Estate Holding CompanyGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
St Mary's Health Care System Inc
1230 Baxter StreetAthensGA30606580566223HospitalGA501(c)(3)Line 31Catholic Health East
St Mary's Foundation Inc
1230 Baxter StreetAthensGA30606582544232FundraisingGA501(c)(3)Line 11b, II1St Mary's Health Care System Inc
St Mary's Highland Hills Inc
1230 Baxter StreetAthensGA30606020576648Assisted Living & Retirement CommunityGA501(c)(3)Line 31St Mary's Health Care System Inc
St Mary's Medical Group Inc
1230 Baxter StreetAthensGA30606261858563Hospital / Physician ServicesGA501(c)(3)Line 31St Mary's Health Care System Inc
Mercy Medical Corporation
PO Box 1090 101 Villa DriveDaphneAL36526636002215HospitalAL501(c)(3)Line 31Catholic Health East
Mercy LIFE of Alabama
PO Box 1090 101 Villa DriveDaphneAL36526273163002HospitalAL501(c)(3)Line 31Mercy Medical Corporation
Allegany Franciscan Ministries Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684581492325Management & Support ServicesFL501(c)(3)Line 11b, II1Catholic Health East
St Francis Hospital Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684590624442HospitalFL501(c)(3)Line 11a, I1Allegany Franciscan Ministries Inc
Holy Cross Hospital Inc
4725 North Federal HighwayFt LauderdaleFL33308590791028HospitalFL501(c)(3)Line 31Catholic Health East
Holy Cross Long-Term Inc
4725 North Federal HighwayFt LauderdaleFL33308650787320Medical ServicesFL501(c)(3)Line 31Holy Cross Hospital Inc
Holy Cross Medical Properties Inc
4725 North Federal HighwayFt LauderdaleFL33308650666283Medical Building Real Estate ManagementFL501(c)(2)N/A1Holy Cross Hospital Inc
Mercy Hospital Foundation Inc
3663 South Miami AvenueMiamiFL33133591709438FundraisingFL501(c)(3)Line 71Mercy Hospital Inc
Mercy Hospital Inc
3663 South Miami AvenueMiamiFL33133590791034HospitalFL501(c)(3)Line 31Catholic Health East
Mercy Medical Development Inc
3663 South Miami AvenueMiamiFL33133592789194Outpatient ServicesFL501(c)(3)Line 91Mercy Hospital Inc
Mercy Mission Services Inc
3663 South Miami AvenueMiamiFL33133650435764Health CareFL501(c)(3)Line 11a, I1Mercy Hospital Inc
Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital
3663 South Miami AvenueMiamiFL33133510461511HospitalFL501(c)(3)Line 31Mercy Hospital Inc
Global Health Ministry
3805 West Chester Pike Suite 100Newtown SquarePA19073233068656Health CarePA501(c)(3)Line 71Catholic Health East
VNA Home Health & Hospice
50 Foden RoadSouth PortlandME04106010246804Home Health & HospiceME501(c)(3)Line 11a, I1Mercy Health System of Maine
Providence Place Inc
5 Gamelin StreetHolyokeMA01040043404084Retirement CommunityMA501(c)(3)Line 91Sisters of Providence Health System Inc
Intercoastal Health Systems
3805 West Chester Pike Suite 100Newtown SquarePA19073650556413Management & Support ServicesPA501(c)(3)Line 11a, I1Catholic Health East
Sunnyview Hospital & Rehabilitation Center Foundation
1270 Belmont AveSchenectadyNY12308222505127Supporting foundationNY501(c)(3)Line 11a, I0Sunnyview Hospital & Rehabilitation Ctr

Form990 Schedule R Part III Form990ScheduleRPartIII (21 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
St Peter's Ambulatory Surgery Center LLC
1375 Washington Avenue Ste 201AlbanyNY12206460463892SurgeryNYN/A
Catherine Horan Building Limited Partnership
1221 Main Street Room 108HolyokeMA010400000042723429Property ManagementMAN/A
Western Massachusetts PETCT Imaging Center LLC
100 Bayview Circle Ste 400Newport BeachCA92660204744663Outpatient Medical ServicesDEN/A
Central New Jersey Heart Services LLC
10720 Sikes Places Ste 300CharlotteNC28277208525458Cardiac ProgramNJN/A
Langhorne MOB Partners LP
1201 Langhorne-Newtown RoadLanghornePA19047232622772Investment and operation of a medical buildingPAN/A
SMMC MOB II LP
1201 Langhorne-Newtown RoadLanghornePA19047364559869Investment and operation of a medical buildingPAN/A
The Ambulatory Surgery Center at St Mary LLC
1203 Langhorne-Newton RoadLanghornePA19047232871206Outpatient SurgeryPAN/A
AmeriHealth Mercy Health Plan
200 Stevens Drive Suite 350PhiladelphiaPA19113232859523Medicaid Managed Care OrganizationPAN/A
Amerihealth Mercy of Indiana LLC
200 STEVENS DRIVE Suite 350PhiladelphiaPA19113204948091PREPAID HEALTH CARE SERVICESINN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
Gateway Health Plan
300 Grant StreetPittsburghPA15219251691945Medicaid & Medicare/Special Needs Managed Care OrganizationPAN/A
Keystone Mercy Health Plan
100 Stevens DrivePhiladelphiaPA19113232842344Medicaid Managed Care OrganizationPAN/A
MercyManor Partnership
PO Box 10086ToledoOH436990086521931012Nursing HomePAN/A
St Agnes Long Term Intensive Care LLP
