2016-11-01T08:47:20-05:00 2015-12-31 990 2015-01-01 222565278 CATHOLIC HEALTH SYSTEM INC CATH 7168282974 144 GENESEE ST No 4TH FL BUFFALO NY 14203 DAVID P MACHOLZ VP FINANCE, CORP CONTROLLER 7168282974 2016-11-01 2015 2017-02-10 21:41:12Z JOSEPH D MCDONALD CATHOLIC HEALTH ADMINISTRATION 6TH FLOOR 144 GENESEE STREET BUFFALO NY 14203 153668454 0 X WWW.CHSBUFFALO.ORG X 1998 NY The Catholic Health System (CHS) Mission is to provide quality healthcare services in a (an) (acute care, long term care, home care) setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2015 Community Service Plan can be found at www.chsbuffalo.org. 22 20 1381 8 0 7644 0 1137694 126255996 135878008 348021 48009 1667183 16604743 128271200 153668454 0 0 0 0 79316512 81860564 0 0 0 48300713 58339164 127617225 140199728 653975 13468726 190071792 300714094 166558179 237249210 23513613 63464884 X The Catholic Health System (CHS) Mission is to provide quality healthcare services in a (an) (acute care, long term care, home care) setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2015 Community Service Plan can be found at www.chsbuffalo.org. 0 0 131836026 135878008 The Catholic Health System (CHS) provides administrative support services to the Catholic Health System entities which include: Acute Care, Continuing Care, Home Care, and Primary Care services. The program services are support services that are provided for the benefits of the health care delivery system. These include Compliance, Facility Planning, Finance, Human Resources, Information Technology, Legal Services, Marketing, Revenue Management Center, and other services. More information can be found on the Catholic Health System website www.CHSBUFFALO.ORG. 131836026 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 165 0 1 1381 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DAVID P MACHOLZ 7168282974 144 GENESEE STREET 4TH FLOOR BUFFALO NY 14203 BRIAN BEITZ DIRECTOR 2.00 X 0 0 0 CARMEN GRANTO DIRECTOR 2.00 X 0 0 0 WILLIAM J BUSCAGLIA JR CHAIRMAN OF THE BOARD 4.00 X 0 0 0 PEGGY CHOONG PHD DIRECTOR 2.00 X 0 0 0 ROBERT GREENE DIRECTOR 2.00 X 0 0 0 KEVIN KEENAN DIRECTOR 2.00 X 0 0 0 MARSHA LEWIS PHD DIRECTOR 2.00 X 0 0 0 CANDACE JOHNSON PHD DIRECTOR 2.00 X 0 0 0 JOSEPH MCDONALD PRESIDENT & CEO 55.00 X X 1582915 0 204904 JAY MCWATTERS DIRECTOR 2.00 X 0 0 0 ROBERT A MINICUCCI SR DIRECTOR 2.00 X 0 0 0 SR PATRICIA PRINZIG DIRECTOR 2.00 X 0 0 0 MICHAEL MURRAY DIRECTOR 2.00 X 0 0 0 KATHLEEN NATWIN DC DIRECTOR 2.00 X 0 0 0 DAVID L ROGERS DIRECTOR 2.00 X 0 0 0 ARTHUR RUSS JR DIRECTOR 2.00 X 0 0 0 HONORABLE HUGH B SCOTT DIRECTOR 2.00 X 0 0 0 SHELDON SMITH ESQ DIRECTOR 2.00 X 0 0 0 MONSIGNOR ROBERT E ZAPFEL DIRECTOR 2.00 X 0 0 0 JOSEPH SAFFIRE DIRECTOR 2.00 X 0 0 0 STEVEN D TIMMEL DIRECTOR 2.00 X 0 0 0 ROBERT J TRAVIS CPA DIRECTOR 2.00 X 0 0 0 MARK SULLIVAN EXECUTIVE VP, CHIEF OPERATING OFFICER 55.00 X 831321 0 134963 JAMES A DUNLOP JR EXECUTIVE VP, CHIEF FINANCIAL OFFICER 55.00 X 887601 0 110616 DR BRIAN D'ARCY SENIOR VP, MEDICAL AFFAIRS 55.00 X 588913 0 86724 BARTHOLOMEW RODRIGUES SENIOR VP, MISSION INTEGRA 55.00 X 244505 0 18413 DR MICHAEL GALANG SENIOR VP, CHIEF INFORMATION OFFICER 55.00 X 509718 0 81005 NANCY SHEEHAN SENIOR VP, LEGAL SERVICES/GENERAL COUNSEL 