ST VINCENTS AMBULATORY CARE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ST VINCENTS AMBULATORY CARE INC (EIN 59-2292041)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201811359349311126
- Schema version
- 2016v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-15T16:05:08-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592292041 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Vincent's Ambulatory Care Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STVI | BusinessNameControlTxt |
| Phone | 3147338000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 Belfort Road 4020 | AddressLine1Txt |
| City | Jacksonville | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tonya Mershon | PersonNm |
| Person Title | Tax Officer | PersonTitleTxt |
| Signature | 2017-09-27 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tom VanOsdol | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 SHIRCLIFF WAY | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $72,246,793 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.JAXHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 849 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,138,466 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,115,702 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $67,763,992 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $67,220,952 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$208,358 | PYInvestmentIncomeAmt |
| CY Investment Income | -$8,267 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,874,973 | PYOtherRevenueAmt |
| CY Other Revenue | $3,469,133 | CYOtherRevenueAmt |
| PY Total Revenue | $72,569,073 | PYTotalRevenueAmt |
| CY Total Revenue | $71,797,520 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $89,040,637 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $93,600,796 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,579,897 | PYOtherExpensesAmt |
| CY Other Expenses | $26,283,037 | CYOtherExpensesAmt |
| PY Total Expenses | $109,620,534 | PYTotalExpensesAmt |
| CY Total Expenses | $119,883,833 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$37,051,461 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$48,086,313 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,620,930 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,782,175 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,073,217 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,288,015 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,452,287 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,494,160 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $110,826,088 | ExpenseAmt |
| Revenue | $69,028,830 | RevenueAmt |
| Desc | 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 ACCESSIBIILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE UNINSURED AND THE UNDERSERVED. APPROXIMATELY 54% OF THE VALUE OF SERVICES WERE RENDERED TO PATIENTS UNDER THE MEDICARE PROGRAM AND APPROXIMATELY 5% OF THE SERVICES PROVIDED TO PATIENTS UNDER THE MEDICAID PROGRAM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,548,423 | ExpenseAmt |
| Revenue | $1,548,423 | RevenueAmt |
| Desc | MOBILE HEALTH OUTREACH PROVIDES QUALITY OUT-PATIENT CARE TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. MOBILE HEALTH OUTREACH HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE INDIGENT AND MIGRANT POPULATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $29,988 | ExpenseAmt |
| Revenue | $29,988 | RevenueAmt |
