BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP (EIN 45-2964467)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201443189349305529
- Schema version
- 2013v3.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T15:17:37-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 Peachtree Street Suite 2000 | AddressLine1 |
| City | Atlanta | City |
| State | GA | State |
| ZIP Code | 303031749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452964467 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bon Secours Charity Health System Affiliated Group | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BONS | BusinessNameControlTxt |
| Phone | 8453685000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1 |
| City | Suffern | City |
| State | NY | State |
| ZIP Code | 10901 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Leahy MD | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 8453685000 | PhoneNum |
| Signature | 2014-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | David A Craig | PreparerPersonNm |
| PTIN | P00542227 | PTIN |
| Phone | 4042201500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mary Leahy MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1 |
| City | Suffern | City |
| State | NY | State |
| ZIP Code | 10901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $473,866,542 | GrossReceiptsAmt |
| Group Return For Affiliates | Yes (1) | GroupReturnForAffiliatesInd |
| All Affiliates Included | Yes (1) | AllAffiliatesIncludedInd |
| Group Exemption | 5747 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | charity.bonsecours.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Activity Or Mission | Acute care hospitals, physician services and long-term care facilities | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 3542 | TotalEmployeeCnt |
| Total Volunteers | 445 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,266,805 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,816,195 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $444,769,571 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $458,143,916 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$253,847 | PYInvestmentIncomeAmt |
| CY Investment Income | $395,047 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,135,778 | PYOtherRevenueAmt |
| CY Other Revenue | $5,465,277 | CYOtherRevenueAmt |
| PY Total Revenue | $457,918,307 | PYTotalRevenueAmt |
| CY Total Revenue | $473,820,435 | 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 | $253,284,803 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $252,694,520 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $219,549,437 | PYOtherExpensesAmt |
| CY Other Expenses | $229,076,816 | CYOtherExpensesAmt |
| PY Total Expenses | $472,834,240 | PYTotalExpensesAmt |
| CY Total Expenses | $481,771,336 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$14,915,933 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,950,901 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $251,954,297 | TotalAssetsBOYAmt |
| Total Assets EOY | $260,737,781 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $298,567,414 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $314,851,929 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$46,613,117 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$54,114,148 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help people and communities to health and wholeness. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $443,734,028 | ExpenseAmt |
| Revenue | $462,277,765 | RevenueAmt |
| Desc | Bon Secours Charity Health System Affiliated Group is composed of three acute care hospitals, primary and specialty medical care practices and two long-term care and residential facilities: Good Samaritan Hospital of Suffern, NY; Bon Secours Community Hospital; St. Anthony Community Hospital; Bon Secours Charity Health System Medical Group, PC; St. Francis Center at the Knolls (dba Mount Alverno Center); and Villas Francis at the Knolls (dba Schervier Pavilion).Good Samaritan Hospital of Suffern, New York, is a non-profit, 326-bed hospital providing emergency, medical, surgical, obstetrical / gynecological and acute care services to residents of Rockland and southern Orange Counties in New York; and northern Bergen County, New Jersey. The hospital also serves these communities as an Area Level II Trauma Center. Good Samaritan Regional Medical Center provides regional specialty services, including comprehensive cancer treatment services and the first and only cardiovascular program in the lower Hudson Valley area which includes, open heart surgery, cardiac catheterization laboratory, emergency angioplasty, electrophysiology studies, and a pacemaker clinic. Good Samaritan offers a brand new Wound Care Center, and we also offer maternal/child services, including a high level II special care nursery and the Children's Diagnostic Center, which utilizes the services of pediatric subspecialists from Westchester County Medical Center. The hospital also provides social, psychiatric and substance abuse services for the area and kidney dialysis services through its Frank and Fannie Weiss Renal Center. Good Samaritan Regional Medical Center's Certified Home Care Agency provides home health care service to the residents of Rockland and Orange Counties, New York.Bon Secours Community Hospital is a non-profit, 122-bed hospital providing acute care and medical/surgical services, including long-term care and behavioral health services. The Emergency Department features highly trained physicians, nurses and technicians, providing the Tri-State community with a vital, life-saving service. Bon Secours Community Hospital offers the Bariatric Surgery Center of Excellence, a complete program dedicated to weight loss surgery, dietary counseling and support groups to help the morbidly obese patients turn their life around.St. Anthony Community Hospital is a non-profit, 60-bed hospital serving the residents of Orange County, NY, Sussex and Passaic Counties in NJ. The hospital has been a primary resource for emergency, quality medical and wellness care since 1939. Among the services provided are comprehensive women's health programs, which include the Kennedy Birthing Center. The new Center for Ambulatory Services offers the clinical and support services needed - all in one location. These include admitting, pre-admission