FURP.ORG / PUBLIC DATA EXPLORER

ST CATHERINE HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST CATHERINE HOSPITAL INC (EIN 35-1738708)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-14
IRS object ID
201301349349307240
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

FieldValueIRS element (for citing)
Timestamp2013-05-14T18:06:16-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351738708EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE HOSPITALINCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARY ANN SHACKLETTInCareOfName
Name ControlSTCANameControl
Phone2193921700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14321 FIR STREETAddressLine1
CityEAST CHICAGOCity
StateINState
ZIP Code46312ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY ANN SHACKLETTName
TitleSR. VP & SYSTEM CFOTitle
Date Signed2013-05-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJO ANN BIRDZELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14321 FIR STREETAddressLine1
CityEAST CHICAGOCity
StateINState
ZIP Code46312ZIPCode
FieldValueIRS element (for citing)
Gross Receipts166190031GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.comhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1928YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionSt. Catherine Hospital is committed to providing the highest quality care in the most cost-efficient manner, respecting the dignity of the individual, providing for the (continued on note on mission statement)ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1501TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI836765TotalGrossUBI
Contributions Grants Prior Year280420ContributionsGrantsPriorYear
Contributions Grants Current Year1199357ContributionsGrantsCurrentYear
Program Service Revenue Prior Year156492325ProgramServiceRevenuePriorYear
Program Service Revenue CY159322493ProgramServiceRevenueCY
Investment Income Prior Year59752InvestmentIncomePriorYear
Investment Income Current Year-93943InvestmentIncomeCurrentYear
Other Revenue Prior Year3117084OtherRevenuePriorYear
Other Revenue Current Year5292786OtherRevenueCurrentYear
Total Revenue Prior Year159949581TotalRevenuePriorYear
Total Revenue Current Year165720693TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year72563824SalariesEtcPriorYear
Salaries Etc Current Year72891515SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year94689895OtherExpensePriorYear
Other Expenses Current Year95280849OtherExpensesCurrentYear
Total Expenses Prior Year167253719TotalExpensesPriorYear
Total Expenses Current Year168172364TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7304138RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2451671RevenuesLessExpensesCY
Total Assets BOY54867614TotalAssetsBOY
Total Assets EOY66165015TotalAssetsEOY
Total Liabilities BOY22333865TotalLiabilitiesBOY
Total Liabilities EOY32133975TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32533749NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34031040NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionST. CATHERINE HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL, PROVIDING FOR THE WELL-BEING OF THE COMMUNITY AND SERVING THE NEEDS OF ALL PEOPLE, INCLUDING THE POOR AND DISADVANTAGED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense60998274Expense
Revenue60019443Revenue
DescriptionNURSING - 26,451 PATIENT DAYSDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15029479Expense
Revenue45563563Revenue
DescriptionSURGERY - 5,032 IP AND OP SURGERIESDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense10564695Expense
Revenue14442342Revenue
DescriptionPHYSICIANS - 31,747 OFFICE VISITSDescription

Activity Other ActivityOther (32 entries)

ExpenseExpenseRevenueRevenueDescriptionDescription
760033534070343CARDIOLOGY - 21,426 VISITS
729256231235476PHARMACY - 2,591,879 DOSES ADMINISTERED
664804751772348LAB - 545,510 SPECIMENS COLLECTED
609998610812595IMCU - 10,648 PATIENT DAYS
535264133278800ER 30,703 VISITS WITH 4,821 ADMISSIONS
44399024172334OCC HEALTH - 14,532 VISITS
430679414948462PT OT SPEECH - 125,283 PROCEDURES
388393349662716RADIOLOGY - 61,052 PROCEDURES
3810398756DIETARY - 149,876 IP MEALS
30347733943642ICU - 2,559 PATIENT DAYS
2735156PATIENT SERVICES - 43,678 VISITS
2504984HIM - 89,652 MEDICAL RECORDS CODED
22801722568432HOME HEALTH - 27,132 VISITS
18447078760387RESPIRATORY THERAPY - 56,285 PROCEDURES
1247663SECURITY
1217381ADMITTING - 9,243 IP ADMISSIONS
9432846058523NUCLEAR MED - 2,189 PROCEDURES
835481MEDICAL STAFF
650203922422PSYCH - 2,884 VISITS & PROCEDURES
6275414954518CYBERKNIFE - 331 CLICKS
5270741622021OUTPATIENT SERVICES - 88,314 VISITS
422026119603CENTRAL SUPPLY - 2,853 CHARGEABLE SUPPLIES
372195CENTRAL STERILIZATION - PROVIDE STERILE INSTRUMENT
326686PUBLIC RELATIONS
1483332695871EEG - 6,688 PROCEDURES
106920POB