| Desc | ST. VINCENT'S ("SV") P.A.T.H. PROGRAM PROVIDES QUALITY OUT-PATIENT CARE TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. SV'S P.A.T.H. 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 UNDERSERVED. SV'S P.A.T.H. SERVICES INCLUDE PRIMARY CARE, PRESCRIPTION ASSISTANCE, RN HEALTH COACHING/EDUCATION, CASE MANAGEMENT, AND PREVENTIVE CARE SCREENINGS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $112,404,499 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 69 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 849 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kara Mathe | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9043087300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4205 BELFORT ROAD SUITE 4020 | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32216 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (41 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ESTRELLITA REDMON MD | ||||||||||
| AMG Clinical Dyad Leader / Board President | 30.0 | 25.0 | Yes (X) | Yes (X) | $0 | $466,618 | $33,002 | |||
| DAVID G KULIK | ||||||||||
| VICE CHAIRMAN (END 1/2017) | 1.0 | 5.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KYLE E SANDERS | ||||||||||
| AMG Administrative Dyad Leader | 30.0 | 25.0 | Yes (X) | Yes (X) | $0 | $538,451 | $37,857 | |||
| THOMAS J VANOSDOL | ||||||||||
| INTERIM PRESIDENT & CEO | 7.0 | 48.0 | Yes (X) | Yes (X) | $0 | $731,746 | $44,269 | |||
| WILLIAM CODY MD | ||||||||||
| CHAIRMAN (START 2/2017) | 1.0 | 54.0 | Yes (X) | Yes (X) | $0 | $149,933 | $28,315 | |||
| PAUL J CHAPPANO MD | ||||||||||
| CHAIRMAN (END 1/2017) | 1.0 | 4.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SONYA J DOMINGUEZ MD | ||||||||||
| VICE CHAIRMAN (START 2/2017) | 1.0 | 54.0 | Yes (X) | Yes (X) | $0 | $257,582 | $42,079 | |||
| RICHARD JONES | ||||||||||
| SECRETARY/TREASURER (END 1/2017) | 1.0 | 4.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Samer Garas MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $1,526,319 | $0 | $45,221 | ||||
| FRANK H GILBERSTADT MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 54.0 | Yes (X) | $0 | $546,654 | $34,156 | ||||
| CARLA HARRIS | ||||||||||
| MEMBER (END 1/2017) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| Wesley Mills MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $288,780 | $0 | $24,097 | ||||
| RICARDO MORALES JR | ||||||||||
| MEMBER (END 9/2016) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| Ashutosh Pradhan MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $1,467,492 | $0 | $49,706 | ||||
| SISTER JEAN D RHOADES | ||||||||||
| MEMBER (END 1/2017) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| HELEN D ROWAN | ||||||||||
| MEMBER (END 1/2017) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| VAN D ROYAL | ||||||||||
| MEMBER (END 1/2017) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| SIDNEY S SIMMONS II | ||||||||||
| MEMBER (END 9/2016) | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||||
| Markus Sonntag MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $191,661 | $0 | $37,948 | ||||
| Maymon Thint MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $262,135 | $0 | $35,846 | ||||
| Deborah Weyer MD | ||||||||||
| MEMBER (START 2/2017) | 1.0 | 0 | Yes (X) | $219,045 | $0 | $28,405 | ||||
| PAMELA M HESS | ||||||||||
| CFO-Mnstry Mkt Jacksonville | 7.0 | 48.0 | Yes (X) | $0 | $413,439 | $36,631 | ||||
| MICHAEL H SCHATZLEIN MD | ||||||||||
| REGIONAL CEO (END 12/2016) | 1.0 | 49.0 | Yes (X) | $0 | $3,128,428 | $37,373 | ||||
| MICHELLE ADAMOLEKUN | ||||||||||
| CHIEF HUMAN RESOURCES OFFICER REGIONAL VP | 7.0 | 48.0 | $0 | $418,829 | $20,226 | Yes (X) | ||||
| JOHN J CASSANI | ||||||||||
| VP, CLINICAL LEAD (END 3/2016) | 3.0 | 53.0 | $0 | $488,155 | $26,057 | Yes (X) | ||||
| TERESA LOFTIS | ||||||||||
| VP Msn-CMIO Mnstry Mkt JAX | 7.0 | 48.0 | $0 | $304,707 | $37,635 | Yes (X) | ||||
| WILLIAM R MAYHER | ||||||||||
| SVP - Reg Dev & Corp Resp | 7.0 | 48.0 | $0 | $264,903 | $38,151 | Yes (X) | ||||
| JOHN D MEYER III | ||||||||||
| CSMO-Mnstry Mkt Jacksonville | 7.0 | 48.0 | $0 | $463,974 | $39,721 | Yes (X) | ||||
| JEFFREY H MIDDLEBROOKS | ||||||||||
| MEMBER (START 2/2017) | 7.0 | 48.0 | $0 | $476,627 | $33,342 | Yes (X) | ||||
| ABDALLAH KAFROUNI MD | ||||||||||