screening, endoscopy, minor surgery and same-day surgery. Patients seeking comfortable and convenient infusion therapy can now utilize the Outpatient Infusion Center within the hospital. Bon Secours Charity Health System Medical Group, PC provides medical services to Suffern, NY and sounding communities. Their services include primary care and various pseicalty profesional services. The organization seeks to locate its physician practice sites in areas that most effectively meet the needs of a community.Mount Alverno Center is a New York State-licensed Adult Home with an Assisted Living Program serving 85 residents. The goal of the organization is for residents to maintain a maximum level of independence. Individualized care plans are designed to help residents reach their utmost daily potential. Services are based on a team approach and are provided by highly competent professionals dedicated to the comfort and safety of our residents.Schervier Pavilion is a 120-bed skilled nursing facility. The goal of the organization is to help each resident maintain the highest level of daily independence possible. Residents participate in a broad range of therapeutic and social activities designed to enhance their physical and mental capabilities providing healthcare services to acute care patients. | Desc |
| Total Program Service Expenses | $443,734,028 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 | 0 | 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 | 305 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3542 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Larkin | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4433672204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8990 Old Annapolis Road | AddressLine1 |
| City | Columbia | City |
| State | MD | State |
| ZIP Code | 21045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Steve Albanese | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Maureen Creegan | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Tamer El-Rayess | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sandra Grannum | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Steve Kent | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sylvain Klein | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sr Roseann Mazzeo | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sr Mary Eilleen O'Brien | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Robert Porr | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Clement Osei MD | ||||||||||
| Board Member | 24.00 | 0.00 | Yes (X) | $185,926 | $0 | $26,393 | ||||
| Daniel Rifkin | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kenneth Steinglass MD | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Andrea Schmid-Mazzoccoli | ||||||||||
| Board Member | 2.00 | 48.00 | Yes (X) | $0 | $497,282 | $67,346 | ||||
| Fred Kelly | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| John Wallenhorst PhD | ||||||||||
| Board Member | 2.00 | 48.00 | Yes (X) | $0 | $337,082 | $24,753 | ||||
| Stephen Dormer | ||||||||||
| Chairman | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Sr Anne Lutz | ||||||||||
| President - BSCHS | 3.00 | 47.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Sr Ellen Dauwer | ||||||||||
| Secretary - BSCHS | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Philip Patterson | ||||||||||
| CEO - BSCHS (Jan-Sept) | 49.00 | 1.00 | Yes (X) | $0 | $600,007 | $72,532 | Yes (X) | |||
| Mary Leahy MD | ||||||||||
| CEO - BSCHS (Sept-Dec) | 49.00 | 1.00 | Yes (X) | $506,375 | $0 | $43,233 | Yes (X) | |||
| Martin Evers MD | ||||||||||
| President - BSCHS MedPC | 50.00 | 0.00 | Yes (X) | $323,097 | $0 | $36,715 | Yes (X) | |||
| Rodney Williams MD | ||||||||||
| CMO - BSCHS | 50.00 | 0.00 | $536,471 | $0 | $29,340 | Yes (X) | ||||
| Eileen Dobbing | ||||||||||
| CNO - BSCHS | 50.00 | 0.00 | $384,036 | $0 | $20,478 | Yes (X) | ||||
| Pam Tarulli | ||||||||||
| SVP HR - BSCHS | 49.00 | 1.00 | $370,763 | $0 | $32,779 | Yes (X) | ||||
| Jeffrey Reilly | ||||||||||
| SVP OPS - CH & SACH | 50.00 | 0.00 | $322,317 | $0 | $7,573 | Yes (X) | ||||
| Sophie Crawford-Rosso | ||||||||||
| VP PCS - CH | 50.00 | 0.00 | $156,301 | $0 | $16,915 | Yes (X) | ||||
| Judith Lindberg | ||||||||||
| VP PCS - SACH | 50.00 | 0.00 | $165,091 | $0 | $18,936 | Yes (X) | ||||
| John Fiore | ||||||||||
| Medical Director - SACH | 50.00 | 0.00 | $353,222 | $0 | $36,716 | Yes (X) | ||||
| Toni Clark | ||||||||||
| EVP Sr Services - MA&SP | 50.00 | 0.00 | $232,680 | $0 | $22,473 | Yes (X) | ||||
| Edward Lundy MD | ||||||||||
| Dir of Cardiac Surgery | 50.00 | 0.00 | $1,018,083 | $0 | $34,374 | Yes (X) | ||||
| Cary Hirsch MD | ||||||||||
| Physician | 50.00 | 0.00 | $996,664 | $0 | $20,037 | Yes (X) | ||||
| Thomas Facelle MD | ||||||||||
| Dir of Surgery | 50.00 | 0.00 | $815,346 | $0 | $20,574 | Yes (X) | ||||
| Anuj Shah MD | ||||||||||
| Cardiologist | 50.00 | 0.00 | $692,935 | $0 | $28,326 | Yes (X) | ||||
| Seth Hurwitz MD | ||||||||||
| Cardiologist | 50.00 | 0.00 | $626,719 | $0 | $40,030 | Yes (X) | ||||
| David Capone | ||||||||||
| Former CFO | 0.00 | 0.00 | $261,699 | $0 | $9,284 | Yes (X) | ||||
| Melinda Hancock | ||||||||||
| Former Interim CFO | 0.00 | 0.00 | $0 | $365,950 | $30,891 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,947,725 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,800,321 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $639,698 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 337 | 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 (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Holt Construction Corp | |||||
| 50 East Washington Avenue | Pearl River | NY | 10965 | Construction Capital Projects | $9,607,756 |
| Crothall Services Group | |||||
| 13028 Collections Center | Chicago | IL | 60693 | Engineering | $5,046,978 |
| Hunter Partners | |||||
| PO Box 919359 | Orlando | FL | 32891 | Consulting | $2,894,971 |
| Morrison Management Specialists | |||||
| PO Box 102289 | Atlanta | GA | 30368 | Dietary | $2,319,432 |
| Shiftwise | |||||
| 1800 SW 1st Avenue Suite 510 | St Paul | MN | 97201 | Temp Services | $2,043,271 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 55 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $191,019 | RelatedOrganizationsAmt |
| Government Grants | $9,622,711 | GovernmentGrantsAmt |
| All Other Contributions | $2,465 | AllOtherContributionsAmt |