57954LTAC
454288MISC
-187073639CONTRACTUALS
-16933947CHARITY
-11176804BAD DEBT
-3734228INTERCOMPANY ELIMINATION
FieldValueIRS element (for citing)
Total Of Other Program Service Exp69317131TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev43134919TotalOfOtherProgramServiceRev
Total Program Service Expense155909579TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096159NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1501NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARY ANN SHACKLETTNamePerson
Telephone Number2199348250TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DR STE 201AddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
LORENZO ARREDONDO
DIRECTOR1.0X000
JOHN ARTIS
DIRECTOR1.0X000
MARIA LUZ CORONA MAGISTRATE
DIRECTOR1.0X000
R LOUIE GONZALEZ
DIRECTOR1.0X000
JUDITH GRESKO
DIRECTOR1.0X000
HENRY HADIDIAN MD
DIRECTOR10.0X7234000
DAVID HERBSTMAN MD
DIRECTOR1.0X000
SR ANNEMARIE KAMPWERTH PHJC
DIRECTOR1.0X000
THOMAS P KEILMAN
DIRECTOR1.0X000
JOSEPH SEMANCIK MONSIGNOR
DIRECTOR1.0X0304000
JAIME RUIZ-MONTERO MD
DIRECTOR29.0X13950400
GEORGE RYAN
DIRECTOR1.0X000
EDWARD WILLIAMS PHD
DIRECTOR1.0X0383150
JOSEPH COSTANZA
PRESIDENT1.0X0311000X
PEGGY GERARD RN DNSC
VICE PRESIDENT1.0X000X
KIMBERLY ARTHUR MD
SECRETARY41.0X303907023490X
JOHN CABAN
TREASURER1.0X000X
JOANN BIRDZELL
ADMINISTRATOR41.0X496187076433X
MARY ANN SHACKLETT
SR VP & SYSTEM CFO1.0054659156960X
JOSEPH WINTERHALER
VP OF FINANCE/CFO40.0212271021434X
PAULA SWENSON
VP & CNO41.0221195016845X
CRAIG BOLDA
CHIEF OPERATING OFFICER41.0021688052762X
PASTOR LLOBET MD
PHYSICIAN40.074678408950X
SAMER ABBAS MD
PHYSICIAN40.055048608950X
DANIEL SAAH MD
PHYSICIAN40.0517990031105X
SUBHASH JOSHI MD
PHYSICIAN40.0389961023728X
JATIN PATEL DO
PHYSICIAN40.0365225033979X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4015850TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs863286TotalReportableCompFrmRltdOrgs
Total Other Compensation354636TotalOtherCompensation
Number Individuals GT100 K101NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHAB CARE GROUP INC
PO BOX 502096ST LOUISMO63150REHAB SERVICES2299322
COOPERATIVE MANAGED CARE SERVICES L
ST FRANCIS HOSPITAL DEPT 9010BEECH GROVEIN46107CLAIMS PROCESSING1615679
ISM SECURITY MANAGEMENT
905 W GLEN PARK AVENUEGRIFFITHIN46319security870526
EPMG OF INDIANA PC
2000 GREEN ROAD SUITE 3000ANN ARBORMI48105EMERGENCY ROOM SRVCS421196
MECHANICAL CONCEPTS INCORPORATED
750 S COUNTY LINE ROADGARYIN46403HEATING/COOLING SRVS396899
FieldValueIRS element (for citing)
Number Of Contractors GT100 K24NumberOfContractorsGT100K
Government Grants1087397GovernmentGrants
All Other Contributions111960AllOtherContributions
Total Contributions1199357TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REVENUE900099129933367129096602836765
CAPITATION REVENUE9000992938912629389126
FieldValueIRS element (for citing)
Total Program Service Revenue159322493TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column68214TotalRevenueColumn
Exclusion$68,214ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1037404Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real306831Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real730573Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column730573TotalRevenueColumn
Exclusion$730,573ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other350Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other162507Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-162157Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-162157TotalRevenueColumn
Exclusion-$162,157ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
OCC HEALTH OFFSITE STAFFING90009927763022776302
CAFETERIA900099602030$602,030
PHARMACY 340B900099425163425163

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column758718TotalRevenueColumn
Related Or Exempt Function Income636309RelatedOrExemptFunctionIncome
Exclusion$122,409ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4562213TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column165720693TotalRevenueColumn
Related Or Exempt Function Income162323502RelatedOrExemptFunctionIncome
Unrelated Business Revenue836765UnrelatedBusinessRevenue
Exclusion$1,361,069ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1312567Total
Program Services393529ProgramServices
Management And General919038ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total12714Total
Program Services12714ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57214377Total
Program Services52941881ProgramServices
Management And General4272496ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3205948Total
Program Services2926300ProgramServices
Management And General279648ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6926871Total
Program Services6407894ProgramServices
Management And General518977ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4219038Total
