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Bon Secours DePaul Medical Center Inc: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
Bon Secours DePaul Medical Center Inc (EIN 54-1820093)
Tax period
2009-09-01 to 2010-08-31
Filed
2011-07-12
IRS object ID
201121939349300537
Schema version
2009v1.7
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)
Timestamp2011-07-12T20:08:10-05:00Timestamp
Tax Period End Date2010-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2009-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN541820093EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours DePaul Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone7578895000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael KernerName
TitleSecretary/TreasurerTitle
Phone7578895000Phone
Date Signed2011-07-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameEmily Hayes SmithName
Phone7032511000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonMichael KernerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1150 Kingsley LaneAddressLine1
CityNorfolkCity
StateVAState
ZIP Code23505ZIPCode
FieldValueIRS element (for citing)
Gross Receipts170396410GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.bonsecourshamptonroads.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionAcute Care HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees1013TotalNbrEmployees
Total Nbr Volunteers148TotalNbrVolunteers
Total Gross UBI3961899TotalGrossUBI
Net Unrelated Business Txbl Income-386290NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year233637ContributionsGrantsPriorYear
Contributions Grants Current Year160247ContributionsGrantsCurrentYear
Program Service Revenue Prior Year144190514ProgramServiceRevenuePriorYear
Program Service Revenue CY168064618ProgramServiceRevenueCY
Investment Income Prior Year-838745InvestmentIncomePriorYear
Investment Income Current Year-1445812InvestmentIncomeCurrentYear
Other Revenue Prior Year4738865OtherRevenuePriorYear
Other Revenue Current Year1502699OtherRevenueCurrentYear
Total Revenue Prior Year148324271TotalRevenuePriorYear
Total Revenue Current Year168281752TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year56426799SalariesEtcPriorYear
Salaries Etc Current Year58612863SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year93196843OtherExpensePriorYear
Other Expenses Current Year112601609OtherExpensesCurrentYear
Total Expenses Prior Year149623642TotalExpensesPriorYear
Total Expenses Current Year171214472TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1299371RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2932720RevenuesLessExpensesCY
Total Assets BOY76833398TotalAssetsBOY
Total Assets EOY79304838TotalAssetsEOY
Total Liabilities BOY107517950TotalLiabilitiesBOY
Total Liabilities EOY113455426TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-30684552NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-34150588NetAssetsOrFundBalancesEOY
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 bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense32460444Expense
Revenue34684994Revenue
DescriptionDePaul continues a strong focus on orthopaedic care for residents of Norfolk and Virginia Beach. A special expertise exists in the treatment of spine disorders, with a significant cadre of spine and neurosurgeons. DePaul was also recently recognized as a Blue Distinction Center of Excellence to attest to the excellence of care. This service includes a continuum of care from pre-operative education through post-op recovery, and is supported by state-of-the-art technology and expert physicians, as well as a comprehensive rehab network. In addition, a strong focus exists on community education through seminars and classes.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15443019Expense
Revenue14391061Revenue
DescriptionDePaul recently established a bariatric surgery program, modeled on the successful program already in place at sister facility Maryview. DePaul has long been known for its premier gynecological oncology program, treating women from a 5-state area. Specialized OR, diagnostic, therapeutic, and nursing services are available to treat this disease, alongside specialty-trained expert physicians. Finally, DePaul is working extensively with neurosurgeons in expanding this part of the surgery service. New services added in 2010 include craniotomy surgery, deep brain stimulation, advanced spinal surgeries, and other neurosurgical procedures. As with other services and part of our mission, a strong focus exists on community education through seminars and classes.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense12164272Expense
Revenue12656631Revenue
DescriptionDePaul has committed significant resources to the care of cardiac patients. The comprehensive Early Detection Center is aimed at identifying cardiac disease early and referring patients to physicians as necessary for prompt and effective treatment. DePaul also upgraded equipment and nursing services to better support the service line. In FY10, Bon Secours DePaul began operating a state-of-the art, fully digital cardiac catheterization laboratory. In addition, DePaul's CT was upgraded to a 64-slice unit, enabling "beating heart" scans. DePaul continues strong relationships with other Bon Secours hospitals for the delivery of advanced cardiac interventions, such as cardiac surgery. In addition, a strong focus also exists on community education through seminars, classes, screenings, and special events, such as Day of Dance.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense96061024Expense
Revenue102490040Revenue