| Total Contributions | $9,816,195 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Rev. | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $458,143,916 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $458,143,916 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $458,143,916 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $170,767 | TotalRevenueColumnAmt |
| Exclusion | $170,767 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $438,978 | RealAmt |
| Personal | $9,628 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $438,978 | RealAmt |
| Personal | $9,628 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $448,606 | TotalRevenueColumnAmt |
| Exclusion | $448,606 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $270,387 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $46,107 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $270,387 | SecuritiesAmt |
| Other | -$46,107 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $224,280 | TotalRevenueColumnAmt |
| Exclusion | $224,280 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Capitation Rev/Incent. | 900099 | $1,685,526 | $1,685,526 |
| Self-Ins Trust Distrib | 900099 | $1,558,741 | $1,558,741 |
| Med. Readings & Educ | 900099 | $862,041 | $862,041 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $910,363 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,541 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $882,822 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,016,671 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473,820,435 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $462,277,765 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,726,475 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,829,222 | TotalAmt |
| Program Services | $3,446,299 | ProgramServicesAmt |
| Management And General | $382,923 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,452,317 | TotalAmt |
| Program Services | $166,007,085 | ProgramServicesAmt |
| Management And General | $18,445,232 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,954,850 | TotalAmt |
| Program Services | $7,159,365 | ProgramServicesAmt |
| Management And General | $795,485 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,955,012 | TotalAmt |
| Program Services | $35,059,511 | ProgramServicesAmt |
| Management And General | $3,895,501 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,503,119 | TotalAmt |
| Program Services | $15,752,807 | ProgramServicesAmt |
| Management And General | $1,750,312 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $819,652 | TotalAmt |
| Program Services | $737,687 | ProgramServicesAmt |
| Management And General | $81,965 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,339 | TotalAmt |
| Program Services | $398,105 | ProgramServicesAmt |
| Management And General | $44,234 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,506 | TotalAmt |
| Program Services | $90,455 | ProgramServicesAmt |
| Management And General | $10,051 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,878,379 | TotalAmt |
| Program Services | $22,878,379 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,756,322 | TotalAmt |
| Program Services | $1,580,690 | ProgramServicesAmt |
| Management And General | $175,632 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,267,577 | TotalAmt |
| Program Services | $7,440,819 | ProgramServicesAmt |
| Management And General | $826,758 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,672,203 | TotalAmt |
| Program Services | $11,404,983 | ProgramServicesAmt |
| Management And General | $1,267,220 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,727,433 | TotalAmt |
| Program Services | $7,854,690 | ProgramServicesAmt |
| Management And General | $872,743 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $934,253 | TotalAmt |
| Program Services | $840,828 | ProgramServicesAmt |
| Management And General | $93,425 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,427,560 | TotalAmt |
| Program Services | $2,184,804 | ProgramServicesAmt |
| Management And General | $242,756 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,141,231 | TotalAmt |
| Program Services | $5,141,231 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,216,316 | TotalAmt |
| Program Services | $14,594,684 | ProgramServicesAmt |
| Management And General | $1,621,632 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,288,819 | TotalAmt |
| Program Services | $7,459,937 | ProgramServicesAmt |
| Management And General | $828,882 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $55,568,355 | $55,568,355 | |
| Purchased Services | $50,079,139 | $45,071,225 | $5,007,914 |
| Bad Debt | $17,810,292 | $17,810,292 | |
| BSHSI Mgmt Dues | $8,560,731 | $7,704,658 | $856,073 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,385,709 | TotalAmt |
| Program Services | $7,547,139 | ProgramServicesAmt |
| Management And General | $838,570 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $481,771,336 | TotalAmt |
| Program Services | $443,734,028 | ProgramServicesAmt |
| Management And General | $38,037,308 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,012 | BOYAmt |
| EOY | $165,997 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $306,537 | BOYAmt |
| EOY | $306,621 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500 | BOYAmt |
| EOY | $1,504,671 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,445,243 | BOYAmt |
| EOY | $57,384,930 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,262,557 | BOYAmt |
| EOY | $2,862,274 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,032,302 | BOYAmt |
| EOY | $6,582,029 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,819,888 | BOYAmt |
| EOY | $3,517,389 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $271,126,014 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $148,205,450 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,828,330 | BOYAmt |
| EOY | $122,920,564 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,786,131 | BOYAmt |
| EOY | $5,314,515 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,285,437 | BOYAmt |
| EOY | $1,007,310 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,791,360 | BOYAmt |
| EOY | $59,171,481 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,954,297 | BOYAmt |
| EOY | $260,737,781 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,730,917 | BOYAmt |