Program Services3851020ProgramServices
Management And General368018ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2006000Total
Program Services1938072ProgramServices
Management And General67928ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total144837Total
Program Services1600ProgramServices
Management And General143237ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total2303Total
Management And General2303ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9125553Total
Program Services7813867ProgramServices
Management And General1311686ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total306210Total
Program Services285886ProgramServices
Management And General20324ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2050385Total
Program Services1550085ProgramServices
Management And General500300ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total108830Total
Program Services39645ProgramServices
Management And General69185ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2113720Total
Program Services2084225ProgramServices
Management And General29495ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total131403Total
Program Services126503ProgramServices
Management And General4900ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total60323Total
Program Services56808ProgramServices
Management And General3515ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total850067Total
Program Services850067ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total29400Total
Program Services29400ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4788380Total
Program Services4418678ProgramServices
Management And General369702ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2126635Total
Program Services1970847ProgramServices
Management And General155788ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CAPITATION EXPENSE2478409024784090
CORP SUPP SRVCS ALLOCATION17774541162241031550438
MEDICAL SUPPLIES1749233117492331
HEALTH ASSESSMENT FEE42488714248871

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7136970Total
Program Services5461163ProgramServices
Management And General1675807ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total168172364Total
Program Services155909579ProgramServices
Management And General12262785ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5642445BOY
EOY5401715EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY136076BOY
EOY134364EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15811128BOY
EOY20091682EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4320457BOY
EOY4990493EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY668885BOY
EOY799277EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis65024385LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec39832774LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY26099844BOY
EOY25191611EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2188779BOY
EOY9555873EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY54867614BOY
EOY66165015EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20737503BOY
EOY28078959EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY372864BOY
EOY282589EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1223498BOY
EOY3772427EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY22333865BOY
EOY32133975EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32317614BOY
EOY33792070EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY216135BOY
EOY238969EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32533749BOY
EOY34031039EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54867614BOY
EOY66165015EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2451671ReconcilationRevenueExpenses
Reconcilation Other Changes3948961ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$2,303OtherActivitiesAmount
Total Lobbying Expenditures IIB2303TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationPT II-B LINE 1i THE INDIANA HOSPITAL ASSOCIATION ESTIMATED THAT 5.44% OF ITS DUES ARE ATTRIBUTABLE TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis25245OtherCostOrOtherBasis
Book Value25245BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis28611642OtherCostOrOtherBasis
Depreciation16116226Depreciation
Book Value12495415BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis853821OtherCostOrOtherBasis
Depreciation104178Depreciation
Book Value749643BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis33965645OtherCostOrOtherBasis
Depreciation22482707Depreciation
Book Value11482938BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1568031OtherCostOrOtherBasis
Depreciation1129663Depreciation
Book Value438369BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings25191610TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
