ST MARYS WARRICK HOSPITAL INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ST MARYS WARRICK HOSPITAL INC (EIN 35-1343019)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-13
IRS object ID
201941339349307909
Schema version
2017v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-13T19:18:34-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351343019EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST MARYS WARRICK HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTMABusinessNameControlTxt
Phone3147338000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11116 MILLIS AVENUEAddressLine1Txt
CityBOONVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTonya MershonPersonNm
Person TitleTax OfficerPersonTitleTxt
Signature2019-05-13SignatureDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ST VINCENT WARRICKBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1DAN PARODBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11116 MILLIS AVENUEAddressLine1Txt
CityBOONVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,150,327GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stvincent.org/Locations/Hospitals/WarrickWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1971FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTo improve the health and well-being of all people in the communities we serve.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee157TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$352,241TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$57,158NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,691PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$15,339,345PYProgramServiceRevenueAmt
CY Program Service Revenue$16,053,137CYProgramServiceRevenueAmt
PY Investment Income$148PYInvestmentIncomeAmt
CY Investment Income-$17,693CYInvestmentIncomeAmt
PY Other Revenue$124,185PYOtherRevenueAmt
CY Other Revenue$114,883CYOtherRevenueAmt
PY Total Revenue$15,469,369PYTotalRevenueAmt
CY Total Revenue$16,150,327CYTotalRevenueAmt
PY Grants And Similar Paid$561PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,640CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,990,605PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,109,701CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,354,255PYOtherExpensesAmt
CY Other Expenses$10,946,010CYOtherExpensesAmt
PY Total Expenses$16,345,421PYTotalExpensesAmt
CY Total Expenses$18,066,351CYTotalExpensesAmt
PY Revenues Less Expenses-$876,052PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,916,024CYRevenuesLessExpensesAmt
Total Assets BOY$14,028,874TotalAssetsBOYAmt
Total Assets EOY$8,642,818TotalAssetsEOYAmt
Total Liabilities BOY$13,412,448TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,940,394TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$616,426NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,297,576NetAssetsOrFundBalancesEOYAmt
MissionOur 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,235,231ExpenseAmt
Grant$10,640GrantAmt
Revenue$15,708,936RevenueAmt
DescSt. Mary's Warrick Hospital, Inc. is a 35-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, St. Mary's Warrick Hospital, Inc. treated 545 adults and children for a total of 6,483 patient days of service. The hospital also provided services for 23,975 outpatient visits, which included 321 outpatient surgeries and 6,229 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions.Desc
Total Program Service Expenses$11,235,231TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee157EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SARA OBRIENBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3147338070PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111775 BORMAN DRIVEAddressLine1Txt
CityMARYLAND HEIGHTSCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63146ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DANIEL A PAROD
CEO/PRESIDENT/EX-OFFICIO1.049.0Yes (X)Yes (X)$0$546,663$49,395
JAMES SANDGREN
CHAIR1.02.0Yes (X)Yes (X)$0$0$0
SALLY RIDEOUT
VICE CHAIR1.02.0Yes (X)Yes (X)$0$0$0
RITA EYKAMP
SECRETARY/TREASURER1.02.0Yes (X)Yes (X)$0$0$0
NADINE COUDRET
DIRECTOR1.02.0Yes (X)$0$0$0
E LYNN JOHNSON
DIRECTOR1.02.0Yes (X)$0$0$0
SISTER SHARON RICHARDT
DIRECTOR1.02.0Yes (X)$0$0$0
KARL W SASH MD
DIRECTOR1.049.0Yes (X)$0$647,462$51,828
BRIAN SCHYMIK MD
DIRECTOR1.02.0Yes (X)$0$0$0
LAURENCE STEENBERG
DIRECTOR1.02.0Yes (X)$0$0$0
JEFFERY WOLF
DIRECTOR1.02.0Yes (X)$0$0$0
MARK L MARCHINO
EXECUTIVE DIRECTOR, WARRICK HOSPITAL40.00.0$187,663$2,851$33,987Yes (X)
WILLIAM BRYANT
CHIEF NURSING OFFICER40.00$103,936$0$29,239Yes (X)
LISA MILLER
DIRECTOR OF NURSING40.00$102,622$0$12,010Yes (X)
JOHN L SCHELLHASE
REGISTERED NURSE40.00$140,443$0$16,432Yes (X)
LINDA S SEILER
REGISTERED NURSE40.00$100,071$0$15,796Yes (X)
DENNIS KEITH JEWELL
FORMER OFFICER (END 2/2017)0.00.0$0$193,326$4,949Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$634,735TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,390,302TotReportableCompRltdOrgAmt
Total Other Compensation$213,635TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HORIZON MENTAL HEALTH MANAGEMENT
PO BOX 840839DALLASTX75284PHYSICIAN SERVICES$688,738
KENNETH R PARKER MD
2222 HUFFMAN RDBOONVILLEIN47601PHYSICIAN SERVICES$268,400
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Service Revenue621990$15,947,895$15,603,694$344,201
Rental Income from Affiliates531120$106,243$106,243
Lab Services621500$80$80
Income from Joint Ventures900099-$1,081-$1,081

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$16,053,137TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$17,704TotalRevenueColumnAmt
Exclusion-$17,704ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$36,458RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$36,458RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,458TotalRevenueColumnAmt
Exclusion$36,458ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$11OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$11OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$11TotalRevenueColumnAmt
Exclusion$11ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Cafeteria/Vending Revenue722514$48,101$48,101
Fitness Club Revenue713940$20,093$20,093
Housekeeping561720$8,040$8,040

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,191TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,191ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$78,425OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,150,327TotalRevenueColumnAmt
Related Or Exempt Func Income$15,708,936RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$352,241UnrelatedBusinessRevenueAmt
Exclusion$89,150ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,640TotalAmt
Program Services$10,640ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$469,457TotalAmt