| MEDICAL DIRECTOR, SPECIALTIES | 55.0 | 0 | $656,159 | $0 | $47,583 | Yes (X) | ||||
| WILLIE PENNICK MD | ||||||||||
| MEDICAL DIRECTOR, PRIMARY CARE | 55.0 | 0 | $291,241 | $0 | $36,583 | Yes (X) | ||||
| ALI CHAHLAVI MD | ||||||||||
| PHYSICIAN | 54.0 | 1.0 | $3,333,908 | $0 | $62,339 | Yes (X) | ||||
| ERIC GABRIEL MD | ||||||||||
| PHYSICIAN | 55.0 | 0 | $1,888,078 | $0 | $53,865 | Yes (X) | ||||
| MARIANO B MIKULIC MD | ||||||||||
| PHYSICIAN | 55.0 | 0 | $1,591,148 | $0 | $47,572 | Yes (X) | ||||
| ERIC W NOTTMEIER MD | ||||||||||
| PHYSICIAN | 55.0 | 0 | $1,252,874 | $0 | $48,569 | Yes (X) | ||||
| SAUMIL R OZA MD | ||||||||||
| PHYSICIAN | 55.0 | 0 | $1,272,504 | $0 | $40,199 | Yes (X) | ||||
| JANICE G LIPSKY | ||||||||||
| FORMER KEY EMPLOYEE (END 12/2015) | 0.0 | 0.0 | $0 | $242,643 | $15,284 | Yes (X) | ||||
| DENISE MCKROW | ||||||||||
| FORMER KEY EMPLOYEE (END 10/2015) | 0.0 | 0.0 | $0 | $157,065 | $12,630 | Yes (X) | ||||
| MOODY CHISHOLM | ||||||||||
| FORMER OFFICER (END 3/2015) | 0.0 | 0.0 | $0 | $514,219 | $0 | Yes (X) | ||||
| KIMBERLY HODGKINSON | ||||||||||
| FORMER OFFICER (END 6/2016) | 0.0 | 0.0 | $0 | $177,153 | $14,511 | Yes (X) | ||||
| DONNIE L ROMINE JR | ||||||||||
| FORMER OFFICER (END 10/2015) | 0.0 | 0.0 | $0 | $579,018 | $4,228 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,241,344 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,320,144 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,093,400 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 143 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| MAYO CLINIC | ||||||
| 200 1ST STREET SW | ROCHESTER | MN | 55905 | MEDICAL SERVICES | $183,117 | |
| NEWVENTURE OF JACKSONVILLE INC | ||||||
| 8130 BAYMEADOWS CIRCLE W 306 | JACKSONVILLE | FL | 32256 | COMMERCIAL CLEANING SERVICES | $143,931 | |
| THERAIC ENTERPRISES OF JACKSONVILLE LLC | ||||||
| 6321 DANIELS PARKWAY | FORT MEYERS | FL | 33912 | INVESTMENT FEES | $135,003 | SUITE 200 |
| JAMES D BAKER III MD PA | ||||||
| 2 SHIRCLIFF WAY | JACKSONVILLE | FL | 32204 | PHYSICIAN SERVICES | $132,660 | SUITE 415 |
| MED-LINK STAFFING INC | ||||||
| 163 HAMPTON POINT DRIVE | SAINT AUGUSTINE | FL | 320923060 | STAFFING SERVICES | $104,631 | SUITE 3 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,115,702 | RelatedOrganizationsAmt |
| Total Contributions | $1,115,702 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medicare/Medicaid | 621990 | $42,788,176 | $42,788,176 |
| Net Patient Service Revenue | 621990 | $23,957,443 | $23,957,443 |
| Mobile Health Outreach | 621990 | $472,078 | $472,078 |
| EKG Reading Revenue | 621990 | $3,255 | $3,255 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $67,220,952 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,385 | TotalRevenueColumnAmt |
| Exclusion | $15,385 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $356,655 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $425,621 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$68,966 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$68,966 | TotalRevenueColumnAmt |
| Exclusion | -$68,966 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $23,652 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$23,652 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,652 | TotalRevenueColumnAmt |
| Exclusion | -$23,652 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Incentive Payments | 900099 | $2,621,853 | $2,621,853 | |
| Medical Records | 900099 | $151,810 | $151,810 | |
| ON-CALL/MEDICAL DIRECTOR INCOME | 900099 | $764,436 | $764,436 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,538,099 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,797,520 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,607,241 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $74,577 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,208,221 | TotalAmt |