| EOY | $54,094,273 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,903,465 | BOYAmt |
| EOY | $2,555,455 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,390 | BOYAmt |
| EOY | $121,751 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $334,553 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,829,642 | BOYAmt |
| EOY | $257,745,897 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,567,414 | BOYAmt |
| EOY | $314,851,929 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$47,386,207 | BOYAmt |
| EOY | -$54,888,198 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $773,090 | BOYAmt |
| EOY | $774,050 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$46,613,117 | BOYAmt |
| EOY | -$54,114,148 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,954,297 | BOYAmt |
| EOY | $260,737,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$7,950,901 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $211,674 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $238,196 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $100,506 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $100,506 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,589,780 | OtherCostOrOtherBasisAmt |
| Book Value | $4,589,780 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,726,567 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,669,651 | DepreciationAmt |
| Book Value | $75,056,916 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,401,361 | OtherCostOrOtherBasisAmt |
| Depreciation | $272,157 | DepreciationAmt |
| Book Value | $1,129,204 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,618,420 | OtherCostOrOtherBasisAmt |
| Depreciation | $83,780,997 | DepreciationAmt |
| Book Value | $26,837,423 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,789,886 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,482,645 | DepreciationAmt |
| Book Value | $15,307,241 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $122,920,564 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (10 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| LT Non-Cash Inv - HPL/GL | $52,113,392 |
| Medicare Settlements | $2,332,111 |
| Due from Affiliate | $1,843,782 |
| Deferred Medicare | $1,243,148 |
| LT 3rd Party Reserves | $725,213 |
| Organizational Costs | $284,492 |
| Deposits | $125,044 |
| Assets Held in Trust for Others | $107,215 |
| Physician Loans | $41,926 |
| All Other | $355,158 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $59,171,481 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to BSHSI | $108,874,746 |
| Other Debt LT General | $76,510,000 |
| HPL/GL Liability | $52,113,392 |
| LT Building Development Liab | $4,390,000 |
| Medicare Settlements | $4,155,641 |
| FIN47 LT Asbestos Liab | $3,864,675 |
| Capital Leases LT General | $3,654,799 |
| LT Liab - Post Retirement Benefits | $2,936,765 |
| Due to Affiliates | $348,529 |
| Other Misc LT Liabilities | $897,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $257,745,897 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Line 2b: | FormAndLineReferenceDesc |
| Explanation | Certain facilities hold, safeguard, manage and account for the personal funds of residents who have authorized the facility in writing to manage any personal funds. Fund requests less than $50 are available for immediate distribution to residents and written requests for $50 or more are honored, by check, within a reasonable time frame. Generally, all custodial funds in excess of $50 are held in interest bearing accounts separate from that of the organization. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,480,092 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $516,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,963,207 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,916,694 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,525,494 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,391,200 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $662,550 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $556,087 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $106,463 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,059,336 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,598,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,460,870 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 33 | ActivitiesOrProgramsCnt |
| Persons Served | 197463 | PersonsServedCnt |
| Total Community Benefit Expns | $735,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $735,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 6508 | PersonsServedCnt |
| Total Community Benefit Expns | $3,809,763 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,809,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 3678 | PersonsServedCnt |
| Total Community Benefit Expns | $41,882 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $41,882 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 44 | ActivitiesOrProgramsCnt |
| Persons Served | 207649 | PersonsServedCnt |
| Total Community Benefit Expns | $4,586,924 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,586,924 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 44 | ActivitiesOrProgramsCnt |
| Persons Served | 207649 | PersonsServedCnt |
| Total Community Benefit Expns | $75,646,260 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,598,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,047,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05570 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 1612 | PersonsServedCnt |
| Total Community Benefit Expns | $129,281 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $129,281 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 159 | PersonsServedCnt |
| Total Community Benefit Expns | $2,823 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 2715 | PersonsServedCnt |
| Total Community Benefit Expns | $256,160 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $256,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 4486 | PersonsServedCnt |
| Total Community Benefit Expns | $388,264 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $388,264 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $13,993,515 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $137,217,056 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $137,136,664 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $80,392 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 3 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (3 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|---|---|