55.00 X 380105 0 52927 MARIA FOTI SENIOR VP, STRATEGIC PLANNING 55.00 X 347846 0 63087 MICHAEL MOLEY SENIOR VP, HUMAN RESOURCES 55.00 X 687938 0 105480 LEE GUTERMAN MD PHYSICIAN 55.00 X 1105053 0 36096 LEE C RUOTSI MD PHYSICIAN/MEDICAL DIRECTOR 55.00 X 375970 0 36048 DR MICHAEL EDBAUER CHIEF CLINICAL OFFICER 55.00 X 362923 0 70687 WILLIAM J LAGALY DO PHYSICIAN 55.00 X 325459 0 31106 MICHAEL MEYER MD PHYSICIAN 55.00 X 325086 0 31725 8555353 0 1063781 119 0 1 0 INFOR (US) INC NW 7418 PO BOX 1450 MINNEAPOLIS MN 554857418 CONSULTING SERVICES 3671365 SIEMENS MEDICAL SOLUTIONS USA DEPT AT 40065 ATLANTA GA 311920065 MAINTENANCE SERVICES 3339976 CERNER HEALTH SERVICES INC PO BOX 959167 ST LOUIS MO 631959167 SOFTWARE CONSULTING SERVICES 2827661 ADVISORY BOARD COMPANY PO BOX 79461 BALTIMORE MD 212799461 CONSULTING SERVICES 2496935 DELOITTE CONSULTING LLP PO BOX 844717 DALLAS TX 752844717 CONSULTING SERVICES 1850095 46 1137694 1137694 ADMINISTRATIVE/CLINICAL 621610 135862184 135862184 15824 15824 135878008 48009 48009 GAIN ON ACQUISITION 900099 13566353 13566353 IT SUPPORT SERVICES 561000 1293369 1293369 HEALTHHOME PARTNERS 621610 1277247 1277247 467774 467774 16604743 153668454 135878008 0 16652752 6918982 5131163 1787819 55423865 55196272 227593 7872261 7691611 180650 6160980 6136726 24254 5484476 5484476 879192 406609 472583 574552 574552 151380 151380 3647192 3325693 321499 2416009 2399538 16471 443834 439829 4005 22699868 22699868 899174 835526 63648 350705 306412 44293 193417 85922 107495 4392709 4392709 7111934 7111934 376667 376667 CONTRACTED SERVICES 6660198 6139578 520620 DUES 4675693 135646 4540047 MISCELLANEOUS 2061729 2012478 49251 BANK FEES 415822 415822 389089 385615 3474 140199728 131836026 8363702 0 117476 5060128 31772885 22884520 4144020 3798819 101355744 20082125 77224957 81273619 5353731 59446924 71458723 128250084 190071792 300714094 27593226 31144603 83200296 9211900 14283702 129753053 108620609 166558179 237249210 X 23513613 60005966 3412671 46247 23513613 63464884 190071792 300714094 X 13468726 26482545 X X 0 1 X 1 0 X 103572038 117603442 122166373 126247587 136999878 606589318 30947 28180 21680 2290 29324 112421 103602985 117631622 122188053 126249877 137029202 606701739 0 0 0 606701739 20186 19586 20566 35915 34162 130415 20186 19586 20566 35915 34162 130415 55706 45368 76875 437669 467774 1083392 13566353 13566353 103678877 117696576 122285494 126723461 151097491 621481899 0.97620 0.99860 0.00020 0.00020 X PART III, LINE 12 GAIN ON ACQUISITION RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 120000 0 1 31380 151380 0 Part II-B, Line 1: LINE 1i: OTHER LOBBYING ACTIVITIES: CATHOLIC HEALTH SYSTEM, INC. PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, CATHOLIC HEALTH ASSOCIATION, AND THE BUFFALO NIAGARA PARTNERSHIP THAT UTILIZE A PORTION OF THOSE DUES FOR LOBBYING ACTIVITIES. IN 2015, THE LOBBYING COMPONENT OF THESE DUES WAS APPROXIMATELY $31,380. ADDITIONALLY, CHS RETAINS INDIVIDUALS TO ADVOCATE ON BEHALF OF THE CATHOLIC HEALTH SYSTEM, INC. WITH THE NEW YORK STATE LEGISLATURE RELATING TO ISSUES THAT IMPACT THE SYSTEM. COSTS INCURRED IN RELATION TO SUCH ACTIVITIES AMOUNTED TO $120,000 IN 2015. 