| Management And General | $5,208,221 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,230,697 | TotalAmt |
| Program Services | $79,475,654 | ProgramServicesAmt |
| Management And General | -$1,244,957 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,561,668 | TotalAmt |
| Program Services | $1,585,711 | ProgramServicesAmt |
| Management And General | -$24,043 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,454,998 | TotalAmt |
| Program Services | $4,458,174 | ProgramServicesAmt |
| Management And General | -$3,176 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,145,212 | TotalAmt |
| Program Services | $3,962,823 | ProgramServicesAmt |
| Management And General | $182,389 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $675 | TotalAmt |
| Program Services | $645 | ProgramServicesAmt |
| Management And General | $30 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,361 | TotalAmt |
| Program Services | $7,993 | ProgramServicesAmt |
| Management And General | $368 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,086 | TotalAmt |
| Program Services | $442,404 | ProgramServicesAmt |
| Management And General | $112,682 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,585 | TotalAmt |
| Program Services | $53,585 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $971,655 | TotalAmt |
| Program Services | $768,542 | ProgramServicesAmt |
| Management And General | $203,113 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,263 | TotalAmt |
| Program Services | $8,584 | ProgramServicesAmt |
| Management And General | $3,679 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,183,971 | TotalAmt |
| Program Services | $4,924,772 | ProgramServicesAmt |
| Management And General | $259,199 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $403,096 | TotalAmt |
| Program Services | $302,322 | ProgramServicesAmt |
| Management And General | $100,774 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,056 | TotalAmt |
| Program Services | $29,292 | ProgramServicesAmt |
| Management And General | $9,764 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,055,385 | TotalAmt |
| Program Services | $1,023,723 | ProgramServicesAmt |
| Management And General | $31,662 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,634,372 | TotalAmt |
| Program Services | $1,634,372 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased services | $6,628,920 | $5,283,249 | $1,345,671 |
| Medical Supplies | $5,966,117 | $5,936,286 | $29,831 |
| Intra/Intercompany Other Operating Expense | $1,886,863 | $917,015 | $969,848 |
| Minor Equipment | $584,734 | $550,235 | $34,499 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,298,898 | TotalAmt |
| Program Services | $1,039,118 | ProgramServicesAmt |
| Management And General | $259,780 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,883,833 | TotalAmt |
| Program Services | $112,404,499 | ProgramServicesAmt |
| Management And General | $7,479,334 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,130,626 | BOYAmt |
| EOY | $6,993,506 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,149,092 | BOYAmt |
| EOY | $5,486,761 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $453,086 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,018 | BOYAmt |
| EOY | $217,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,139,881 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,804,775 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,461,640 | BOYAmt |
| EOY | $15,335,106 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,615,881 | BOYAmt |
| EOY | $1,806,952 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,130,673 | BOYAmt |
| EOY | $9,489,502 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,620,930 | BOYAmt |
| EOY | $39,782,175 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,468,092 | BOYAmt |
