ST MARY MEDICAL CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ST MARY MEDICAL CENTER INC (EIN 35-2007327)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201611339349303586
- Schema version
- 2014v6.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T13:27:41-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4000 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352007327 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MARY ANN SHACKLETT | InCareOfNm |
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 2199420551 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH LAKE PARK AVENUE | AddressLine1Txt |
| City | HOBART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46342 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY ANN SHACKLETT | PersonNm |
| Person Title | SR VP FINANCE & CFO | PersonTitleTxt |
| Signature | 2016-05-12 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BEN PITCHKITES | PreparerPersonNm |
| PTIN | P00362066 | PTIN |
| Phone | 3176817000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY ANN SHACKLETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10010 DONALD S POWERS DR 201 | AddressLine1Txt |
| City | MUNSTER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46321 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $239,981,067 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | ST. MARY MEDICAL CENTER,INC. IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1505 | TotalEmployeeCnt |
| Total Volunteers | 165 | TotalVolunteersCnt |
| Total Gross UBI | $1,158,188 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $201,312 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,071,601 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,925,577 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $223,378,954 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $234,758,269 | CYProgramServiceRevenueAmt |
| PY Investment Income | $254,723 | PYInvestmentIncomeAmt |
| CY Investment Income | $862,166 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,761,073 | PYOtherRevenueAmt |
| CY Other Revenue | $1,675,385 | CYOtherRevenueAmt |
| PY Total Revenue | $226,466,351 | PYTotalRevenueAmt |
| CY Total Revenue | $239,221,397 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $172,519 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $125,248 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $76,562,640 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $78,765,689 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $134,804,387 | PYOtherExpensesAmt |
| CY Other Expenses | $136,655,178 | CYOtherExpensesAmt |
| PY Total Expenses | $211,539,546 | PYTotalExpensesAmt |
| CY Total Expenses | $215,546,115 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $14,926,805 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $23,675,282 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $163,405,216 | TotalAssetsBOYAmt |
| Total Assets EOY | $185,031,443 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,367,164 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,908,966 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $112,038,052 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $150,122,477 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ST. MARY MEDICAL CENTER,INC. IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL, PROVIDING FOR THE WELL-BEING OF THE COMMUNITY AND SERVING THE NEEDS OF ALL PEOPLE, INCLUDING THE POOR AND DISADVANTAGED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $198,241,036 | ExpenseAmt |
| Grant | $125,248 | GrantAmt |
| Revenue | $235,666,304 | RevenueAmt |
| Desc | St. Mary Medical Center, Inc. is a 195 bed acute care hospital that offers a broad range of services to care for its patients without regard to their ability to pay. St. Mary Medical Center, Inc. provides leading-edge care to patients in northwest Indiana. Through its dedication to quality and innovation, St. Mary Medical Center, Inc. has earned a multitude of accreditations, awards, and certifications in its pursuit of improving the health of its patients and community. | Desc |
| Total Program Service Expenses | $198,241,036 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 140 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1505 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY ANN SHACKLETT | PersonNm |
| Phone | 2199348250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10010 DONALD S POWERS DR 201 | AddressLine1Txt |
| City | MUNSTER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46321 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| CARY BOSAK | |||||||||
| DIRECTOR START 7/1/2014 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| PEGGY BUFFINGTON PHD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| LINDA BUZINEC MAYOR | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| FRANKIE FESKO | |||||||||
| DIRECTOR | 1.0 | 16.0 | Yes (X) | $0 | $98,645 | $0 | |||
| LISA FIELD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MILTON GASPARIS MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS GOLUBSKI MD | |||||||||
| DIRECTOR START 7/1/2014 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SHARON HARIG MD | |||||||||
| DIRECTOR START 7/1/2014 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| FAY IORIO | |||||||||
| DIRECTOR START 7/1/2014 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| PETER MAVRELIS MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| HON JAMES MOODY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JOHN WALSH | |||||||||
| DIRECTOR START 7/1/2014 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT WELSH | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $16,200 | $0 | |||
| KEN KRUPINSKI CPA | |||||||||
| PRESIDENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SR MICHELE DVORAK PHJC | |||||||||
| VICE PRESIDENT | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BILL JOINER | |||||||||
| SECRETARY AND TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JANICE RYBA | |||||||||
| ADMINISTRATOR | 40.0 | 1.0 | Yes (X) | $0 | $612,574 | $55,523 | Yes (X) | ||