Program Services$402,794ProgramServicesAmt
Management And General$66,663ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,211,324TotalAmt
Program Services$4,471,391ProgramServicesAmt
Management And General$739,933ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$204,770TotalAmt
Program Services$175,696ProgramServicesAmt
Management And General$29,074ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$829,078TotalAmt
Program Services$711,361ProgramServicesAmt
Management And General$117,717ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$395,072TotalAmt
Program Services$338,977ProgramServicesAmt
Management And General$56,095ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$283,727TotalAmt
Program Services$283,727ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$797TotalAmt
Management And General$797ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$583TotalAmt
Management And General$583ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,756,418TotalAmt
Program Services$1,698,200ProgramServicesAmt
Management And General$58,218ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$639TotalAmt
Management And General$639ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$35,215TotalAmt
Program Services$13,655ProgramServicesAmt
Management And General$21,560ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,646TotalAmt
Program Services$2,646ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$393,785TotalAmt
Program Services$2,750ProgramServicesAmt
Management And General$391,035ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,375TotalAmt
Program Services$4,479ProgramServicesAmt
Management And General$2,896ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,527TotalAmt
Program Services$2,499ProgramServicesAmt
Management And General$28ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$154,673TotalAmt
Management And General$154,673ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$567,877TotalAmt
Program Services$171,223ProgramServicesAmt
Management And General$396,654ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$47,770TotalAmt
Management And General$47,770ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Purchased Services$3,217,638$1,143,447$2,074,191
Management Fee to Affiliate$1,589,098$1,589,098
Corporate Expense$979,495$979,495
Provider Tax$933,597$933,597

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$972,150TotalAmt
Program Services$868,149ProgramServicesAmt
Management And General$104,001ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,066,351TotalAmt
Program Services$11,235,231ProgramServicesAmt
Management And General$6,831,120ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$548EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,751,084BOYAmt
EOY$320,309EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,590,946BOYAmt
EOY$3,019,059EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$157,363BOYAmt
EOY$173,646EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$14,341BOYAmt
EOY$14,341EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,497,746LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,410,304LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,875,263BOYAmt
EOY$4,087,442EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$19,895BOYAmt
EOY$18,814EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$139,231BOYAmt
EOY$34,287EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,480,751BOYAmt
EOY$974,372EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,028,874BOYAmt
EOY$8,642,818EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,444,899BOYAmt
EOY$1,438,407EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,967,549BOYAmt
EOY$8,501,987EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,412,448BOYAmt
EOY$9,940,394EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$616,426BOYAmt
EOY-$1,297,576EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$616,426BOYAmt
EOY-$1,297,576EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,028,874BOYAmt
EOY$8,642,818EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,916,024ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$2,022OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$583OtherActivitiesAmt
Total Lobbying Expenditures$583TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYLobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Mary's Warrick Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYLobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Mary's Warrick Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$181,810OtherCostOrOtherBasisAmt
Book Value$181,810BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,922,929OtherCostOrOtherBasisAmt
Depreciation$10,913,260DepreciationAmt
Book Value$3,009,669BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,267OtherCostOrOtherBasisAmt
Depreciation$14,267DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,691,726OtherCostOrOtherBasisAmt
Depreciation$5,219,785DepreciationAmt
Book Value$471,941BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$687,014OtherCostOrOtherBasisAmt
Depreciation$262,992DepreciationAmt
Book Value$424,022BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,087,442TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
PHYSICIAN GUARANTEE
Total Deferred Compensation Asset
Miscellaneous Current Assets$155,551
Due from Affiliates$587,456
Other Receivables$221,207
Estimated 3rd Party Payor Settlements$10,158
FieldValueIRS element (for citing)
Total Book Value Other Assets$974,372TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)

DescDescAmtAmt
DEFERRED COMPENSATION
PHYSICIAN GUARANTEE
PENSION AND POSTRETIREMENT LIABILITY
AH SAVINGS PLAN LIABILITY
Due to Affiliates$2,512,861
INTERCOMPANY PAYABLE TO ST. MARY'S HEALTH, INC.$514,124
Estimated 3rd Party Payor Settlement$1,804,728
Recovery Tail Liability$210,000
Accrued Tax Liability$327
Debt with Ascension Health Alliance$3,459,947
FieldValueIRS element (for citing)
Total Liability$8,501,987TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationTHE 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.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,201,098TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,201,098NetCommunityBenefitExpnsAmt
Total Expense0.0665TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,808,161TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$780,208DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,027,953NetCommunityBenefitExpnsAmt
Total Expense0.1676TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$5,009,259TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$780,208DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,229,051NetCommunityBenefitExpnsAmt