| EOY | $11,698,903 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,103,227 | BOYAmt |
| EOY | $966,610 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,501,898 | BOYAmt |
| EOY | $22,622,502 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,073,217 | BOYAmt |
| EOY | $35,288,015 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,452,287 | BOYAmt |
| EOY | $4,494,140 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $20 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,452,287 | BOYAmt |
| EOY | $4,494,160 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,620,930 | BOYAmt |
| EOY | $39,782,175 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$48,086,313 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $760,768 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $54,271,992 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,544,933 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,161,998 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,063,420 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,138,466 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,115,702 | CurrentTaxYearAmt |
| Total | $6,024,519 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,739,102 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $46,281,581 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $68,710,618 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $71,656,981 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $70,607,241 | CurrentTaxYearAmt |
| Total | $300,995,523 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,284,035 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47,443,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $69,774,038 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,795,447 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $71,722,943 | CurrentTaxYearAmt |
| Total | $307,020,042 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $307,020,042 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $336,387 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $436,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $168,771 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $70,433 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $372,040 | CurrentTaxYearAmt |
| Total | $1,384,210 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $336,387 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $436,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $168,771 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $70,433 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $372,040 | CurrentTaxYearAmt |
| Total | $1,384,210 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $344,622 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $178,865 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,416 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $231,122 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $151,810 | CurrentTaxYearAmt |
| Total | $1,055,835 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,965,044 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,059,023 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $70,092,225 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $73,097,002 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,246,793 | CurrentTaxYearAmt |
| Total | $309,460,087 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.9921 | PublicSupportCY509Pct |
| Public Support PY509 | 0.9905 | PublicSupportPY509Pct |
| Investment Income CY | 0.0045 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0047 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - MISCELLANEOUS INCOME / MEDICAL RECORDS, COLUMN A - 344622.0, COLUMN B - 178865.0, COLUMN C - 149416.0, COLUMN D - 231122.0, COLUMN E - 151810.0, COLUMN F - 1055835.0; | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,038,154 | OtherCostOrOtherBasisAmt |