| MARY ANN SHACKLETT | |||||||||
| SR VP FINANCE & SYSTEM CFO | 1.0 | 47.0 | $0 | $707,309 | $59,253 | Yes (X) | |||
| MARY SUDICKY | |||||||||
| VP OF FINANCE/CFO | 40.0 | 0.0 | $302,673 | $0 | $62,791 | Yes (X) | |||
| TAMMIE JONES | |||||||||
| VP PATIENT CARE SERVICES/CNO | 40.0 | 0.0 | $301,178 | $0 | $29,347 | Yes (X) | |||
| RANDY NORRIS | |||||||||
| DIRECTOR SUPPORT SERVICES | 40.0 | 0.0 | $134,469 | $0 | $48,227 | Yes (X) | |||
| MICHELLE MEYER | |||||||||
| DIRECTOR PHARMACY | 40.0 | 0.0 | $138,998 | $0 | $35,489 | Yes (X) | |||
| TIA S SPARKS | |||||||||
| SR PHARMACIST | 40.0 | 0.0 | $130,852 | $0 | $36,024 | Yes (X) | |||
| ANDREW KASIANCHUK | |||||||||
| CLINICAL PHARMACIST | 40.0 | 0.0 | $121,356 | $0 | $31,743 | Yes (X) | |||
| PETER DYBA | |||||||||
| DIRECTOR IMAGING SERVICES | 40.0 | 0.0 | $113,722 | $0 | $35,338 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,243,248 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,434,728 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $393,735 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 57 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WALSH CONSTRUCTION | |||||
| 929 WEST ADAMS STREET | CHICAGO | IL | 60607 | CONSTRUCTION | $4,759,861 |
| REHABCARE GROUP INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | REHAB CARE SERVICES | $3,019,721 |
| LAKESHORE ANESTHESIA PC | |||||
| 1755 FULTON STREET | ELKHART | IN | 46514 | ANESTHESIA SERVICES | $2,710,483 |
| YOUNA MECHANICAL INC | |||||
| 350 CROSSEN AVENUE | ELK GROVE VILLAGE | IL | 60007 | CONSTRUCTION | $2,438,460 |
| INCOMPASS HEALTH INC | |||||
| 318 MAXWELL ROAD SUITE 500 | ALPHARETTA | GA | 30009 | HOSPITALIST SERVICES | $980,982 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 31 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,783,740 | GovernmentGrantsAmt |
| All Other Contributions | $141,837 | AllOtherContributionsAmt |
| Total Contributions | $1,925,577 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $232,649,081 | $232,649,081 | |
| MEDICAL LABORATORY | 621511 | $1,158,188 | $1,158,188 | |
| INTERCOMPANY RENT REVENUE | 531120 | $951,000 | $951,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $234,758,269 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $625,850 | TotalRevenueColumnAmt |
| Exclusion | $625,850 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $650,071 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $696,460 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$46,389 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$46,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$46,389 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $299,526 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $63,210 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $236,316 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $236,316 | TotalRevenueColumnAmt |
| Exclusion | $236,316 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA | 722514 | $765,049 | $765,049 | |
| LEGAL SETTLEMENT | 900099 | $563,616 | $563,616 | |
| EDUCATION AND TRAINING | 611430 | $198,439 | $198,439 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $194,670 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $192,369 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,301 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,721,774 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $239,221,397 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $234,508,116 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,158,188 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,629,516 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,248 | TotalAmt |
| Program Services | $125,248 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710,824 | TotalAmt |
| Management And General | $710,824 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,777,639 | TotalAmt |
| Program Services | $57,000,494 | ProgramServicesAmt |
| Management And General | $4,777,145 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,945,668 | TotalAmt |
| Program Services | $2,687,322 | ProgramServicesAmt |
| Management And General | $258,346 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,588,226 | TotalAmt |
| Program Services | $7,366,845 | ProgramServicesAmt |
| Management And General | $1,221,381 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,743,332 | TotalAmt |
| Program Services | $4,327,324 | ProgramServicesAmt |
| Management And General | $416,008 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,336 | TotalAmt |
| Management And General | $646,336 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,736 | TotalAmt |
| Management And General | $229,736 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,137 | TotalAmt |
| Management And General | $15,137 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,372,535 | TotalAmt |
| Program Services | $17,355,255 | ProgramServicesAmt |
| Management And General | $2,017,280 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $673,290 | TotalAmt |
| Program Services | $637,424 | ProgramServicesAmt |
| Management And General | $35,866 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,395,843 | TotalAmt |
| Program Services | $1,635,443 | ProgramServicesAmt |
| Management And General | $760,400 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,111 | TotalAmt |
| Program Services | $141,852 | ProgramServicesAmt |
| Management And General | $2,259 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,257,984 | TotalAmt |
| Program Services | $3,183,779 | ProgramServicesAmt |
| Management And General | $74,205 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,212 | TotalAmt |
| Program Services | $98,168 | ProgramServicesAmt |
| Management And General | $16,044 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,020 | TotalAmt |
| Program Services | $23,811 | ProgramServicesAmt |
| Management And General | $7,209 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,196,516 | TotalAmt |
| Management And General | $1,196,516 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,041 | TotalAmt |
