ST MARYS HEALTHCARE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ST MARYS HEALTHCARE (EIN 14-1347719)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-12
IRS object ID
201801329349300535
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

FieldValueIRS element (for citing)
Return2018-05-12T12:06:37-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN141347719EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Mary's HealthcareBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTMABusinessNameControlTxt
Phone3147338000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1427 Guy Park AvenueAddressLine1Txt
CityAmsterdamCityNm
State AbbreviationNYStateAbbreviationCd
ZIP120101054ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTonya MershonPersonNm
Person TitleTax OfficerPersonTitleTxt
Signature2017-10-23SignatureDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Victor GiulianelliBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1427 Guy Park AvenueAddressLine1Txt
CityAmsterdamCityNm
State AbbreviationNYStateAbbreviationCd
ZIP120101054ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$168,444,272GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.smha.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1903FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTo improve the health and well-being of all people in the communities we serve.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee1935TotalEmployeeCnt
Total Volunteers200TotalVolunteersCnt
Total Gross UBI$647,817TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$134,538NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,749,772PYContributionsGrantsAmt
CY Contributions Grants$6,032,811CYContributionsGrantsAmt
PY Program Service Revenue$157,346,043PYProgramServiceRevenueAmt
CY Program Service Revenue$157,581,407CYProgramServiceRevenueAmt
PY Investment Income$402,935PYInvestmentIncomeAmt
CY Investment Income$3,255,727CYInvestmentIncomeAmt
PY Other Revenue$1,510,408PYOtherRevenueAmt
CY Other Revenue$1,346,644CYOtherRevenueAmt
PY Total Revenue$169,009,158PYTotalRevenueAmt
CY Total Revenue$168,216,589CYTotalRevenueAmt
PY Grants And Similar Paid$56,359PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$53,690CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$101,890,274PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$105,890,058CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$64,196,842PYOtherExpensesAmt
CY Other Expenses$66,894,653CYOtherExpensesAmt
PY Total Expenses$166,143,475PYTotalExpensesAmt
CY Total Expenses$172,838,401CYTotalExpensesAmt
PY Revenues Less Expenses$2,865,683PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,621,812CYRevenuesLessExpensesAmt
Total Assets BOY$165,325,721TotalAssetsBOYAmt
Total Assets EOY$172,889,674TotalAssetsEOYAmt
Total Liabilities BOY$52,289,310TotalLiabilitiesBOYAmt
Total Liabilities EOY$67,854,573TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$113,036,411NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$105,035,101NetAssetsOrFundBalancesEOYAmt
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$151,323,604ExpenseAmt
Grant$53,690GrantAmt
Revenue$156,683,182RevenueAmt
DescSt. Mary's Healthcare provides a substantial portion of its services to the elderly and poor. During the twelve month period ending June 30, 2017, approximately 38.32% of the values of services rendered were to elderly patients under the Medicare program and approximately 17.92% of the services were provided to patients who were deemed indigent under state, county or hospital guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's 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, underinsured, and the underserved. During the twelve month period ending June 30, 2017, the estimated cost of providing care of persons living in poverty totaled $15.7 million, including $732,000 cost of charity care, $4.07 million in programs for persons living in poverty, and $10.9 million in the unpaid cost of public programs. These amounts vary from Schedule H due to different methods of calculation. In the twelve months ending June 30, 2017, St. Mary's Healthcare provided health care services to 7,030 inpatients and 427,639 outpatients, and 57,450 days of care to residents of the skilled nursing facility. The inpatient care covered medical/surgical, psychiatric, alcohol rehabilitation, physical rehabilitation, maternity and newborn patients. The outpatient visits included 27,017 emergency visits; 7,072 outpatient surgeries; 152,598 referred visits (including imaging, laboratory, therapies, and cardiac rehab), total other outpatient visits of 37,640 including 1,139 visits to nursing home patients, 7,507 adult day care visits, 27,418 urgent care visits, 771 occupational medicine visits and 805 visits to the diabetes center; 63,161 family health center visits; total specialty visits of 24,120 including 4,749 urology health center visits, 4,656 cancer treatment center visits 6,609 Amsterdam OB/GYN Center, 1,388 Johnstown OB Center, Cancer Center Chemotherapy 1,284, Gastroenterology 5,434 and total mental health and alcohol visits of 109,798 including , 8,969 alcohol clinic visits, and 100,829 mental health clinic visits. St. Mary's Healthcare administers one of the most comprehensive mental health outpatient programs in New York State. In the twelve months ending June 30, 2017, the Hospital provided a variety of services through various grant-funded programs including psych-social clubs, prevocational/employment assistance programs, mobile geriatric/senior citizen programs, and alcohol intervention service programs. In addition, caring families provided family care services and hospital personnel provided case management counseling under various grant-funded programs.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,265,000ExpenseAmt
DescCommunity benefits are programs or activities that provide treatment and / or promote health and healing as a response to identified community needs. To promote healthy living, St. Mary's Healthcare has made available the following programs to the community: reduced cost programs providing senior citizens with Lifeline equipment enabling them to solicit help should the need arise; community continuing education programs providing information on a variety of subjects including child abuse, day-to-day parenting, seat belt use and safety. Smoking cessation, weight loss, and other wellness programs; help and support groups for victims and their family members; and providing meeting facilities for victims of alcohol abuse.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$882,632ExpenseAmt
Revenue$898,225RevenueAmt
DescSt. Mary's Healthcare's other program service revenue includes continuing education programs, psychological services provided to Montgomery county, medical director services, cafeteria sales to visitors and employees, and rebates / refunds of expenses.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$155,471,236TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
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 OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
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 OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document162IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1935EmployeeCnt
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 OffalseForm8282PropertyDisposedOfInd
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Rick HenzeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5188417434PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1427 Guy Park AvenueAddressLine1Txt
CityAmsterdamCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12010ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
VICTOR F GIULIANELLI
PRESIDENT & CEO40.02.0Yes (X)Yes (X)$886,698$0$40,074
EMILY T ETZKORN MD
CHAIRMAN2.00Yes (X)Yes (X)$0$0$0
ANDREW HECK
VICE-CHAIRMAN2.00Yes (X)Yes (X)$0$0$0
SISTER MARY A HEENAN
SECRETARY2.00Yes (X)Yes (X)$0$0$0
THOMAS F CICHY
TREASURER2.00Yes (X)Yes (X)$0$0$0
GREGORY J ABBATTISTI CPA
DIRECTOR2.01.0Yes (X)$0$0$0
MOHAMMED R GHAZI-MOGHADAM MD
DIRECTOR/PHYSICIAN40.00Yes (X)$503,421$0$38,615
SISTER NANCY GREGG
DIRECTOR2.00Yes (X)$0$0$0
RONALD LIMONCELLI
DIRECTOR2.00Yes (X)$0$0$0
RONALD MARSH MD
DIRECTOR/PHYSICIAN40.00Yes (X)$78,537$0$6,278
MICHAEL J PEPE
DIRECTOR2.00Yes (X)$0$0$0
BRENT E PHETTEPLACE
DIRECTOR2.00Yes (X)$0$0$0
MICHAEL M SHERIDAN DO
DIRECTOR/PHYSICIAN40.00Yes (X)$137,975$0$14,363
FREDERICK E HENZE JR
VP OF FINANCE & CFO40.01.0Yes (X)$217,514$0$11,116
SCOTT M BRUCE
VP OF OPERATIONS40.01.0$366,256$0$39,308Yes (X)
DONALD W MASSEY
VP OF CONTINUUM CARE40.00$215,749$0$26,173Yes (X)
WILLIAM D MAYER
VP OF MEDICAL AFFAIRS40.00$422,306$0$24,566Yes (X)
DUANE S MILLER
VP OF BEHAVIORAL HEALTH40.00$179,393$0$30,427Yes (X)
ALBERT V TURO
VP OF DEVELOPMENT & PLANNING (END 12/2016)34.55.5$238,894$0$22,662Yes (X)
MICHELE M WALSH
VP OF NURSING40.00$257,808$0$20,126Yes (X)
JAMES M CHARLAND MD
PHYSICIAN40.00$587,770$0$41,658Yes (X)
MICHAEL J FINNEGAN MD
PHYSICIAN40.00$777,090$0$44,726Yes (X)
DAVID J LEHR MD
PHYSICIAN40.00$449,543$0$42,456Yes (X)
GARY SINENSKY MD
PHYSICIAN40.00$553,868$0$36,108Yes (X)
ZAINUL A SYED MD
PHYSICIAN40.00$524,616$0$23,315Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,397,438TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$461,971TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K80IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
ATLANTIC PROFESSIONAL SERVICES OF RI
PO BOX 635988CINCINNATIOH45263HOSPITALISTS$1,879,297
ARUP LABORATORIES
500 S CIPETA WAYSALT LAKE CITYUT84108LABORATORY SERVICES$982,606
ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC
315 S MANNING BLVDALBANYNY122081707MEDICAL SERVICES$738,825
MOHAWK VALLEY MEDICAL ANESTH ASSC PLLC
178 CLIZBE AVEAMSTERDAMNY12010PHYSICIAN SERVICES$446,194
MOHWAK VALLEY MRI
5010 STATE HIGHWAY 30AMSTERDAMNY12010MEDICAL SERVICES$316,404SUITE 205
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Related Organizations$97,374RelatedOrganizationsAmt
Government Grants$5,935,437GovernmentGrantsAmt
Total Contributions$6,032,811TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue621990$157,159,401$157,159,401
OTHER PROGRAM SERVICE621990$108,424$108,424
intercompany shared service revenue900099$313,582$313,582