40222259 1659568 38562691 8406494 1083630 7322864 45512218 17338927 28173291 7214773 7214773 81273619 DUE FROM RELATED SUBSIDIARIES 93635515 INSURANCE RECOVERIES 1266063 MISCELLANEOUS RECEIVABLES 6323235 ACQUISITION INVESTMENT 27025271 128250084 DUE TO RELATED FACILITIES 14560794 ACCRUED PENSION 52818240 EQUIPMENT LEASES/LOANS 783532 INSURANCE IBNR 2380273 REGIONAL TRAINING CENTER CAPITAL LEASE 38077770 108620609 X 153668454 0 153668454 0 153668454 140199728 0 140199728 0 140199728 Part X, Line 2: THE FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES, AS CHS IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE TAX-EXEMPT ORGANIZATIONS ARE SUBJECT TO FEDERAL TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE WHICH ARE REPORTED AS OTHER EXPENSES IN THE FINANCIAL STATEMENTS. X X X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 JOSEPH MCDONALD PRESIDENT & CEO 1582915 0 0 0 0 0 180650 0 24254 0 1787819 0 0 0 MARK SULLIVAN EXECUTIVE VP, CHIEF OPERATING OFFICE 831321 0 0 0 0 0 112959 0 22004 0 966284 0 0 0 JAMES A DUNLOP JR EXECUTIVE VP, CHIEF FINANCIAL OFFICE 887601 0 0 0 0 0 89631 0 20985 0 998217 0 0 0 DR BRIAN D'ARCY SENIOR VP, MEDICAL AFFAIRS 588913 0 0 0 0 0 65094 0 21630 0 675637 0 0 0 BARTHOLOMEW RODRIGUES SENIOR VP, MISSION INTEGRA 244505 0 0 0 0 0 12457 0 5956 0 262918 0 0 0 DR MICHAEL GALANG SENIOR VP, CHIEF INFORMATION OFFICER 509718 0 0 0 0 0 78087 0 2918 0 590723 0 0 0 NANCY SHEEHAN SENIOR VP, LEGAL SERVICES/GENERAL CO 380105 0 0 0 0 0 43525 0 9403 0 433033 0 0 0 MARIA FOTI SENIOR VP, STRATEGIC PLANNING 347846 0 0 0 0 0 54191 0 8896 0 410933 0 0 0 MICHAEL MOLEY SENIOR VP, HUMAN RESOURCES 687938 0 0 0 0 0 82554 0 22926 0 793418 0 0 0 LEE GUTERMAN MD PHYSICIAN 1105053 0 0 0 0 0 13846 0 22250 0 1141149 0 0 0 LEE C RUOTSI MD PHYSICIAN/MEDICAL DIRECTOR 375970 0 0 0 0 0 16623 0 19425 0 412018 0 0 0 DR MICHAEL EDBAUER CHIEF CLINICAL OFFICER 362923 0 0 0 0 0 59457 0 11231 0 433611 0 0 0 WILLIAM J LAGALY DO PHYSICIAN 325459 0 0 0 0 0 12236 0 18870 0 356565 0 0 0 MICHAEL MEYER MD PHYSICIAN 325086 0 0 0 0 0 12408 0 19317 0 356811 0 0 0 Part I, Line 1a Tax Indemnification and Gross up payments: Officers and key employees received a tax indemnification and gross-up payment for reimbursement of withholding taxes in conjunction with certain taxable benefits paid on behalf of employee. Health or social club dues or initiation fees: Taxable benefits for Club expenses were paid per the terms and conditions of the employment agreement for one key employee and are included as taxable income. Personal services: Personal services for income tax preparation expenses were paid per the terms and conditions of the employment agreement for one key employee and are included as taxable income. Part I, Line 4b 4b: Certain Officers and Key employees participated in a supplemental nonqualified retirement plan. The intention is to provide additional retirement compensation to address any gaps in the compensation limit. ADDITIONAL SUPPLEMENTAL INFORMATION Certain portions of the incentive compensation paid in 2015 are a result of the targets that were achieved in 2014. Deferred compensation reported in 2015 includes both qualified deferred pension compensation and employer contribution for 403b for certain Sisters of Charity Hospital associates, as well as deferred