| Program Services | $17,041 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,912,007 | TotalAmt |
| Program Services | $9,042,687 | ProgramServicesAmt |
| Management And General | $869,320 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $874,001 | TotalAmt |
| Program Services | $797,348 | ProgramServicesAmt |
| Management And General | $76,653 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $49,980,480 | $49,980,480 | |
| CORPORATE ALLOCATION | $22,258,193 | $20,306,066 | $1,952,127 |
| MEDICAID ASSESSMENT FEE | $11,456,649 | $11,456,649 | |
| PHYSICIAN ALLOCATION | $8,436,271 | $7,696,378 | $739,893 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,643,816 | TotalAmt |
| Program Services | $4,361,422 | ProgramServicesAmt |
| Management And General | $1,282,394 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,546,115 | TotalAmt |
| Program Services | $198,241,036 | ProgramServicesAmt |
| Management And General | $17,305,079 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,360,969 | BOYAmt |
| EOY | $4,519,730 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,625,144 | BOYAmt |
| EOY | $29,835,298 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,550,829 | BOYAmt |
| EOY | $6,114,609 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $795,869 | BOYAmt |
| EOY | $768,499 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $230,090,765 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $93,210,302 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,774,743 | BOYAmt |
| EOY | $136,880,463 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,403,157 | BOYAmt |
| EOY | $2,403,157 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,894,505 | BOYAmt |
| EOY | $4,509,687 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,405,216 | BOYAmt |
| EOY | $185,031,443 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,396,340 | BOYAmt |
| EOY | $15,452,077 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,415 | BOYAmt |
| EOY | $320,142 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,672,409 | BOYAmt |
| EOY | $19,136,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,367,164 | BOYAmt |
| EOY | $34,908,966 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,925,897 | BOYAmt |
| EOY | $149,941,444 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,155 | BOYAmt |
| EOY | $181,033 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,038,052 | BOYAmt |
| EOY | $150,122,477 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,405,216 | BOYAmt |
| EOY | $185,031,443 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $23,675,282 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $14,409,143 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,606,822 | OtherCostOrOtherBasisAmt |
| Book Value | $12,606,822 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $115,639,314 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,261,406 | DepreciationAmt |
| Book Value | $74,377,908 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $277,004 | OtherCostOrOtherBasisAmt |
| Depreciation | $180,192 | DepreciationAmt |
| Book Value | $96,812 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,778,446 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,088,070 | DepreciationAmt |
| Book Value | $19,690,376 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,789,179 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,680,634 | DepreciationAmt |
| Book Value | $30,108,545 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $136,880,463 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| DEVELOPER REIMBURSEMENT | $13,755,318 |
| LT LEGAL CLAIM LIABILITY | $1,993,193 |
| CONSTRUCTION RETAINAGE | $1,601,271 |
| 61ST AVE. WIDENING | $1,000,000 |
| LEASE OBLIGATIONS | $432,407 |
| MISCELLANEOUS OBLIGATIONS | $237,934 |
| 3RD PARTY LIABILITIES | $116,624 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,136,747 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1430 | PersonsServedCnt |
| Total Community Benefit Expns | $3,239,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $146,005 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,093,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 23530 | PersonsServedCnt |
| Total Community Benefit Expns | $32,718,608 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,956,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,762,437 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05920 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 24960 | PersonsServedCnt |
| Total Community Benefit Expns | $35,958,253 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,102,176 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,856,077 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07360 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 244 | ActivitiesOrProgramsCnt |
| Persons Served | 6688 | PersonsServedCnt |
| Total Community Benefit Expns | $488,177 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $73,285 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $414,892 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 137 | ActivitiesOrProgramsCnt |
| Persons Served | 1262 | PersonsServedCnt |
| Total Community Benefit Expns | $1,313,693 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,313,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00610 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 19 | PersonsServedCnt |
| Total Community Benefit Expns | $383,080 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $346,694 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 89 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $125,248 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $125,248 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 470 | ActivitiesOrProgramsCnt |
| Persons Served | 7969 | PersonsServedCnt |
| Total Community Benefit Expns | $2,310,198 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $419,979 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,890,219 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 470 | ActivitiesOrProgramsCnt |
