ST ELIZABETHS HOME FOR THE AGED: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ST ELIZABETHS HOME FOR THE AGED (EIN 16-0743154)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-10-28
- IRS object ID
- 201513019349300936
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-10-28T12:48:12-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743154 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ELIZABETHS HOME FOR THE AGED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEL | BusinessNameControlTxt |
| Phone | 7168282974 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 GENESEE STREET4TH FLOOR-FINANCE | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID P MACHOLZ | PersonNm |
| Person Title | VP FINANCE/CORPCONTROLLER | PersonTitleTxt |
| Phone | 7168282794 | PhoneNum |
| Signature | 2015-10-28 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOSEPH MCDONALD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ADMINISTRATION-6TH FLOOR144 GENESEE | AddressLine1Txt |
| Address Line2 | ST | AddressLine2Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,990,991 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CHSBUFFALO.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE CATHOLIC HEALTH SYSTEM (CHS) MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A LONG TERM 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 2014 COMMUNITY SERVICE PLAN CAN BE FOUND AT WWW.CHSBUFFALO.ORG. | ActivityOrMissionDesc |
| Voting Members Governing Body | 28 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 20 | VotingMembersIndependentCnt |
| Total Employee | 80 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,046,567 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,976,474 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$4,720 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,219 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,043 | PYOtherRevenueAmt |
| CY Other Revenue | $13,298 | CYOtherRevenueAmt |
| PY Total Revenue | $2,051,890 | PYTotalRevenueAmt |
| CY Total Revenue | $1,990,991 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,177,127 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,036,962 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $697,023 | PYOtherExpensesAmt |
| CY Other Expenses | $741,944 | CYOtherExpensesAmt |
| PY Total Expenses | $2,874,150 | PYTotalExpensesAmt |
| CY Total Expenses | $2,778,906 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$822,260 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$787,915 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,003,426 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,228,550 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,161,954 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,365,134 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$158,528 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,136,584 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CATHOLIC HEALTH SYSTEM (CHS) MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A LONG TERM 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 2014 COMMUNITY SERVICE PLAN CAN BE FOUND AT WWW.CHSBUFFALO.ORG. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,261,485 | ExpenseAmt |
| Revenue | $1,989,772 | RevenueAmt |
| Desc | NURSING HOME CARE: ST ELIZABETHS HOME IS AN ADULT NURSING FACILITY THAT TENDS PRIMARILY TO THE POOR AND ELDERLY AND IS LOCATED IN ERIE COUNTY, NEW YORK. IN 2014 OVER 52.61% OF THE RESIDENTS WERE COVERED BY MEDICAID. THIS 52.61% MEDICAID POPULATION EQUALLED 20,537 MEDICAID DAYS. SEE COMMUNITY SERVICE PLAN AT WWW.CHSBUFFALO.ORG. | Desc |
| Total Program Service Expenses | $2,261,485 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 80 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 28 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 20 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID P MACHOLZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7168282974 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 GENESEE STREET4TH FLOOR-FINANCE | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14203 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (43 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JOSEPH MCDONALD | ||||||||
| PRESIDENT AND CEO, CHS | 37.50 | Yes (X) | Yes (X) | $0 | $1,344,183 | $55,937 | ||
| MARK SULLIVAN | ||||||||
| EXEC VP/COO | 37.50 | Yes (X) | Yes (X) | $0 | $716,018 | $47,406 | ||
| EDWARD FLYNN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOYCE MARKIEWICZ | ||||||||