| Book Value | $2,038,154 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,603,795 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,573,744 | DepreciationAmt |
| Book Value | $4,030,051 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,897,769 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,313,554 | DepreciationAmt |
| Book Value | $1,584,215 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,035,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,846,647 | DepreciationAmt |
| Book Value | $2,189,227 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,564,289 | OtherCostOrOtherBasisAmt |
| Depreciation | $70,830 | DepreciationAmt |
| Book Value | $5,493,459 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,335,106 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deposits | |
| AH deferred compensation | $5,329,740 |
| AR IntraCompany with HM and with System Office | $3,059,958 |
| Other Assets | $763,990 |
| Other Receivables | $335,814 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,489,502 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (12 entries)
| DescDesc | AmtAmt |
|---|---|
| AP InterCompany Between HMs | $14,270,033 |
| Ascension deferred compensation liabiliity | $5,329,740 |
| General Professional Liability payable | |
| AH Savings Plan Liability | $774,259 |
| Current Portion Workers Comp | |
| Accrued Real Estate Tax | |
| Accrued Sales Tax | |
| Deposit Liability | |
| Misc Current Liabilities | $3,693 |
| Other Taxes Payable | $32,111 |
| Pension and Other Post retirement Liability | $1,948,901 |
| Recovery Tail Liability | $263,765 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $22,622,502 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | 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, 2017. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (32 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ESTRELLITA REDMON MD | ||||||||||||||
| AMG Clinical Dyad Leader / Board President | $0 | $356,515 | $0 | $88,945 | $0 | $21,158 | $0 | $13,250 | $0 | $19,752 | $0 | $499,620 | $0 | $0 |
| KYLE E SANDERS | ||||||||||||||
| AMG Administrative Dyad Leader | $0 | $368,965 | $0 | $131,554 | $0 | $37,932 | $0 | $14,575 | $0 | $23,282 | $0 | $576,308 | $0 | $0 |
| THOMAS J VANOSDOL | ||||||||||||||
| INTERIM PRESIDENT & CEO | $0 | $435,581 | $0 | $196,664 | $0 | $99,501 | $0 | $15,900 | $0 | $28,369 | $0 | $776,015 | $0 | $0 |
| WILLIAM CODY MD | ||||||||||||||
| CHAIRMAN (START 2/2017) | $0 | $147,098 | $0 | $0 | $0 | $2,835 | $0 | $9,421 | $0 | $18,894 | $0 | $178,248 | $0 | $0 |
| SONYA J DOMINGUEZ MD | ||||||||||||||
| VICE CHAIRMAN (START 2/2017) | $0 | $249,435 | $0 | $7,656 | $0 | $491 | $0 | $15,953 | $0 | $26,126 | $0 | $299,661 | $0 | $0 |
| Samer Garas MD | ||||||||||||||
| MEMBER (START 2/2017) | $501,260 | $0 | $1,023,371 | $0 | $1,688 | $0 | $15,900 | $0 | $29,321 | $0 | $1,571,540 | $0 | $0 | $0 |
| FRANK H GILBERSTADT MD | ||||||||||||||
| MEMBER (START 2/2017) | $0 | $422,811 | $0 | $96,644 | $0 | $27,199 | $0 | $13,250 | $0 | $20,906 | $0 | $580,810 | $0 | $0 |
| Wesley Mills MD | ||||||||||||||
| MEMBER (START 2/2017) | $191,931 | $0 | $96,237 | $0 | $612 | $0 | $10,816 | $0 | $13,281 | $0 | $312,877 | $0 | $0 | $0 |
| Ashutosh Pradhan MD | ||||||||||||||
| MEMBER (START 2/2017) | $1,094,975 | $0 | $371,377 | $0 | $1,140 | $0 | $14,575 | $0 | $35,131 | $0 | $1,517,198 | $0 | $0 | $0 |
| Markus Sonntag MD | ||||||||||||||
| MEMBER (START 2/2017) | $168,087 | $0 | $23,196 | $0 | $378 | $0 | $10,755 | $0 | $27,193 | $0 | $229,609 | $0 | $0 | $0 |
| Maymon Thint MD | ||||||||||||||
| MEMBER (START 2/2017) | $181,290 | $0 | $79,929 | $0 | $916 | $0 | $12,329 | $0 | $23,517 | $0 | $297,981 | $0 | $0 | $0 |
| Deborah Weyer MD | ||||||||||||||
| MEMBER (START 2/2017) | $170,486 | $0 | $47,284 | $0 | $1,275 | $0 | $10,010 | $0 | $18,395 | $0 | $247,450 | $0 | $0 | $0 |