| Persons Served | 32929 | PersonsServedCnt |
| Total Community Benefit Expns | $38,268,451 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,522,155 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,746,296 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08240 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $11,219 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,794 | NetCommunityBenefitExpnsAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 44 | PersonsServedCnt |
| Total Community Benefit Expns | $8,222 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,222 | NetCommunityBenefitExpnsAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 697 | PersonsServedCnt |
| Total Community Benefit Expns | $16,047 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 962 | PersonsServedCnt |
| Total Community Benefit Expns | $21,044 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 47 | ActivitiesOrProgramsCnt |
| Persons Served | 1703 | PersonsServedCnt |
| Total Community Benefit Expns | $56,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,320,097 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $23,201 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $100,724,345 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $108,208,284 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,483,939 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH LAKE PARK AVENUE | AddressLine1Txt |
| City | HOBART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46342 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | COMHS.ORG/STMARY | WebsiteAddressTxt |
| State License | 14-005786-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.comhs.org/stmary | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://chsstmary.healthforecast.net | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.comhs.org/stmary | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | comhs.org/stmary/charity-care.asp | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | comhs.org/stmary/charity-care.asp | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | comhs.org/stmary/charity-car | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B, Line 5 - Community stakeholders | Focus groups held as part of this CHNA incorporated input from 44 key informants (or community stakeholders) in the area with special emphasis on persons who work with or have special knowledge about vulnerable populations in the four counties, including low income individuals, minority populations, those with chronic conditions, and other medically underserved residents. The five groups consisted of Doctors, Other Health Providers, Social Service Providers, Business Leaders, and Other Community Leaders. The complete list can be found on pages 103 and 104 of our CHNA. |
| Part V, Section B, Line 6a - Hospital facilities CHNA was conducted with | Community Healthcare System: Community Hospital St. Catherine Hospital, Inc. Franciscan Alliance: St. Anthony Health St. Margaret Health - Hammond St. Margaret Health - Dyer The Methodist Hospitals, Inc.: Northlake campus Southlake campus |
| Part V, Section B, Line 11 - CHNA significant needs identified | Our hospitals chose four priority areas: Diabetes, Heart Disease & Stroke, Nutritional & Weight Status and Maternal, Infant & Child Health. All of these areas have a common link to modifiable lifestyle risk factors, education and access to medical services. Key issues of concerns among our community informant included access to healthcare services, health education and prevention, obesity and substance abuse, and as such align with the focus areas chosen. In targeting these four areas for health improvement, the hospitals will seek to: " Align and re-align resources to focus on these health issues " Develop partnerships and collaborations for outreach screening and education initiatives as well as to target at-risk populations " Expand best practice efforts through the primary care setting, in particular, our employed physicians group " Seek additional opportunities to achieve our goals " Leverage our resources to provide services by partnering with other community groups and seeking grant funding The Community Health Needs assessment conducted by the hospitals of the Community Healthcare System identified areas of concern not identified in the hospital's implementation plan. These areas include: " Access to Health Services " Cancer " Chronic Kidney Disease " Family Planning " Injury & Violence Prevention " Oral Health Many of these areas are being addressed by the hospitals of the Community Healthcare System as well as by other community organizations. For example, Community Healthcare System supports a large cancer program with a separate research foundation focused on improving access to clinical trials for area residents as well as providing free support and mind-body services through its Cancer Resource Centre. All hospitals provide routine low-cost and free screening programs for a variety of cancers. As the hospital focuses on lifestyle, education, prevention and access to care issues surrounding its four focused areas, positive outcomes will likely have positive effects on the health needs not addressed. To have the greatest impact, however, the hospital has chosen to focus on three of the most serious diseases and the related lifestyle issues facing our community as well as investing in the health of the most vulnerable residents - our newborns. |
| Part V, Section B, Line 22d - FAP Eligibility | OUR MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE BASED ON A SLIDING SCALE. UP TO 200% OF FEDERAL POVERTY GUIDELINES (FPG) IS 100% FREE CARE. 201%-300% IS CHARGED BASED ON MEDICARE RATES. OVER 300% IS CHARGED BASED ON AVERAGE OF MEDICARE AND LOWEST MANAGED CARE RATES COMBINED. PATIENTS MAY ALSO BE ELIGIBLE FOR SELF-PAY/PROMPT PAY DISCOUNTS REGARDLESS OF FEDERAL POVERTY LEVEL. WE OFFER 30% DISCOUNT TO TRUE SELF-PAY ACCOUNTS AND AN ADDITIONAL 10% DISCOUNT FOR PROMPT PAYMENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Outpatient Surgery at Lake Park | ||||
| 7921 Grand Boulevard | Hobart | IN | 46342 | Outpatient Surgery |