DescriptionOther major services offered by Bon Secours DePaul Medical Center include a Birthing Center, Sleep, Gastroenterology and Pulmonary services. In addition, Bon Secours DePaul Medical Center offers a full service 24 hour Emgency Room and as well as a innovative Senior Assessment Program.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp96061024TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev102490040TotalOfOtherProgramServiceRev
Total Program Service Expense156128759TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109696NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1013NumberOfEmployees
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
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 Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7572152709TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17007 Harbourview Blvd Ste 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Michael D Blount
Board Member4.00X000
Rise Faith E Dajao
Board Member4.00X000
William H Kline
Board Member4.00X000
Robert W Knapp
Board Member4.00X000
Michael S LaRock
Board Member4.00X000
Bennie L Marshall
Board Member4.00X000
Margaret U Moser
Board Member4.00X000
Mary Jane Nero
Board Member4.00X000
R B Seal
Board Member4.00X000
Deborah K Stearns
Board Member4.00X000
Alfred E Abiouness
Board Member4.00X000
Sr Rita Thomas
Board Member4.00X000
Timothy J Davis
Board Member50.00X01223989129362
Sr Anne Lutz
Board Member50.00X000
J Robert Bray
Board Member4.00X000
Arthur Collins
Board Member4.00X000
Sr Elaine Davia
Board Member4.00X000
Carol Ormond
Board Member4.00X000
Wayne K Sawyer
Chairman (Sept - Dec)6.00X000X
Linwood E Howard
Chairman (Jan - Aug)6.00X000X
Michael Kerner
Secretary/Treasurer50.00X0940681126469X
Sr Patricia Heath
President50.00X000X
Daniel Duggan
Executive Vice-President50.00042402463036X
Gregory Simia
CFO - Hampton Roads50.00040407551557X
Theresa Nero
VP Patient Care Services50.00141923020592X
David Setchel
Vice President - Operations50.00211937036345X
James Mosure MD
Physician50.00395951015072X
Harikrishanan Damodarannair MD
Physician50.00336638027281X
Kochicheril N Moni MD
Physician50.00317899017542X
Ray Marling MD
Physician50.00288375011911X
Nena G Aceveda
RN50.00232051010173X
Edward Boyer
Former Board Member0.00093841717317X
Richard Hanson
Former CEO/Secretary/Treasurer0.000772746108243X
Joseph Buccheit
Former CFO0.00035413444775X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1782851TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5058066TotalReportableCompFrmRltdOrgs
Total Other Compensation659083TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
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
Rehabcare Group Inc
PO Box 502096St LouisMO631502096Rehab3710758
Wellspring Valuation Partners
123 North Wacker Drive Ste 900ChicagoIL60606Operations Consulting1468476
Eastern Virginia Medical School
721 Fairfax AveNorfolkVA23507Residence/ Director Fees1251162
Staff Care Inc
5001 Statesman DrIrvingTX750632414Anesthesia Staffing1219970
Alliance Healthcare Svcs Inc
PO Box 96485ChicagoIL606936485MRI Services1023149
FieldValueIRS element (for citing)
Number Of Contractors GT100 K34NumberOfContractorsGT100K
Related Organizations103179RelatedOrganizations
Government Grants56968GovernmentGrants
All Other Contributions100AllOtherContributions
Total Contributions160247TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code621500BusinessCode
Total Revenue Column168064618TotalRevenueColumn
Related Or Exempt Function Income164222726RelatedOrExemptFunctionIncome
Unrelated Business Revenue3841892UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue168064618TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column201430TotalRevenueColumn
Exclusion$201,430ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real511243Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real467416Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real43827Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column43827TotalRevenueColumn
Exclusion$43,827ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities111490Securities
Other1535752Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-111490Securities
Other-1535752Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1647242TotalRevenueColumn
Exclusion-$1,647,242ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Tuition - Nurses Aide900099197773$197,773
Joint venture income621999166394$166,394
Answering Service517000120007120007

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column974698TotalRevenueColumn
Exclusion$974,698ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1458872TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column168281752TotalRevenueColumn
Related Or Exempt Function Income164222726RelatedOrExemptFunctionIncome
Unrelated Business Revenue3961899UnrelatedBusinessRevenue
Exclusion-$63,120ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total375694Total
Program Services338125ProgramServices
Management And General37569ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total45654495Total
Program Services41089045ProgramServices
Management And General4565450ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1532121Total
Program Services1378909ProgramServices
Management And General153212ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7868155Total
Program Services7081340ProgramServices
Management And General786815ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3182398Total
Program Services2864158ProgramServices
Management And General318240ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total87263Total
Program Services78537ProgramServices
Management And General8726ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5084Total
Program Services4576ProgramServices
Management And General508ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total28013Total
Program Services25212ProgramServices