| PRESIDENT & CEO HOME AND COMMUNITY BASED CARE | 37.50 | Yes (X) | Yes (X) | $0 | $336,389 | $49,581 | ||
| MARK MEYERHOFER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES MILLARD | ||||||||
| DIRECTOR | 37.50 | Yes (X) | $0 | $360,108 | $217,116 | |||
| ROBERT NASSO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHERRY POMEROY PHD RN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SR MARY ANNE WELDON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MONSIGNOR ROBERT E ZAPFEL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID MACHOLZ | ||||||||
| OFFICER/DIRECTOR | 37.50 | Yes (X) | Yes (X) | $0 | $253,185 | $42,733 | ||
| CHARLES J URLAUB | ||||||||
| OFFICER/DIRECTOR | 37.50 | Yes (X) | Yes (X) | $0 | $500,168 | $48,207 | ||
| DRMICHAEL EDBAUER | ||||||||
| DIRECTOR | 18.80 | Yes (X) | $0 | $306,246 | $23,873 | |||
| PETER BERGMANN | ||||||||
| DIRECTOR | 37.50 | Yes (X) | $0 | $521,653 | $39,456 | |||
| LOUIS BAUMANN MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN BEITZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANCES CROSBY RN PHD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD CURRAN MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN DAVANZO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DENNIS DOMBEK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID DURANTE MDDAVID DURANTE MD | ||||||||
| DIRECTOR | 18.80 | Yes (X) | $0 | $113,038 | $0 | |||
| JOSEPH GELORMINI MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM LAWLEY JR | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LI LIN PHD | ||||||||
| CHAIRMAN OF MINISTRY SERVICES | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JUDITH MANESS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES MANZELLA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RAQUEL MARTIN DO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL MONTANTE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT NASSO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK PODLAS MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD SLATE MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY TURKIEWIECZ MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SR MARY ANNE WELDON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CYNTHIA ZANE EDD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES A DUNLOP JR | ||||||||
| EXEC VP, FINANCE/CFO | 37.50 | Yes (X) | $0 | $610,886 | $180,721 | |||
| JUDITH HUMES | ||||||||
| ADMINISTRATOR | 37.50 | Yes (X) | $107,555 | $0 | $30,310 | |||
| MICHAEL MOLEY | ||||||||
| SR. VP HUMAN RESOURCES | 37.50 | $0 | $602,383 | $52,698 | Yes (X) | |||
| JOHN STAVROS | ||||||||
| SR. VP MARKETING | 37.50 | $0 | $299,464 | $45,380 | Yes (X) | |||
| BARTHOLOMEW RODRIGUES | ||||||||
| SR. VP MISSION INTEGRATION | 37.50 | $0 | $256,461 | $42,237 | Yes (X) | |||
| DR MICHAEL GALANG | ||||||||
| CIO | 37.50 | $0 | $415,734 | $36,231 | Yes (X) | |||
| NANCY SHEEHAN | ||||||||
| VP LEGAL SVC, OGC | 37.50 | $0 | $340,246 | $41,133 | Yes (X) | |||
| MARIA FOTI | ||||||||
| SR. VP, STRATEGIC PLANNING | 37.50 | $0 | $302,471 | $40,116 | Yes (X) | |||
| CHRISTINE KLUCKHOHN | ||||||||
| FORMER-PRES/CEO, CONTINUING CARE | 37.50 | $0 | $289,537 | $123,443 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $107,555 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,568,170 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,116,578 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NURSEFINDERS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 910738 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75391 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | NURSING SERVICES | ServicesDesc |
| Compensation | $269,612 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PRIVATE AND SSI | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $1,976,474 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,976,474 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,976,474 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,219 | TotalRevenueColumnAmt |
| Exclusion | $1,219 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISC | 900099 | $8,554 | $8,554 |
| VENDING INCOME | 900099 | $4,744 | $4,744 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,298 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,990,991 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,989,772 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,219 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,865 | TotalAmt |