| Center for Imaging & Radiation Oncology | ||||
| 300 WEST 61st Avenue | Hobart | IN | 46342 | Radiology |
| OUTPATIENT REHABILITATION | ||||
| 320 WEST 61ST AVENUE | HOBART | IN | 46342 | REHABILITATION |
| WOMEN'S DIAGNOSTIC CENTER | ||||
| 320 WEST 61st Avenue | Hobart | IN | 46342 | DIAGNOSTIC CENTER |
| PORTAGE HEALTH CENTER II | ||||
| 3545 ARBORS STREET | PORTAGE | IN | 46368 | OUTPATIENT CENTER |
| WILLOWCREEK HEALTH CENTER | ||||
| 3170 WILLOWCREEK ROAD | PORTAGE | IN | 46368 | Outpatient Center |
| WINFIELD FAMILY HEALTH CENTER | ||||
| 10607 RANDOLPH STREET | CROWN POINT | IN | 46307 | Outpatient Center |
| Health & Rehabilitation Spectrum | ||||
| 1354 SOUTH Lake Park Avenue | Hobart | IN | 46342 | Outpatient Center |
| Home Health of St Mary Medical Center | ||||
| 1439 SOUTH Lake Park Avenue | Hobart | IN | 46342 | Home Health |
| VALPARAISO HEALTH CENTER | ||||
| 3800 ST MARY DRIVE | VALPARAISO | IN | 46383 | OUTPATIENT CENTER |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, lINE 3C - FACTORS OTHER THAN FPG USED TO DETERMINE FAP ELIGIBILITY | N/A - FPG is the only factor used |
| PART I, LINE 6A - WAS A COMMUNITY BENEFIT REPORT PREPARED: | THE STATE OF INDIANA ACCEPTS FORM 990 SCHEDULE H IN LIEU OF A COMMUNITY BENEFIT REPORT. St. Mary Medical Center, Inc. makes its 990 available to the public. |
| PART I, LINE 7 - FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS AT COST: | COST ACCOUNTING SYSTEM WAS USED FOR COMPUTATIONS. BAD DEBT IS EXCLUDED FROM THE CALCULATION. MEDICAID DIRECT OFFSETTING REVENUE INCLUDES THE INCREASED HAF REIMBURSEMENT. THE EXPENSE INCLUDES THE HAF FEE. |
| PART II - COMMUNITY BUILDING ACTIVITIES | Community Support (line 3) - This category can include "disaster readiness and public health emergency activities, such as readiness training beyond what is required by accrediting bodies or government entities." Expenses and revenues relating to the Bio-terrorism department of the hospital have been included in this category. Leadership development and training for community member (line 5) - This category includes "training in conflict resolution; civic, cultural or language skills; and medical interpreter skills for community residents." The costs reported here relate to a mentoring program that is held at a local high school. Coalition building (line 6) - This category is to include "participation in community coalitions and other collaborative efforts with the community to address health and safety issues." The costs reported here pertain to participation in functions with the local Chamber of Commerce. Community health improvement advocacy (line 7) - This category is to include "efforts to support policies and programs to safeguard or improve public health access to health care services." The primary activities of the hospital in this category have been sponsorships of a number of community health fairs. |
| PART III, LINE 2 - METHODOLOGY USED TO ESTIMATE BAD DEBT AT COST: | THE COST TO CHARGE RATIO PER THE S-10 WORKSHEET OF THE MEDICARE COST REPORT IS USED TO ESTIMATE BAD DEBT AT COST. |
| PART III, LINE 3 - BAD DEBT EXPENSE ATTRIBUTABLE TO FAP ELIGIBLE PATIENTS: | WE ESTIMATE 1% OF THE BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE FROM AUDIT: | Patient service revenue, net of contractual allowances and discounts, is reduced by the provision for bad debts, and net accounts receivable are reduced by an allowance for uncollectible accounts. The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration the trends in health care coverage, economic trends, and other collection indicators. Management regularly assesses the adequacy of the allowances based upon historical write-off experience by major payor category and aging bucket. The results of the review are then utilized to make modifications, as necessary, to the provision for bad debts to provide for an appropriate allowance for bad debts. A significant portion of the hospitals' uninsured patients will be unable or unwilling to pay for services provided, and a significant portion of the hospitals' insured patients will be unable or unwilling to pay for co-payments and deductibles. Thus, the hospitals record a significant provision for bad debts related to uninsured patients in the period the services are provided. After all reasonable collection efforts have been exhausted in accordance with CFNI's policy, accounts receivable are written off and charged against the allowance for bad debts. |
| PART III, LINE 8 - WHY MEDICARE SHORTFALL SHOULD BE COMMUNITY BENEFIT: | WE PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED OR THE REIMBUSEMENT RECEIVED FROM MEDICARE, QUALIFYING THE SHORTFALL AS A COMMUNITY BENEFIT. THE medicare allowable costs of care were CALCULATED BY USING INFORMATION FROM THE COST ACCOUNTING SYSTEM. |
| PART III, LINE 9B - COLLECTION PRACTICES FOR QUALIFYING FA PATIENTS: | COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW. |
| 2. NEEDS ASSESSMENT | IN COLLABORATION WITH COMMUNITY HEALTHCARE SYSTEM, FRANCISCAN ALLIANCE, AND THE METHODIST HOSPITALS, inc., ST. MARY MEDICAL CENTER, INC., CONTRACTED WITH A THIRD PARTY TO PERFORM OUR COMMUNITY HEALTH NEEDS ASSESSMENT AS PER REGULATION 501(R). The most recent CHNA was conducted in 2013 and is available ON the following websites: HTTP://WWW.COMHS.ORG/STMARY HTTP://WWW.CHSSTMARY.HEALTHFORECAST.NET |
| 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENTS WHO ARE ADMITTED WITHOUT INSURANCE ARE DIRECTED TO THE HOSPITAL'S FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS PERFORM AN INTERVIEW WITH THE PATIENTS TO EXPLAIN TO THEM THE PROCESS NECESSARY TO RECEIVE FINANCIAL ASSISTANCE. THIS PROCESS INCLUDES APPLYING FOR MEDICAID OR OTHER GOVERNMENT AID. THE APPLICANT THEN MUST FILL OUT A FINANCIAL INFORMATION WORKSHEET AND SUBMIT VARIOUS INFORMATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS POSTED IN THE EMERGENCY ROOM AREA AS WELL AS AT EACH INPATIENT WAITING DESK. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. |