compensation for the amounts that are able to be estimated in 2015. Actual W-2 compensation paid to the executive is as per Schedule J Part II B. A BUFFALO AND ERIE COUNTY INDUSTRIAL LAND DEVELOPMENT CORPORATION 222413596 NONEAVAIL 2015-04-30 75540000 SEE PART VI 0 0 0 A 83526118 5515154 369937 2434992 26996822 48209213 2015 0 0 0 1 A 0 1 1 1 0 0.02810 0.00000 0.02810 0 0 0 A 0 1 0 0 0 0 0 0 1 A 1 PART I A (C) CUSIP #: THE 2015 BOND SERIES WERE ISSUED UNDER NUMEROUS CUSIP #S WITH VARYING MATURITY DATES. THE ASSOCIATED CUSIP #S ARE AS FOLLOWS: 11943KBG6, 11943KBH4, 11943KBJ0, 11943KBK7, 11943KBL5, 11943KBM3, 11943KBN1, 11943KBP6, 11943KBQ4, 11943KBR2, 11943KBS0, 11943KBT8, 11943KBU5, 11943KBV3, 11943KBW1, 11943KBX9, 11943KBY7. PART I A (F) DESCRIPTION OF PURPOSE: TO FINANCE THE COST OF AN APPROXIMATELY 140,000 SQUARE FOOT CORPORATE HEADQUARTERS AND ASSOCIATED LEASEHOLD IMPROVEMENTS AND FOR THE IMPLEMENTATION OF AN ENTERPRISE RESOURCE PLANNING SOFTWARE PACKAGE SYSTEM WIDE. KATHLEEN ZAPFEL SISTER-IN-LAW OF BOARD OF DIRECTOR MEMBER, MSGR ROBERT ZAPFEL 65837 HUMAN RESOURCE EMPLOYEE OF CATHOLIC HEALTH SYSTEM 0 Form 990, Part VI, Section A, line 6 CHS has three members: Ascension Health, Trinity Health, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws. Form 990, Part VI, Section A, line 7a According to the CHS Bylaws, each member is equally allowed to appoint up to three individuals to act as its representatives on the Corporate Member Board, and in undertaking any action in its capacity as a Member. The Corporate Member Board oversees the governance of the Catholic Health System. Form 990, Part VI, Section A, line 7b Each member is entitled to one vote on each matter properly submitted at any membership meeting, and the members also have reserve powers which allow approval for certain business events and ratification of certain business transactions. Form 990, Part VI, Section B, line 11 Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6. Schedule J: Compensation Information 7. Schedule L: Transactions with Interested Persons 8. Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information Form 990, Part VI, Section B, line 12c All associates on the Merit program; all Physicians and Non Physician Practitioners as well as Physician groups who are independent contractors or employees of CHS; and all board members must complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner. Form 990, Part VI, Section B, line 15 CHS, in determining the compensation for the CEO, utilizes a process of review and approval, governed by the Board of Directors that includes an outside nationally recognized independent compensation consultant experienced in compensation and benefit matters for non-profit healthcare organizations, and comparability data. In 2015, the Catholic Health System utilized a Compensation Committee of the Board of Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives. Form 990, Part VI, Section C, line 19 We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws. Form 990, Part XI, line 9: PENSION LIABILITY 3,728,006. CAPITAL EQUITY CONTRIBUTIONS/DISTRIBUTIONS (INTERCOMPANY) 19,755,345. GRANT REVENUE FOR CAPITAL 135,200. OTHER CHANGES IN NET ASSETS -594,924. ACQUIRED INVESTMENT 