Total Expense0.2341TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs13ActivitiesOrProgramsCnt
Persons Served878PersonsServedCnt
Total Community Benefit Expns$20,933TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$20,933NetCommunityBenefitExpnsAmt
Total Expense0.0012TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served1924PersonsServedCnt
Total Community Benefit Expns$8,812TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,812NetCommunityBenefitExpnsAmt
Total Expense0.0005TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs17ActivitiesOrProgramsCnt
Persons Served2802PersonsServedCnt
Total Community Benefit Expns$29,745TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$29,745NetCommunityBenefitExpnsAmt
Total Expense0.0016TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs17ActivitiesOrProgramsCnt
Persons Served2802PersonsServedCnt
Total Community Benefit Expns$5,039,004TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$780,208DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,258,796NetCommunityBenefitExpnsAmt
Total Expense0.2357TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served120PersonsServedCnt
Total Community Benefit Expns$1,414TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,414NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served977PersonsServedCnt
Total Community Benefit Expns$6,604TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,604NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served21PersonsServedCnt
Total Community Benefit Expns$1,059TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,059NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served1118PersonsServedCnt
Total Community Benefit Expns$9,077TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,077NetCommunityBenefitExpnsAmt
Total Expense0.0005TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,079,188ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,986,528CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$92,660MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S WARRICK HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11116 MILLIS AVENUEAddressLine1Txt
CityBOONVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47601ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.stvincent.org/Locations/Hospitals/WarrickWebsiteAddressTxt
State License17-005111-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S WARRICK HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.stvincent.org/how-we-are-different/community-assessmentOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.stvincent.org/how-we-are-different/community-assessmentStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.stvincent.org/Billing-ServicesFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.stvincent.org/Billing-ServicesFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.stvincent.org/Billing-ServicesFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3ETo better target community resources on the county's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. Facilitated by HCI, participants utilized a prioritization toolkit to examine how well each of the 10 significant health needs (resulting from analysis of the primary and secondary data) met the criteria. Next, participants ranked the top 5 most pressing health needs, which were then aggregated by rank. The top 5 most pressing health needs, as prioritized by the group, will be under consideration for the development of an implementation plan that will address some of the health issues.
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - ST. MARY'S WARRICK HOSPITAL, INC.. As federally required by the Affordable Care Act, the following is an overview of the methods and process used to identify and prioritize significant health needs in Warrick County, Indiana. St. Vincent Health contracted Healthy Communities Institute (HCI) to help facilitate their system wide CHNA work and document all efforts. The secondary data included over 100 community health and quality of life indicators covering over 20 topic areas. Health indicators for Warrick County were compared to other counties in Indiana and nationwide to score health topics and compare relative areas of need. Other considerations for health areas of need included trends over time, Healthy People 2020 targets, and disparities by gender and race/ethnicity. The needs assessment was further informed by interviews with community members who have a fundamental understanding of Warrick County's health needs and represent the broad interests of the community. Two key informants provided valuable input on the county's health challenges, the sub-populations most in need, and existing resources for county residents. The informants included: * Warrick County Schools * Warrick County Health Department
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - ST. MARY'S WARRICK HOSPITAL, INC.. The hospital conducted its CHNA in conjunction with St. Mary's, Deaconess Health System, ECHO Community Health Care.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - ST. MARY'S WARRICK HOSPITAL, INC.. The St. Vincent FY 2017-2019 Implementation Strategy specifically addresses the following three SWHIPs: 1) Access to Health Services - St. Mary's Warrick Hospital Inc. will use the RUAH Pathway Program to increase its reported number of completed pathways (i.e., verification from FSSA) in FY 2015 by 5% each year for FYs 2017-2019. Achieving this goal will contribute to the percentage of people who have health insurance in Warrick County. Specific action steps include the following: Health Advocate (HA) assesses for eligibility and educates individuals about coverage options; HA submits application and works through any issues or delays; and HA verifies eligibility in order to complete the Pathway. 2) Exercise, Nutrition & Weight - St. Mary's Warrick Hospital Inc. will partner with a school and a food source to provide eligible students with a weekend backpack of nutritious food throughout the school year in order to reduce the school's number of families in FY 2018 who are food insecure (based on survey responses) by 5% at the end of FY 2019 (June 30, 2019). (NOTE: FY 2017 is the planning year for the program.) Specific action steps include the following: complete the Weekend Feeding Program Preparation Checklist; meet with all stakeholders to determine program logistics; plan the specifics of your program's protocol; make final preparations for the program's "go live" date in FY 2018; and distribute and collect surveys, enter survey data into software at the beginning and end of the school year (twice a year in FY 2018 and FY 2019). 