| 4. COMMUNITY INFORMATION | LOCATED IN HOBART, INDIANA, THE COMMUNITY SERVED INCLUDES NORTHWEST INDIANA. LATEST U.S. CENSUS BUREAU DEMOGRAPHIC INFORMATION COMPARING HOBART TO THE STATE OF INDIANA: Hobart Indiana Persons under 18 years, percent, 2010 23.1% 24.8% Persons 65 years and over, percent, 2010 14.4% 13.0% White alone, percent, 2010 (a) 85.3% 84.3% Black or African American alone, percent, 2010 (a) 7.0% 9.1% Hispanic or Latino, percent, 2010 (b) 13.9% 6.0% White alone, not Hispanic or Latino, percent, 2010 76.9% 81.5% High school graduate or higher, age 25+, 2010-2014 88.5% 87.6% Bachelor's degree or higher, age 25+, 2010-2014 15.8% 23.6% Median household income, 2010-2014 $55,840 $48,737 Persons in poverty, percent, 2010-2014 10.4% 15.2% (a) Includes persons reporting only one race. (b) Hispanics may be of any race, so also are included in applicable race categories. |
| 5. PROMOTION OF COMMUNITY HEALTH | Since 1973, St. Mary Medical Center, Inc. has met the healthcare needs of the Northwest Indiana community, having started through the ministry of the Poor Handmaids of Jesus Christ. This order of Ancilla Domini sisters began their ministry in Lake County when they came to Mercy Hospital in Gary in 1913. The sisters continue their mission here today, at St. Mary Medical Center, Inc. and throughout Lake County. In 2001, St. Mary Medical Center, Inc. became part of Community Healthcare System, comprised of St. Mary Medical Center in Hobart, St. Catherine Hospital, Inc. in East Chicago, and Community Hospital in Munster. St. Mary Medical Center, Inc. remains dedicated to its Roman Catholic tradition. It is our goal to be the premier hospital system in Indiana. Our dedication to this end is evident in the caring spirit of our staff, coupled with the best facilities and technologies we can offer our patients and their families. In 2004, the hospital expanded with a new $40 million Patient Tower offering comfortable, private rooms and advanced bedside technology. During the next decade, growth continued with the opening of a new advanced imaging center, a new and expanded emergency department, the opening of additional outpatient locations in Portage, Hobart and Valparaiso. In 2015, the hospital opened a new $40 million surgical pavilion, furthering our commitment to providing the highest quality care with the most advanced technologies, to provide patients of Northwest Indiana the finest health care available today. St. Mary Medical Center, Inc. takes pride in being responsive to the needs of our community. Below, we have listed current programs to meet those needs. THE DESIGNATED POPULATION THAT ST. MARY MEDICAL CENTER IS FOCUSING ON INCLUDES THOSE INDIVIDUALS WHOSE LIFE-STYLE BEHAVIORS PUT THEM AT RISK FOR DISEASE AND ILLNESS. OUR PRIMARY FOCUS THIS YEAR IS ON DISEASES THAT HAVE BEEN IDENTIFIED AS HEALTH DISCREPANCIES IN LAKE COUNTY, INDIANA - DIABETES, HEART DISEASE & STROKE, AND MATERNAL INFANT & CHILD HEALTH. THE INCIDENCE OF THESE DISEASES IN OUR REGION SURPASSED STATE AND NATIONAL AVERAGES, AND THEREFORE DEMANDED OUR PRIMARY FOCUS. ALL OF THESE AREAS HAVE A COMMON LINK TO MODIFIABLE LIFESTYLE RISK FACTORS, EDUCATION, PREVENTION AND ACCESS TO MEDICAL SERVICES. ST. MARY MEDICAL CENTER HAS INVESTED GREATLY IN RECENT YEARS IN TREATMENT AND EDUCATION PROGRAMS AND IN OFFERING PATIENTS ACCESS TO TREATMENTS NOT AVAILABLE ELSEWHERE IN THE COUNTY. WE ARE EXPANDING BEST PRACTICE EFFORTS THROUGH THE PRIMARY CARE SETTING, IN PARTICULAR OUR EMPLOYED PHYSICIANS GROUP. THE FOCUS OF OUR COMMUNITY BENEFIT IS TO USE RESOURCES TO REACH BEYOND THE TREATMENT OF THESE DISEASES TO HELP EDUCATE, SUPPORT AND EMPOWER INDIVIDUALS TO LOWER THEIR RISKS. Alzheimer's Support Group - Alzheimer's Support Group meets the third Tuesday of each month at St. Mary Medical Center. This group is for patients, family and friends dealing with Alzheimer's. Participants in support groups receive emotional support, practical assistance in coping with the issues they face and the latest information about research. American Cancer Society Road to Recovery Volunteer Program - This volunteer training program prepares volunteers to transport patients with cancer to and from appointments when they are unable to transport themselves. The hospital provides space, organization and professionals to help train volunteers. Bariatric Seminar - Using a team approach to achieving weight loss, bariatric surgeons and medical weight-loss professionals discuss the etiology of obesity, its effect on an individual's physical, emotional and psychological health. The goal is to improve the medical complications of life-threatening obesity. Beat the Holiday Blues - Presentation on recognizing the signs and symptoms of depression and various treatment options and coping mechanisms. Blood Profile Screening - These screenings offer a way for those concerned about heart health to monitor cholesterol, HDL, triglycerides or glucose. No physician order is necessary for the screening. Blood Pressure Screening - These are blood pressure screenings free to the public at the Portage YMCA. Participants are counseled by an RN and given educational material regarding blood pressure and how it relates to their health. BMI/Body Fat Analysis - These are BMI and body fat screenings free to the public at the Portage YMCA. Participants are counseled by an RN and given educational material regarding BMI and body fat percentage and how it relates to their health. Breastfeeding Class - This class provides education and support for women who what to breastfeed. Teens, partners, and grandparents welcome. Cancer Survivors Day - The Cancer Resource Centre and St. Mary Medical Center provide a local celebration of this national event, honoring the strength and courage of those who have lived - and continue to live - with cancer. Prizes are raffled and each attendee receives a motivational gift as well as food and entertainment. Cancer Survivorship Symposium - This symposium featured vendors, activities, and keynote speaker who provide support for those living with, through and beyond a cancer diagnosis. Attendees learned about food and nutritional needs that can support them through the various stages of