ST MARYS AT HOME INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS AT HOME INC (EIN 35-1899560)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201301349349300480
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T08:01:57-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2000 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462045108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351899560 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S AT HOME INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STMA | NameControl |
| Phone | 8124854178 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIM HODGKINSON | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8124854178 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHAWNA M JIMENEZ | Name |
| PTIN | P01222873 | PTIN |
| Phone | 3174648600 | Phone |
| Date Prepared | 2013-05-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIMOTHY A FLESCH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6487328 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARYS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | PROVIDES HOME HEALTH CARE SERVICES AND DURABLE MEDICAL EQUIPMENT FOR PATIENTS IN THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5805021 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6433221 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 56290 | InvestmentIncomePriorYear |
| Investment Income Current Year | 53978 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 25 | OtherRevenuePriorYear |
| Other Revenue Current Year | 66 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5861336 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6487265 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3586388 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3993760 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2357689 | OtherExpensePriorYear |
| Other Expenses Current Year | 2243294 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5944077 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6237054 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -82741 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 250211 | RevenuesLessExpensesCY |
| Total Assets BOY | 2582528 | TotalAssetsBOY |
| Total Assets EOY | 3054070 | TotalAssetsEOY |
| Total Liabilities BOY | 905992 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1168729 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1676536 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1885341 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDES HOME HEALTH CARE SERVICES AND DURABLE MEDICAL EQUIPMENT FOR PATIENTS IN THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5024678 | Expense |
| Revenue | 6433287 | Revenue |
| Description | PROGRAM SERVICES ARE DEVOTED TO SUPPORTING ST. MARY'S MEDICAL CENTER OF EVANSVILLE, INC. BY PROVIDING HOME HEALTH CARE SERVICES AND DURABLE MEDICAL EQUIPMENT TO PERSONS IN THE EVANSVILLE AREA. NO INDIVIDUALS ARE REFUSED NEEDED MEDICAL CARE AT HOME DUE TO INABILITY TO PAY FOR SERVICES. ST. MARY'S AT HOME IS PART OF ASCENSION HEALTH AND FOLLOWS THE CHARITY CARE POLICIES OF ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. SEE SCHEDULE O FOR ADDITIONAL DETAILS. | Description |
| Total Program Service Expense | 5024678 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KIMBERLY A HODGKINSON | NamePerson |
| Telephone Number | 8124854178 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVENUE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| GWEN SANDEFUR | ||||||
| CHAIR | 65.00 | X | X | 0 | 372781 | 48407 |
| DARCY ELLISON | ||||||
| BOARD MEMBER | 65.00 | X | 0 | 349902 | 85631 | |
| DOUG KNIES | ||||||
| BOARD MEMBER | 65.00 | X | 0 | 168989 | 58758 | |
| JANET RAISOR | ||||||
| BOARD MEMBER | 60.00 | X | 0 | 147984 | 51760 | |
| JANICE K ERNEST | ||||||
| BOARD MEMBER | 60.00 | X | 0 | 228659 | 96993 | |
| JOHN RODRIGUES MD | ||||||
| BOARD MEMBER | 60.00 | X | 0 | 386048 | 10037 | |
| DEBBIE POOLE | ||||||
| BOARD MEMBER | 60.00 | X | 0 | 10075 | 644 | |
| MARK MARCHINO | ||||||
| BOARD MEMBER | 65.00 | X | 0 | 130895 | 8845 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1795333 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 361075 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS STREET SUITE 200 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658011190 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | PATIENT BILLING RECOVERY | DescriptionOfServices |
| Compensation | 180523 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 621610 | BusinessCode |
| Total Revenue Column | 6433221 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6433221 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6433221 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54041 | TotalRevenueColumn |