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$157,581,407TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,300,237TotalRevenueColumnAmt
Exclusion$3,300,237ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$85,199RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$176,173RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$90,974RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$90,974TotalRevenueColumnAmt
Exclusion-$90,974ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$7,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$51,510OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$44,510OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$44,510TotalRevenueColumnAmt
Exclusion-$44,510ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
LABORATORY SERVICES621500$554,515$554,515
MEDICAL DIRECTOR SERVICES623990$20,414$20,414
ATHLETIC TRAINING SERVICES621400$71,538$71,538

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$791,151TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,350UnrelatedBusinessRevenueAmt
Exclusion$789,801ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,437,618OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$168,216,589TotalRevenueColumnAmt
Related Or Exempt Func Income$157,581,407RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$647,817UnrelatedBusinessRevenueAmt
Exclusion$3,954,554ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,100TotalAmt
Program Services$13,100ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$40,590TotalAmt
Program Services$40,590ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,778,259TotalAmt
Program Services$566,739ProgramServicesAmt
Management And General$3,211,520ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$82,807,343TotalAmt
Program Services$78,220,777ProgramServicesAmt
Management And General$4,586,566ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,317,519TotalAmt
Program Services$2,171,937ProgramServicesAmt
Management And General$145,582ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$11,014,204TotalAmt
Program Services$10,322,311ProgramServicesAmt
Management And General$691,893ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,972,733TotalAmt
Program Services$5,972,733ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$227,500TotalAmt
Program Services$170,146ProgramServicesAmt
Management And General$57,354ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$111,664TotalAmt
Management And General$111,664ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$23,805TotalAmt
Management And General$23,805ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$750TotalAmt
Management And General$750ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$17,952,384TotalAmt
Program Services$16,154,698ProgramServicesAmt
Management And General$1,797,686ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$71,940TotalAmt
Program Services$65,454ProgramServicesAmt
Management And General$6,486ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$490,180TotalAmt
Program Services$411,537ProgramServicesAmt
Management And General$78,643ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,446,307TotalAmt
Program Services$7,446,307ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,389,069TotalAmt
Program Services$3,087,096ProgramServicesAmt
Management And General$301,973ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$276,983TotalAmt
Program Services$208,237ProgramServicesAmt
Management And General$68,746ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$195,024TotalAmt
Program Services$162,016ProgramServicesAmt
Management And General$33,008ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,006,072TotalAmt
Program Services$6,481,317ProgramServicesAmt
Management And General$524,755ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,297,831TotalAmt
Management And General$1,297,831ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$19,311,127$19,187,385$123,742
PROVIDER TAX$1,296,391$1,296,391
PURCHASED SERVICES AFFILIATES$3,547,646$3,547,646
EQUIPMENT RENT$655,192$641,236$13,956