3) Behavioral Health - St. Mary's Warrick Hospital Inc. will offer Rx for Change training at no charge to anyone who works in a health care setting to increase the proportion of training participants who screen and refer to the Indiana Tobacco Quitline by 10% by the end of FY 2019 (June 30, 2019). Achieving this goal will contribute to the percentage of tobacco users who have been screened and referred to the Indiana Tobacco Quitline. Specific action steps include the following: complete the Provider Training Checklist - Action Step #1; plan at least two Rx for Change trainings in your community in FY 2018 and ensure continuing education credits are available, if applicable (See Provider Training Checklist - Action Step #2); develop a strategy to promote trainings to the community; promote and offer at least two Rx for Change trainings at no charge to your community in FY 2018; enter FY 2018 baseline survey data into database within two weeks of each training; for FY 2019 - Repeat Action Steps #2-4 to plan, develop, and promote and offer at least two Rx for Change trainings at no charge to your community in FY 2019; and enter FY 2019 baseline survey data into database within two weeks of each training. Needs That Will Not Be Addressed - The hospital is committed to improving community health by directly, and indirectly, addressing prioritized health needs. However, certain factors impact the hospital's ability to fully address all priorities health needs. The needs listed below are not included in the hospital's implementation strategy plan for the following reasons: Transportation - This identified health need is not being monitored and evaluated in the Implementation Strategy due to limitations within the hospital's financials and human resources. However, St. Vincent Warrick supports the effort of organizations that are focusing on this issue. Economy - This identified health need is not being monitored and evaluated in the Implementation Strategy because it is outside the scope of the hospital's core mission. However, St. Vincent Warrick does support efforts of organizations focused on economic development for Warrick County.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
COMMUNITY BENEFIT REPORTSt. Mary's Warrick Hospital, Inc. is a Catholic healthcare facility located in the state of Indiana. St. Mary's Warrick Hospital, Inc. is a part of St. Vincent Health, a non-profit healthcare system consisting of 24 locally-sponsored ministries which includes a comprehensive network of affiliated joint ventures, medical practices, and clinics. St. Vincent Health is one of the largest healthcare employers in the state and is sponsored by Ascension Health, the nation's largest Catholic healthcare system. St. Vincent creates strong partnerships with businesses, community organizations, local, state and federal government. Working with its partners, and utilizing the CHNA completed every three years, St. Mary's Warrick Hospital, Inc. is committed to addressing community health needs and developing and executing an implementation strategy to meet identified needs to improve health outcomes within the community. Community benefit is not the work of a single department or group within St. Mary's Warrick Hospital, Inc., but is part of the St. Vincent mission and cultural fabric. The hospital leadership team provides direction and resources in developing and executing the Implementation Strategy in conjunction with the St. Vincent Health Community Development & Health Improvement Department but associates at all levels of the organization contribute to community benefit and health improvement. Part I Certain Other Community Benefits at Cost Community health improvement efforts must take a comprehensive approach and utilize diverse methods to reach intended audiences. As a system, St. Vincent works to improve the health of communities through a variety of approaches, including community health improvement services, health professions education, subsided health services, generalizable research, and cash and in-kind contributions. During fiscal year 2018, St. Vincent supported the community in the following ways: Community Health Improvement Services Community Health Education St. Vincent provides health education on several topics and issues facing the local community throughout the year. The information is offered to the community through a variety of methods, which include, but are not limited to the following: health fairs, health promotion and wellness programs, lectures, school health education programs, and support groups. Social and Environmental Improvement Activities Programs and activities that improve the health of persons in the community by addressing the determinants of health, which include the social, economic and physical environment, which includes removal of harmful materials in public housing, participation in community coalitions to increase jobs with health insurance and conducing a separate assessment for community disaster preparedness. Cash and In-Kind Contributions St. Vincent makes cash and in-kind contributions to a variety of organizations focused on improving the health status in the community. Examples include cash donations to nonprofits in response to natural disasters, event sponsorships focused on addressing an identified community health need, donation of employee time/services to outside organizations, and the representation of the hospital on community boards and committees. Community Benefit Operations St. Vincent staff dedicates significant time and costs to lead and manage community benefit programs and activities. Resources are also allocated to conduct a community health needs assessment and develop an implementation strategy. Community benefit is tracked and reported to St. Vincent leadership, Ascension leadership, state and federal government entities. System Wide Health Improvement Priorities FY18 was the second year of the three-year SWHIP implementation strategy (FY17-19). Below is a year 2 update for each SWHIP: 1) Access to Health Services: Community benefit=$87; Staff time=1 hour During the second year of the strategy, the HA helped 48 people obtain medical insurance (FY18 goal=36; FY18 goal attainment=133%). 2) Exercise, Nutrition & Weight: Community benefit=$6,000; Staff time=0 hours FY18 was an implementation year. The hospital distributed and collected surveys, then entered survey data into a secured St. Vincent web application at the beginning and end of the school year (twice a year in FY18). Analysis of survey #1-baseline showed (aggregated at the program level): - A total of 25 families participated in the program - 60% (n=15) of families responded to the baseline survey - 27% (n=4) reported being food secure - 73% (n=11) reported being food insecure Surveys #2 was administered in FY18. Consolidation and retirement of antiquated software systems necessitated migration of this data to a new system by the IT department. Analysis of this survey was rescheduled and will be completed in FY19. Additionally, surveys #3-4 will be administered in FY19. 