HEALTH ASSESSMENT FEE RCVBL6264484
MISCELLANEOUS RECEIVABLE1466997
LT LEGAL CLAIMS RECEIVABLE1207584
US STEEL RCVBL - OCC HEALTH616808
FieldValueIRS element (for citing)
Total Book Value Other Assets9555873TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
CAPITAL LEASES-CURRENT PORTION$38,218
ASSET RETIREMENT OBLIGATION$594,514
3RD PARTY SETTLEMENTS$1,603,856
CAPITAL LEASES-LT PORTION$16,405
LT LEGAL CLAIMS LIABILITY$1,519,434
FieldValueIRS element (for citing)
Total Of Amounts3772427TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationThe adoption of ASC 740 did not materially impact the financial statements.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served4924PersonsServed
Total Community Benefit Expense5912477TotalCommunityBenefitExpense
Direct Offsetting Revenue1978DirectOffsettingRevenue
Net Community Benefit Expense5910499NetCommunityBenefitExpense
Percent Of Total Expense0.03510PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served28434PersonsServed
Total Community Benefit Expense40296625TotalCommunityBenefitExpense
Direct Offsetting Revenue33621466DirectOffsettingRevenue
Net Community Benefit Expense6675159NetCommunityBenefitExpense
Percent Of Total Expense0.03960PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served33358PersonsServed
Total Community Benefit Expense46209102TotalCommunityBenefitExpense
Direct Offsetting Revenue33623444DirectOffsettingRevenue
Net Community Benefit Expense12585658NetCommunityBenefitExpense
Percent Of Total Expense0.07470PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs90NumberOfActivitiesOrPrograms
Persons Served12854PersonsServed
Total Community Benefit Expense455863TotalCommunityBenefitExpense
Direct Offsetting Revenue1385DirectOffsettingRevenue
Net Community Benefit Expense454478NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served285PersonsServed
Total Community Benefit Expense262871TotalCommunityBenefitExpense
Net Community Benefit Expense262871NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served52PersonsServed
Total Community Benefit Expense125682TotalCommunityBenefitExpense
Direct Offsetting Revenue106889DirectOffsettingRevenue
Net Community Benefit Expense18793NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs43NumberOfActivitiesOrPrograms
Total Community Benefit Expense29731TotalCommunityBenefitExpense
Net Community Benefit Expense29731NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs143NumberOfActivitiesOrPrograms
Persons Served13191PersonsServed
Total Community Benefit Expense874147TotalCommunityBenefitExpense
Direct Offsetting Revenue108274DirectOffsettingRevenue
Net Community Benefit Expense765873NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs143NumberOfActivitiesOrPrograms
Persons Served46549PersonsServed
Total Community Benefit Expense47083249TotalCommunityBenefitExpense
Direct Offsetting Revenue33731718DirectOffsettingRevenue
Net Community Benefit Expense13351531NetCommunityBenefitExpense
Percent Of Total Expense0.07930PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,876,787BadDebtExpenseAmount
Amount Attributable To38768AmountAttributableTo
Amount Reimbursed By Medicare55007387AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare63453898CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8446511MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14321 FIR STREETAddressLine1
CityEAST CHICAGOCity
StateINState
ZIP Code46312ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities12NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HOME HEALTH OF ST CATHERINE HOSPITAL
4321 FIR STREETEAST CHICAGOIN46312HOME HEALTH
HESSVILLE FAMILY CARE
3432 169TH STREETHAMMONDIN46323PHYSICIAN PRACTICE
FAMILY HEALTH AND WELLNESS CENTER
8141 KENNEDY AVENUEHIGHLANDIN46322PHYSICIAN PRACTICE
OCCUPATIONAL HEALTH
4320 FIR STREET STE 313EAST CHICAGOIN46312PHYSICIAN PRACTICE
ENT
4320 FIR STREET STE 410EAST CHICAGOIN46312PHYSICIAN PRACTICE
ORTHOPEDIC CLINIC
4320 FIR STREET STE 201EAST CHICAGOIN46312PHYSICIAN PRACTICE
COMMUNITY HEALTHCARE SYSTEM CARE NETWORK
4035 ELM STREETEAST CHICAGOIN46312PHYSICIAN PRACTICE
ST CATHERINE CARE NETWORK
2020 EAST COLUMBUS DRIVE-SUITE 2AEAST CHICAGOIN46312PHYSICIAN PRACTICE
ST CATHERINE CARE NETWORK
7217 INDIANAPOLIS BLVDHAMMONDIN46324PHYSICIAN PRACTICE
ST CATHERINE CARDIOLOGY ASSOC
4320 FIR STREET SUITE 320EAST CHICAGOIN46312PHYSICIAN PRACTICE
ST CATHERINE CARE NETWORK
1534 119TH STREETWHITINGIN46394PHYSICIAN PRACTICE
CENTER OF HOPE
100 WEST CHICAGO AVENUEEAST CHICAGOIN46312PHYSICIAN PRACTICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (29 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART V, LINE 19N/A
PART I, LINE 6AN/A
PART I, LINE 7GCOMPLETED THE IRS WORKSHEETS AND USED COST TO CHARGE RATIO FOR THE METHODOLOGY. WE DID NOT INCLUDE ANY PHYSICIAN PRACTICE INFORMATION WHEN CALCULATING SUBSIDIZED SERVICES.