| Management And General | $137,865 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,513,897 | TotalAmt |
| Program Services | $1,341,865 | ProgramServicesAmt |
| Management And General | $172,032 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,095 | TotalAmt |
| Program Services | $260,496 | ProgramServicesAmt |
| Management And General | $32,599 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,105 | TotalAmt |
| Program Services | $74,825 | ProgramServicesAmt |
| Management And General | $17,280 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,943 | TotalAmt |
| Program Services | $7,200 | ProgramServicesAmt |
| Management And General | $42,743 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,150 | TotalAmt |
| Program Services | $108,150 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$45,402 | TotalAmt |
| Program Services | $4,173 | ProgramServicesAmt |
| Management And General | -$49,575 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASE SERVICES | $298,393 | $181,790 | $116,603 |
| SUPPLIES | $221,102 | $217,018 | $4,084 |
| BAD DEBTS EXPENSE | $62,308 | $62,308 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,450 | TotalAmt |
| Program Services | $3,660 | ProgramServicesAmt |
| Management And General | $43,790 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,778,906 | TotalAmt |
| Program Services | $2,261,485 | ProgramServicesAmt |
| Management And General | $517,421 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,344 | BOYAmt |
| EOY | $49,081 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,040 | BOYAmt |
| EOY | $399,995 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $812,847 | BOYAmt |
| EOY | $85,694 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,928,235 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,399,529 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $581,327 | BOYAmt |
| EOY | $528,706 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,153,868 | BOYAmt |
| EOY | $2,165,074 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,003,426 | BOYAmt |
| EOY | $3,228,550 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,496 | BOYAmt |
| EOY | $283,324 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,803,458 | BOYAmt |
| EOY | $4,081,810 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,161,954 | BOYAmt |
| EOY | $4,365,134 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$158,528 | BOYAmt |
| EOY | -$1,136,584 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$158,528 | BOYAmt |
| EOY | -$1,136,584 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,003,426 | BOYAmt |
| EOY | $3,228,550 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$787,915 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$190,141 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,208,397 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,185,660 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,167,800 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,056,610 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,989,772 | CurrentTaxYearAmt |
| Total | $10,608,239 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,208,397 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,185,660 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,167,800 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,056,610 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,989,772 | CurrentTaxYearAmt |
| Total | $10,608,239 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,608,239 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,328 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,096 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,167 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,219 | CurrentTaxYearAmt |
| Total | $8,188 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,328 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,096 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,167 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,219 | CurrentTaxYearAmt |
| Total | $8,188 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,209,775 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,186,988 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,168,896 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,059,777 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,990,991 | CurrentTaxYearAmt |