3,458,918. Form 990, Part XII, Line 2c: Oversight of the financial statement audit process has not changed from the prior year. MERCY HOSPITAL OF BUFFALO 565 ABBOTT ROAD BUFFALO NY 14220 160756336 ACUTE CARE HOSPITAL NY 501 C 509(a)(1),170(b)(1)( CATHOLIC HEALTH SYSTEM INC 0 SISTERS OF CHARITY HOSPITAL 2157 MAIN STREET BUFFALO NY 14214 160743187 ACUTE CARE HOSPITAL NY 501 C 509(a)(1),170(b)(1)( CATHOLIC HEALTH SYSTEM INC 0 KENMORE MERCY HOSPITAL 2950 ELMWOOD AVENUE KENMORE NY 14217 160762843 ACUTE CARE HOSPITAL NY 501 C 509(a)(1),170(b)(1)( CATHOLIC HEALTH SYSTEM INC 0 NAZARETH HOME OF THE FRANCISCAN SISTERS 291 NORTH STREET BUFFALO NY 14201 160813142 SKILLED NURSING FACILITY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 ST ELIZABETH HOME FOR THE AGED 5539 BROADWAY LANCASTER NY 14086 160743154 ADULT HOME NY 501 C 509(A)(2) CATHOLIC HEALTH SYSTEM INC 0 ST FRANCIS HOME OF WILLIAMSVILLE 147 REIST STREET WILLIAMSVILLE NY 14221 160743153 SKILLED NURSING FACILITY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 ST FRANCIS OF BUFFALO INC 34 BENWOOD AVENUE BUFFALO NY 14214 161523535 SKILLED NURSING FACILITY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 ST VINCENT MANOR 319 WASHINGTON AVENUE DUNKIRK NY 14048 160743167 ADULT HOME NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 WNY CATHOLIC LONG TERM CARE INC 6400 POWERS ROAD ORCHARD PARK NY 14127 161434368 SKILLED NURSING FACILITY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 NIAGARA HOMEMAKER SERVICES (MERCY HOME CARE) 144 GENESEE STREET BUFFALO NY 14203 161317960 HOMECARE PROVIDER NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 MCAULEY SETON HOMECARE 144 GENESEE STREET BUFFALO NY 14203 161310062 HOMECARE PROVIDER NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 CATHOLIC HEALTH SYSTEM INFUSION PHARMACY INC 6350 TRANSIT ROAD DEPEW NY 14043 200198518 HOMECARE INFUSION SERVICES NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 OLV RENAISSANCE CORPORATION 144 GENESEE STREET BUFFALO NY 14203 200167745 REAL ESTATE HOLDING COMPANY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 OLV COMMUNITY HOUSING (CHODO) 144 GENESEE STREET BUFFALO NY 14203 200372194 COMMUNITY HOUSING DEVELOPMENT (CHODO) NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 CHS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY INC 55 MELROY AVENUE LACKAWANNA NY 14218 261252884 ALL-INCLUSIVE CARE FOR THE ELDERLY NY 501 C 509(a)(1),170(b)(1)( CATHOLIC HEALTH SYSTEM INC 0 TRINITY MEDICAL WNY PC 2625 HARLEM ROAD CHEEKTOWAGA NY 14225 272576645 PRIMARY CARE PROVIDER NY 501 C 509(a)(3) CATHOLIC HEALTH SYSTEM INC 0 MCAULEY MERCY CORPORATION 144 GENESEE STREET BUFFALO NY 14203 161279834 MANAGEMENT NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 KMH HOMES INC 144 GENESEE STREET BUFFALO NY 14203 161387890 REAL ESTATE HOLDING COMPANY NY 501 C 509(a)(2) CATHOLIC HEALTH SYSTEM INC 0 MOUNT ST MARY'S HOSPITAL OF NIAGARA FALLS 5300 MILITARY ROAD LEWISTON NY 14092 161523353 ACUTE CARE HOSPITAL NY 501 C 509(a)(1),170(b)(1)( CATHOLIC HEALTH SYSTEM INC 0 HEALTH HOME PARTNERS OF WNY LLC 227 THORN AVENUE BOX 631 ORCHARD PARK NY 14127 455343851 HEALTH HOME NY RELATED 99625 482691 0 0 0.50000 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1