PART I, LINE 7, COLUMN FBAD DEBT OF $11,176,805 IS EXCLUDED FROM THE CALCULATION.
PART I, LINE 7THE METHODOLOGY TOOK THE FINANCIAL STATEMENT COST TO CHARGE RATIO AND MULTIPLIED IT BY THE RELATED CHARGES. THIS NUMBER WAS THEN REDUCED BY THE ACTUAL PAYMENTS RECEIVED.
PART III, LINE 4ST. CATHERINE HOSPITAL EVALUATES THE COLLECTIBILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. ST. CATHERINE HOSPITAL DOES NOT REQUIRE COLLATERAL.
PART III, LINE 8THE TOTAL REVENUE RECEIVED FROM MEDICARE WAS CALCULATED BY USING THE COST TO CHARGE RATIO. WE PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED OR THE REIMBURSEMENT RECEIVED FROM MEDICARE, QUALIFYING THE $8,446,511 OF MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.
PART III, LINE 9BCOLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW.
PART V, LINE 1JN/A
PART V, LINE 3N/A
PART V, LINE 5CN/A
PART V, LINE 6IN/A
PART V, LINE 7N/A
PART V, LINE 11HN/A
PART V, LINE 13GN/A
PART V, LINE 15EN/A
PART V, LINE 16EN/A
PART V, LINE 17EN/A
PART V, LINE 18DN/A
PART V, LINE 19DOur maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care is based on a sliding scale. Up to 200% of federal poverty guidelines (FPG) is 100% free care. 201% -250% is charged based on Medicare rates. 251%-300% is charged based on average of lowest managed care rates. 301%-400% is charged based on average managed care rates.
PART V, LINE 20N/A
PART V, LINE 21N/A
NEEDS ASSESSMENTST. CATHERINE HOSPITAL USES A THIRD-PARTY CONSULTING FIRM TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. ST. CATHERINE HOSPITAL SERVES ONE OF THE LARGEST POPULATIONS IN NORTHWEST INDIANA AND IS THE OLDEST POPULATION IN THE AREA WITH AN EXPECTED LOSS OF POPULATION IN THE NEXT FIVE YEARS. ST. CATHERINE HAS DOMINANT MARKET POSITION IN ALL PRODUCT LINES AND CONTINUES TO SEE GROWTH IN AREAS SUCH AS ORTHOPEDICS, ONCOLOGY AND GENERAL SURGERY.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPATIENTS WHO ARE ADMITTED WITHOUT INSURANCE ARE REFERRED TO THE HOSPITAL'S FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS PERFORM AN INTERVIEW WITH THE PATIENT TO EXPLAIN TO THEM THE PROCESS NECESSARY TO RECEIVE FINANCIAL ASSISTANCE. THIS PROCESS INCLUDES APPLYING FOR MEDICAID OR OTHER GOVERNMENT AID. THE APPLICANT THEN MUST FILL OUT A FINANCIAL INFORMATION WORKSHEET AND SUBMIT VARIOUS INFORMATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. THE FINANCIAL ASSISTANCE POLICY IS POSTED AT EACH INPATIENT WAITING DESK.