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,594,788TotalAmt
Program Services$2,851,229ProgramServicesAmt
Management And General$743,559ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$172,838,401TotalAmt
Program Services$155,471,236ProgramServicesAmt
Management And General$17,367,165ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,259,052BOYAmt
EOY$1,164,211EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$21,321,320BOYAmt
EOY$21,477,436EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,449,565BOYAmt
EOY$1,842,570EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$419,139BOYAmt
EOY$462,287EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$115,729,341LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$60,291,349LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$58,519,476BOYAmt
EOY$55,437,992EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,357,018BOYAmt
EOY$1,246,555EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$81,000,151BOYAmt
EOY$91,258,623EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$165,325,721BOYAmt
EOY$172,889,674EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$18,058,335BOYAmt
EOY$16,913,277EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,035,402BOYAmt
EOY$1,241,701EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$49,914BOYAmt
EOY$78,782EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,145,659BOYAmt
EOY$49,620,813EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$52,289,310BOYAmt
EOY$67,854,573EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$105,328,979BOYAmt
EOY$96,069,179EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,201,912BOYAmt
EOY$2,460,177EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,505,520BOYAmt
EOY$6,505,745EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$113,036,411BOYAmt
EOY$105,035,101EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$165,325,721BOYAmt
EOY$172,889,674EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$4,621,812ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,732,459NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,111,957OtherChangesInNetAssetsAmt
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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$23,805OtherActivitiesAmt
Total Lobbying Expenditures$23,805TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 Detailed description of the Lobbying activityFormAndLineReferenceDesc
ExplanationLobbying expenses include the portion of dues paid to National and State Associations that are specifically allocable to lobbying. St. Mary's Healthcare does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or its opposition to ) and candidate for public office.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,423,426BeginningYearBalanceAmt
Contributions$225ContributionsAmt
Investment Earnings Or Losses$950,998InvestmentEarningsOrLossesAmt
Other Expenditures$269,700OtherExpendituresAmt
End Year Balance$9,104,949EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,505,491BeginningYearBalanceAmt
Contributions$4,152ContributionsAmt
Investment Earnings Or Losses$170,156InvestmentEarningsOrLossesAmt
Other Expenditures$2,256,373OtherExpendituresAmt
End Year Balance$8,423,426EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,044,819BeginningYearBalanceAmt
Contributions$1,760ContributionsAmt
Investment Earnings Or Losses$466,208InvestmentEarningsOrLossesAmt
Other Expenditures$7,296OtherExpendituresAmt
End Year Balance$10,505,491EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,561,895BeginningYearBalanceAmt
Contributions$11,814ContributionsAmt
Investment Earnings Or Losses$471,685InvestmentEarningsOrLossesAmt
Other Expenditures$575OtherExpendituresAmt
End Year Balance$10,044,819EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,241,842BeginningYearBalanceAmt
Contributions$8,009ContributionsAmt
Investment Earnings Or Losses$1,317,915InvestmentEarningsOrLossesAmt
Other Expenditures$5,871OtherExpendituresAmt
End Year Balance$9,561,895EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.71PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.29TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,341,923OtherCostOrOtherBasisAmt
Book Value$9,341,923BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,571,070OtherCostOrOtherBasisAmt
Depreciation$31,510,554DepreciationAmt
Book Value$32,060,516BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,893,722OtherCostOrOtherBasisAmt
Depreciation$28,780,795DepreciationAmt
Book Value$13,112,927BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$922,626OtherCostOrOtherBasisAmt
Book Value$922,626BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$55,437,992TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
Estimated Settlements from Third-Party Payor$757,189
Other Receivables$5,369,925
Interest in Investments by Ascension Health Alliance$68,015,106
Interest in Net Assets of Foundation$8,965,923
Intangible Pension Asset$2,044,410
Physician Receivable$263,819
intercompany receivables$5,842,251
FieldValueIRS element (for citing)
Total Book Value Other Assets$91,258,623TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (13 entries)

DescDescAmtAmt
Estimated Settlement to Third-Party Payor$1,826,134
Pension and Other Post retirement Liability$19,649,996
Intercompany Debt to Ascension Health Alliance$8,332,136
Asset Retirement Obligation$1,500,000
Patient Credit Liabilities$424,402
IBNR Liability
Third Party Advance
Other Advances$239,099
INCOME GUARANTEE$239
VALUATION GUARANTEE$433,382
HISTORICAL ALLOWANCES$400,000
RECOVERY TAIL HOSPITAL LIABILITY$563,381
INTERCOMPANY ACCOUNTS PAYABLE$16,252,044
FieldValueIRS element (for citing)
Total Liability$49,620,813TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part IV, Line 2b Explanation of escrow agreementThe Hospital maintains accounts for residents of the skilled nursing facility which totaled $78,782 at 06/30/2017
Schedule D, Part V, Line 4 Intended uses of endowment fundsThe intended use of the endowment fund is to assist St. Mary's Healthcare at Amsterdam to develop and expand its services to the community.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteTHE 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.

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
Percent350Yes (X)Percent350Ind
Free Care Medically IndigentfalseFreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
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$975,662TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$160,422DirectOffsettingRevenueAmt
Net Community Benefit Expns$815,240NetCommunityBenefitExpnsAmt
Total Expense0.0047TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$55,142,939TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$44,245,839DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,897,100NetCommunityBenefitExpnsAmt
Total Expense0.0630TotalExpensePct

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$56,118,601TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$44,406,261DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,712,340NetCommunityBenefitExpnsAmt
Total Expense0.0678TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,377,603TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$53,420DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,324,183NetCommunityBenefitExpnsAmt
Total Expense0.0192TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,011,187TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,011,187NetCommunityBenefitExpnsAmt
Total Expense0.0059TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,061,933TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,371,595DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,690,338NetCommunityBenefitExpnsAmt
Total Expense0.0156TotalExpensePct

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$301,238TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$301,238NetCommunityBenefitExpnsAmt
Total Expense0.0017TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$19,751,961TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,425,015DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,326,946NetCommunityBenefitExpnsAmt
Total Expense0.0424TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$75,870,562TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,831,276DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,039,286NetCommunityBenefitExpnsAmt
Total Expense0.1102TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

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

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,161TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,161NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

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)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