| Good Samaritan Hospital of Suffern NY | ||||||||||
| 1 | 255 Lafayette Avenue | Suffern | NY | 10901 | goodsamhosp.org | 4329000H | Yes (X) | Yes (X) | Yes (X) | A |
| St Anthony Community Hospital | ||||||||||
| 2 | 15 Maple Avenue | Warwick | NY | 10990 | stanthonycommunityhosp.org | 3529000H | Yes (X) | Yes (X) | Yes (X) | A |
| Bon Secours Community Hospital | ||||||||||
| 3 | 160 East Main Street | Port Jervis | NY | 12771 | bonsecourscommunityhosp.org | 3535001H | Yes (X) | Yes (X) | Yes (X) | A |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Facility Reporting Group - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | Yes (1) | 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 (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | bschs.org/about-us-community-health-needs | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B | Facility Reporting Group A |
| Facility Reporting Group A consists of: | - Facility 1: Good Samaritan Hospital of Suffern, NY, - Facility 2: St. Anthony Community Hospital, - Facility 3: Bon Secours Community Hospital |
| Facility Reporting Group - A Part V, Section B, line 3: | The Rockland County DOH, led by E. Oscar Alleyne, D.Ph., MPH, and Director of Epidemiology & Public Health Planning, was the lead agency to coordinate the data collection and direct the focus group interviews. Other agencies with knowledge of vulnerable populations that participated in the county's process were Nyack Hospital, Hudson River HealthCare, Refuah Health Center, Dominican College, Northern Services Group, the Rockland County Office for the Aging, ARC of Rockland, the Haitian American Cultural and Social Organization (HACSO) of Rockland and the Lower Hudson Valley Perinatal Network. Each of these agencies has special knowledge of the population sector that they serve. Specifically, Hudson River HealthCare and Refuah Health Center are federally qualified health centers that provide health care for a largely medically underserved population and HACSO of Rockland exclusively serves the Haitian minority population in Rockland County. |
| Facility Reporting Group - A Part V, Section B, line 4: | The following hospitals within Bon Secours Charity Health System, conducted a joint CHNA: Good Samaritan Hospital of Suffern, NY; St. Anthony Community Hospital;Bon Secours Community Hospital. |
| Facility Reporting Group - A Part V, Section B, line 7: | Based on data from the community assessment and the NYS Prevention Agenda priorities, the most significant health needs of the service area are as follows: Chronic Disease prevention Healthy and Safe environments Healthy Women, Infants and Children Mental Health and Substance Abuse Communicable Diseases Both priorities BS Charity will address are components of Chronic Disease prevention. BS Charity has identified other participant organizations and community resources that will focus on and provide responses to the needs of the community for the remaining significant health needs on the NYS Prevention Agenda priorities. |
| Facility Reporting Group - A Part V, Section B, line 12i: | Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy. |
| Facility Reporting Group - A Part V, Section B, line 14g: | Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy. |
| Facility Reporting Group - A Part V, Section B, line 20d: | Please see the narrative for Part VI, Line 3 regarding the Financial Assistance Policy. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| Regional Kidney Center | ||||
| 33-1 Route 17M | Harriman | NY | 10926 | Output Dialysis Center |
| Women's Imaging Center | ||||
| 55 Ronald Regan Blvd | Warwick | NY | 10990 | Outpatient Women's Imaging Center |
| The Ambulatory Surgery Center | ||||
| 257 Lafayette Avenue | Suffern | NY | 10901 | Ambulatory Surgery Center |
| Monsignor Patrick J Frawley Mental | ||||
| 3 Campbell Avenue | Suffern | NY | 10901 | Mental Health |
| Center for Physical Rehabilitation | ||||
| 153 South Route 94 | Warwick | NY | 10990 | Out Patient Rehab |
| Good Samaritan Home Care | ||||
| 1 Crosfield Ave Ste 202 | West Nyack | NY | 10994 | Home Care |
| Good Samaritan Home Care | ||||
| 15 Matthew St Suite 302 | Goshen | NY | 10924 | Home Care |
| St Anthony Sleep Disorder Institute | ||||
| 74 North Main Street | Florida | NY | 10921 | Sleep Lab |
| Center For Physical Rehabilitation | ||||
| 70 Hatfield Lane | Goshen | NY | 10924 | Outpatient Physical Therapy |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges captured in the patient accounting system and general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 13,993,515. |
| Part II, Community Building Activities: | Bon Secours is actively engaged in improving community health in the Port Jervis area through its Building Healthy Communities initiative. The BSCHS Director of Building Healthy Communities is focused on improving community health in the Port Jervis area. Building Healthy Communities has partnered with local residents, business owners, and government officials to bring opportunities for physical activity into the community and improve access to health screenings for low income residents. This initiative, along with related educational programs on healthy cooking and eating, are a step forward in addressing a major community-identified barrier to health. |
| Part III, Line 4: | Part III, line 2: Bad debt expense reported on line 2 is consistent with the expense reported in the audited financial statements. Bad debt expense per the audited financial statements and general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates. Please note that in prior years, the bad debt expense reported on Line 2 reflected bad debt expense at cost which was computed by applying the cost-to-charge ratio computed on Worksheet 2, of the Schedule H instructions, to the aggregate bad debt expense for patient accounts recorded in the general ledger.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.Part III, Line 4: Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on pages 9-10 in the attached BSCHS consolidated audited financial statements ("AFS"). "Allowance for doubtful accounts" is discussed in the second paragraph in Footnote "(8) Net Patient Service Revenue" on page 25 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS. |