COMMUNITY INFORMATIONTHE COMMUNITY SERVED INCLUDES NORTHWEST INDIANA. OUR MARKET SHARE FOR THE PRIMARY SERVICE AREA IS 69%. THE POPULATION IS AMONG THE YOUNGEST WITH THE LOWEST MEDIAN INCOME WHEN COMPARED TO OTHER MARKETS IN NORTHWEST INDIANA. OUR MEDIAN INCOME IS $28,386. WE ALSO HAVE THE LEAST INSURANCE COVERAGE - 62% UNINSURED OR MEDICAID.
PROMOTION OF COMMUNITY HEALTHSEE COMMUNITY BENEFITS STATEMENT IN SCHEDULE O
AFFILIATED HEALTH CARE SYSTEMST. CATHERINE HOSPITAL IS PART OF AN AFFILIATED SYSTEM. EACH HOSPITAL IN THE SYSTEM PROVIDES MEDICAL SERVICES TO THEIR COMMUNITIES AND ADJOINING COMMUNITIES. EACH ENTITY'S PURPOSE IS TO PROVIDE HEALTH CARE TO THOSE WHO NEED IT, INCLUDING THE UNINSURED OR UNDERINSURED.
PART III, LINE 7Cost Report (826,798) Physician practices (2,578,521) Medicare Managed Care (434,159) Fee-based Outpatient charges (2,222,060) Disallowed Medicare expenses (2,384,973) Total (Shortfall) (8,446,511)
STATE FILING OF COMMUNITY BENEFIT REPORTIN,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KIMBERLY ARTHUR MD
3015850002322079560155340327397000
JOANN BIRDZELL
38279301019230114710542530221800572620000
MARY ANN SHACKLETT
03696820148077028832034787022173060355100
JOSEPH WINTERHALER
1685700432150486014630199710233705000
PAULA SWENSON
177502042920077309012078330238040000
CRAIG BOLDA
018785402786501161030761022001026964200
PASTOR LLOBET MD
74322000356407350016000755734000
SAMER ABBAS MD
55000000048607350016000559436000
DANIEL SAAH MD
503168012500023220104320206730549095000
SUBHASH JOSHI MD
3863970003564097770139510413689000
JATIN PATEL DO
364373000852073500266290399204000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationPART I, LINE 1a THE ORGANIZATION PAYS HEALTH/SOCIAL CLUB DUES ON BEHALF OF CERTAIN OFFICERS, KEY EMPLOYEES AND THE FIVE HIGHEST PAID EMPLOYEES WHICH IS THEN TAXED AS A FRINGE BENEFIT TO THE INDIVIDUAL.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Jaime Ruiz-Montero MD
Owner of Centro Medical139504House Physician & Medical Dir.false
PATRICK WINTERHALER
FAM MEM OF J WINTERHALER12714EMPLOYMENTfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL INFORMATIONPart III Line 4a and Schedule H - Other InformationIn 1928, St. Catherine Hospital, East Chicago, Indiana was opened to fill a need for health service to the communities of East Chicago, Whiting, Hammond and Gary. Today the hospital continues to provide a full range of medical services for inpatients and outpatients. St. Catherine Hospital is a non-profit hospital operating as a part of the Community Healthcare System, which includes Community Hospital in Munster, Indiana and St. Mary Medical Center in Hobart, Indiana. The hospitals are committed to providing the highest quality healthcare in the most cost-efficient manner, respecting the dignity of the individual, providing for the well-being of the community and serving the needs of all people, including the poor and disadvantaged. Community Healthcare System is the leading medical provider in Northwest Indiana, operating three non-profit hospitals, several outpatient clinics and physician offices. Together, the three operate the largest cardiovascular and cancer programs in the area. In the spirit of Katherine Kasper's founding charisma, St. Catherine Hospital continues to minister to our neighbors within the community; providing compassionate care of body and spirit. St. Catherine Hospital focuses on designing and providing services that meet the needs of its diverse community in East Chicago and the surrounding communities of Northwest Indiana. The hospital regularly surveys its patients to ascertain their satisfaction with its facilities and the programs that are offered and to identify the community's outstanding needs. By working in conjunction with our medical staff and associates, we ensure that programs and services not only address the patient's medical needs, but consider the patient's cultural and social needs as well. At St. Catherine Hospital, our mission and values guide us to provide quality, compassionate care for our patients and comfort for our visitors. Our philosophy is to care for all guests as if they were members of our own family. We have been recognized locally and nationally for various programs, proving our commitment to excellent service. The Joint Academy and Hand Center provides evidence based care for joint replacement surgeries. The Chest Pain Center is certified by the Society of Chest Pain Centers. It