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 Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$13,161TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,161NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$6,998,302BadDebtExpenseAmt
Bad Debt Expense Attributable$1,193,649BadDebtExpenseAttributableAmt
Reimbursed By Medicare$66,645,377ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$71,108,595CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,463,218MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
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 HealthcareBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1427 Guy Park AvenueAddressLine1Txt
CityAmsterdamCityNm
State AbbreviationNYStateAbbreviationCd
ZIP120101054ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://www.smha.org/WebsiteAddressTxt
State License2801001HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Mary's HealthcareBusinessNameLine1Txt
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 URLhttp://www.smha.org/st-marys/community-health-needs-assessment1OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.smha.org/st-marys/community-health-needs-assessment1StrategyWebsiteURLTxt
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 Care350.0FPGFamilyIncmLmtDscntCarePct
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 Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
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 5 Facility , 1Facility , 1 - St. Mary's Healthcare. As part of the Community Health Assessment, a Community Health Survey was conducted in the Spring of 2015 to the Fall of 2015 for the reporting period of 2015-2018. A random survey 750 individuals 18 and older in St. Mary's Healthcare service area were interviewed by telephone. An online survey was also conducted to solicit input from key informants. St. Mary's Healthcare supplied a list of recommended participants including physicians, public health representatives, other health professionals, social service providers, and a variety of community leaders. The community leaders include those who work with low-income minority populations and medically underserved populations. St. Mary's Healthcare uses reliable, third-party resources, including data from government sources to assess the healthcare needs for the community it serves: Fulton and Montgomery Counties in New York State. These reports include vital information regarding key health status, socioeconomic and demographic indicators that point to areas of need and include, but are not limited to, reports from: Catholic Charities of Fulton and Montgomery Counties, FulMont Community Action Agency, Fulton County Department of Public Health, Fulton County Office for the Aging, Fulton County YMCA, HFM (Hamilton, Fulton and Montgomery) Prevention Council, Montgomery County Department of Public Health, Montgomery County Office for the Aging, US Census Bureau, etc. To access a complete listing of resources, please refer to the St. Mary's Healthcare 2015 Community Health Needs Assessment. St. Mary's Healthcare utilizes these resources to help guide community education programs and provide services throughout the region. In addition, St. Mary's Healthcare considers the healthcare needs of the overall community when evaluation internal financial and operational decisions. Input from persons representing broad interests of the community and populations which are underserved, low-income, minority and/or with chronic disease needs were included through randomized phone surveys and an online key informant survey via email.
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - St. Mary's Hospital. St. Mary's Healthcare conducted its CHNA with the following other hospital facility: St. Mary's Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - St. Mary's Healthcare. The CHNA Steering Committee met on January 7, 2016 to determine the health needs to be prioritized for action. The Areas of Opportunity were prioritized by the Committee as follows: Substance Abuse, Mental Health, Nutrition/Physical Activity/Weight Management, Cancer, Heart Disease & Stroke and Diabetes. St. Mary's Healthcare is continually working to meet the goals set forth in their Community Health Needs Assessment (CHNA) Implementation Strategy 2015-2018. Nutrition and Weight Status - St. Mary's is working with Johnstown Pediatric Center, Memorial Family Health Center, FulMont Head Start, Dr. Emily Etzkorn's office, and St. Mary's Institute, to implement a childhood obesity prevention program, "5210." This program will help providers talk to children and their families about the importance of healthy eating and physical activity. St. Mary's Healthcare will also enforce the "5210" message to all associates. The Hospital regularly offers free glucose testing and education as requested by local school, community and civic groups. St. Mary's has a Diabetes and Nutrition Education Center to provide nutritional counseling to the community, the Pregnancy Care Center, and Cardiac Rehabilitation. Primary care providers and their staff discuss nutritional concerns with the patients they see on a regular basis. They are able to make referrals for nutritional counseling as necessary. St. Mary's continues to stock the "Mission Cupboard," which serves as an emergency food pantry for patients. St. Mary's continues to promote "Baby Friendly" to improve maternal and child health. The goal is to increase the number of women who initiate and exclusively breastfeed without medical reason for formula to 78% by May 2019. (Baseline: 68% in 2015) Cancer Peer Education began a "Fun and Free Walking Program" for Amsterdam residents in June 2017. This continued into the fall 2017 and will begin again June 2018. Chronic Disease - St. Mary's was the recipient of a grant from the New York State Department of Health for Peer Education. This three- to five-year grant will reduce breast cancer mortality by 10% and increase awareness and education surrounding prostate cancer. In their first year, the team educated 1055 women about breast cancer screenings and 757 men about prostate cancer screenings. They referred 246 women an 158 men to resources in the community. 46 women disclosed they received mammograms after a discussion with their healthcare provider, and 56 men disclosed they had a discussion with their healthcare provider about prostate cancer. Three St. Mary's associates are trained in "The Butt Stops Here," a tobacco cessation program. Two sessions were held in January 2017 and May 2017. A third session is set for Spring 2018. The first inaugural Medical Mission at Home event was held on May 6th, 2017 at the Family Health Center at the Carondelet Pavilion. This served as an opportunity for anyone in the community to come and receive free healthcare, social and support services, regardless of health insurance status. Substance Abuse/Mental Health - St. Mary's Healthcare continues to participate as a member of the Fulton Montgomery Suicide Prevention Task Force. The hospital is available to provide educational materials and resources to schools in Fulton and Montgomery counties. A community program regarding teen cyber safety, "Born 2B Viral," was presented at the Lynch Literacy Academy in November 2016. 30 community members were in attendance. A Human Trafficking Critical Team was formed and meets monthly in order to address the gaps in services for sex and labor trafficking victims. St. Mary's implemented a human trafficking policy along with educational modules about how to respond to potential victims and survivors. St. Mary's added a new ambulatory detox center, which opened December 2016. The first inaugural Medical Mission at Home event was held on May 6th, 2017 at the Family Health Center at the Carondelet Pavilion. This served as an opportunity for anyone in the community to come and receive free healthcare, social and support services, regardless of health insurance status. Narcan kits were handed out by trained professionals to anyone who needed them. St. Mary's held a SBIRT training for other community professionals in substance abuse in April 2017. St. Mary's held a Binge Eating Disorder awareness program on May 12th, 2017, for the community at large. 20 people were in attendance. A survivor of Binge Eating Disorder came to speak about her story and the benefits of support groups, such as Overeaters Anonymous. Other Needs - St. Mary's Healthcare offers our Pregnancy Care Center, a comprehensive pre-natal program for uninsured, low-income women who become pregnant. The care includes routine pregnancy medical checkups, lab work and access to specialists. The Hospital provides information about pregnancy, labor and delivery as well as hospital care during pregnancy and delivery. Medical care is provided for the mother for at least two months after delivery and for the baby at least one year after birth. St. Mary's asks every patient they see for services if they use tobacco. Medical providers at primary care centers provide counseling and inpatients receive a visit from the Respiratory Therapy Department who provides smoking cessation counseling and materials. St. Mary's Healthcare Birth Center has been recognized by Healthgrades for the 2016 Labor and Delivery Excellence Award. In addition, St. Mary's was also recognized by Healthgrades for Superior Performance in Labor and Delivery, among the top 10% of hospitals evaluated for labor and delivery for two years in a row, a Five-star recipient for natural delivery two years in a row and five-star recipient for C-Section delivery in 2016. St. Mary's was awarded the 2017 America's 100 Best Hospitals for Orthopedic Surgery Award St. Mary's provides free flu shots to the local college and BOCES's students in the CNA, LPN, and RN nursing classes and to our migrant farm workers in the rural sections of Montgomery County. The Hospital partners with local physicians and medical providers to offer educational programs on joint, bone and back health. We have a partnership with a local orthopedic practice to offer "Joint School" which educates candidates for joint replacement on surgery, treatment, care, and management of bone and joint tissues. St. Mary's currently audits patient records to ensure that all diabetics are receiving the care they need to prevent renal disease as a result of complications from their diabetes.
Schedule H, Part V, Section B, Line 16 Facility , 1Facility , 1 - St. Mary's Healthcare. Individual letters are mailed to all uninsured patients informing them of the financial assistance programs available.
FieldValueIRS element (for citing)
Facility16FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
St Mary's Healthcare
4988 State Highway 30AmsterdamNY12010Diagnostic Care, Primary Care, Cancer Medicine, and Inpatient Physical Rehab
Wilkinson Residential Health Care Fac
4988 State Highway 30AmsterdamNY12010Residential Health Care Facility
Johnstown Family Health Center
700 S Perry StreetJohnstownNY12095Family Health Center
Amsterdam OBGYN Center
446A Guy Park AveAmsterdamNY12010OB/GYN Center
Canajoharie Family Health Center
48 Erie BoulevardCanajoharieNY13317Family Health Center
Montgomery County Addiction Services
76 Guy Park AveAmsterdamNY12010Addiction Services
Broadalbin Health Center
3768 ST HWY 30BroadalbinNY12025Family Health Center
Fulton County Addiction Services
73 North Main StreetGloversvilleNY12078Addiction Services
Carondelet Family Health Center
380 Guy Park AveAmsterdamNY12010Family Health Center
Fulton County Day Rehab Addiction Svc
57 E Fulton StreetGloversvilleNY12078Addiction Rehabilitation Center
Gloversville Family Health Center
84 E State StreetGloversvilleNY12078Family Health Center
Children's Mental Health Clinic
8 Northampton RoadAmsterdamNY12010Children's Mental Health Center
Diagnostic Service Center
110 Holland Circle DriveAmsterdamNY12010Diagnostic Care Center
Northville Family Health Center
331 Bridge StreetNorthvilleNY12134Family Health Center
Children's Day Treatment Program
234 Lincoln StreetGloversvilleNY12078Children's Treatment Center