living with cancer. Cardiopulmonary Rehab "Breathless" Support Group - This support group provides patients with information about how to live and thrive while dealing with cardiopulmonary issues. Group provides a supportive resource for patients and family members. Choices in Childbirth - Six educational classes are offered each session for those in their last trimester of pregnancy. Classes include informative lectures about comfort measures and medication available for pain. The last session focuses on management of breast-feeding and newborn behavior patterns. Clinical Education for Ministry - Training college students for pastoral care. Cooking Demonstrations - Chef Ryan C. Smith demonstrates delectable appetizers, salads, entrees, desserts and more in these fun and interactive demonstrations that helps participants learn about nutrition and attainable food preparation. Coronary Health Appraisal - This appraisal helps to determine risk for heart disease and other related medical conditions. This discounted screening includes: cholesterol (total, HDL, LDL, triglycerides), blood sugar, metabolic syndrome, blood pressure, body mass index and a Heart Health Profile. Coumadin Class - A pharmacist and dietician discuss appropriate diet and medications to avoid while taking Coumadin. Diabetes Class - This is a class that discusses diabetes management, the proper use of medication, glucose monitoring, meal planning and diabetes complications. Duneland Chamber of Commerce - Art after Dark event, St. Mary Medical Center physicians manned a kids' booth for attendees and their children to learn health safety tips, and healthy childhood nutrition. Health Education and Seminars - St. Mary Medical Center physicians offered numerous free community presentations on a variety of health topics including heart disease, arthritis, spine care, ENT/sinus, pulmonary health, gastroenterology, and more. Healthy Kids Day YMCAs - St. Mary Medical Center manned a booth and provided support and health education information for the Healthy Kids Days at the Portage and Hobart Family YMCAs. Hearts of Hope - The Hearts of Hope tree at St. Mary Medical Center shines with the help and support of donations to cardiac research. The Hearts of Hope tree is decorated with lights that represent contributions made in honor of or in memory or someone who has been affected by heart disease. Monies raised through donations fund vitally needed research for heart disease. Donors and honorees are invited to a Hearts of Hope tree lighting ceremony that celebrates cardiac research success stories of St. Mary Medical Center. Hobart Chamber of Commerce Business Expo - Various hospital departments provide information about service lines and screenings, such as blood pressure, body composition, bone density, and grip strength testing. Hope Network Cancer Support Group - The last Wednesday of each month this group meets for informative sessions where they can share thoughts and feelings in a comfortable and confidential atmosphere. IUN - HIT Summer Clinical - 10 days of free clinical nursing education and training for IUN nursing students. Knox Suite - Knox Suite is similar to a hotel room that is located on the fourth floor of the hospital and accommodates families that need a place to stay. Look Good-Feel Better - This class helps improve the physical appearance of cancer patients by helping them with make-up and wigs to aide in their mental and emotional well-being in their struggle with cancer. This class is put on by the staff from Women's Diagnostic Center in conjunction with the American Cancer Society. Medical Student Internships - Medical students interested in lea |
| 6. AFFILIATED HEALTH CARE SYSTEM | ST. MARY MEDICAL CENTER, INC. IS PART OF AN AFFILIATED SYSTEM. EACH HOSPITAL IN THE SYSTEM PROVIDES MEDICAL SERVICES TO THEIR COMMUNITIES AND ADJOINING COMMUNITIES. EACH ENTITY'S PURPOSE IS TO PROVIDE HEALTH CARE TO THOSE WHO NEED IT, INCLUDING THE UNINSURED OR UNDERINSURED. |
| 7. STATE FILING OF COMMUNITY BENEFIT REPORT | INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| PORTAGE TOWNSHIP YMCA | |||||||
| 3100 WILLOWCREEK ROAD | PORTAGE | IN | 46368 | 351404478 | 501(C)3 | $63,942 | SPONSORSHIP |
| GREATER VALPARAISO CHAMBER OF COMMERCE | |||||||
| 162 WEST LINCOLNWAY | VALPARAISO | IN | 46383 | 350727140 | 501(C)6 | $6,000 | SPONSORSHIP |
| HOBART CHAMBER OF COMMERCE | |||||||
| 1001 LILLIAN STREET | HOBART | IN | 46342 | 350982628 | 501(c)6 | $5,230 | SPONSORSHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | REQUESTS FOR DONATIONS FROM QUALIFIED 501(C)(3) CHARITIES, UNIVERSITIES, AND OTHER EXEMPT ORGANIZATIONS ARE EVALUATED AS TO WHETHER THE POTENTIAL DONEE ORGANIZATION WILL USE THE FUNDS IN A MANNER CONSISTENT WITH OUR CHARITABLE MISSION AND THE INTENTION OF THE CONTRIBUTION. OUR DONATIONS/CONTRIBUTIONS ARE PRIMARILY MADE TO LOCAL ORGANIZATIONS. SINCE THESE ARE NOT GRANTS, THERE IS NO NEED TO MONITOR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JANICE RYBA | ||||||||||||||
| ADMINISTRATOR | $0 | $392,427 | $0 | $196,225 | $0 | $23,922 | $0 | $39,520 | $0 | $16,003 | $0 | $668,097 | $0 | $0 |
| MARY ANN SHACKLETT | ||||||||||||||
| SR VP FINANCE & SYSTEM CFO | $0 | $397,935 | $0 | $287,098 | $0 | $22,276 | $0 | $39,520 | $0 | $19,733 | $0 | $766,562 | $0 | $0 |
| MARY SUDICKY | ||||||||||||||
| VP OF FINANCE/CFO | $217,878 | $0 | $84,094 | $0 | $701 | $0 | $39,520 | $0 | $23,271 | $0 | $365,464 | $0 | $0 | $0 |
| TAMMIE JONES | ||||||||||||||
| VP PATIENT CARE SERVICES/CNO | $191,670 | $0 | $108,549 | $0 | $959 | $0 | $10,734 | $0 | $18,613 | $0 | $330,525 | $0 | $0 | $0 |
| RANDY NORRIS | ||||||||||||||
| DIRECTOR SUPPORT SERVICES | $132,790 | $0 | $0 | $0 | $1,679 | $0 | $28,011 | $0 | $20,216 | $0 | $182,696 | $0 | $0 | $0 |
| MICHELLE MEYER | ||||||||||||||
| DIRECTOR PHARMACY | $138,717 | $0 | $0 | $0 | $281 | $0 | $6,153 | $0 | $29,336 | $0 | $174,487 | $0 | $0 | $0 |
| TIA S SPARKS | ||||||||||||||
| SR PHARMACIST | $130,768 | $0 | $0 | $0 | $84 | $0 | $6,104 | $0 | $29,920 | $0 | $166,876 | $0 | $0 | $0 |
| ANDREW KASIANCHUK | ||||||||||||||