3) Behavioral Health: Community benefit=$486; Staff time=14 hours The hospital offered 1 Rx for Change training to the community on November 1, 2018. Due to changes in staffing, the hospital was unable to offer the second training that was originally planned. A total of ten participants attended the training. Participants represented University of Southern Indiana and St. Mary's Warrick Hospital, Inc. (community members=9, 90%; St. Vincent associates=1, 10%). Each participant was eligible to earn two continuing education units for the training. The continuing education unit request form doubled as the baseline survey. To increase the response rate, participants were allotted two weeks to complete the brief, online form. The response rate for the baseline was 10% (n=1). NOTE: Due to a miscommunication between the hospital and Rx for Change teams, baseline questions about "Preferred Provider" status and changes in ask/advise/recommend/refer as a result of the training were not asked at baseline in any training before February 2018. However, all participants were asked to rate their overall ability to discuss cessation with patients. On a scale of 1-5 (Poor-Excellent), the participant rated their overall ability as "Very Good". Thirty days after the training, a brief, follow-up survey was emailed to all participants (email address provided by participant). To increase the response rate, participants received a friendly reminder message with link to the survey once a week for four weeks. Participants who answered the email within the 4-week follow-up period were removed from the email queue and did not receive subsequent messages. Timestamps indicate that participants completed the survey within the first week of the 4-week follow-up period. No incentives were offered for survey completion. Baseline and follow-up surveys were matched at the individual participant level using a unique ID number. Ten percent of all participants completed the baseline and 30-day follow-up surveys (n=1). Of those responding to both surveys: - 1 participant reported being/working for an organization that is registered with the quitline as a "Preferred Provider" - 1 participant reported asking more patients about tobacco use - 1 participant reported advising more tobacco users to quit - 1 participant reported recommending medications for quitting - 1 participant reported referring patients to the tobacco quitline Participants (n=1) responding to both surveys were asked to consider the 30 days following the training and approximate the number of patients that they: - Asked about tobacco use = ~15 - Advising more tobacco users to quit = ~15 - Recommending medications for quitting = ~5 - Referring patients to the quitline = ~10 Although the small size precludes detecting changes in screening behaviors with statistical significance, these findings provide may provide insight into: - Respondents awareness of their own/organizational status as a registered quitline "Preferred Provider" - Respondents perception of the number of patients they screen for tobacco use in a 30-day period - Hospital can determine next steps, if any, for similar programs in the future.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
Schedule H, Part II Community Building ActivitiesResearch shows that social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on the root causes of health problems, ultimately influence and improve health status. Examples of community building activities include physical improvement and housing, economic development, community support, environmental improvements, leadership development and leadership training for community members, coalition building, advocacy for community health improvements and safety, and workforce development.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountAFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED, IN ACCORDANCE WITH THE CORPORATION'S POLICIES.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyTHE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITION, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteTHE ORGANIZATION IS A PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THE DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 21.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsA COST-TO-CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceTHE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY AND THE FINANCIAL ASSISTANCE PROGRAM IS FOLLOWED.
Schedule H, Part V, Section B, Line 16a FAP website- ST. MARY'S WARRICK HOSPITAL, INC: Line 16a URL: https://www.stvincent.org/Billing-Services;
Schedule H, Part V, Section B, Line 16b FAP Application website- ST. MARY'S WARRICK HOSPITAL, INC: Line 16b URL: https://www.stvincent.org/Billing-Services;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- ST. MARY'S WARRICK HOSPITAL, INC: Line 16c URL: https://www.stvincent.org/Billing-Services;
Schedule H, Part VI, Line 2 Needs assessmentSt. Mary's Warrick Hospital, Inc. uses reliable, third party reports, including data from government sources to assess the health care needs of the communities it serves. These reports provide information about key health, socioeconomic and demographic indicators that point to area of need and include but are not limited to reports from Indiana State Department of Health, Indiana Business Research Center at Indiana University, U.S. Census Bureau, Alliance for a Heathier Indiana, Tobacco Prevention & Cessation Commission and Indiana Hospital Association. St. Mary's Warrick Hospital, Inc. utilizes information from these secondary sources to develop programs and provide services throughout the region. In addition, St. Mary's Warrick Hospital, Inc. considers the health care needs of the overall community when evaluating internal financial and operational decisions.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceST. MARY'S WARRICK HOSPITAL, INC. COMMUNICATES WITH PATIENTS IN MULTIPLE WAYS TO ENSURE THAT THOSE WHO ARE BILLED FOR SERVICES ARE AWARE OF THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS THEIR POTENTIAL ELIGIBILITY FOR LOCAL, STATE OR FEDERAL PROGRAMS. SIGNS ARE PROMINENTLY POSTED IN EACH SERVICE AREA. IN ADDITION, THE HOSPITAL CONTRACTS HEALTH ACCESS WORKERS AND ENROLLMENT SPECIALISTS WHO CONSULT WITH PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AND HELP PATIENTS IN APPLYING FOR ANY PUBLIC PROGRAMS FOR WHICH THEY MAY QUALIFY.