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 17 Billing and Collection PolicyDuring tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization.
Schedule H, Part I, Line 7g Subsidized Health ServicesThe organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe cost of providing charity care, means tested government programs, and 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 charity care, a specific cost-to-charge ratio was applied; for other categories in the table, a cost accounting system was used.
Schedule H, Part II Community Building ActivitiesSt. Mary's Healthcare provided the following community building activities in July 2016 - June 2017. * Donated turkeys to 30 migrant farm families in November 2016. A community dinner was also held for them in November 2016 at the St. Mary's Healthcare Memorial Campus. * In 2016-2017 St. Mary's Healthcare, together with leaders of local community agencies and the Department of Social Services continued to address the homeless issues in Amsterdam. Through their continued collaboration, the homeless shelter continues to operate and provide critical housing services for those in emergent need. Danielle's house also offers intensive case management services, job assistance and low-income apartment rentals for those who need a more permanent place to stay and the support of a case manager. * St. Mary's donated both funding and staff time by three associates to the local Habitat for Humanity Chapter. The first house was built by this chapter over a period of three and a half years. * November 3, 2016: St. Mary's held a Poverty Simulation at the Paul Nigra Center, Mayfield. This provided community members and associates a first-hand experience of what it might be like to live in a low-income family. * September 2016: Provided a free community Narcan training program at the St. Mary's Healthcare Carondelet Pavilion. * February 18, 2017: Healthy Women's Day at the Rao Outpatient Pavilion was a day where uninsured women could receive free mammograms, PAP smears, blood pressure screenings, and lab work, along with a chance to enroll in health insurance programs. * The first inaugural Medical Mission at Home event was held on May 6th, 2017 at the Family Health Center at the Carondelet Pavilion. This served as an opportunity for anyone in the community to come and receive free healthcare, social and support services, regardless of health insurance status. Thirteen patients were seen, 14 local community organizations showcased their programs and services, and St. Mary's had over 70 associates volunteer their time that day. This also included six healthcare providers. * A community program regarding teen cyber safety, "Born 2B Viral," was presented at the Lynch Literacy Academy in November 2016. 30 community members were in attendance. * St. Mary's held two sessions of the tobacco cessation program, "The Butt Stops Here," a 7-week program to help smokers quit tobacco use. One session was January 2017 and the other May 2017. * Cancer Peer Education began a "Fun and Free Walking Program" for the Amsterdam community, where 37 residents participated, while the peer educators were able to encourage healthy behaviors, such as eating well and exercise, along with getting screened regularly for breast and prostate cancers. * "Reach Out and Read" is a well-recognized, national literacy based program for children and primary care providers. Primary care providers "prescribe" a book for the child to read, or for the parents to read to the child. This has been ongoing at St. Mary's for three years.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountSt. Mary's Healthcare writes an accounts receivable off as a bad debt after collection efforts have been followed in accordance with the hospital's policies. Discounts and insurance payments have been applied to each patient account and reasonable efforts have been made to collect the remaining balance due from the patient.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe bad debt expense attributable to patients eligible under the organization's financial assistance policy is calculated from the amount of bad debt transfers for uninsured patients. The ratio of cost to charge is applied to the total transfers less the cost of the bad debt recoveries. This bad debt is not included as a community benefit.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteThe organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsAscension Health and 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.
Schedule H, Part VI, Line 2 Needs assessmentIn 2012 and 2015, the Hospital contracted with Professional Research Consultants, Inc. (PRC) to conduct St. Mary's Healthcare's Community Health Needs Assessment (CHNA). The assessment, completed in December 2015, incorporated data from both quantitative and qualitative sources including random sampling of community members, key informant online surveys, and secondary data sources. The key informant survey consisted of input from persons who represent the community we serve, including business leaders, community-based and social service agencies, school districts and those with a special knowledge or expertise in public health. The data from this assessment was made available to the public via the hospital's website, http://www.smha.org/st-marys/community-health-needs-assessment1 and upon request. The hospital also used data from our county health departments' community needs surveys. Additionally, the Hospital sought input from its Board of Trustees, Medical Executive Committee, leadership staff and community partners when completing its annual Integrated Strategic, Operational, and Financial Plan (ISOFP). The ISOFP uses pertinent data and comprehensive feedback to outline current and future critical healthcare needs for the Hospital's service area, as well as the resources needed to address the identified issues. In 2016, the hospital, in collaboration with our County Health Department, used indicator data from the New York State Department of Health and it's Prevention Agenda to develop the hospital's three-year (2015-2018) Community Service Plan (CSP).
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceSt. Mary's Healthcare, in keeping with the mission and policies of Ascension Health, strives to maintain a balance between providing care of the poor with the ability of the Hospital to maintain quality health care for the community it serves. As part of its financial assistance policies, the Hospital offers a self pay discount to all uninsured patients as a percentage off the standard charge; the discounts were set at 32% for inpatient services and 46% for outpatient services. For the twelve month period (July 2016-June 2017), the discounts provided to the uninsured were $1,981,908. The Carondelet Care assistance program is the next level of financial assistance available to the Hospital's patients. This program is available to all patients who can demonstrate a financial burden associated with their patient responsibility. Financial assistance is provided through collaboration between the health insurance enrollment and financial assistance staff. Although the two departments offer different financial assistance services, the enrollment staff is trained to help those individuals who do not qualify for any government sponsored programs to access the Carondelet Care assistance program. Similarly, the Financial Counselors often refer patients in need of insurance to our Enrollment Specialist. The enrollment staff is available to meet with community members at the main hospital, at our Memorial campus and at all six of our off-site family health centers. Staff is also trained to refer individuals to free or low cost health care programs within the community if no other options are immediately available. The Hospital enroller works collaboratively with community agencies to further expand its outreach. Large posters describing the Hospital's willingness to help patients with financial assistance are displayed in all main entrances to the Hospital and the off-site locations, as well as in our multiple registration sites and waiting rooms. The informational posters are in English and Spanish and urge patients to call if they are concerned about bill payment. Translation services are also available as needed via language line telephones and iPad video application. Brochures in English and Spanish are available at all service sites and offer detailed information about the various levels of assistance. In addition to offering discounts, St. Mary's offers options for payment plans and payment schedules. The English and Spanish brochures are also available on the Hospital web site. Information on financial assistance is also contained in the Patient Information Guide given to all inpatients at St. Mary's Healthcare.