1900 S Broad StreetPhiladelphiaPA19145200984882Long Term Intensive CarePAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
St Agnes Long Term Intensive Care LLP
1900 S Broad StreetPhiladelphiaPA19145200984882Long Term Intensive CarePAN/A
SJV Management LLC
200 Century Pkwy Ste 200EMount LaurelNJ08054202273476RadiologyNJN/A
Physicians Outpatient Surgery Center LLC
1000 NE 56thOakland ParkFL33334352325646Ambulatory Surgery CenterFLN/A
Center for Surgery & Digestive Orders
3641 South Miami AvenueMiamiFL33133510438152Outpatient Medical ServicesFLN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (34 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryProvince Or StateAddressForeign/ProvinceOrStatePostal CodeAddressForeign/PostalCode
Samaritan Medical Office Building Inc
2212 Burdett AvenueTroyNY12180141607244Real EstateNYN/AC
Affiliated Management Services Corporation Inc
1300 Massachusetts AvenueTroyNY12180141668024Real EstateNYN/AC
Catherine Horan Building Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938180Building ManagementMAN/AC
Diversified Community Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043128890Medical ServicesMAN/AC
Mercy Inpatient Medical Associates Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043029829Medical ServicesMAN/AC
Providence Home Care Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043317426Health Care ServicesMAN/AC
System Coordinated Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938181Lab ServicesMAN/AC
Physicians Medical Office Building Condominium Trust
1221 Main Street Room 108HolyokeMA010400000046608649Property ManagementMAN/AC
SJM Properties Inc
411 Canisteo StreetHornellNY148482104161294991Property HoldingsNYN/AC
Carbondale Area Physicians' Association PC
100 Lincoln AveCarbondalePA18407232801677Medical Insurance ContractingPAN/AC
Carbondale Area Physicians' PHO Inc
100 Lincoln AveCarbondalePA18407232801676InactivePAN/AC
Carbondale Physicians' Services Inc
100 Lincoln AveCarbondalePA18407232365077PharmacyPAN/AC
Chestnut Risk Services Ltd
InsuranceN/AC11 Victoria StreetHamiltonBDBD
LifeCare Physicians PC
601 Hamilton AvenuetrentonNJ086291986261649038Health Care ServicesNJN/AC
Multicare Plus Inc
601 Hamilton AvenueTrentonNJ086291986223435844InactiveNJN/AC
Langhorne Services II Inc
1201 Langhorne-Newtown RoadLanghornePA190470000253795549General Partner of LMOB Partners, IIPAN/AC
Langhorne Services Inc
1201 Langhorne-Newtown RoadLanghornePA190470000232625981General Partner of LMOB PartnersPAN/AC
AMHP Holdings Corp
200 Stevens DrivePhiladelphiaPA19113261144363Behavorial HealthPAN/AC
Select Health of South Carolina Inc
4390 Belle Oaks Drive Suite 400CharlestonSC29405571032456Health Maintenance OrganizationSCN/AC
Gateway Health Plan Inc
600 Grant StreetPittsburghPA15219251505506Health CarePAN/AC
Gateway Health Plan Inc of Ohio
600 Grant StreetPittsburghPA15219300282076Health CarePAN/AC
MCMC Eastwick Inc
c/o MHS One West Elm StreetConshohockenPA19428232184261Medical Office BuildingsPAN/AC
Community Behavorial Healthcare Network of PA Inc
8040 Carlson RoadHarrisburgPA17112251765391Behavorial HealthPAN/AC
Health Management Services Org Inc
500 Grove Street Suite 100Haddon HeightsNJ08035223366580Health Care BillingNJN/AC
Jeannette Medical Providers
3805 West Chester PikeNewtown SquarePA19073251787334Holding CompanyPAN/AC
Jeannette OBGYN Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890748Holding CompanyPAN/AC
Jeannette Primary Care Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890743Holding CompanyPAN/AC
Georgia Health Enterprises LLC
11440 Commerce Park DriveRestonVA20191541806329HealthcareVAN/AC
St Mary's Highland Hills Village Inc
1660 Jennings Mill PklyBogartGA30622582276801Assisted LivingGAN/AC
GHE Physicians PC
3500 Piedmont RoadAtlantaGA30305582277939Practice ManagementGAN/AC
Nursing Network Inc
4725 North Federal HighwayFort Lauderdale HighwaFL333080000591145192Medical ServicesFLN/AC
Mercy Physician Group Inc
3663 South Miami AvenueMiamiFL33133202970015Health CareFLN/AC
Stella Maris Insurance Company Limited
980078266InsuranceN/ACPO Box 69Grand CaymanCJCJCayman IslandsKY1-1102
Catholic Health East Senior Services
3805 West Chester Pike Suite 100Newtown SquarePA19073371572595Senior ServicesPAN/AC
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 Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
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 Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1St James Mercy FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved16518AmountInvolved
Method Of Amt DeterminationFair Market ValueMethodOfAmtDetermination