| Exclusion | $54,041 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 63 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -63 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -63 | TotalRevenueColumn |
| Exclusion | -$63 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PURCHASE DISCOUNTS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 66 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 66 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6487265 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6433287 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $53,978 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3129893 | Total |
| Program Services | 2380619 | ProgramServices |
| Management And General | 749274 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 635481 | Total |
| Program Services | 483351 | ProgramServices |
| Management And General | 152130 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228386 | Total |
| Program Services | 173712 | ProgramServices |
| Management And General | 54674 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135969 | Total |
| Program Services | 103419 | ProgramServices |
| Management And General | 32550 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7035 | Total |
| Program Services | 5351 | ProgramServices |
| Management And General | 1684 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186300 | Total |
| Program Services | 141701 | ProgramServices |
| Management And General | 44599 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168870 | Total |
| Program Services | 128444 | ProgramServices |
| Management And General | 40426 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5036 | Total |
| Program Services | 3830 | ProgramServices |
| Management And General | 1206 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24282 | Total |
| Program Services | 18469 | ProgramServices |
| Management And General | 5813 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27840 | Total |
| Program Services | 27840 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| COST OF GOODS SOLD | 1144910 | 1144910 | |
| SUPPLIES | 221559 | 168519 | 53040 |
| OTHER PURCHASED SERVICE | 108277 | 82356 | 25921 |
| REPAIRS AND MAINTENANCE | 37868 | 28802 | 9066 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 175348 | Total |
| Program Services | 133355 | ProgramServices |
| Management And General | 41993 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6237054 | Total |
| Program Services | 5024678 | ProgramServices |
| Management And General | 1212376 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77319 | BOY |
| EOY | 87834 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1124917 | BOY |
| EOY | 1317504 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1025054 | BOY |
| EOY | 1118185 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 272744 | BOY |
| EOY | 468311 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8085 | BOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 702851 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 652787 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74409 | BOY |
| EOY | 50064 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 12172 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2582528 | BOY |
| EOY | 3054070 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 653087 | BOY |
| EOY | 892552 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117581 | BOY |
| EOY | 141911 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135324 | BOY |
| EOY | 134266 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 905992 | BOY |
| EOY | 1168729 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1676536 | BOY |
| EOY | 1885341 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1676536 | BOY |
| EOY | 1885341 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2582528 | BOY |
| EOY | 3054070 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 250211 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -41406 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVANSVILLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350869065 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 139260 | OtherCostOrOtherBasis |
| Depreciation | 98115 | Depreciation |
| Book Value | 41145 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 563591 | OtherCostOrOtherBasis |
| Depreciation | 554672 | Depreciation |
| Book Value | 8919 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 50064 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE | Description |
| Amount | $134,266 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 134266 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GWEN SANDEFUR | |||||||||||||