| Total | $10,616,427 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99920 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99930 | PublicSupportPY509Pct |
| Investment Income CY | 0.00080 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $857,600 | OtherCostOrOtherBasisAmt |
| Depreciation | $833,649 | DepreciationAmt |
| Book Value | $23,951 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,070,635 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,565,880 | DepreciationAmt |
| Book Value | $504,755 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $528,706 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATE | Desc |
| Book Value | $2,165,074 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,165,074 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| LONG TERM PENSION OBLIGATION | $974,556 |
| ASSET RETIREMENT OBLIGATION | $141,626 |
| OTHER LONG TERM LIABILITIES | $122,865 |
| DUE TO AFFILIATES | $2,842,763 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,081,810 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSEPH MCDONALD | ||||||||||||||
| PRESIDENT AND CEO, CHS | $0 | $748,734 | $0 | $280,841 | $0 | $314,608 | $0 | $34,856 | $0 | $21,081 | $0 | $1,400,120 | $0 | $0 |
| MARK SULLIVAN | ||||||||||||||
| EXEC VP/COO | $0 | $467,326 | $0 | $113,773 | $0 | $134,919 | $0 | $28,266 | $0 | $19,140 | $0 | $763,424 | $0 | $0 |
| JOYCE MARKIEWICZ | ||||||||||||||
| PRESIDENT & CEO HOME AND COMMUNITY B | $0 | $263,677 | $0 | $33,005 | $0 | $39,707 | $0 | $31,253 | $0 | $18,328 | $0 | $385,970 | $0 | $0 |
| JAMES MILLARD | ||||||||||||||
| DIRECTOR | $0 | $271,916 | $0 | $48,125 | $0 | $40,067 | $0 | $216,802 | $0 | $314 | $0 | $577,224 | $0 | $0 |
| DAVID MACHOLZ | ||||||||||||||
| OFFICER/DIRECTOR | $0 | $195,706 | $0 | $31,223 | $0 | $26,256 | $0 | $22,835 | $0 | $19,898 | $0 | $295,918 | $0 | $0 |
| CHARLES J URLAUB | ||||||||||||||
| OFFICER/DIRECTOR | $0 | $369,957 | $0 | $72,644 | $0 | $57,567 | $0 | $29,025 | $0 | $19,182 | $0 | $548,375 | $0 | $0 |
| DRMICHAEL EDBAUER | ||||||||||||||
| DIRECTOR | $0 | $228,520 | $0 | $52,981 | $0 | $24,745 | $0 | $13,975 | $0 | $9,898 | $0 | $330,119 | $0 | $0 |
| PETER BERGMANN | ||||||||||||||
| DIRECTOR | $0 | $391,424 | $0 | $84,427 | $0 | $45,802 | $0 | $20,550 | $0 | $18,906 | $0 | $561,109 | $0 | $0 |
| JAMES A DUNLOP JR | ||||||||||||||
| EXEC VP, FINANCE/CFO | $0 | $400,137 | $0 | $123,435 | $0 | $87,314 | $0 | $162,397 | $0 | $18,324 | $0 | $791,607 | $0 | $0 |
| MICHAEL MOLEY | ||||||||||||||
| SR. VP HUMAN RESOURCES | $0 | $331,461 | $0 | $85,478 | $0 | $185,444 | $0 | $33,027 | $0 | $19,671 | $0 | $655,081 | $0 | $0 |
| JOHN STAVROS | ||||||||||||||
| SR. VP MARKETING | $0 | $213,088 | $0 | $44,797 | $0 | $41,579 | $0 | $24,145 | $0 | $21,235 | $0 | $344,844 | $0 | $0 |
| BARTHOLOMEW RODRIGUES | ||||||||||||||
| SR. VP MISSION INTEGRATION | $0 | $170,867 | $0 | $45,920 | $0 | $39,674 | $0 | $23,834 | $0 | $18,403 | $0 | $298,698 | $0 | $0 |
| DR MICHAEL GALANG | ||||||||||||||
| CIO | $0 | $326,118 | $0 | $49,909 | $0 | $39,707 | $0 | $28,978 | $0 | $7,253 | $0 | $451,965 | $0 | $0 |
| NANCY SHEEHAN | ||||||||||||||
| VP LEGAL SVC, OGC | $0 | $291,960 | $0 | $28,135 | $0 | $20,151 | $0 | $33,594 | $0 | $7,539 | $0 | $381,379 | $0 | $0 |
| MARIA FOTI | ||||||||||||||
| SR. VP, STRATEGIC PLANNING | $0 | $214,638 | $0 | $48,282 | $0 | $39,551 | $0 | $33,051 | $0 | $7,065 | $0 | $342,587 | $0 | $0 |
| CHRISTINE KLUCKHOHN | ||||||||||||||
| FORMER-PRES/CEO, CONTINUING CARE | $0 | $0 | $0 | $0 | $0 | $289,537 | $0 | $106,137 | $0 | $17,306 | $0 | $412,980 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PER THE TERMS AND CONDITIONS OF THEIR EMPLOYMENT CONTRACT. PENSION GAP SERP JOSEPH MCDONALD $26,000 $117,093 MARK SULLIVAN $19,500 PETER BERGMANN $ 7,334 A SEVERANCE PAYMENT OF $288,763 WAS MADE FOR CHRISTINE KLUCKHOHN, AN ASSOCIATE WHO WAS LISTED IN PART 1A. |
| PART I, LINE 7 | EXECUTIVE MANAGEMENT EMPLOYED BY CATHOLIC HEALTH ARE COMPENSATED UNDER A MULTI-TIERED, GOAL-BASED PROGRAM WHICH INCLUDES BASE PAY AND A VARIABLE PORTION. THE VARIABLE PORTION IS REFERRED TO AS "AT RISK COMPENSATION." EACH OF THE ELIGIBLE MEMBERS OF EXECUTIVE MANAGEMENT IS ASSIGNED PERFORMANCE GOALS ALIGNED WITH ORGANIZATIONAL STRATEGIC GOALS. EACH GOAL HAS MINIMUM THRESHOLD CRITERIA, TARGET CRITERIA AND A MAXIMUM. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JAMES MANZELLA | |||
| ACUTE CARE BOARD MEMBER | $161,739 | KEY EMPLOYEE OF MANZELLA MARKETING | 0 |
| SUSAN URLAUB | |||
| WIFE OF MERCY CEO,C.J. URLAUB | $82,776 | CORPORATE NURSE EDUCATOR | 0 |