| CLINICAL PHARMACIST | $120,786 | $0 | $0 | $0 | $570 | $0 | $12,048 | $0 | $19,965 | $0 | $153,369 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A - PROVIDED TO/FOR A PERSON IN 990, PART VII, SEC. A, LN 1A | THE ORGANIZATION PAYS HEALTH/SOCIAL CLUB DUES ON BEHALF OF CERTAIN OFFICERS, KEY EMPLOYEES, AND FIVE HIGHEST PAID EMPLOYEES, WHICH IS THEN TAXED AS A FRINGE BENEFIT TO THE INDIVIDUAL. |
| PART I, LINE 3 - USED TO ESTABLISH COMPENSATION OF ORG. CEO/EXEC. DIR. | ST. MARY MEDICAL CENTER, INC. FOLLOWS ITS PARENT, (CFNI), COMPENSATION POLICIES. THE CFNI BOARD HAS ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS. |
| PART I, LINE 7 - NON-FIXED PAYMENTS NOT DESCRIBED IN LINES 5 AND 6 | DESCRETIONARY BONUS IS PAID BASED ON FINANCIAL PERFORMANCE AND QUALITY INDICATORS TO CERTAIN EXECUTIVES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART VI, LINE 6 - MEMBERS OR STOCKHOLDERS | COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. IS THE SOLE MEMBER/SHAREHOLDER. |
| PART VI, LINE 7A - WHO HAS THE POWER TO ELECT MEMBERS OF GOVERNING BODY | COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. (CFNI) IS THE PARENT COMPANY OF ST. MARY MEDICAL CENTER, INC. AND HAS CONTROL TO ELECT MEMBERS OF THE GOVERNING BODY. |
| PART VI, LINE 7B - GOVERNANCE ISSUES RESERVED OTHER THAN GOVERNING BODY | COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. IS THE PARENT COMPANY OF ST. MARY MEDICAL CENTER, INC. AND HAS RIGHTS TO APPROVE DECISIONS MADE BY ST. MARY MEDICAL CENTER, INC. |
| PART VI, LINE 11B - GOVERNING BODY 990 REVIEW PROCESS | THE 990 IS SUBMITTED TO THE SR VP AND SYSTEM CFO FOR REVIEW, ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS TO REVIEW PRIOR TO FILING. |
| PART VI, LINE 12C - PROCESS TO MONITOR CONFLICT OF INTEREST | AS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS, OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION. RESTRICTIONS ON MEMBERS WITH A CONFLICT - MEMBERS WITH A CONFLICT ARE REQUIRED TO RECUSE THEMSELVES FROM ANY DELIBERATION AND MUST ABSTAIN FROM THE VOTE. |
| PART VI, LINE 15 - EXECUTIVE & BOARD COMPENSATION | THE CFNI BOARD HAS ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS. |
| PART VI, LINE 19 - PUBLIC AVAILABILITY OF FS, COI POLICY, & GOVERNING DOCS | ST. MARY MEDICAL CENTER, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, ST. MARY MEDICAL CENTER, INC. THROUGH COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. MAKES ITS FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE. |
| PART VII, SECTION A - OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHEST COMP | CERTAIN SALARIES AND MEDICAL DIRECTORSHIPS ARE PAID BY A RELATED ORGANIZATION, USUALLY THE PARENT (CFNI), WHILE THE HOURS ARE APPLICABLE TO THE REPORTING ORGANIZATION. |
| PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS | TRANSFERS FROM RELATED ORGS 19,865,218 TRANSFERS TO RELATED ORGS (5,456,074) TOTAL CHANGE IN NET ASSETS 14,409,144 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY FOUNDATION OF NW INDIANA INC | ||||||||||
| 10010 DONALD S POWERS DR 201 | MUNSTER | IN | 46321 | 311128781 | SUPPORT ORG | IN | 501(c)(3) | 11(c) | NA | false |
| MUNSTER MEDICAL RESEARCH FNDNINC | ||||||||||
| 901 MACARTHUR BOULEVARD | MUNSTER | IN | 46321 | 351107009 | HOSPITAL | IN | 501(c)(3) | 3 | CFNI | Yes (true) |
| ST CATHERINE HOSPITAL INC | ||||||||||
| 4321 FIR STREET | EAST CHICAGO | IN | 46312 | 351738708 | HOSPITAL | IN | 501(c)(3) | 3 | CFNI | Yes (true) |
| COMMUNITY CANCER RESEARCH FNDN INC | ||||||||||
| 901 MACARTHUR BOULEVARD | MUNSTER | IN | 46321 | 352146374 | Cancer Funds | IN | 501(c)(3) | 7 | MMRF | Yes (true) |
| COMMUNITY VILLAGE INC | ||||||||||
| 10000 COLUMBIA AVENUE | MUNSTER | IN | 46321 | 351956395 | RETIRMT HOME | IN | 501(c)(3) | 9 | CFNI | Yes (true) |
| CVPA HOLDING COMPANY | ||||||||||
| 1040 RIDGE ROAD | MUNSTER | IN | 46321 | 351938136 | TITLE HLDG CO | IN | 501(c)(2) | N/A | CFNI | Yes (true) |
| THEATRE AT THE CENTER INC | ||||||||||
| 1040 RIDGE ROAD | MUNSTER | IN | 46321 | 351939427 | PLAYS & ARTS | IN | 501(c)(3) | 9 | CFNI | Yes (true) |
| COMMUNITY CARE NETWORK INC | ||||||||||
| 901 MACARTHUR BOULEVARD | MUNSTER | IN | 46321 | 454158203 | PHYS SERVICES | IN | 501(c)(3) | 3 | MMRF SCH SMM | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALPARAISO MED DEV | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 ST MARY DRIVE | AddressLine1Txt |
| City | VALPARAISO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46383 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453194502 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$51,841 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $8,748,852 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY RESOURCES INC | |||||||||||
| 907 RIDGE ROAD | MUNSTER | IN | 46321 | 351727711 | MGMT SERVICES | IN | CFNI | C CORP | $0 | $0 | Yes (true) |
| COMMUNITY MEDICAL & PROFESSIONAL CENTER | |||||||||||
| 800 MACARTHUR BOULEVARD | MUNSTER | IN | 46321 | 237437942 | CONDO ASSOC | IN | CFNI | C CORP | $0 | $0 | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (14 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST CATHERINE HOSPITAL INC | ||
| B | $85,544 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| C | $5,022,252 | FMV |
| MUNSTER MEDICAL RESEARCH FOUNDATION INC | ||
| C | $1,347,731 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| H | $51,028 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| J | $980,517 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| O | $18,418,099 | FMV |
| MUNSTER MEDICAL RESEARCH FOUNDATION INC | ||
| O | $932,250 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| O | $76,985 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| P | $9,859,151 | FMV |
| MUNSTER MEDICAL RESEARCH FOUNDATION INC | ||
| P | $1,298,000 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| P | $242,876 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| Q | $461,463 | FMV |
| COMMUNITY CARE NETWORK INC | ||
| Q | $324,321 | FMV |
| MUNSTER MEDICAL RESEARCH FOUDNATION INC | ||
| Q | $166,980 | FMV |
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