Management And General2801ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3666293Total
Program Services3299664ProgramServices
Management And General366629ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total400526Total
Program Services360473ProgramServices
Management And General40053ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total705274Total
Program Services634747ProgramServices
Management And General70527ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3587504Total
Program Services3228754ProgramServices
Management And General358750ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total235001Total
Program Services211501ProgramServices
Management And General23500ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12717Total
Program Services11445ProgramServices
Management And General1272ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2167313Total
Program Services2167313ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6615799Total
Program Services5954219ProgramServices
Management And General661580ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1594635Total
Program Services1435171ProgramServices
Management And General159464ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services40587830365290464058784
Supplies28781884259036962878188
Bad Debt18190016181900160
Equipment Rental31521132836902315211
Repairs14431211298809144312

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1341223Total
Program Services1207101ProgramServices
Management And General134122ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total171214472Total
Program Services156128759ProgramServices
Management And General15085713ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4500BOY
EOY4800EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY19217220BOY
EOY20006909EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2280963BOY
EOY2538596EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY190392BOY
EOY287132EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis103635109LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec65948841LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY36586198BOY
EOY37686268EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8815996BOY
EOY9487193EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9738129BOY
EOY9293940EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY76833398BOY
EOY79304838EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9057473BOY
EOY11732058EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY98460477BOY
EOY101723368EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY107517950BOY
EOY113455426EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-30661808BOY
EOY-34130581EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY-22744BOY
EOY-20007EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-30684552BOY
EOY-34150588EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY76833398BOY
EOY79304838EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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)
Volunteers1Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$16,200DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$11,813OtherActivitiesAmount
Total Lobbying Expenditures IIB28013TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationThe organization paid dues to the Virginia Healthcare and Hospital Association (VHHA) and American Hospital Association (AHA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities for each of these organizations is as follows: These organizations disclosed that 23.07% ($6,856) and 23.76% ($4,957)respectively, of their dues were used for lobbying purposes.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3750384OtherCostOrOtherBasis
Book Value3750384BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis30354217OtherCostOrOtherBasis
Depreciation17500071Depreciation
Book Value12854146BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4112485OtherCostOrOtherBasis
Depreciation1373018Depreciation
Book Value2739467BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis65418023OtherCostOrOtherBasis
Depreciation47075752Depreciation
Book Value18342271BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings37686268TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Goodwill5247764
Inv in Bed Licenses, net of amortization2057699
Organizational Costs496400
Other1492077
FieldValueIRS element (for citing)
Total Book Value Other Assets9293940TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Other Current Liabilities$1,808,425
Due to affiliates$91,787,613
Pension Liability$5,125,758
Deferred Rent$2,204,421
FIN 48 LT Asbestos Liability$797,151
FieldValueIRS element (for citing)
Total Of Amounts101723368TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationSchedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48. As the organization does not conduct a separate audit of its financial statement, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $98,300 and $117,200 of net operating loss carryforwards as of August 31, 2010 and 2009, respectively, which expire in varying periods through 2030 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2010 and 2009. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.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 Expense3463733TotalCommunityBenefitExpense
Net Community Benefit Expense3463733NetCommunityBenefitExpense
Percent Of Total Expense0.02260PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14730135TotalCommunityBenefitExpense
Direct Offsetting Revenue12487401DirectOffsettingRevenue
Net Community Benefit Expense2242734NetCommunityBenefitExpense
Percent Of Total Expense0.01470PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense18193868TotalCommunityBenefitExpense
Direct Offsetting Revenue12487401DirectOffsettingRevenue