| 0 | 318830 | 0 | 48877 | 0 | 5074 | 0 | 19559 | 0 | 28848 | 0 | 421188 | 0 | 0 |
| DARCY ELLISON | |||||||||||||
| 0 | 234660 | 0 | 41424 | 0 | 73818 | 0 | 62096 | 0 | 23535 | 0 | 435533 | 0 | 0 |
| DOUG KNIES | |||||||||||||
| 0 | 124689 | 0 | 26493 | 0 | 17807 | 0 | 53911 | 0 | 4847 | 0 | 227747 | 0 | 0 |
| JANET RAISOR | |||||||||||||
| 0 | 127730 | 0 | 11695 | 0 | 8559 | 0 | 33596 | 0 | 18164 | 0 | 199744 | 0 | 0 |
| JANICE K ERNEST | |||||||||||||
| 0 | 173139 | 0 | 29489 | 0 | 26031 | 0 | 73586 | 0 | 23407 | 0 | 325652 | 0 | 0 |
| JOHN RODRIGUES MD | |||||||||||||
| 0 | 371480 | 0 | 0 | 0 | 14568 | 0 | 4550 | 0 | 5487 | 0 | 396085 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 3: ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. A RELATED ORGANIZATION OF ST. MARY'S AT HOME, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 4B: ALL EMPLOYEES AND AMOUNTS LISTED ARE VOLUNTARY DEFERRALS OR COMPANY CONTRIBUTIONS TO VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457 (F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. NO PAYMENTS WERE MADE TO LISTED PERSONS IN PART VII UNDER THE VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE YEAR. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ST. MARY'S AT HOME, INC. HAS A SINGLE CORPORATE MEMBER, SETON HEALTH CORPORATION OF SOUTHERN INDIANA, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. MARY'S AT HOME, INC. HAS A SINGLE CORPORATE MEMBER, SETON HEALTH CORPORATION OF SOUTHERN INDIANA, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S AT HOME, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S AT HOME, INC. FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, SETON HEALTH CORPORATION OF SOUTHERN INDIANA, INC. | |
| FORM 990, PART VI, SECTION B, LINE 11 | ST. MARY'S HEALTH SYSTEM OF AMERICA, INC.'S FINANCE COMMITTEE REVIEWS THE FORM 990 IN MARCH UPON RECEIVING DIRECTION FROM ITS TAX PREPARER. THE FORM 990 IS THEN SENT TO THE GOVERNING BODY IN APRIL TO ALLOW FOR A THOROUGH REVIEW BY THE GOVERNING BODY PRIOR TO THE FILING DATE OF MAY 15TH. THE GOVERNING BODY WILL REVIEW THE FORM 990 VIA A SECURE WEB-BASED PORTAL AND ASK ANY QUESTIONS REGARDING THE FORM 990. ANY QUESTIONS AND RESPONSES WILL BE POSTED TO THE WEB-BASED PORTAL BEFORE THE RETURN IS FILED. ALL QUESTIONS AND RESPONSES WILL BE REVIEWED AND DISCLOSED IN THE MEETING MINUTES OF THE NEXT BOARD MEETING FOLLOWING THE REVIEW OF THE FORM 990. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. | |
| COMPENSATION DETERMINATIONS OF ST. MARY'S AT HOME, INC.'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL ARE MADE BY A COMPENSATION COMMITTEE OF ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMMITTEE OF THE ST MARY'S HEALTH SYSTEM BOARD REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT WERE COMPARED TO OTHER HOSPITALS IN THE AREA THAT HOLD THE SAME POSITION. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. COMPENSATION DETERMINATIONS OF ST. MARY'S AT HOME, INC.'S OTHER OFFICERS OR KEY EMPLOYEES ARE MADE BY A COMPENSATION COMMITTEE OF ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMMITTEE OF THE ST MARY'S HEALTH SYSTEM BOARD REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME POSITION. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. | |
| FORM 990, PART VII, LINE 1A, COLUMN B: | OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF ST. MARY'S AT HOME, INC. PROVIDE SERVICES TO ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. AND AFFILIATES. HOURS WORKED ARE NOT TRACKED SEPARATELY FOR EACH ENTITY. THEREFORE, HOURS FOR ALL INDIVIDUALS REPORTED ON FORM 990, PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS REPRESENT AGGREGATE HOURS WORKED PER WEEK FOR ALL ENTITIES. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -41,406. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART IV, LINE 24A: | ST MARY'S AT HOME, INC. IS A HEALTH FACILITY THAT IS PART OF THE ASCENSION HEALTH SYSTEM. ASCENSION HEALTH IS THE BORROWER FOR TAX-EXEMPT HOSPITAL REVENUE BONDS. ST. MARY'S AT HOME, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE WITH ASCENSION HEALTH, AND THIS INFORMATION IS REPORTED ON THE BALANCE SHEET. | |
| FORM 990, PART VII, LINE 1A, COLUMNS D, E, AND F: | OFFICERS OF ST. MARY'S AT HOME, INC. PROVIDE SERVICES TO ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. AND ITS AFFILIATES. COMPENSATION IS NOT REPORTED SEPARATELY BY ENTITY. THEREFORE, COMPENSATION AMOUNTS REPORTED ON FORM 990, PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES REPRESENT COMPENSATION PAID FOR MANAGING ST. MARY'S HEALTH SYSTEM OF AMERICA, INC. AND ALL RELATED ENTITIES. | |