| Part III, Line 8: | Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Section B, Line 7-8: Good Samaritan Hospital and Bon Secours Community Hospital both receives significant Medicare disproportionate share (DSH) payments, which are intended to partially compensate hospitals for the uncompensated care that arises from serving an usually large percentage of uninsured, low-income patients in their area. While these payments are a component of Medicare reimbursement, they do not relate to the Medicare allowable costs reported in line 6, but are more closely related to the Medicaid shortfall reported in Part I, Line 7 b, column (e). |
| Part III, Line 9b: | The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility. |
| Part VI, Line 2: | Over the period of nine months, Bon Secours Charity Health System worked collaboratively with the Rockland County and Orange County Departments of Health on individual Community Health Needs Assessments for Bon Secours Community Hospital located in Port Jervis, NY, St. Anthony Community Hospital located in Warwick, NY, and Good Samaritan Hospital located in Suffern, NY. This process included community surveys and interviews with representatives of our community with a knowledge of public health. Additionally, the New York State Department of Health (NYSDOH) Indicators for Tracking Public Health Priority Areas, 2013-2017 helped form the foundation for the needs assessment process. In addition to performing a Community Health Needs Assessment, all hospitals in New York State (NYS) are required to submit a three year Community Service Plan to the NYS Department of Health by November 2013. NYS mandates that each Community Service Plan is based on the NYS Prevention Agenda 2013-17. This Prevention Agenda is the blueprint for state and local action to improve the health of New Yorkers in five priority areas and to reduce health disparities for racial, ethnic, disability, socioeconomic and other groups who experience them. Based on data from the above mentioned community assessment activities and the NYS Prevention Agenda priorities, the most significant health needs of our service area are as follows: Chronic Disease prevention, Healthy and Safe environments, Healthy Women, Infants and Children, Mental Health and Substance Abuse, and Communicable Diseases. In this report we have identified community wide resources that can assist in addressing the health needs of our community. We will work with many of these health facilities and organizations to develop plans and programs to improve the health of our community. |
| Part VI, Line 3: | Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 250% of the Federal Poverty Guidelines ("FPG"), A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process. |
| Part VI, Line 4: | BSCHS facilities operate and serve populations of lower New York State, principally Rockland and Orange counties. Rockland County is located approximately 30 miles north of Manhattan on the West side of the Hudson River. The County is a popular residence for people who commute to work in nearby Westchester and Bergen Counties, as well as Manhattan. The County comprises approximately 115,000 acres and contains more than 35,000 acres of preserved open space and park land. Rockland continues to experience steady population growth in its five towns and 19 villages. The most recent Census Department estimates indicate that Rockland County grew 8.7% from 2000 to 2010, and now includes 311,687 residents. Orange County is located in the Hudson River Valley, bordering New Jersey. The County comprises approximately 816 square miles. Orange County continues to experience steady population growth, with the 2010 Census indicating that Orange County grew 9.2% from 2000 to 2010, and now includes 372,813 residents. In Rockland County, there was substantial growth in all age cohorts 65 and older, a consistent trend nationally. Gender among the age groups is roughly equal from the early age cohorts through the 40s, but after age 65, women continue to outnumber men. Population projections - Preliminary population projections through 2035 show that Rockland County's older population may double in size in the next three decades, while those ages 30 to 44 may shrink in size. While projections are based on historical data and do not always predict accurate trends, the dramatic possible increase in the elderly population is a trend that should be of importance to County service providers and planners. Based on 2010 U.S. Census population estimates, the median age in Orange County has increased by more than 2 years since 2007, to 36.6 years; the largest cohort of residents is age 45-49. The number of residents ages 65-69 is forecasted to more than double from 2000-2020 primarily due to the entry of 'baby boomers' into these age ranges.Twenty-one percent of Rockland County's population was estimated to be foreign-born in 2010. Among the 63,058 Rockland county residents estimated to be foreign born in 2007, the largest group was born in the Latin America and the Caribbean (48%). One quarter of foreign-born residents (25%) originated from Asia. Approximately another quarter (23%) came from Europe and 3% from Africa. Countywide, 32.9% of persons over age 5 speak a language other than English at home.According to the U.S. Census, 11.1% of residents in Orange County were foreign born, with 22.3% of persons over the age of five speaking a language other than English at home. Rockland County's rate of poverty for children under 18 increased to 16.9% in 2009 when compared to (15%) in 2000. Poverty rates in Orange County vary greatly based on municipality. Poverty rates exceeding 25% for families with related children under 18 are found in Orange County's three cities (Middletown, Newburgh, and Port Jervis), as well as in the town of Monroe, largely due to the impact of the village of Kiryas Joel, where the poverty rate is more than 4 times the county average. |