Schedule H, Part VI, Line 4 Community informationSt. Mary's Healthcare serves a rural community consisting of Montgomery and Fulton counties in New York State as its primary service area (PSA), and is the only acute care hospital in Montgomery County. On average, 65% of hospital admissions come from Montgomery County, and 26% come from Fulton County. The main hospital campus is located in the city of Amsterdam, though a number of vital services are available on the Memorial campus in the town of Amsterdam. The Hospital operates seven primary care centers; three sites in Montgomery County (two located in Amsterdam, one in Canajoharie) and four sites in Fulton County (Johnstown, Gloversville, Broadalbin and Northville), in addition to a cancer medicine center and specialty practices in, urology, gastroenterology, obstetrics/gynecology, and ENT. The Hospital's comprehensive behavioral health programs provide extensive mental health and addiction services, including inpatient and outpatient treatment in Montgomery and Fulton Counties. The Hospital also has three urgent care centers: two in Montgomery County (Amsterdam and St. Johnsville) and one in Fulton County. (Gloversville) The PSA represents one of the oldest regions in NYS. Estimates indicate that the 65 and older population will continue to grow. According to Cornell University's Program on Applied Demographics, the only segment of our population showing growth is the 65+, and the percentage of residents aged 65 or older is expected to grow from 18.2% from 2015, to 25.3% by 2030. In Fulton County, the percentage of residents aged 65 or older is expected to grow from 17.7% from 2015, to 23% by 2030. The unemployment rate in Fulton and Montgomery Counties continues to be among the highest in NYS, exceeding the State average of 4.8%. There are many factors that contribute to the community's poverty levels, including the high school dropout rate in both counties. Reports indicate that 30% of ninth graders entering school will not complete high school in four years in our PSA. The lack of education affects the workforce, contributes to higher unemployment and greater risk of working without health insurance. Forty-five percent of all families in poverty are headed by a single parent with children. Research indicates a decline in the Caucasian population, which is a consistent trend over several years. The Hispanic community is our largest minority community, with the largest concentration within the city of Amsterdam. The 2010 Census indicates that 26.2% of the residents of Amsterdam are identified as Hispanic and according to the estimates this segment of our population will grow by 12.7% in the next five years. The Hospital employs bilingual and bicultural healthcare professionals to meet the needs of the Hispanic community. Health statistics relevant to the community's health status are as follows: Over 71% of the St. Mary's Healthcare Service Area is overweight. Especially alarming is that 34% of our children are overweight. The relationship of being overweight with other health issues such as high blood pressure, chronic depression, arthritis and diabetes are significant. Poor nutritional habits and lack of physical activity are significant contributing factors to the overweight status of our community. Access to quality health care services is important for increasing the quality of life for everyone. It impacts overall physical, social and mental health status; the prevention of disease and disability; quality of life; preventable death and life expectancy. Uninsured individuals comprise 5% of the population in Fulton and Montgomery Counties. Over 6% of the population in St. Mary's Healthcare's service area went without any type of healthcare insurance coverage at some point in the past year. Over 6% of those with low-income went without some type of coverage the past year. These numbers are significantly less favorable than the US average of 4.8%. Additionally, nearly 40% of respondents reported some type of difficulty or delays in receiving needed health care in the past year, with those who are uninsured much more likely to report barriers when compared to the insured population. The Hospital serves a disproportionate share of the Medicaid population, and approximately 27% of the total inpatient discharges are Medicaid.
Schedule H, Part VI, Line 5 Promotion of community healthSt. Mary's Healthcare's governing body is comprised of persons representing diverse aspects and interests of the community. Many members of St. Mary's Healthcare's 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. Many surplus funds find their way to mission trips in third world countries or stay here for the annual spring Medical Mission at Home event. St. Mary's Healthcare promotes the health of its community through various activities, including the following: * During July 2016-June 2017, approximately 4,150 people were provided community education on topics such as Concussion Education, Alzheimer's disease, Arthritis, Breast, Cervical and Colorectal Cancer Screenings, Health Insurance, Childbirth Education, Bone and Joint Health, Brain Injury Awareness, Heart Health, Infant CPR, Lactation Support, Ebola, Physical Activity and Nutrition, Suicide Prevention, Health Care Proxys, General Mental Well-Being, Poverty, Gastroenterology, and other wellness areas. St. Mary's associates gave 13,415.25 hours of their time engaging in these community benefit activities. * Hosted five American Red Cross Blood Drives to address the critical need for blood in our service area. * Provided Healing Touch Treatments to women who have breast cancer or who are breast cancer survivors. * St. Mary's partnered with our local school districts hosting three school tours in the period July 2016 - June 2017, providing children first-hand knowledge and experience of the operations of a hospital. Our Registered Dieticians participated in school wellness days to teach children about the importance of healthy eating and physical activity. * From July 2016- June 2017, St. Mary's associates gave 900 hours back to their community serving on various boards including The Amsterdam Homeless Coalition, DSRIP, Teen Action Alliance, St. Jude's, NAMI, Your Home Care Network, Dear Neighbor, Breast Health Brunch Committee, Children's Steering Committee, PHIP, Health Advisory Committee, Montgomery County United Way, Community Hospice, Catholic Charities of Fulton and Montgomery Counties, Community Health Center (CHC) , Greater Amsterdam Volunteer Ambulance Corp (GAVAC), Regional Perinatal Outreach Advisory, Montgomery County Public Health Quality Assurance Committee, Minority Health Task Force, Sexual Assault Task Force, Fulton-Montgomery Community College, Fulmont Community Action, Liberty ARC Board, Montgomery County Office for the Aging, The Sanford Home, Montgomery County Habitat for Humanity, the Minority Health Task Force, the Suicide Prevention Task Force, Fulton-Montgomery Regional