Net Community Benefit Expense5706467NetCommunityBenefitExpense
Percent Of Total Expense0.03730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served13547PersonsServed
Total Community Benefit Expense503433TotalCommunityBenefitExpense
Direct Offsetting Revenue300DirectOffsettingRevenue
Net Community Benefit Expense503133NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2031359TotalCommunityBenefitExpense
Direct Offsetting Revenue1014626DirectOffsettingRevenue
Net Community Benefit Expense1016733NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense381211TotalCommunityBenefitExpense
Net Community Benefit Expense381211NetCommunityBenefitExpense
Percent Of Total Expense0.00250PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense137102TotalCommunityBenefitExpense
Net Community Benefit Expense137102NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served13547PersonsServed
Total Community Benefit Expense3053105TotalCommunityBenefitExpense
Direct Offsetting Revenue1014926DirectOffsettingRevenue
Net Community Benefit Expense2038179NetCommunityBenefitExpense
Percent Of Total Expense0.01330PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served13547PersonsServed
Total Community Benefit Expense21246973TotalCommunityBenefitExpense
Direct Offsetting Revenue13502327DirectOffsettingRevenue
Net Community Benefit Expense7744646NetCommunityBenefitExpense
Percent Of Total Expense0.05060PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served457PersonsServed
Total Community Building Expense8702TotalCommunityBuildingExpense
Net Community Building Expense8702NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Persons Served1011PersonsServed
Total Community Building Expense30058TotalCommunityBuildingExpense
Net Community Building Expense30058NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served1143PersonsServed
Total Community Building Expense50859TotalCommunityBuildingExpense
Net Community Building Expense50859NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served2611PersonsServed
Total Community Building Expense89619TotalCommunityBuildingExpense
Net Community Building Expense89619NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,791,003BadDebtExpenseAmount
Amount Reimbursed By Medicare37989122AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare37699586CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall289536MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (6 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Radiology Svcs-Hampton Rds
Radiology Services0.25000
Management Services LLC
Management Services0.20000
Posit Emiss Tomography
Operate PET Scanner0.137500.45000
Peninsula Hospital Svcs
Laundry Services0.13500
VA Health Network Inc
Insurance Networks0.07000
VA Beach Surgery Ctr LLC
Outpatient Surgery0.468800.24500

Form990 Schedule H Part V Form990ScheduleHPartV (13 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursOtherOther
DePaul Medical Center
150 Kingsley LaneNorfolkVA23505XXXX
Bon Secours Health Center VA Beach
828 Healthy WayVirginia BeachVA23462Imaging & Other OP Svcs
DePaul In-Motion Physical Ther - Norfolk
7300 Newport Ave Ste 300NorfolkVA23505Physical, Occupational & Speech Therapy
Bon Secours In-Motion at Hilltop
1817 Laskin Rd Ste 100Virginia BeachVA23454Physical Therapy & Sports Rehab
Hampton Roads OBGYN
100 Kingsley Lane Ste 100NorfolkVA23505Physician Practice
Towne Center Medical Associates
4445 Corporation Lane Ste 100Virginia BeachVA23562Physician Practice
Cardiovascular Specialists
160 Kingsley Lane Ste 100ANorfolkVA23505Physician Practice
Tidewater Surgical Specialists DePaul
160 Kingsley Lane Ste 400NorfolkVA23505Physician Practice
DePaul Medical Associates
100 Kingsley LaneNorfolkVA23505Physician Practice
Bon Secours Medical Associates
828 Healthy Way Ste 220Virginia BeachVA23462Physician Practice
Amelia Medical Associates
855 Kempsville Rd Ste 320NorfolkVA23502Physician Practice
Patient Choice Ghent
957 W 21st St Ste ENorfolkVA23517Physician Practice
Patient Choice Oceana
1232 Perimeter Parkway Ste 101Virginia BeachVA23464Physician Practice

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnPart I, Line 6a: Community benefit information is included in the Bon Secours Hampton Roads Health System newsletter which is published and mailed out three times each year. The report contains a summary of outreach activities, community benefits, uncompensated care, and accomplishments. The newsletters are distributed to approximately 90,000 households.AnnualCommunityBenefitExpln
Costing Method UsedPart 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 non patient 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.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g: DePaul Medical Center provides financial and in-kind support to Park Place Medical Center, a federally qualified health clinic in Norfolk that serves uninsured and underinsured individuals.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: The bad debt expense included in Part IX, line 25 and excluded from the "percent of total expense" calculation is $18,190,016.PercentOfTotalExpenseExpln
Bad Debt FootnotePart 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.BadDebtFootnote
Shortfall As Community BenefitPart 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 non reimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and non reimburseable 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.ShortfallAsCommunityBenefit
Debt Collection PolicyPart 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 FAP account.Specific criteria exist for how much 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 Financial Assistance Program (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 approval. 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.DebtCollectionPolicy