| MOODY CHISHOLM | ||||||||||||||
| FORMER OFFICER (END 3/2015) | $0 | $0 | $0 | $0 | $0 | $514,219 | $0 | $0 | $0 | $0 | $0 | $514,219 | $0 | $0 |
| KIMBERLY HODGKINSON | ||||||||||||||
| FORMER OFFICER (END 6/2016) | $0 | $175,306 | $0 | $0 | $0 | $1,847 | $0 | $4,327 | $0 | $10,184 | $0 | $191,664 | $0 | $0 |
| DONNIE L ROMINE JR | ||||||||||||||
| FORMER OFFICER (END 10/2015) | $0 | $0 | $0 | $0 | $0 | $579,018 | $0 | $0 | $0 | $4,228 | $0 | $583,246 | $0 | $0 |
| PAMELA M HESS | ||||||||||||||
| CFO-Mnstry Mkt Jacksonville | $0 | $299,889 | $0 | $61,995 | $0 | $51,555 | $0 | $15,900 | $0 | $20,731 | $0 | $450,070 | $0 | $0 |
| MICHAEL H SCHATZLEIN MD | ||||||||||||||
| REGIONAL CEO (END 12/2016) | $0 | $980,084 | $0 | $1,692,000 | $0 | $456,344 | $0 | $14,575 | $0 | $22,798 | $0 | $3,165,801 | $0 | $0 |
| JANICE G LIPSKY | ||||||||||||||
| FORMER KEY EMPLOYEE (END 12/2015) | $0 | $0 | $0 | $0 | $0 | $242,643 | $0 | $0 | $0 | $15,284 | $0 | $257,927 | $0 | $0 |
| DENISE MCKROW | ||||||||||||||
| FORMER KEY EMPLOYEE (END 10/2015) | $0 | $0 | $0 | $0 | $0 | $157,065 | $0 | $0 | $0 | $12,630 | $0 | $169,695 | $0 | $0 |
| MICHELLE ADAMOLEKUN | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFICER REGIONAL VP | $0 | $254,379 | $0 | $117,659 | $0 | $46,791 | $0 | $14,575 | $0 | $5,651 | $0 | $439,055 | $0 | $0 |
| JOHN J CASSANI | ||||||||||||||
| VP, CLINICAL LEAD (END 3/2016) | $0 | $98,053 | $0 | $87,995 | $0 | $302,107 | $0 | $3,154 | $0 | $22,903 | $0 | $514,212 | $0 | $0 |
| TERESA LOFTIS | ||||||||||||||
| VP Msn-CMIO Mnstry Mkt JAX | $0 | $202,011 | $0 | $94,646 | $0 | $8,050 | $0 | $15,786 | $0 | $21,849 | $0 | $342,342 | $0 | $0 |
| WILLIAM R MAYHER | ||||||||||||||
| SVP - Reg Dev & Corp Resp | $0 | $188,407 | $0 | $59,808 | $0 | $16,688 | $0 | $14,880 | $0 | $23,271 | $0 | $303,054 | $0 | $0 |
| JOHN D MEYER III | ||||||||||||||
| CSMO-Mnstry Mkt Jacksonville | $0 | $260,564 | $0 | $167,395 | $0 | $36,015 | $0 | $17,225 | $0 | $22,496 | $0 | $503,695 | $0 | $0 |
| JEFFREY H MIDDLEBROOKS | ||||||||||||||
| MEMBER (START 2/2017) | $0 | $304,983 | $0 | $139,478 | $0 | $32,166 | $0 | $8,806 | $0 | $24,536 | $0 | $509,969 | $0 | $0 |
| ABDALLAH KAFROUNI MD | ||||||||||||||
| MEDICAL DIRECTOR, SPECIALTIES | $487,482 | $0 | $167,794 | $0 | $883 | $0 | $10,394 | $0 | $37,189 | $0 | $703,742 | $0 | $0 | $0 |
| WILLIE PENNICK MD | ||||||||||||||
| MEDICAL DIRECTOR, PRIMARY CARE | $244,556 | $0 | $44,348 | $0 | $2,337 | $0 | $12,246 | $0 | $24,337 | $0 | $327,824 | $0 | $0 | $0 |
| ALI CHAHLAVI MD | ||||||||||||||
| PHYSICIAN | $2,470,406 | $0 | $861,792 | $0 | $1,710 | $0 | $13,250 | $0 | $49,089 | $0 | $3,396,247 | $0 | $0 | $0 |
| ERIC GABRIEL MD | ||||||||||||||
| PHYSICIAN | $1,441,104 | $0 | $444,352 | $0 | $2,622 | $0 | $14,575 | $0 | $39,290 | $0 | $1,941,943 | $0 | $0 | $0 |
| MARIANO B MIKULIC MD | ||||||||||||||
| PHYSICIAN | $542,473 | $0 | $1,046,086 | $0 | $2,589 | $0 | $15,900 | $0 | $31,672 | $0 | $1,638,720 | $0 | $0 | $0 |
| ERIC W NOTTMEIER MD | ||||||||||||||
| PHYSICIAN | $1,048,454 | $0 | $202,710 | $0 | $1,710 | $0 | $13,250 | $0 | $35,319 | $0 | $1,301,443 | $0 | $0 | $0 |
| SAUMIL R OZA MD | ||||||||||||||
| PHYSICIAN | $479,870 | $0 | $791,621 | $0 | $1,013 | $0 | $13,250 | $0 | $26,949 | $0 | $1,312,703 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: -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 - $279,866 Moody Chisholm - $514,219 Janice G. Lipsky - $239,720 Denise McKrow - $155,996 Donnie L Romine, Jr. - $396,213 |
| 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 individuals received current year distributions. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 4 Significant changes to organizational documents | THE ARTICLES OF INCORPORATION FOR ST. VINCENT'S AMBULATORY CARE, INC. WERE AMENDED FOR A CHANGE IN CORPORATE MEMBERSHIP. THE SINGLE CORPORATE MEMBER CHANGED FROM ST. VINCENT'S HEALTH SYSTEM, INC. TO ASCENSION MEDICAL GROUP, LLC. |