Chamber of Commerce, Glove City and Amsterdam Rotary, Children's Aid Society, New Dimensions in Healthcare and Fulton County Long-term Care Council Boards. * From July 2016 through June 2017, St. Mary's associates gave their time to better the community by participating in walks including the American Cancer Society's Relay for Life, Alzheimer's Association Walk to End Alzheimer's and other awareness walks as well as taking part in clean-up projects in both Fulton and Montgomery Counties. The hospital supported the work of many community groups including the Canajoharie Library, The Mental Health Association of FM Counties, The Office for Aging, Caring Together Ovarian Cancer Association, the Alzheimer's Association of NENY, Catholic Charities, St. Mary's Institute, Boy Scouts, YMCA, Liberty Foundation, Mountain Valley Hospice, Rotary Clubs, Montgomery County SPCA, Montgomery County Habitat for Humanity, Fulton County Habitat for Humanity, Wishful Thinking and numerous school clubs, sport teams and community groups through its fiscal donations. * St. Mary's providers are able to refer uninsured or underinsured patients with medication needs to the Dispensary of Hope program at the Hospital. This program provides free prescription medications to those who lack prescription drug coverage. * St. Mary's also has a partnership with Palmer's Pharmacy in Johnstown. If patients are in need of medication and cannot either pay for it or pick up their prescriptions, Palmer's will deliver to the hospital, their home, or have it ready for pick-up for the patient. * Continued to be a leader and collaborator with a group of partners from local health care entities and community agencies whose mission is to improve the health status for all we serve. During 2016, we continued to carry out our work we committed to in our Implementation Strategy and Community Service Plan. * In 2016, we continued our fourteenth year of distributing educational information on insurance eligibility for children through the school system, public service announcements, advertising and appearances at "back to school" events such as PTA meetings and open houses. * Enrolled nearly 554 individuals in State-sponsored insurance programs and programs through the newly created NY State of Health Marketplace. * Provided 510 life-saving cancer screenings to 198 uninsured individuals through the Cancer Services Program. * Supported a Promotora who provided outreach education, referral, follow-up, case management and advocacy services to our Latino and migrant community. The goal of the program is to promote needed primary health services and prevention efforts in a culturally appropriate manner. The Promotora has an average of 500 client contacts/communications per month. Additionally, there are countless other communications, educational trainings, community events, individual and family visits, and service navigation that has been made available by the program. * Maintained the importance of culturally sensitive and accurate communication with Latino patients and patients with limited English proficiency through the use of translation services which include professional phone and video translation services and the translation of key documents. English and Spanish are the most prominent languages spoken in the community, so all signage is posted in both English and Spanish throughout the organization. The iPad video services also serve those who are in need of sign language services. * Provided free blood pressure screenings at various health fairs and community events throughout the year. * Provided nutrition education to 600 individuals in the community at health events and educational programs. * Hosted eight different support groups including the Women's Cancer, Brain Injury, Behavioral/Mental Health, Ostomy, Diabetes, Survivors of a Loved One's Suicide (SOLOS), Alzheimer's Caregiver Support and Community Hospice Groups supporting nearly 150 community members who receive peer support and educational opportunities to manage their concerns. * The Medical Explorers, a group for young adults, meets monthly for education and socialization with the goal of assisting youth to explore the various options in healthcare careers. * Club 60, an educational and social group for seniors aged 60 and above, meets monthly for updates on health-related issues such as the flu vaccine and specialized primary care services. * A majority of the Hospital's Board of Trustees is comprised of persons who reside in the organization's primary service area and are neither employees nor independent contractors of the Hospital, nor family members thereof. * The Hospital established the Carondelet Community Fund, which provides modest assistance to local programs and agencies whose values and mission align with the values of St. Mary's Healthcare. Grants from the fund are made to eligible non-profit community agencies which are located within the service area of St. Mary's Healthcare and which share the values of St. Mary's with an emphasis on service to the poor and vulnerable, and holistic care. The total amount awarded from this fund during July 2016-June 2017 in $13,100.
Schedule H, Part VI, Line 6 Affiliated health care systemSt. Mary's Healthcare (the Hospital) is a member of Ascension Health. In December 2011, Ascension Health Alliance became 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 health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Hospital, located in Amsterdam, New York, is a nonprofit acute care hospital. The consolidated financial statements include the Hospital, Medical Services Enhancement, Inc. (MSE), and an equity interest in The Foundation of St. Mary's Healthcare, Inc. (Foundation). MSE operates a medical office building to retain and attract physician specialists to better serve the healthcare needs of the community. The Foundation's primary purpose is to assist the Hospital to develop and expand its services to the community by providing a focal point as the recipient for philanthropic support and by transferring funds to the Hospital. The Hospital provides acute inpatient, outpatient, and emergency care services for the residents of Montgomery, Fulton, and Hamilton counties. The Hospital also provides an array of Behavioral Health services including inpatient mental health and alcohol rehabilitation plus outpatient mental health and alcohol related services. Admitting physicians are primarily practitioners in the local area. Additionally, the Hospital operates a 160-bed skilled nursing facility which provides housing, healthcare and other related services to residents who are severely limited in their ability to care for themselves due to illness and/or disability, and a medical adult day care program. The Hospital is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. Ascension Health Alliance directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health Alliance's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health Alliance uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs. - Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. - Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed cost of programs intentionally designed to serve persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with Acquired Immune Deficiency syndrome. - Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings. Discounts are provided to all uninsured patients in the acute care facility, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS). The amount of traditional charity care provided, determined on the basis of cost, excluding the provision for bad debt expense was approximately $732,000 for the twelve months ended June 30, 2017 and $332,000 for the twelve months ended June 30, 2016. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying other financial information.
Schedule H, Part VI, Line 7 State filing of community benefit reportNY

Schedule I IRS990ScheduleI

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

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDesc
Family Care - Entitlement Provider4$4,505FMV
Family Care - Entitlement Resident10$6,895FMV
Intensive Care Management - Patient Service Dollars45$16,002FMV
Supportive Care Management - Patient Service Dollars24$2,846FMV
Targeted Care Management - Patient Service Dollars58$10,342FMV

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 grant funds awarded are to clients of the family care, intensive case management, and supportive case management programs which are administered through the Hospital's behavioral health services division. The amounts are determined based on evaluation of client needs as determined by their individual case managers. All amounts are processed in accordance with the Hospital's disbursements practices which require evidence of supporting documentation for all required approvals. The usage of funding for Family Care and Case Management are in accordance with the Office of Mental Health procedural guidelines by program code and funding score.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
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 (15 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
VICTOR F GIULIANELLI
PRESIDENT & CEO$352,312$0$438,024$0$96,362$0$17,225$0$22,849$0$926,772$0$0$0
MOHAMMED R GHAZI-MOGHADAM MD
DIRECTOR/PHYSICIAN$418,376$0$44,852$0$40,193$0$14,575$0$24,040$0$542,036$0$0$0
MICHAEL M SHERIDAN DO
DIRECTOR/PHYSICIAN$131,773$0$4,420$0$1,782$0$2,781$0$11,582$0$152,338$0$0$0
FREDERICK E HENZE JR
VP OF FINANCE & CFO$166,000$0$41,629$0$9,885$0$8,986$0$2,130$0$228,630$0$0$0
SCOTT M BRUCE
VP OF OPERATIONS$256,675$0$58,114$0$51,467$0$17,225$0$22,083$0$405,564$0$0$0
DONALD W MASSEY
VP OF CONTINUUM CARE$167,073$0$35,127$0$13,549$0$9,990$0$16,183$0$241,922$0$0$0
WILLIAM D MAYER
VP OF MEDICAL AFFAIRS$335,463$0$73,917$0$12,926$0$13,250$0$11,316$0$446,872$0$0$0
DUANE S MILLER
VP OF BEHAVIORAL HEALTH$137,986$0$29,073$0$12,334$0$8,794$0$21,633$0$209,820$0$0$0
ALBERT V TURO
VP OF DEVELOPMENT & PLANNING (END 12/2016)$178,988$0$36,647$0$23,259$0$11,402$0$11,260$0$261,556$0$0$0
MICHELE M WALSH
VP OF NURSING$194,105$0$43,394$0$20,309$0$10,539$0$9,587$0$277,934$0$0$0
JAMES M CHARLAND MD
PHYSICIAN$526,883$0$27,481$0$33,406$0$14,575$0$27,083$0$629,428$0$0$0
MICHAEL J FINNEGAN MD
PHYSICIAN$489,499$0$273,949$0$13,642$0$14,575$0$30,151$0$821,816$0$0$0
DAVID J LEHR MD
PHYSICIAN$398,220$0$49,271$0$2,052$0$15,900$0$26,556$0$491,999$0$0$0
GARY SINENSKY MD
PHYSICIAN$444,558$0$101,618$0$7,692$0$13,250$0$22,858$0$589,976$0$0$0
ZAINUL A SYED MD
PHYSICIAN$496,820$0$6,176$0$21,620$0$13,250$0$10,065$0$547,931$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Travel for companionsPer St. Mary's Healthcare's accountability plan, spousal travel is reimbursed if there is a business purpose, however the amount reimbursed is also included as income on the individual's W-2. Certain St. Mary's Healthcare employees are reimbursed for cell phone/PDA expense, which is included on the respective employee's W-2. These payments are grossed up to include tax related obligations paid. St. Mary's Healthcare offers a fitness club membership credit to all employees to reimburse half of the cost of a yearly fitness club membership up to $150 per year. St. Mary's Healthcare included imputed income for one of the individuals listed in Part VII. St. Mary's Healthcare "grossed up" applicable non-business expenses and included in the employees' W-2 as additional taxable compensation.
Schedule J, Part I, Line 1a Tax indemnification and gross-up paymentsAscension Health, a related organization of St. Mary's Healthcare, uses the following to establish the compensation of the organization's CEO/Executive Director: - Compensation committee - Independent compensation consultant - Compensation survey or study - Approval by the board or compensation committee
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. No individuals received current year distributions.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part IV, Line 20b audited financial statementsThe activity of St. Mary's Healthcare is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Mary's Healthcare is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Mary's Healthcare.
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. ASCENSION HEALTH IS THE SOLE CORPORATE MEMBER OF ST. MARY'S HEALTHCARE. 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 ASCENSION HEALTH. ASCENSION HEALTH IS THE SOLE CORPORATE MEMBER OF ST. MARY'S HEALTHCARE. 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 Healthcare has a single corporate member, Ascension Health.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodySt. Mary's Healthcare has a single corporate member, Ascension Health , which has the ability to elect members to the governing body of the Hospital.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersAscension Health has designed a system of authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organization and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
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 describe 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 designated 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 designated powers annually signs a statement which affirms such person has received a copy of the conflict 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 the public inspection upon request.
Form 990, Part VII, Section A Compensation Paid to DirectorDuring 2016, the Hospital paid the following physicians for services rendered in their role as a physician of the Hospital, not for their duties as a board member. Mohammed R Ghazi-Moghadam, MD Ronald Marsh, MD Michale M Sheridan, DO
Form 990, Part VIII, Line 11d Other Miscellaneous RevenuePHYSICAL THERAPY OPEN GYM - Total Revenue: 1350, Related or Exempt Function Revenue: , Unrelated Business Revenue: 1350, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; cafeteria/vending - Total Revenue: 684640, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 684640; other revenue - Total Revenue: 105161, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 105161;
Form 990, Part IX, Line 11g Other FeesAGENCY STAFFING - Total Expense: 799380, Program Service Expense: 799380, Management and General Expenses: , Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 10977391, Program Service Expense: 10025733, Management and General Expenses: 951658, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 2924698, Program Service Expense: 2690833, Management and General Expenses: 233865, Fundraising Expenses: ; OTHER PROFESSIONAL - Total Expense: 3250915, Program Service Expense: 2638752, Management and General Expenses: 612163, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesPension Liability Adjustment - -3103107; Temporarily Restricted Interest in Foundation - 327328; Permenently Restricted Interest in Foundation - 225; Unrestricted Interest in Foundation - 930937; transfers to affiliates - -3267340;
Form 990, Part XII, Line 2c oversight of audit or selection of independent accountantST. MARY'S HEALTHCARE 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 (4 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
THE FOUNDATION OF ST MARY'S HEALTHCARE INC
427 GUY PARK AVEAMSTERDAMNY12010133254655FOUNDATIONNY501(c)(3)Type III-FINAfalse
MEDICAL SERVICES ENHANCEMENT INC
427 GUY PARK AVEAMSTERDAMNY12010141776546MEDICAL OFFICE BUILDINGNY501(c)(25)ST MARY'S HEALTHCAREYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MEDICAL SERVICES ENHANCEMENT INC
K$316,742FAIR MARKET VALUE
MEDICAL SERVICES ENHANCEMENT INC
M$148,321FAIR MARKET VALUE
MEDICAL SERVICES ENHANCEMENT INC
Q$1,482,368FAIR MARKET VALUE

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.