| FORM 990, PART III, LINE 4A: | CATEGORY 1 CARE OF THE POOR CHARITY - $134,242 CATEGORY 2 CARE OF THE POOR MEDICAID - $721 CATEGORY 5 BAD DEBTS ATTRIBUTABLE TO CHARITY - $58,711 | CHARITY CARE SUMMARY FOR FISCAL PERIOD JULY 1, 2011 TO JUNE 30, 2012 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| ST MARY'S BREAST CENTER LLC | |||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 351935526 | MAMMOGRAPHY | IN | 919860 | 1477316 | SETON |
| PHYSICIANS' HEALTH GROUP LLC | |||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 043679294 | DISSOLVED | IN | 0 | 0 | SMMC |
| ST MARY'S PHYSICIANS' HEALTH GROUP LLC | |||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 261356310 | PHYSICIAN PRACTICE | IN | -3093234 | 2385048 | SMMC |
| ST MARY'S AT WORK LLC | |||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 272085003 | DORMANT | IN | 0 | 0 | SETON |
| ST MARY'S MEDICAL GROUP LLC | |||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 261356310 | DORMANT | IN | 0 | 0 | SMMC |
Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST MARY'S BUILDING CORPORATION | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237248362 | REAL ESTATE | IN | 501(C)(2) | SETON | 1 | ||
| ST MARY'S WARRICK EMS INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 205342518 | EMS | IN | 501(C)(4) | SMHS | 1 | ||
| MEDICAL MANAGEMENT INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351831570 | DORMANT | IN | 501(C)(3) | SMHS | 1 | 11C, III-FI | |
| ST MARY'S HEALTH SYSTEM OF AMERICA INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 352057801 | HEALTH MINISTRY PARENT | IN | 501(C)(3) | ASCENSION HEALTH | 0 | 11C, III-FI | |
| ST MARY'S PHYSICIAN NETWORK LLC | |||||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 205023387 | PHYSICIAN PRACTICE | IN | 501(C)(3) | SMMC | 1 | 9 | |
| PRIMARY PHYSICIAN NETWORK LLC | |||||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 208775914 | PHYSICIAN PRACTICE | IN | 501(C)(3) | SMMC | 1 | 9 | |
| SETON HEALTH CORPORATION OF SOUTHERN INDIANA INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351679526 | INVESTMENT | IN | 501(C)(3) | SMHS | 1 | 11C, III-FI | |
| ST MARY'S HOME HEALTH CARE SERVICES INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 351899562 | DORMANT | IN | 501(C)(3) | SETON | 1 | 11A, I | |
| ST MARY'S MEDICAL CENTER FOUNDATION INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 237045370 | FUNDRAISING | IN | 501(C)(3) | SMMC | 1 | 11A, I | |
| ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | |||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | 350869065 | HOSPITAL | IN | 501(C)(3) | SMHS | 1 | 3 | |
| ST MARY'S WARRICK HOSPITAL FOUNDATION INC | |||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351961890 | FUNDRAISING | IN | 501(C)(3) | SMW | 1 | 11A, I | |
| ST MARY'S WARRICK HOSPITAL INC | |||||||||||
| 1116 MILLIS AVENUE | BOONVILLE | IN | 47601 | 351343019 | HOSPITAL | IN | 501(C)(3) | SMHS | 1 | 3 | |
| ST MARY'S OHIO VALLEY HEARTCARE LLC | |||||||||||
| 901 ST MARYS DRIVE | EVANSVILLE | IN | 47714 | 273474697 | CARDIOLOGIST SERVICES | IN | 501(C)(3) | SMMC | 1 | 11A, I | |
| SVSM INC | |||||||||||
| 2001 W 86TH STREET | INDIANAPOLIS | IN | 46260 | 810607827 | HOLDING COMPANY | IN | 501(C)(3) | SVH | 1 | 11A, I | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | 0 | 11A, I | N/A | |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMBULATORY CARE CENTER LLC | |||||||||||||
| 1125 PROFESSIONAL BLVD | EVANSVILLE | IN | 47714 | 352006018 | OP SURGERY | IN | SETON | RELATED | 3892985 | 4257562 | 0 | 0 | 0.50000 |
| ST MARY'S ACUTE DIALYSIS SERVICES LLC | |||||||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 271346179 | MANAGEMENT | IN | SETON | RELATED | 618570 | 119625 | 0 | 0 | 0.50000 |
| SETON HEALTH SERVICES LLC | |||||||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 270451316 | EQUIP RENTAL | IN | SETON | RELATED | 28967 | 140493 | 0 | 0 | 0.50000 |
| ST MARY'S PERIPHERAL VASCULAR SERVICES MANAGEMENT COMPANY LLC | |||||||||||||
| 3700 WASHINGTON AVE | EVANSVILLE | IN | 47750 | 205062635 | MANAGEMENT | IN | SMOVHC | RELATED | -12633 | 40241 | 0 | 0 | 0.50000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL GROUP INC AND SUB | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3700 WASHINGTON AVE | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47750 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352076827 | EIN |
| Primary Activity | INVESTMENT | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMHS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -611983 | ShareOfTotalIncome |
| Share Of EOY Assets | 641965 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S MEDICAL CENTER OF EVANSVILLE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionType |
| Amount Involved | 5778180 | AmountInvolved |
| Method Of Amt Determination | FMV OR SERVICES OR CASH | MethodOfAmtDetermination |