| 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 XI, Line 9 Other changes in net assets or fund balances | Deferred Pension Costs - -316301; Transfer from Affiliates - 54588293; |
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| ST VINCENT'S HEALTH SYSTEM INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 593650609 | PARENT ENTITY | FL | 501(c)(3) | Type II | ASCENSION HEALTH | false |
| ST VINCENT'S MEDICAL CENTER INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 590624449 | HOSPITAL | FL | 501(c)(3) | 3 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST LUKE'S-ST VINCENT'S HEALTHCARE INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 260479484 | HOSPITAL | FL | 501(c)(3) | 3 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST VINCENT'S FOUNDATION INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 592219923 | FUND RAISING | FL | 501(c)(3) | 7 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
| ST VINCENT'S MEDICAL CENTER CLAY COUNTY INC | ||||||||||
| 4205 BELFORT ROAD SUITE 4020 | JACKSONVILLE | FL | 32216 | 461523194 | HOSPITAL | FL | 501(c)(3) | 3 | ST VINCENT'S HEALTH SYSTEM INC | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CONSOLIDATED PHARMACY SERVICES INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593398033 | RETAIL PHARMACY & PATIENT TRANSPORT | FL | NA | C Corporation | Yes (true) |
| ADVANCED PATIENT TRANSPORTATION INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593381444 | TRANSPORT SERVICES | FL | NA | C Corporation | Yes (true) |
| SETON PHARMACY INC | |||||||||
| 4205 BELFORT ROAD SUITE 4030 | JACKSONVILLE | FL | 32216 | 593001427 | RETAIL PHARMACY | FL | NA | C Corporation | Yes (true) |
| FAMILY MEDICINE CENTER CONDOMINIUM ASSOCIATION INC | |||||||||
| 1 SHIRCLIFF WAY | JACKSONVILLE | FL | 32204 | 261983355 | CONDOMINIUM ASSOCIATION | FL | NA | C Corporation | Yes (true) |
| St Vincent's Strategic Ventures Inc | |||||||||
| 4205 Belfort Road Suite 4030 | Jacksonville | FL | 33213 | 593133073 | LEASING | FL | NA | C Corporation | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (18 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CONSOLIDATED PHARMACY SERVICES INC | ||
| Q | $57,117 | FMV |
| ST LUKE'S HOSPITAL | ||
| K | $1,031,830 | FMV |
| ST LUKE'S HOSPITAL | ||
| O | $105,511 | FMV |
| ST LUKE'S HOSPITAL | ||
| P | $131,657 | FMV |
| ST LUKE'S HOSPITAL | ||
| R | $138,119 | FMV |
| ST VINCENT'S FOUNDATION INC | ||
| C | $1,115,702 | FMV |
| ST VINCENT'S FOUNDATION INC | ||
| O | $240,125 | FMV |
| ST VINCENT'S FOUNDATION INC | ||
| P | $1,091,140 | FMV |
| ST VINCENT'S FOUNDATION INC | ||
| S | $401,769 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| K | $1,065,351 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| L | $586,308 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| M | $906,320 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| O | $1,682,829 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| P | $3,267,278 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| Q | $646,256 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| S | $486,032 | FMV |
| ST VINCENT'S MEDICAL CENTER INC | ||
| R | $3,177,636 | FMV |
| ST VINCENT'S MEDICAL CENTER-CLAY COUNTY INC | ||
| R | $1,372,767 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part II St. Vincent's Ambulatory Care, Inc. | FormAndLineReferenceDesc |
| Explanation | Due to a corporate reorganization during FY 2017, the sole corporate member of St. Vincent's Ambulatory Care, Inc. changed from St. Vincent's Health System, Inc. to Ascension Medical Group, a disregarded entity of Ascension Health, EIN 31-1662309. At that time, St. Vincent's Ambulatory Care, Inc. ceased to be a member of the Ascension Jacksonville group. | ExplanationTxt |
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