provides evidence based guidelines for patients arriving with a complaint of chest pain. For patients experiencing chest pain, the hospital achieves the ninety minute door to balloon time for STEMI (ST Segment Elevation Myocardial Infarction) patients. The Stroke Unit is Joint Commission certified. Our Emergency Services are recognized by HealthGrades. St. Catherine Hospital takes pride in being responsive to the needs of our community. Over the last several years, focused efforts have been made to develop outreach education programs and offer health screenings that address challenges unique in our neighborhoods. STOP Diabetes in East Chicago, Lupus education, the Well Walkers' Club, and free car seats provided to all families who deliver at St. Catherine Hospital are just a few of these programs. When possible, our community outreach team embraces innovative approach-taking programs out of the hospital and into local churches, community centers and the workplace. This approach allows us to serve more people in settings they find comfortable and convenient. A.A. Support Group-Our Alcoholics Anonymous support groups are open meetings for anyone wanting to learn how Alcoholics Anonymous functions. Blood Profile Screening-These screenings offer a way for those concerned about heart health to monitor cholesterol, HDL, triglycerides or glucose. No physician order is necessary for the screening. Cancer Survivors Day-The Cancer Resource Centre and St. Catherine Hospital provide a local celebration of this national event, honoring the strength and courage of those who have lived - and continue to live - with cancer. Prizes are raffled and each attendee receives a strength gift. Food and entertainment are also provided. Cardiac Rehab-Informational sessions are held that give patients an opportunity to ask a pharmacist questions regarding their cardiac medications. Handouts are provided to patients comparing certain blood pressure medications. Consoling Hearts Grief Support-This support group is offered to those suffering from the loss of a loved one. Participants include family members, friends, or those who are having a difficulty dealing with the loss of a loved one. Coronary Health Appraisal-This appraisal helps to determine risk for heart disease and other related medical conditions. Screening includes: cholesterol (total, HDL, LDL, triglycerides), blood sugar, metabolic syndrome, blood pressure, body mass index and a Heart Health Profile. Hope Network Cancer Support Group-The last Wednesday of each month this group meets for informative sessions where they can share thoughts and feelings in a comfortable and confidential atmosphere. Keeping Baby Safe and Healthy-Pediatrician, Dr. Iyer, discusses when to call the doctor, child-proofing the house, what to do in an emergency and nutritional needs of babies. Information on child seat safety is also available. Moving Forward-Stroke Education-This five part series helps Stroke survivors and caregivers learn to prevent future strokes through risk detection and management. N.A. Support-Narcotics Anonymous offers hope for anyone with the desire to stop using narcotics and a willingness to try a new way of life. Nutrition Counseling-Dietary evaluation and counseling is provided by a registered dietitian. PAD-What's It All About?-The Cardiac Rehabilitation Medical Director discusses peripheral arterial disease (PAD). Attendees learn the signs, symptoms, causes and treatment of this serious disease. Skin Cancer Screenings-Physician examines any questionable areas of the body to look for indications of cancer or pre-cancerous conditions. This screening takes place at a participating St. Catherine Hospital physician's office on a monthly basis.
Collection PolicySchedule H Part III Line 9BCollection policies are the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. If at any point in the collection process, documentation is received that indicates the patient is potentially eligible for financial assistance but has not applied for it, the account is referred back for a financial assistance review.
PART VI Line 7aCommunity Foundation of Northwest Indiana Inc is the parent company of St Catherine Hospital Inc and has control to elect members of their governing body.
PART VI Line 7bCommunity Foundation of Northwest Indiana Inc is the parent of St Catherine Hospital Inc and has the rights to approve decisions made by St Catherine Hospital Inc.