| KATHLEEN ZAPFEL | |||
| SISTER-IN-LAW OF BOD, MSGR. ROBERT ZAPFEL | $70,537 | HR EMPLOYEE OF CHS | 0 |
| MARIE PACKARD | |||
| DAUGHTER OF BOD,DENNIS DOMBEK | $84,949 | MERCY PHYSICAL THERAPIST | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 CATHOLIC HEALTH SYSTEM 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. SCHUDULE H: HOSPITAL 5. SCHUDULE 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 IT NOTED, IT IS DISCUSSED BY THE MANAGER, 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 THE 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 | 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; COO; CFO; CEO'S FOR EACH MINISTRY; AND ALL SENIOR VICE PRESIDENTS. THE COMPENSATION COMMITTEE PROVIDES OVERSIGHT TO MANAGEMENT DECISIONS WHICH ARE BASED ON OUTLINES APPROVED BY THE COMMITTEE, AND PERFORMS A REVIEW OF DATA. THE OUTCOME OF THESE MEETINGS IS DOCUMENTED. |
| 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: | MINIMUM PENSION LIABILITY ADJUSTMENT -211,670. DONATION FOR CAPITAL ASSETS 21,529. |
| FORM 990, PART VI, SECTION B, LINE 16B | THE CATHOLIC HEALTH SYSTEM HAS A PROCESS TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS UNDER APPLICABLE FEDERAL TAX LAW, AND HAS TAKEN STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS, AND HAS DEVELOPED A FORMAL POLICY TO FORMAIZE THE PROCESS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM INC | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 222565278 | HEALTH CARE DELIVERY SYSTEM | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| MERCY HOSPITAL OF BUFFALO | ||||||||||
| 565 ABBOTT ROAD | BUFFALO | NY | 14220 | 160756336 | ACUTE CARE HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM INC | 0 |
| SISTERS OF CHARITY HOSPITAL | ||||||||||
| 2157 MAIN STREET | BUFFALO | NY | 14214 | 160743187 | ACUTE CARE HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM INC | 0 |
| KENMORE MERCY HOSPITAL | ||||||||||
| 2950 ELMWOOD AVENUE | KENMORE | NY | 14217 | 160762843 | ACUTE CARE HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM INC | 0 |
| NAZARETH HOME OF THE FRANCISCAN SISTERS | ||||||||||
| 291 NORTH STREET | BUFFALO | NY | 14201 | 160813142 | SKILLED NURSING FACILITY | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| ST FRANCIS HOME OF WILLIAMSVILLE | ||||||||||
| 147 REIST STREET | WILLIAMSVILLE | NY | 14221 | 160743153 | SKILLED NURSING FACILITY | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| ST FRANCIS OF BUFFALO INC | ||||||||||
| 34 BENWOOD AVENUE | BUFFALO | NY | 14214 | 161523535 | SKILLED NURSING FACILITY | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| ST VINCENT MANOR | ||||||||||
| 319 WASHINGTON AVENUE | DUNKIRK | NY | 14048 | 160743167 | ADULT HOME | NY | 501(C)(3) | LINE 9 | 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)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| NIAGARA HOMEMAKER SERVICES (MERCY HOME CARE) | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 161317960 | HOME CARE PROVIDER | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| MCAULEY SETON HOME CARE | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 161310062 | HOME CARE PROVIDER | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| CATHOLICE HEALTH SYSTEM INFUSION PHARMACY INC | ||||||||||
| 2875 UNION ROAD SUITE 14 | CHEEKTOWAGA | NY | 14227 | 200198518 | HOME CARE INFUSION SERVICES | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| CHS CONTINUING CARE FOUNDATION | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 200947831 | FOUNDATION | NY | 501(C)(3) | LINE 7 | CATHOLIC HEALTH SYSTEM INC | 0 |
| OLV RENAISSANCE CORPORATION | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 200167745 | REAL ESTATE HOLDING COMPANY | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| CHS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY INC | ||||||||||
| 55 MELROY AVENUE | LACKAWANA | NY | 14218 | 261252884 | ALL-INCLUSIVE CARE FOR THE ELDERLY | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM INC | 0 |
| TRINITY MEDICAL WNY PC | ||||||||||
| 2625 HARLEM ROAD | CHEEKTOWAGA | NY | 14225 | 272576645 | PRIMARY CARE PROVIDER | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM INC | 0 |
| KMH HOMES INC | ||||||||||
| 144 GENESEE STREET | BUFFALO | NY | 14203 | 161387890 | REAL ESTATE HOLDING COMPANY | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM INC | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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