General ExplanationPartnership with Federally Qualified Health Clinic in Norfolk - BSDMC and Park Place Medical Center work together to provide uninsured and underinsured individuals with a medical home and receive a full range of primary care services. BSDMC makes financial and/or in-kind donations to Park Place that includes equipment, services, and cash assistance for patient administration support, clinical staffing, case management, and patient outreach.GeneralExplanation
General ExplanationThe Life Coach model of Care was implemented in March 30, 2007 at Bon Secours DePaul Medical Center. Through partnerships with Park Place Healthcare Medical Center and The Southeastern Tidewater Opportunity Project, Inc. (STOP) organization, the uninsured, underinsured and those without a medical home who present at the Bon Secours DePaul Emergency Department (ED) are referred after treatment for evaluation by the Life Coaches who arrange a follow-up appointment at Park Place Medical Center where the patient receives a medical home with their own a primary care physician. The patient also receives follow-up phone calls from the life coach to educate the patient related to their primary care diagnosis and to offer assistance for any social needs such as emergency assistance or help with obtaining affordable medications. The goal of the Life Coach Model of Care is to develop and implement community partnerships to better serve the economically poor with respect and dignity and to improve access to primary care. In 2010, the DePaul life coaches helped 1000 patients, of those, only 12 patients returned to the emergency department for a non-emergent reason. In the summer, Bon Secours Maryview Medical Center partnered with Catholic Charities to place two life coaches in their emergency room to assist patients who are uninsured and do not have a primary care physician.GeneralExplanation
General ExplanationFaith Community Health Ministries builds on the skills of the registered nurse through additional training in holistic (body, mind and spirit) health services; the faith community nurse partners with the congregational leadership to promote good health by serving as an educator, counselor, referral agent and advocate. Specialized training has also been developed to prepare non-licensed persons to serve in congregational health ministry. Additionally, the Influenza Vaccination Administration program provided 500-750 vaccines for select covenanted partners to host annual vaccine clinics. BSHRHS employs a Director and Coordinator to provide education and support to more than 108 faith communities and 208 registered nurses and lay health promoters.GeneralExplanation
General ExplanationThe Lets Get Real (LGR) Program was created by BSHRHS in response to alarming data revealing an excessively high death rate from heart disease among African Americans in Hampton Roads. LGR is a heart health community outreach and education campaign specifically designed to bring valuable information to African-American women and their families. The goal is to raise awareness and lower risk factors for heart disease through culturally sensitive education, healthy cooking demonstrations, baseline and follow-up health screenings & risk-factor assessments and physical activity with an ethnic flair. Program components are centered on Cooking Light nutrition seminars and Tree of Life family history/genealogy research.GeneralExplanation
Needs AssessmentPart VI, Line 2: Bon Secours Hampton Roads Health System (BSHR) utilizes multiple approaches when assessing community health needs. Typically, BSHR conducts a comprehensive needs assessment every three to five years, looking at the needs for residents of the greater Hampton Roads area, and more specifically for our three hospitals' distinct service areas. Most recently, a comprehensive meta analysis was conducted in partnership with Old Dominion University's School of Community Health Sciences, utilizing national data (Health People 2010, Thomson Reuters Health Status surveys, etc.), state-wide data (infant mortality, etc), local/county data, as well as discussions with leaders of community services organizations such as Consortium for the Immunization on Norfolk's Children (CINCH), Peninsula Institute for Community Health (PICH), Catholic Charities of Eastern Virginia, etc. The compilation identified geographic communities that performed poorly on the majority of health status indicators. Further analysis was then conducted to narrow to some demographic group. As a result, children and adolescents, especially African American, were identified as those with the most health disparity. Combining with the geographic areas of need helped narrow services BSHR could offer to improve the health needs of the communities it serves. Community need assessments are updated using a variety of informational sources including Virginia Health Information (VHI) for state-based performance data, Hammes Company for market and geographic data, Thomson-Reuters Market Expert to retrieve demographic information and trends for the service areas of the various entities within BSHR, patient statistics from our own facilities, etc. While needs may vary by service areas, BSHR always looks for ways to synergize existing services and best practices and deploying them as appropriate to other markets if the identified need is present in another community. This was successfully achieved recently with the Care-a-Van service serving on the Peninsula with plans of expansion to sections of Norfolk and Portsmouth, and the Life Coach program expanding from DePaul to Maryview, thanks to a partnership with Catholic Charities.NeedsAssessment
Patient Education AssistancePart VI, Line 3: BSHRHS is committed to ensuring access to health care services for all. As a health care provider, BSHRHS treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. BSHRHS addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with Medicaid and State Child Health Insurance Program enrollment, and free community-based preventive and primary care services. BSHRHS 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). Potentially eligible patients are referred to the Patient Financial Assistance Department for assistance in completing the documentation required to establish eligibility in, and apply for, government insurance programs or the FAP. 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).For uninsured and underinsured patients with annual family incomes greater than 200% of the Adjusted FPG, the FAP offers 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 communitys relative cost of living. All patients are eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. This patient financial assistance policy is communicated to patients verbally upon registration, visible postings of the policy and brochures in common areas throughout the hospital. The information is also made available in writing to all patients and is promoted on the BSHRHS website at http://bonsecourshamptonroads.com/about/payment_assistance.html.PatientEducationAssistance
Community InformationPart VI, Line 4: Bon Secours DePaul Medical Center's primary service area has a population of 364,569 in 2010. The overall population is expected to decline by 0.9 percent to a total of 361,289 by 2015. Demographic data indicates that 52.3 percent of the population is white, 34.5 percent black, and a Hispanic population of 18,909, or 5.2 percent. The largest ethnic population growth is expected to be among the Hispanic population which will increase by 16.6% percent by 2015. [Data Source: Census data for the state of Virginia for 1990. New projections will be released later this year.] Among age cohorts, the largest growth is expected to be in the 55 - 64 age group, which is expected to increase by 4,909 people, or 11.9 percent of the population by 2015. [Data Source: 2010 Claritas, 2010 Thomson Reuters/Market Expert]The median household income in 2010 was $52,285, compared to the Virginia average of $61,210 (CY 2008) and the national average of $52,029 (CY 2008). 20.17 percent of the population has a household income of less than $25,000, compared to the Virginia average of 17.47 percent and the national average of 22.28 percent. [Data Sources: Census and 2010 Claritas/SiteReports.com]Health Conditions - the most prevalent health conditions impacting the primary service area are hypertension, pain/aching of joints and low back pain. The incidence rate for hypertension is 21.32 per 1,000 population, which is 0.8 percent less than the state wide rate of 21.48 per 1,000. As for pain/aching of joints, the incidence rate is 21.07 per 1,000 which is 1,221.19 per 100,000 less than the state wide rate of 22.29. [Data Source: 2010 Thomson Reuters/Market Expert.] In addition, the top five DRGs based on actual inpatient discharges from the defined service area are for major joint replacement, psychoses, chest pain, severe sepsis, and heart failure. [Data Source: 2009 & 2010 VA inpatient data.] For minority populations, incidence and death rates are even greater. For example, "In 2006 the death rates per 100,000 population from high blood pressure were 15.6 for white males, 51.1 for black males, 14.3 for white females and 37.7 for black females." [Data Source: American Heart Association.]In addition, the service area incidence for these diseases is impacted by risk factors, among them smoking and being overweight. 18.1 percent of residents living in Virginia smoke, and 31.7 percent of residents living in eastern Virginia are considered obese.In fiscal year 2010, Bon Secours DePaul Medical Center cared for 6,938 inpatients, and treated 45,186 patients through the Emergency Department. The Emergency Department is open 24 hours a day and available to all persons regardless of ability to pay. Bon Secours DePaul Medical Center participates in Medicare, Medicaid, CHAMPUS, and other government sponsored health care programs including the state SCHIP/FAMIS program for children.CommunityInformation
Community Building ActivitiesPart VI, Line 5: BSHRHS is working to engage and empower the members of the East Ocean View neighborhood to support them in improving their quality of life and holistic health. East Ocean View has historically been one of the roughest neighborhoods in the community. Among the 6,000 residents, more than 25% of the households are at or below the poverty level and over 20% are single parent households. Family violence, gangs, addictions, housing affordability, access to healthcare, and a lack of educational opportunities affect the health of the individuals living in the neighborhood. In FY 10, the BSHRHS Administrative Director of Building Healthy Communities worked to coordinate efforts and to unite the community. The Director has assessed the needs of the community by conducting resident interviews, and community forums. Through this process, working with East Ocean View residents, businesses and faith communities along with other interested organizations, several priority improvement initiatives have been identified. The local food pantry has been renovated and expanded. BSHRHS and the City implemented an Earn-and-Learn program where BSHRHS provided employment to four teens and the City paid their wages via stimulus money. BSHRHS and the City are also pursuing the development of an Intel Computer Clubhouse to provide computer-training and technology opportunities for the community. Habitat for Humanity has been approved to build a Habitat home in the neighborhood with a tentative build time the Summer of 2011. Habitat and the community are considering opportunities for a building blitz in East Ocean View in 2011 where 10-20 homes would be built in improved the neighborhood. As a start to the desired community beautification efforts, a BSHRHS Board member donated over 1,200 bushes that were planted by residents and BSHRHS volunteers last summer. In addition, the groundwork has been laid for the BSHRHS to bring the Care-A-Van program to provide primary care to the uninsured and underinsured of the community. On a longer term basis, discussions are underway with a local organization who is interested in building a health center in the neighborhood. Talks are underway for the development of a playground and park system as well.CommunityBuildingActivities
Other InformationPart VI, Line 6: BSHRHS operates an emergency room at BSMMC, the Bon Secours Health Center at Harbour View, BSDMC, and MIH that are open 24 hours per day, 7 days per week. In accordance with the bylaws of each of the medical staffs, BSHRHS has an open medical staff with privileges available to all qualified physicians in the region. Board of Directors - The BSHRHS Board of Directors governs facilities located on the Southside of the service area. The BSHRHS Board of Directors is comprised of 17 members. One member, the president of the board, is appointed by Bon Secours Ministries, the Catholic Church sponsor of the health system. The board membership represent expertise in various areas, including finance, real estate, clinical quality, human resources, community outreach, management, representatives from BSHSI and administration. BSDMC's Board of Directors is comprised of 15 members. Three members are appointed by BSHSI, two are members appointed by the Bernardine Franciscan Sisters, and the others represent expertise in various areas, including finance, real estate, clinical quality, human resources, management, representatives from BSHSI and administration. BSHRHS participates in select investigational research studies by external IRB's that are in compliance with the Catholic Health Care Ethical and Religious Directives. Training and Education of Health Care Professionals is provided through regular CME teaching sessions are provided and open to the entire medical staff. BSHRHS hospitals are training sites for Eastern Virginia Medical School residents in Family Practice. In addition, training for residents specializing in Internal Medicine, Diagnostic Radiology, OB GYN (GYN Surgery), Surgery, Ophthalmology and Emergency Medicine are provided in collaboration with area universities without reimbursement to BSHRHS. BSHRHS sponsors a Certified Nurse Aide training program at BSDMC. Nursing students from area schools as well as North Carolina are provided clinical experience as are EVMS/ODU Physician Assistant students, Surgical Assistant students, Radiology and Respiratory Therapy Students. Pharmacy students from Hampton University also receive clinical experiences. Our Wound and Skin Nurse precepts RN's going through college sponsored programs to qualify to sit for the National exams. All BSHRHS facilities participate in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs to also include the Medallion (Medicaid HMO), Medicare Advantage, and the State and Local Hospitalization (SLH) programs.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: Bon Secours Health System, Inc., a Maryland nonprofit, non stock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, non stock 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. Activities directly associated with this purpose are considered operating activities. Operating activities also include other incidental services that are closely related to healthcare.AffiliatedHealthCareSystem
Reports Filed With StatesVAReportsFiledWithStates

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 Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy J Davis
0536658066588002145101101850191770135335100
Michael Kerner
0467646029094701820880994350270340106715000
Daniel Duggan
02644900141461018073044178018858048706000
Gregory Simia
0287470069599047006024464027093045563200
David Setchel
17839903305204860101980261470248282000
James Mosure MD
394972000979000150720411023000
Harikrishanan Damodarannair MD
336340000298000272810363919000
Kochicheril N Moni MD
313729000417003190172230335441000
Ray Marling MD
25703103000001344000119110300286000
Nena G Aceveda
21233701962409003233069400242224000
Edward Boyer
042886504166830928690818809129095573400
Richard Hanson
04079900335679029077080844027399088098900
Joseph Buccheit
0224034047590082510028800015975039890900

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 4b:Bon Secours DePaul Medical Center, Inc. participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting deposits are made into this plan.
Part IIIPart I, Line 3: Bon Secours Health System, Inc., a related organization of Bon Secours DePaul Medical Center, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation committee Independent compensation consultant Written employment contract Compensation survey or study Approval by the board or compensation committeeSupplemental Information

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Meridian GroupBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipDeborah Stearn's (board member) husband is a VP with the Meridian GroupRelationship
Amount Of Transaction250000AmountOfTransaction
Description Of TransactionIndependent contractor for advertising servicesDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Hampton Roads Health System, Inc., which in turn is the sole member of Bon Secours DePaul Medical Center, Inc.
Form 990, Part VI, Section A, line 7aThe Board of Directors of Bon Secours DePaul Medical Center, Inc. is appointed by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bAny decision which is subject to a reserved power is subject to approval by members.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by Bon Secours DePaul Medical Center, Inc.'s audit and compliance board committee and providing the form to the Bon Secours DePaul Medical Center, Inc.'s board of directors to allow for a thorough review by both before the filing date of July 15, 2011. Bon Secours DePaul Medical Center's audit and compliance board committee and Bon Secours DePaul Medical Center, Inc.'s board of directors will review the Form 990 and ask any additional questions regarding the Form 990 before the return is filed July 15, 2011.
Form 990, Part VI, Section B, line 12cBon Secours DePaul Medical Center, Inc. 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 Bon Secours DePaul Medical Center, Inc. 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 participates 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). Part VI, Section B, Line 14: Document Retention and Destruction Policy While Bon Secours Health System, Inc. does not have a written organization-wide document retention and destruction policy, individual department policies and practices are in place to ensure that each department of the organization maintains their documentation in compliance with state and federal requirements. In addition, any areas responsible for medical records have department policies in compliance with Medicare and HIPAA requirements. An organization-wide policy is currently in place for fiscal year ending August 31, 2011.
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of Bon Secours DePaul Medical Center, Inc. The compensation committee consists of a group of independent board members and engages external counsel to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS's rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section b , Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of Bon Secours DePaul Medical Center were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19Bon Secours DePaul Medical Center, Inc 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. Timothy J. Davis' compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as Executive Vice President and Chief Administrative Officer of Bon Secours Health System, Inc. Michael Kerner's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Executive Officer of Bon Secours Hampton Roads Health System. Greg Simia's compensation is paid by Maryview Hospital, a related organization. The compensation he receives is for his role as the Chief Financial Officer of Bon Secours Hampton Roads Health System. Daniel Duggan's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Executive Vice President of DePaul Medical Center. Sr. Pat Heath and Sr. Anne Lutz do not receive payroll distributions as they have taken vows of poverty.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Mary Immaculate Nursing Center
7007 Harbour View Blvd Ste 108SuffolkVA23435541516476Nursing Care CenterVA501(c)(3)Line 9: 509(a)(2)N/A
Mary Immaculate Hospital Inc
7007 Harbour View Blvd Ste 108SuffolkVA23435540548200HealthcareVA501(c)(3)Line 3: 170(b)(1)(A)N/A
Bon Secours Hampton Roads Health System Inc
5818 Harborview BlvdSuffolkVA23435521538513Local System Parent Org.VA501(c)(3)Line 11, Type II: 50N/A
Bon Secours Maryview Nursing Care Center
7007 Harbour View Blvd Ste 108SuffolkVA23435521578169Nursing Care CenterVA501(c)(3)Line 9: 509(a)(2)N/A
Maryview Hospital
7007 Harbour View Blvd Ste 108SuffolkVA23435540506463HealthcareVA501(c)(3)Line 3: 170(b)(1)(A)N/A
Bayley Properties
150 Kingsley LaneNorfolkVA23505541424748RentalVA501(c)(2)N/AN/A
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)Line 11, Type II: 50N/A
Bon Secours DePaul Health Foundation
7007 Harbour View Blvd Ste 108SuffolkVA23435541843876FundraisingVA501(c)(3)Line 11, Type III-FIN/A
Bon Secours Maryview Foundation
7007 Harbour View Blvd Ste 108SuffolkVA23435521694731FundraisingVA501(c)(3)Line 11, Type III-FIN/A
Mary Immaculate Foundation
150 Kingsley LaneNorfolkVA23505311644734FundraisingVA501(c)(3)Line 11, Type III-FIN/A

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Province Place of Maryview LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541842697Assisted LivingVAN/ARelated00
Province Place of DePaul LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541950880Assisted LivingVAN/ARelated00
Western Tidewater Diagnostic Imaging LLC
c/o Roberts Dean PLC 150 Bousch StNorfolkVA23510383655545HealthcareVAN/AExcluded-Investment00

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityPercentage OwnershipPercentageOwnership
Professional Health Care Mgmt Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541241031AdministrativeVAN/AC
Tidewater Diversified Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541431826PharmacyVAN/AC1.00000
OSF Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541369919RentalVAN/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 Org1LoansOrGuaranteesFromOtherOrg
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 Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
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 Line1NoneBusinessNameLine1