PART VI Line 11aTHE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW. ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS TO REVIEW PRIOR TO FILING.
PART VI Line 12cAS PART OF THE ORGANIZATION'S ANNUAL MONITORING AND ENFORCEMENT PROCEDURES RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED AND THOSE OFFICERS, DIRECTORS, OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION.
PART VI Line 15a and 15bSCH FOLLOWS THE PARENT (CFNI) POLICY. THE CFNI BOARD HAS ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS.
PART VI Line 19ST CATHERINE HOSPITAL INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, ST CATHERINE HOSPITAL INC THROUGH COMMUNITY FOUNDATION OF NORTHWEST INDIANA MAKES ITS FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE.
PART VII SECTION A. HOURS FOR RELATED ORGANIZATIONSCFNI SCH SMMC CH CVI TATC CVPA CCRF TOTAL Henry Hadidian, MD 10 10 Joseph Semancik, Monsignor 1 1 1 Jaime Ruiz-Montero, MD 29 29 Edward Williams, PHD 1 1 1 Joseph Costanza 1 1 2 Peggy S. Gerard 1 1 2 Kimberly Arthur, MD 41 41 JoAnn Birdzell 41 41 Mary Ann Shacklett 41 1 1 1 1 1 1 1 48 Craig Bolda 41 41 Henry Hadidian, MD: Compensation is for hours worked as Medical Director of Utilization Review and Wound Care Joseph Semancik, Monsignor: Related organization compensation is for attending CFNI monthly BOD and Committee meetings Jaime Ruiz-Montero, MD: Compensation is for hours worked as Medical Director of Diabetes Center and as a House Physician Edward Williams, PHD: Related organization compensation is for attending CFNI monthly BOD and Committee meetings Joseph Costanza: Related organization compensation is for attending CFNI monthly BOD and Committee meetings Peggy Gerard: Related organization uncompensated CVI BOD and Committee meetings Kimberly Arthur, MD: Compensation is for hours worked as an Employed Physician JoAnn Birdzell: Compensation is for hours worked as the Hospital Administrator Mary Ann Shacklett: Related organization compensation is for hours worked as the system CFO. Related organization hours are for attending BOD and committee meetings Craig Bolda: Related organization compensation is for hours worked as the Hospital COO
Part XI Line 5 Other Changes in Net AssetsAMOUNT TRANSFERED FROM COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. (PARENT) $3,948,961.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
COMMUNITY FOUNDATION OF NW INDIANA INC
10010 DONALD POWERS DRMUNSTERIN46321311128781SUPPORTNG ORGIN501(C)(3)11(C)NAfalse
MUNSTER MEDICAL RESEARCH FOUNDATION INC
800 MACARTHUR BLVDMUNSTERIN46321351107009HOSPITALIN501(C)(3)3CFNItrue
ST MARY MEDICAL CENTER
1500 SOUTH LAKE PARK AVEHOBARTIN46342352007327HOSPITALIN501(C)(3)3CFNItrue
COMMUNITY CANCER RESEARCH FOUNDATION
901 MACARTHUR BLVDMUNSTERIN46321352146374CANCER FUNDRAIN501(C)(3)7MMRFtrue
COMMUNITY VILLAGE INC
10000 COLUMBIA AVEMUNSTERIN46321351956395RETIREMT HOMEIN501(C)(3)9CFNItrue
THEATRE AT THE CENTER
1040 RIDGE RDMUNSTERIN46321351939427CONCERTSIN501(C)(3)9CFNItrue
CVPA HOLDING COMPANY
905 RIDGE RDMUNSTERIN46321351938136SUPPORTNG ORGIN501(C)(2)N/ACFNItrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY RESOURCES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1907 RIDGE RDAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
EIN351727711EIN
Primary ActivityMGMT SERVICESPrimaryActivity
Legal Domicile StateINLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MUNSTER MEDICAL RESEARCH FOUNDATION INC
N2089978FMV
ST MARY MEDICAL CENTER
N331189FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
O5690158FMV
ST MARY MEDICAL CENTER
O1236870FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
P2541255FMV
ST MARY MEDICAL CENTER
P128639FMV