Schedule H, Part VI, Line 4 Community informationSt. Mary's Warrick Hospital, Inc. is located in Boonville, Indiana. St. Mary's Warrick Hospital, Inc. serves Warrick and contiguous counties in Southern Indiana. Warrick County has an estimated population of 62,530 residents. Warrick County borders Vanderburgh County and is located near the Ohio River, which marks the state border between Indiana and Kentucky. According to the 2018 County Health Rankings, Warrick County ranks 12th out of 92 Indiana Counties in overall health outcomes. Warrick County's population is 94.4% Caucasian, 2.2% Asian, and 1.7% Hispanic or Latino. The median household income is about $65,809 annually which is about $13,000 more than that of the state median, and roughly 7.5% of Warrick County families are living in poverty, which is lower than the state of 14%. Warrick County's uninsured rate is 8% which is lower than the state's rate of 11%. By the Indiana State Department of Health and U.S. Department of Health and Human Services, Warrick County is not designated as a Medically Underserved Area (MUA) and Population (MUP).
Schedule H, Part VI, Line 5 Promotion of community healthSt. Mary's Warrick Hospital, Inc.'s governing body is comprised of persons representing diverse aspects and interests of the community. Many members of St. Mary's Warrick Hospital, Inc. governing body reside in the organization's primary service area; who are neither employees nor independent contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties and applies surplus funds to improvements in patient care, medical education, and research.
Schedule H, Part VI, Line 6 Affiliated health care systemSt. Mary's Warrick Hospital, Inc. is an affiliate of St. Vincent Health system and Ascension Health. St. Mary's Warrick Hospital, Inc. affiliates are large multi-faceted, integrated, not-for-profit ministries including hospital and non-hospital ministries (physician group practices, hospital organizations, research, home health, durable medical equipment and senior facilities). These ministries work together to care for patients, joined by common systems and a philosophy of serving as a healing presence with special concern for our neighbors especially those who are vulnerable. This community benefit happens through its focus on patient care, education and research. The organizations work together to serve their communities at the local, regional, state, and national level. Ascension Health Alliance, D/B/A Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health. A Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or health ministries, located in 21 of the United States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a public juridic person. The participating of Ascension sponsor are the Daughters of Charity of St. Vincent De Paul, St. Louise Province; The Congregation of St. Joseph; The Congregation of the Sisters of St. Joseph of Carondelet; The Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. As part of St. Vincent Health, St. Mary's Warrick Hospital, Inc. is dedicated to improving the health status and quality of life for the communities it serves. While designated associates at St. Mary's Warrick Hospital, Inc. devote time to leading and administering local community-based programs and partnerships, associates throughout the organization are active participants in community outreach. They are assisted and supported by designated St. Vincent Health Community Development & Health Improvement associates and other support staff who work with each of its healthcare facilities to advocate for and provide technical assistance for community outreach, needs assessments and partnerships as well as to support regional and state-wide programs, community programs sponsored by St. Vincent Health in which St. Mary's Warrick Hospital, Inc. participates.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1TRI STATE FOOD BANKBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 E MICHIGAN STAddressLine1Txt
CityEVANSVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47711ZIPCd
FieldValueIRS element (for citing)
Recipient EIN351539870RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$6,000CashGrantAmt
Purpose Of GrantOPERATING GRANTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationThe finance committee ensures that funds are distributed appropriately according to Ascension Health's strategic business plan and consistent with corporate policies and procedures.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DANIEL A PAROD
CEO/PRESIDENT/EX-OFFICIO$0$382,126$0$140,450$0$24,086$0$13,500$0$35,895$0$596,058$0$0
KARL W SASH MD
DIRECTOR$0$368,884$0$237,603$0$40,975$0$16,200$0$35,628$0$699,291$0$39,298
DENNIS KEITH JEWELL
FORMER OFFICER (END 2/2017)$0$103,229$0$0$0$90,097$0$2,310$0$2,639$0$198,274$0$62,739
MARK L MARCHINO
EXECUTIVE DIRECTOR, WARRICK HOSPITAL$109,301$0$47,715$0$30,648$2,851$9,054$0$24,933$0$221,651$2,851$0$0
JOHN L SCHELLHASE
REGISTERED NURSE$135,404$0$1,099$0$3,940$0$5,650$0$10,782$0$156,874$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S WARRICK HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4a Severance or change-of-control paymentTHE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION: MARK L MARCHINO - $31,366 LISA MILLER - $18,654
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planEligible 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. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted: KARL SASH, MD - $39,298 KEITH JEWELL - $62,739

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part IV, Line 24a PART IV, LINE 24AST. MARY'S WARRICK HOSPITAL, INC. IS A HEALTH FACILITY THAT IS PART OF THE ASCENSION HEALTH SYSTEM. ASCENSION HEALTH SYSTEM IS THE HOLDER OF THE TAX EXEMPT HOSPITAL REVENUE BONDS. ST. MARY'S WARRICK HOSPITAL, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE WITH ASCENSION HEALTH AND THIS INFORMATION IS REPORTED ON THE BALANCE SHEET.
Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTSTHE ACTIVITY OF ST. MARY'S WARRICK HOSPITAL, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ST. MARY'S WARRICK HOSPITAL, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ST. MARY'S WARRICK HOSPITAL, INC.