| Part VI, Line 5: | All BSCHS facilities have an open medical staff with privileges available to all qualified physicians in the area and are governed by a System board of directors whose composition is representative of the community, with a majority being independent members of the community. BSCHS has a dedicated Community Outreach department responsible for planning, implementing and evaluating all community health and education programs. In 2013, over 20 support groups met monthly in our facilities. The Community Outreach department managed the BSCHS Speakers' Bureau which connected our medical professionals directly with the community on topics such as Cardiac, Orthopedics, Women's health, Obesity, Stroke, Diabetes, Wound Care, Safety, Asthma, Senior Services, etc. The Community Outreach department also managed 2 live radio interview broadcasts each month for a combined listening audience of 16,000/month. In addition to this, the Outreach department also managed service line specific programs such as Breast and Cervical Cancer screenings, Hearing testing, Sleep Disturbances seminars and others. Access to Care: Bon Secours Charity Health System is committed to responding to and participating in addressing the health care needs of the communities in its service area. This is accomplished through several means such as providing charity care; improving access to health care services especially for the underserved population; and offering various opportunities for community members to enroll in governmental and/or community health plans. All three BSCHS hospitals have partnered with local Federally Qualified Health Centers (FQHC) to increase public awareness of the available services that are either free of charge or based on a sliding scale payment. BSCHS also continues to increase the size of its employed Medical Group and, in accordance with our mission, these practitioners are required to accept Medicaid and to participate in programs to provide charity care. Chronic Disease:The goal of our Heart Disease strategies is to increase the public's awareness of the risk factors for heart disease and to give them information on how to diminish their risk. In 2013, BSCHS hosted or participated in free cardiac awareness and prevention programs that were attended by over 8000 people. Specific programs focused on prevention, signs and symptoms, cholesterol, blood pressure screenings, obesity and women and heart disease. In addition, BSCHS also participated in the American Heart Walk which was attended by over 1000 people. The Lower Hudson Valley Mended Hearts Chapter #368 meets monthly at Good Samaritan Hospital offering support and education for cardiac patients and their family members. Through the trained volunteer visitor program, both pre and post cardiac surgery patients are visited by a former heart surgery patient. The BSCHS cancer services provide the community with excellent cancer treatment and support opportunities as well as increase the public's awareness of risk factors and cancer prevention. 2013 BSCHS had two cancer treatment programs, one located at Good Samaritan Hospital and one at Bon Secours Community Hospital. Both programs are accredited by the Commission on Cancer by the American College of Surgeons and Good Samaritan Hospital's Radiation Oncology Services are accredited by the American College of Radiology. BSCHS leadership and cancer program staff work diligently to maintain these accreditations to ensure that the community is receiving the best care available. Additionally, partnerships with the American Cancer Society have helped to develop new community screening programs and to improve patient support offerings.In 2013, BSCHS hosted numerous cancer awareness, early detection, prevention and support programs that reached a total of 7709 people. These programs focused on a wide variety of cancer related illnesses and many of them offered the community the opportunity to meet oncology specialists on a one-to-one basis. In addition, BSCHS participated in the American Cancer Society's Making Strides Against Breast Cancer walk which was attended by 1500 people. A partnership with the Cancer Services Program of Rockland County helped BSCHS to develop ongoing breast and cervical cancer screenings for uninsured and underinsured community members. Through this partnership, 9 free screenings were held in 2013 and 299 people received early detection services. Important to note is that, if a person has a positive finding from any of these free screenings, BSCHS works with the Cancer Services Program to provide all necessary follow up treatment including surgery, chemotherapy and radiation. BSCHS employs a board certified breast surgeon and a board certified colorectal surgeon. Additionally, BSCHS employs a Certified Genetics Counselor who provides patient and family consultations and speaks at free community education programs. A patient navigator assists breast cancer patients to coordinate their care and access available services. BSCHS continues to financially support the American Cancer Society's Making Strides Against Breast Cancer annual fundraising walk. Our restricted donation helps to produce prevention and early detection educational materials for the communities we serve. |
| Part VI, Line 6: | Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to: - Improve Health Locally and Globally- Build Partnerships for Population Health As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations. |
| Part VI, Line 7, Reports Filed With States | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Clement Osei MD | ||||||||||||||
| Board Member | $165,462 | $0 | $0 | $0 | $20,464 | $0 | $12,694 | $0 | $13,699 | $0 | $212,319 | $0 | $0 | $0 |
| Andrea Schmid-Mazzoccoli | ||||||||||||||
| Board Member | $0 | $342,352 | $0 | $91,905 | $0 | $63,025 | $0 | $47,154 | $0 | $20,192 | $0 | $564,628 | $0 | $20,219 |
| John Wallenhorst PhD | ||||||||||||||
| Board Member | $0 | $225,989 | $0 | $63,875 | $0 | $47,218 | $0 | $14,568 | $0 | $10,185 | $0 | $361,835 | $0 | $801 |
| Philip Patterson | ||||||||||||||
| CEO - BSCHS (Jan-Sept) | $0 | $336,904 | $0 | $205,912 | $0 | $57,191 | $0 | $45,612 | $0 | $26,920 | $0 | $672,539 | $0 | $3,750 |
| Mary Leahy MD | ||||||||||||||
| CEO - BSCHS (Sept-Dec) | $300,114 | $0 | $115,252 | $0 | $91,009 | $0 | $21,289 | $0 | $21,944 | $0 | $549,608 | $0 | $0 | $0 |
| Martin Evers MD | ||||||||||||||
| President - BSCHS MedPC | $150,257 | $0 | $172,287 | $0 | $553 | $0 | $16,573 | $0 | $20,142 | $0 | $359,812 | $0 | $0 | $0 |
| Rodney Williams MD | ||||||||||||||
| CMO - BSCHS | $357,040 | $0 | $132,747 | $0 | $46,684 | $0 | $19,539 | $0 | $9,801 | $0 | $565,811 | $0 | $0 | $0 |
| Eileen Dobbing | ||||||||||||||
| CNO - BSCHS | $221,679 | $0 | $95,000 | $0 | $67,357 | $0 | $11,889 | $0 | $8,589 | $0 | $404,514 | $0 | $0 | $0 |
