2019-05-11T10:02:12-05:00 2018-06-30 990 2017-07-01 592292041 St Vincent's Ambulatory Care Inc STVI 3147338000 4205 Belfort Road 4020 Jacksonville FL 32216 Tonya Mershon Tax Officer 2019-05-11 2017 2019-02-21 02:37:17Z Thomas J VanOsdol 1 SHIRCLIFF WAY JACKSONVILLE FL 32204 92052001 false 0928 X N/A X 1983 FL To improve the health and well-being of all people in the communities we serve. 12 0 1012 9 0 4118 1115702 1033600 67220952 90814293 -8267 16238 3469133 187870 71797520 92052001 0 0 0 93600796 112961418 0 0 0 26283037 38570962 119883833 151532380 -48086313 -59480379 39782175 66816786 35288015 37144250 4494160 29672536 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 142769886 0 90814293 ST. VINCENT'S AMBULATORY CARE, INC. PROVIDES QUALITY OUT-PATIENT CARE IN THE FIELDS OF NEUROSCIENCE, CARDIOLOGY, OBSTETRICS/GYNECOLOGY, AND GENERAL SURGERY TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. ST. VINCENT'S AMBULATORY CARE, INC. HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE UNINSURED AND THE UNDERSERVED. 142769886 true true false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 108 0 true 1012 true false false false false false false true false false false X 12 0 false false false false true true true true true false false false true true true true true false false false X SARA OBRIEN 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 WILLIAM CODY MD CHAIRMAN 1.0 49.0 X X 0 115142 27788 SONYA J DOMINGUEZ MD VICE CHAIRMAN 1.0 54.0 X X 0 248981 44620 ESTRELLITA REDMON MD PRESIDENT & CMO 30.0 25.0 X X 0 484761 34679 THOMAS J VANOSDOL CEO, MINISTRY MARKET 0.0 50.0 X X 0 926860 45050 SAMER GARAS MD MEMBER & PHYSICIAN 55.0 0 X 1522955 0 49094 FRANK H GILBERSTADT MD MEMBER 1.0 54.0 X 0 722234 40598 WILLIAM R MAYHER MEMBER (START 6/2018) 7.0 48.0 X 0 233523 39119 WESLEY MILLS MD MEMBER & PHYSICIAN 55.0 0 X 350831 0 25347 ASHUTOSH PRADHAN MD MEMBER & PHYSICIAN 55.0 0 X 1232070 0 54889 KYLE E SANDERS MEMBER & COO (END 2/2018) 30.0 25.0 X 0 506917 40733 MARKUS SONNTAG MD MEMBER & PHYSICIAN 55.0 0 X 225996 0 41550 MAYMON THINT MD MEMBER & PHYSICIAN 55.0 0 X 283069 0 40021 DEBORAH WEYER MD MEMBER & PHYSICIAN 55.0 0 X 222164 0 31322 C SUSAN CORNEJO CFO, GULF COAST MINISTRY MARKET (START 6/2018) 7.0 43.0 X 0 703672 37265 PAMELA M HESS CFO, JACKSONVILLE MINISTRY MARKET (END 6/2018) 7.0 48.0 X 0 688053 35645 MICHELLE ADAMOLEKUN CHRO, MINISTRY MARKET (END 2/2018) 7.0 48.0 X 0 429273 36215 TERESA LOFTIS CMIO, MINISTRY MARKET 7.0 48.0 X 0 311099 39733 JOHN D MEYER III CSMO, MINISTRY MARKET 7.0 48.0 X 0 471398 26977 JEFFREY H MIDDLEBROOK CLO, REGIONAL 5.0 50.0 X 0 537561 35064 ALI CHAHLAVI MD PHYSICIAN 54.0 1.0 X 1876411 0 66422 ERIC GABRIEL MD PHYSICIAN 55.0 0 X 1504397 0 61104 MARIANO B MIKULIC MD PHYSICIAN 55.0 0 X 1411883 0 51494 ERIC W NOTTMEIER MD PHYSICIAN 55.0 0 X 1096041 0 53528 SAUMIL R OZA MD PHYSICIAN 55.0 0 X 1264168 0 45343 JOHN J CASSANI FORMER KEY EMPLOYEE (END 3/2016) 0.0 0.0 X 0 110840 2128 ABDALLAH KAFROUNI MD FORMER KEY EMPLOYEE (END 6/2017) 55.0 0 X 600254 0 52565 WILLIE PENNICK MD FORMER KEY EMPLOYEE (END 6/2017) 55.0 0 X 279153 0 40173 MICHAEL H SCHATZLEIN MD FORMER OFFICER (END 12/2016) 0.0 0.0 X 0 1051835 11195 11869392 7542150 1109661 169 true true false BRASFIELD & GORRIE LLC 3021 7TH AVE S BIRMINGHAM AL 35233 CONSTRUCTION SERVICES 4289504 MAYO CLINIC 200 1ST STREET SW ROCHESTER MN 55905 MEDICAL SERVICES 854546 GRESHAM SMITH AND PARTNERS PO BOX 440029 NASHVILLE TN 37244 CONSTRUCTION SERVICES 612071 NEWVENTURE OF JACKSONVILLE INC 8130 BAYMEADOWS CIRCLE W 306 JACKSONVILLE FL 32256 COMMERCIAL CLEANING SERVICES 213552 THOMAS A TOMLIN MD 113 LAKE JULIA DR N PONTE VEDRA BEACH FL 320823517 PHYSICIAN SERVICES 193136 9 X 1033600 1033600 Net Patient Service Revenue 621990 86772020 86772020 Services to Affiliates 561000 1861506 1861506 Incentives 900099 1061957 1061957 Mobile Health Outreach 621990 346162 346162 Shared Savings Revenue 900099 446623 446623 326025 326025 0 0 90814293 16238 16238 32224 32224 0 32224 32224 0 0 155646 0 0 155646 155646 92052001 90814293 0 204108 4079308 4079308 95949816 92820056 3129760 2913641 2819789 93852 5395074 5220730 174344 4623579 4478563 145016 -4886 -4886 994 994 114270 82005 32265 0 19474 19404 70 649281 512673 136608 55835 53565 2270 6497094 6497233 -139 329312 291089 38223 190565 186864 3701 1100221 1534103 -433882 2214979 1250 2213729 Medical Supplies 16561895 16447554 114341 Purchased Services 8151535 6102249 2049286 Corporate Allocation 1097665 1097665 Minor Equipment 518941 496609 22332 1073787 1131728 -57941 0 151532380 142769886 8762494 0 6993506 29676618 5486761 6781562 0 0 0 0 453086 591465 217262 297256 34643461 9081629 15335106 25561832 0 0 1806952 1201488 9489502 2706565 39782175 66816786 11698903 17111253 966610 908844 0 0 22622502 19124153 35288015 37144250 X 4494140 29972536 20 -300000 4494160 29672536 39782175 66816786 X -59480379 -760768 85419523 X false true X true false X 1161998 1063420 1138466 1115702 1033600 5513186 46281581 68699549 71656981 70607241 90814293 348059645 0 0 0 47443579 69762969 72795447 71722943 91847893 353572831 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353572831 436579 168771 70433 372040 48462 1096285 0 436579 168771 70433 372040 48462 1096285 0 178865 149292 231122 151810 155646 866735 48059023 70081032 73097002 72246793 92052001 355535851 0.9945 0.9921 0.0031 0.0045 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - MISCELLANEOUS INCOME / MEDICAL RECORDS, COLUMN A - 178865.0, COLUMN B - 149292.0, COLUMN C - 231122.0, COLUMN D - 151810.0, COLUMN E - 155646.0, COLUMN F - 866735.0; 543029 543029 10642960 3186029 7456931 3026820 1699277 1327543 6585327 4116422 2468905 13845325 79901 13765424 25561832 Deposit Liability 3692 Other Taxes Payable Due to Affiliates 18745583 Deferred Compensation/Retirement/Pension Liability Savings Plan Liability Recovery Tail Liability 327254 Accrued Tax Liability 47624 19124153 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true false false false false false false false SONYA J DOMINGUEZ MD VICE CHAIRMAN 0 240984 0 7260 0 736 0 15431 0 29189 0 293601 0 0 ESTRELLITA REDMON MD PRESIDENT & CMO 0 394193 0 51516 0 39053 0 13500 0 21179 0 519440 0 0 THOMAS J VANOSDOL CEO, MINISTRY MARKET 0 555860 0 301615 0 69385 0 17550 0 27500 0 971910 0 0 SAMER GARAS MD MEMBER & PHYSICIAN 487404 0 1033840 0 1710 0 16200 0 32894 0 1572049 0 0 0 FRANK H GILBERSTADT MD MEMBER 0 431924 0 233148 0 57162 0 13500 0 27098 0 762832 0 0 WILLIAM R MAYHER MEMBER (START 6/2018) 0 189345 0 24804 0 19374 0 13207 0 25912 0 272642 0 0 WESLEY MILLS MD MEMBER & PHYSICIAN 257958 0 92059 0 814 0 11762 0 13585 0 376179 0 0 0 ASHUTOSH PRADHAN MD MEMBER & PHYSICIAN 1062539 0 168391 0 1140 0 14850 0 40039 0 1286958 0 0 0 KYLE E SANDERS MEMBER & COO (END 2/2018) 0 377949 0 48972 0 79996 0 14850 0 25883 0 547650 0 0 MARKUS SONNTAG MD MEMBER & PHYSICIAN 201033 0 24507 0 456 0 12757 0 28793 0 267547 0 0 0 MAYMON THINT MD MEMBER & PHYSICIAN 210304 0 70764 0 2001 0 12950 0 27071 0 323090 0 0 0 DEBORAH WEYER MD MEMBER & PHYSICIAN 214210 0 5998 0 1956 0 10140 0 21181 0 253485 0 0 0 MICHAEL H SCHATZLEIN MD FORMER OFFICER (END 12/2016) 0 37007 0 0 0 1014828 0 1704 0 9491 0 1063029 0 0 C SUSAN CORNEJO CFO, GULF COAST MINISTRY MARKET (START 6/2018) 0 401722 0 248229 0 53721 0 16200 0 21065 0 740937 0 0 PAMELA M HESS CFO, JACKSONVILLE MINISTRY MARKET (END 6/2018) 0 325338 0 104808 0 257907 0 16200 0 19445 0 723699 0 0 JOHN J CASSANI FORMER KEY EMPLOYEE (END 3/2016) 0 2186 0 0 0 108655 0 0 0 2128 0 112968 0 0 ABDALLAH KAFROUNI MD FORMER KEY EMPLOYEE (END 6/2017) 529482 0 69632 0 1140 0 11458 0 41107 0 652819 0 0 0 WILLIE PENNICK MD FORMER KEY EMPLOYEE (END 6/2017) 244449 0 32343 0 2361 0 12313 0 27860 0 319326 0 0 0 MICHELLE ADAMOLEKUN CHRO, MINISTRY MARKET (END 2/2018) 0 248838 0 141041 0 39395 0 16171 0 20045 0 465489 0 0 TERESA LOFTIS CMIO, MINISTRY MARKET 0 201566 0 94202 0 15331 0 15419 0 24315 0 350833 0 0 JOHN D MEYER III CSMO, MINISTRY MARKET 0 263158 0 166595 0 41645 0 17220 0 9756 0 498375 0 0 JEFFREY H MIDDLEBROOK CLO, REGIONAL 0 333538 0 138824 0 65198 0 9658 0 25406 0 572625 0 0 ALI CHAHLAVI MD PHYSICIAN 1943152 0 -68450 0 1710 0 14842 0 51580 0 1942834 0 0 0 ERIC GABRIEL MD PHYSICIAN 1408368 0 93407 0 2622 0 14850 0 46254 0 1565501 0 0 0 MARIANO B MIKULIC MD PHYSICIAN 490972 0 916009 0 4902 0 16200 0 35294 0 1463377 0 0 0 ERIC W NOTTMEIER MD PHYSICIAN 1032702 0 61630 0 1710 0 13500 0 40028 0 1149569 0 0 0 SAUMIL R OZA MD PHYSICIAN 507591 0 755437 0 1140 0 13500 0 31843 0 1309510 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of St. Vincent's Ambulatory Care, Inc., uses the following to establish the compensation of the organization's President & CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: John J Cassani - $105,134 Michael H Schatzlein, MD - $961,539 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No following individuals received payment from the supplemental nonqualified retirement plan in the current year. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the Organization's President & CEO, the process performed by Ascension Health, a related organization of St. Vincent's Ambulatory Care, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the President & CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the Committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY ASCENSION MEDICAL GROUP, LLC, A RELATED ORGANIZATION OF ST. VINCENT'S AMBULATORY CARE, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE ST. VINCENT'S HEALTH SYSTEM, INC. EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders ST. VINCENT'S AMBULATORY CARE, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION MEDICAL GROUP, LLC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ST. VINCENT'S AMBULATORY CARE, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION MEDICAL GROUP, LLC WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. VINCENT'S AMBULATORY CARE, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. VINCENT'S AMBULATORY CARE, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ASCENSION MEDICAL GROUP, LLC. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part VII, Section A Related Entities The organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting. Form 990, Part VIII, Line 2f Other Program Service Revenue Rental Income from Affiliates - Total Revenue: 326025, Related or Exempt Function Revenue: 326025, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Escheatment Revenue - Total Revenue: 1050, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1050; Late Penalty Fees - Total Revenue: 77, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 77; Miscellaneous Revenue - Total Revenue: 154519, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 154519; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfer with Alpha Fund - 85719543; Change in Value of Interest in St. Vincent's Foundation - -300020; Form 990, Part XII, Line 2b audit of financial statements The activity of St. Vincent's Ambulatory Care, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Vincent's Ambulatory Care, Inc. is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Vincent's Ambulatory Care, Inc. Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant St. Vincent's Ambulatory Care, Inc. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false false false false false false false false false false false false false false false false false false false false