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALTHE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY ASCENSION HEALTH AND ITS SUBSIDIARY ORGANIZATIONS. ASCENSION HEALTH IS THE NATIONAL HEALTH SYSTEM PARENT. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY 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 MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEESTHE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY ST. VINCENT HEALTH, INC. AND ITS SUBSIDIARY ORGANIZATIONS. ST. VINCENT HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF ST. MARY'S WARRICK HOSPITAL, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE 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 stockholdersST. MARY'S WARRICK HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. VINCENT HEALTH, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyST. MARY'S WARRICK HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. VINCENT HEALTH, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF THE ST. MARY'S WARRICK HOSPITAL, INC. BOARD.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S WARRICK HOSPITAL, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST. VINCENT HEALTH, INC.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyDURING 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 policyTHE 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 publicTHE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueMiscellaneous Revenue - Total Revenue: 1501, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1501; Escheatment Revenue - Total Revenue: 690, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 690;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesTransfers with Alpha Fund - 2022;
Form 990, Part XII, Line 2c Audit CommitteeSt. Mary's WARRICK HOSPITAL, 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (39 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ASCENSION HEALTH ALLIANCE
PO BOX 45998ST LOUISMO63145453358926NATIONAL HEALTH SYSTEMMO501(c)(3)Type INAfalse
ASCENSION HEALTH
PO BOX 45998ST LOUISMO63145311662309NATIONAL HEALTH SYSTEMMO501(c)(3)Type IASCENSION HEALTH ALLIANCEfalse
ST VINCENT HEALTH INC
10330 N MERIDIAN STREET STE 430NINDIANAPOLISIN46290352052591PARENT COMPANYIN501(c)(3)Type III-FIASCENSION HEALTHfalse
CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC
2001 W 86TH STREETINDIANAPOLISIN46260351869951FREESTANDING OUTPATIENT CENTERIN501(c)(3)Type III-FIST VINCENT HEALTH INCYes (true)
SVH REAL ESTATE INC
10330 N MERIDIAN STREET STE 430NINDIANAPOLISIN46290205002285REAL ESTATE HOLDING COMPANYIN501(c)(3)Type III-FIST VINCENT HEALTH INCYes (true)
ST JOSEPH HOSPITAL & HEALTH CENTER INC
1907 W SYCAMORE STREETKOKOMOIN46901350992717HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT ANDERSON REGIONAL HOSPITAL INC
2015 JACKSON STREETANDERSONIN46016460877261HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT CARMEL HOSPITAL INC
13500 N MERIDIAN STREETCARMELIN46032743107055HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT CLAY HOSPITAL INC
1206 E NATIONAL AVENUEBRAZILIN47834352112529CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT DUNN HOSPITAL INC
1600 23RD STREETBEDFORDIN47421272192831CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT FISHERS HOSPITAL INC
13861 OLIO ROADFISHERSIN46037454243702HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT FRANKFORT HOSPITAL INC
1300 S JACKSONFRANKFORTIN46041352099320CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT HEALTH WELLNESS AND PREVENTIVE CARE INSTITUTE INC
8333 NAAB ROAD STE 301INDIANAPOLISIN46260461227327HEALTH AND WELLNESS SERVICESIN501(c)(3)10ST VINCENT HEALTH INCYes (true)
ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC
2001 W 86TH STREETINDIANAPOLISIN46260350869066HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT JENNINGS HOSPITAL INC
301 HENRY STREETNORTH VERNONIN47265351841606CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT MADISON COUNTY HEALTH SYSTEM INC
1331 SOUTH A STREETELWOODIN46036350876389HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT MEDICAL GROUP INC
8425 HARCOURT ROADINDIANAPOLISIN46260272039417PHYSICIAN PROFESSIONAL SERVICESIN501(c)(3)10ST VINCENT CARMEL HOSPITAL INCYes (true)
ST VINCENT RANDOLPH HOSPITAL INC
473 GREENVILLE AVENUEWINCHESTERIN47394352103153CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT RAS INC
10330 N MERIDIAN STREET STE 400NINDIANAPOLISIN46290471289091RETAIL AMBULATORY SERVICESIN501(c)(3)10ST VINCENT HEALTH INCYes (true)
ST VINCENT SALEM HOSPITAL INC
911 N SHELBY STREETSALEMIN47167270847538CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT SETON SPECIALTY HOSPITAL INC
8050 TOWNSHIP LINE RDINDIANAPOLISIN46260351712001LONG TERM CARE HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST VINCENT WILLIAMSPORT HOSPITAL INC
412 N MONROE STREETWILLIAMSPORTIN47993350784551CRITICAL ACCESS HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST MARY'S HEALTH INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750350869065HOSPITALIN501(c)(3)3ST VINCENT HEALTH INCYes (true)
ST JOSEPH FOUNDATION OF KOKOMO INDIANA INC
1907 W SYCAMORE STREETKOKOMOIN46901237313206SUPPORTING ORGANIZATIONIN501(c)(3)Type IST JOSEPH HOSPITAL & HEALTH CENTER INCYes (true)
ST MARY'S AT HOME INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351899560DME/HOME CAREIN501(c)(3)Type IST MARY'S HEALTH INCYes (true)
ST MARY'S BUILDING CORPORATION
3700 WASHINGTON AVENUEEVANSVILLEIN47750237248362REAL ESTATE HOLDING COMPANYIN501(c)(2)ST MARY'S HEALTH INCYes (true)
ST MARY'S HEALTH SERVICES INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351679526INVESTMENT SERVICESIN501(c)(3)Type III-FIST MARY'S HEALTH INCYes (true)
ST MARY'S CARE PARTNERS INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750351899562TAX-EXEMPT AFFILIATE REIMBURSEMENTSIN501(c)(3)Type IST MARY'S HEALTH INCYes (true)
ST MARY'S HEALTH FOUNDATION INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750237045370SUPPORTING ORGANIZATIONIN501(c)(3)Type IST MARY'S HEALTH INCYes (true)
ST MARY'S MEDICAL GROUP LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750261356310PHYSICIAN PROFESSIONAL SERVICESIN501(c)(3)10ST VINCENT MEDICAL GROUP INCYes (true)
ST MARY'S OHIO VALLEY HEARTCARE LLC
901 ST MARYS DRIVEEVANSVILLEIN47714273474697DORMANTIN501(c)(3)Type IST MARY'S MEDICAL GROUP LLCYes (true)
PRIMARY PHYSICIAN NETWORK LLC
3700 WASHINGTON AVENUEEVANSVILLEIN47750208775914DORMANTIN501(c)(3)10ST MARY'S HEALTH INCYes (true)
ST VINCENT ANDERSON REGIONAL HOSPITAL FOUNDATION INC
2015 JACKSON STREETANDERSONIN46016352053693SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT ANDERSON REGIONAL HOSPITAL INCYes (true)
ST VINCENT FRANKFORT HOSPITAL FOUNDATION INC
1300 S JACKSONFRANKFORTIN46041351531734SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT FRANKFORT HOSPITAL INCYes (true)
ST VINCENT HOSPITAL FOUNDATION INC
10330 N MERIDIAN STREET STE 430NINDIANAPOLISIN46290356088862SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT HOSPITAL AND HEALTH CARE CENTER INCYes (true)
ST VINCENT MERCY HOSPITAL FOUNDATION INC
1331 SOUTH A STREETELWOODIN46036311066871SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT MADISON COUNTY HEALTH SYSTEM INCYes (true)
ST VINCENT RANDOLPH HOSPITAL FOUNDATION INC
473 GREENVILLE AVENUEWINCHESTERIN47394352133006SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT RANDOLPH HOSPITAL INCYes (true)
ST VINCENT WILLIAMSPORT HOSPITAL FOUNDATION INC
412 N MONROE STREETWILLIAMSPORTIN47993743130159SUPPORTING ORGANIZATIONIN501(c)(3)Type IST VINCENT WILLIAMSPORT HOSPITAL INCYes (true)
ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES INC
3700 WASHINGTON AVENUEEVANSVILLEIN47750205342518AMBULANCE SERVICESIN501(c)(4)ST MARY'S HEALTH SERVICES INCYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtAddress Line2USAddress/AddressLine2TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
ENDOSCOPY CENTER LLC
13421 OLD MERIDIAN STREETSTE 150CARMELIN46032320029881ENDOSCOPY CENTERINNAN/A
STVINCENT HEART CENTER OF INDIANA LLC
10580 N MERIDIAN STREETINDIANAPOLISIN46290364492612HEART HOSPITALINNAN/A
CARMEL AMBULATORY SURGERY CENTER LLC
13421 OLD MERIDIAN STSTE 150CARMELIN46032320014795AMBULATORY SURGERY CENTERINNAN/A
NAAB ROAD SURGERY CENTER LLC
8260 NAAB ROADSTE 100INDIANAPOLISIN46260351991390AMBULATORY SURGERY CENTERINNAN/A
TRI-STATE COMMUNITY CLINICS LLC
8601 N KENTUCKY AVENUESUITE JEVANSVILLEIN47711270885968PRIMARY CARE PHYSICIAN PRACTICESINNAN/A
THP - ST VINCENT VENTURE LLC
1415 LOUISIANA STREET27TH FLOORHOUSTONTX77002813184703FREESTANDING ED'STXNAN/A
AMBROSE PARKWOOD WEST II LLC
55 MONUMENTAL CIRCLESTE 450INDIANAPOLISIN46204270532924LAND HOLDINGSINNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S MEDICAL GROUP INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13700 WASHINGTON AVEAddressLine1Txt
CityEVANSVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47750ZIPCd
FieldValueIRS element (for citing)
EIN352076827EIN
Primary ActivitiesINVESTMENTPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CorporationEntityTypeTxt
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
St Mary's Health Inc
E$57,455FMV
St Mary's Health Inc
L$77,859FMV
St Mary's Health Inc
P$1,109,531FMV
St Mary's Health Inc
Q$276,469FMV
St Mary's Health Inc
R$18,761,167FMV
St Mary's Medical Group LLC
J$106,243FMV

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