| Pam Tarulli | ||||||||||||||
| SVP HR - BSCHS | $226,005 | $0 | $105,070 | $0 | $39,688 | $0 | $17,621 | $0 | $15,158 | $0 | $403,542 | $0 | $0 | $0 |
| Jeffrey Reilly | ||||||||||||||
| SVP OPS - CH & SACH | $196,461 | $0 | $85,647 | $0 | $40,209 | $0 | $6,602 | $0 | $971 | $0 | $329,890 | $0 | $0 | $0 |
| Sophie Crawford-Rosso | ||||||||||||||
| VP PCS - CH | $134,285 | $0 | $20,941 | $0 | $1,075 | $0 | $3,181 | $0 | $13,734 | $0 | $173,216 | $0 | $0 | $0 |
| Judith Lindberg | ||||||||||||||
| VP PCS - SACH | $141,337 | $0 | $22,160 | $0 | $1,594 | $0 | $4,514 | $0 | $14,422 | $0 | $184,027 | $0 | $0 | $0 |
| John Fiore | ||||||||||||||
| Medical Director - SACH | $238,581 | $0 | $112,561 | $0 | $2,080 | $0 | $19,086 | $0 | $17,630 | $0 | $389,938 | $0 | $0 | $0 |
| Toni Clark | ||||||||||||||
| EVP Sr Services - MA&SP | $156,635 | $0 | $35,720 | $0 | $40,325 | $0 | $14,742 | $0 | $7,731 | $0 | $255,153 | $0 | $0 | $0 |
| Edward Lundy MD | ||||||||||||||
| Dir of Cardiac Surgery | $854,954 | $0 | $159,375 | $0 | $3,754 | $0 | $19,539 | $0 | $14,835 | $0 | $1,052,457 | $0 | $0 | $0 |
| Cary Hirsch MD | ||||||||||||||
| Physician | $942,308 | $0 | $50,000 | $0 | $4,356 | $0 | $19,539 | $0 | $498 | $0 | $1,016,701 | $0 | $0 | $0 |
| Thomas Facelle MD | ||||||||||||||
| Dir of Surgery | $603,078 | $0 | $209,337 | $0 | $2,931 | $0 | $19,539 | $0 | $1,035 | $0 | $835,920 | $0 | $0 | $0 |
| Anuj Shah MD | ||||||||||||||
| Cardiologist | $432,660 | $0 | $259,385 | $0 | $890 | $0 | $15,198 | $0 | $13,128 | $0 | $721,261 | $0 | $0 | $0 |
| Seth Hurwitz MD | ||||||||||||||
| Cardiologist | $343,292 | $0 | $282,549 | $0 | $878 | $0 | $18,909 | $0 | $21,121 | $0 | $666,749 | $0 | $0 | $0 |
| David Capone | ||||||||||||||
| Former CFO | $0 | $0 | $0 | $0 | $261,699 | $0 | $0 | $0 | $9,284 | $0 | $270,983 | $0 | $0 | $0 |
| Melinda Hancock | ||||||||||||||
| Former Interim CFO | $0 | $270,243 | $0 | $56,597 | $0 | $39,110 | $0 | $5,235 | $0 | $25,656 | $0 | $396,841 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee |
| Part I, Lines 4a-b | Line 4a: Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: David Capone, $256,154. Line 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Andrea Mazzoccoli, $20,139; Philip Patterson, $4,902; John Wallenhorst, PhD, $903. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Board Members Steve Alabanese and Daniel Rifkin have a business relationship. |
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc. ("BSHSI") is one of two corporate members of Bon Secours Charity Health System, Inc. ("BSCHSI") along with the Sisters of Charity of Saint Elizabeth of Convent Station. BSCHSI is in turn the sole member of each of the members within Bon Secours Charity Health System Affiliated Group ("Group"). Pursuant New York State Law, as an organization engaged in the profession of medicine, Bon Secours Charity Health System Medical Group, PC has a sole shareholder of the organization who is engaged in the practice of medicine and licensed to practice in the state of New York. |
| Form 990, Part VI, Section A, line 7a | The governing bodies of the members within the Group, but for Bon Secours Charity Healthy System Medical Group, PC, are appointed by its Member, BSCHSI, and subject to approval by BSHSI, one of two corporate members of BSCHSI along with the Sisters of Charity of Saint Elizabeth of Convent Station. The governing body of Bon Secours Charity Healthy System Medical Group, PC is appointed by its shareholder with the approval of Bon Secours Charity Health System. The board of directors is comprised of individuals, each of whom is a shareholder of the organization or engaged in the practice of medicine in the organization and licensed to practice medicine in the state of New York. |
| Form 990, Part VI, Section A, line 7b | Certain authorities of the members of the Group, but for Bon Secours Charity Healthy System Medical Group, PC, are reserved to its member or to Bon Secours Health System, Inc. or are jointly reserved to Bon Secours Health System, Inc. and the Sisters of Charity of Saint Elizabeth of Convent Station. Certain authorities of Bon Secours Charity Healthy System Medical Group, PC are reserved to the shareholder, Bon Secours Charity Health System or to Bon Secours Health System, Inc. |
| Form 990, Part VI, Section B, line 11 | The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review and questions by both before the extended filing date. The local system's audit and compliance committee members review the Form 990, schedules time on their meeting agenda, and provide comments before the return is filed. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). |
| Form 990, Part VI, Section B, line 15 | The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors' and compensation committee's minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the positions of other officers or key employees of the organization were compared to similar position market data in comparably situated organizations taking into consideration geographic location and organization size where appropriate. During the review and approval of the compensation, documentation of the decision was recorded in human resources. |
| Form 990, Part VI, Section C, line 19 | The filing organizations provide any documents open to public inspection upon request. |
| Form 990, Part VII: | Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Sr. Anne Lutz does not receive payroll distributions as she has taken a vow of poverty. |
| Form 990, Part XI, line 9: | Pension Related Changes 237,113. Other Misc Changes in Net Assets 1,083. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Bon Secours Health System Inc (BSHSI) | ||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org - Management Services | MD | 501(c)(3) | Line 11b, II | Bon Secours Inc | 0 |
| Good Samaritan Foundation for Better Health | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 10901 | 133400353 | Foundation | NY | 501(c)(3) | Line 7 | BSCHSI | 0 |
| Bon Secours Community Hospital Foundation | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 10901 | 810667395 | Foundation | NY | 501(c)(3) | Line 7 | BSCHSI | 0 |
| Bon Secours Warwick Health Foundation | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 10901 | 141972807 | Foundation | NY | 501(c)(3) | Line 7 | BSCHSI | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |