NIAGARA HOMEMAKER SERVICES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NIAGARA HOMEMAKER SERVICES INC (EIN 16-1317960)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201323169349304032
Schema version
2012v2.1
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)
Timestamp2013-11-12T14:25:25-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN161317960EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mercy Home CareBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone7166854870Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12875 Union Road No 14AddressLine1
CityCheektowagaCity
StateNYState
ZIP Code14227ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid P MacholzName
TitleVP Finance, Corporate ControllerTitle
Phone7166854870Phone
Date Signed2013-11-12DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Mercy Home Care of Western New YorkBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDavid P MacholzNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1515 Abbott RoadAddressLine1
CityBuffaloCity
StateNYState
ZIP Code14220ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7127513GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.chsbuffalo.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionThe Catholic Health System (CHS) Mission is to provide quality healthcare services in a home care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2012 Community Service Plan can be found at www.chsbuffalo.org.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees340TotalNbrEmployees
Total Nbr Volunteers2TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6274821ProgramServiceRevenuePriorYear
Program Service Revenue CY7100513ProgramServiceRevenueCY
Investment Income Prior Year193InvestmentIncomePriorYear
Investment Income Current Year270InvestmentIncomeCurrentYear
Other Revenue Prior Year20312OtherRevenuePriorYear
Other Revenue Current Year26730OtherRevenueCurrentYear
Total Revenue Prior Year6295326TotalRevenuePriorYear
Total Revenue Current Year7127513TotalRevenueCurrentYear
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 Year5202023SalariesEtcPriorYear
Salaries Etc Current Year6007560SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1431318OtherExpensePriorYear
Other Expenses Current Year1582791OtherExpensesCurrentYear
Total Expenses Prior Year6633341TotalExpensesPriorYear
Total Expenses Current Year7590351TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-338015RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-462838RevenuesLessExpensesCY
Total Assets BOY2060378TotalAssetsBOY
Total Assets EOY2155525TotalAssetsEOY
Total Liabilities BOY2159829TotalLiabilitiesBOY
Total Liabilities EOY2745745TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-99451NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-590220NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Catholic Health System (CHS) Mission is to provide quality healthcare services in a home care setting. Committed to a common mission, CHS providers continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2012 Community Service Plan can be found at www.chsbuffalo.org.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5969481Expense
Revenue7100783Revenue
DescriptionThroughout 2012, the staff at Niagara Homemaker Services, Inc. delivered 151,912 HHA hours of care. Additionally, 38,388 PCA hours were also made. Mery Home Care's Shared Aides provided 8,616 hours of care to residents in senior housing. Our registered nurses visits totalled 349 hours.The Home Response program monitored an average of 1,412 units/month during 2012.Description
Total Program Service Expense5969481TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees340NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid P Macholz VP Finance Corp CNamePerson
Telephone Number7168282974TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1515 Abbott RoadAddressLine1
CityBuffaloCity
StateNYState
ZIP Code142202039ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployee
Joseph McDonald
President and CEO, CHS37.50XX0147125738697
Mark Sullivan
Executive VP/COOP, CHS37.50XX083761331269
Joyce Markiewicz
President and CEO, CHS Home Care37.50XX030362038479
Peter Bergman
Director37.50X043328933126
Nils Gunnersen
Director37.50X025298477694
Dennis Horrigan
Director1.00X000
Li Lin PhD
Director1.00X000
Brian O'Herron
Director1.00X000
Michael Osborne
Director37.50X020016327510
Katherine Rogala
Director1.00X000
Miguel Santos
Director1.00X000
Gary Tucker
Director1.00X000
Sr Sheila Marie Walsh
Director1.00X000
Monsignor Robert E Zapfel
Director1.00X000
James A Dunlop Jr
Executive VP/Finance, CHS37.50X0672603115267
Michael Moley
Sr. VP Human Resources37.50061487136811X
John Stavros
Sr. VP Marketing/PR37.50028345336599X
Maria Foti
Sr. VP Planning37.50021043026939X
Bartholomew Rodrigues
Sr. VP Mission Integration37.50022456734605X
Dr Michael Galang
Chief Information Officer37.50039310925395X
Nancy Sheehan
Sr. VP Legal Services, General Counsel37.50024944526369X
Richard j Ruh MD
Sr. VP Service Lines37.50036137132599X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6508775TotalReportableCompFrmRltdOrgs
Total Other Compensation581359TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Doyle Security System IncBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1792 Calkins RoadAddressLine1
CityRochesterCity
StateNYState
ZIP Code146239985ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPersonal Response MonitoringDescriptionOfServices
Compensation206268Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionProgram Service RevenuDescription
Business Code621610BusinessCode
Total Revenue Column7100513TotalRevenueColumn
Related Or Exempt Function Income7100513RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7100513TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column270TotalRevenueColumn
Related Or Exempt Function Income270RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Rental Income from Aff62161024660$24,660
Allocated from CHS6216102070$2,070
FieldValueIRS element (for citing)
Total Other Revenue26730TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7127513TotalRevenueColumn
Related Or Exempt Function Income7100783RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$26,730ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4352116Total
Program Services3853664ProgramServices
Management And General498452ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total98690Total
Program Services87387ProgramServices
Management And General11303ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1216252Total
Program Services1076953ProgramServices
Management And General139299ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total340502Total
Program Services301504ProgramServices
Management And General38998ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total614069Total
Program Services208801ProgramServices
Management And General405268ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3561Total
Program Services3561ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total328056Total
Program Services32513ProgramServices
Management And General295543ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total139996Total
Program Services73658ProgramServices
Management And General66338ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total188157Total
Program Services186063ProgramServices
Management And General2094ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5564Total
Program Services4193ProgramServices
Management And General1371ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total25154Total
Management And General25154ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total88380Total
Management And General88380ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Contractual Allowances121606121606
CHS Dues3306133061
Bad Debt Expense1734017340
Employee Related1062815210476

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7219Total
Program Services2086ProgramServices
Management And General5133ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7590351Total
Program Services5969481ProgramServices
Management And General1620870ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY871563BOY
EOY477820EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY624860BOY
EOY893622EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY11438BOY
EOY4247EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY552517BOY
EOY779836EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2060378BOY
EOY2155525EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1607312BOY
EOY1965909EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY552517BOY
EOY779836EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2159829BOY
EOY2745745EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-390353BOY
EOY-490769EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-99451BOY
EOY-590220EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2060378BOY
EOY2155525EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-462838ReconcilationRevenueExpenses
Reconcilation Other Changes-27931ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4469202CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5368186CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6252316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6274821CurrentTaxYearMinus1Year
Current Tax Year7100513CurrentTaxYear
Total29465038Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4469202CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5368186CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6252316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6274821CurrentTaxYearMinus1Year
Current Tax Year7100513CurrentTaxYear
Total29465038Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50929465038PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21403CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3049CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years557CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year193CurrentTaxYearMinus1Year
Current Tax Year240CurrentTaxYear
Total25442Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21403CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3049CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years557CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year193CurrentTaxYearMinus1Year
Current Tax Year240CurrentTaxYear
Total25442Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22945CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21250CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20312CurrentTaxYearMinus1Year
Current Tax Year30980CurrentTaxYear
Total116477Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4513550CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5392225CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6274123CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6295326CurrentTaxYearMinus1Year
Current Tax Year7131733CurrentTaxYear
Total29606957Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99520PublicSupportPercentage509
Prior Year Support Percentage0.99380PriorYearSupportPercentage
Investment Income Percentage0.00090InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00230PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionWorkers Comp Insurance RecoveryDescription
Book Value779836BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets779836TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionWorkers Comp Insurance RecoveryDescription
Amount$779,836Amount
FieldValueIRS element (for citing)
Total Of Amounts779836TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt7005907TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal7005907RevenueSubtotal
Other Revenues Not Included121606OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt121606RevenueNotRptdOnFinStmt
Total Revenue Per Form9907127513TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7468745TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal7468745ExpensesSubtotal
Other Expenses Not Included121606OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt121606ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907590351TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 4b - Other Adjustments:Contractual Allowances
Part XII, Line 4b - Other Adjustments:Contractual Allowances

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase 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
Joseph McDonald
President and CEO, CHS0691688043681503427540230550156420150995400
Mark Sullivan
Executive VP/COOP, CHS042001902530930164501017302013967086888200
Joyce Markiewicz
President and CEO, CHS Home Care0206941057472039207019954018525034209900
Peter Bergman
Director0355818032583044888014545018581046641500
Nils Gunnersen
Director02013500124270392070774360258033067800
Michael Osborne
Director0150042024409025712012454015056022767300
James A Dunlop Jr
Executive VP/Finance, CHS037261002313590686340101350013917078787000
Michael Moley
Sr. VP Human Resources028770501451640182002022381014430065168200
John Stavros
Sr. VP Marketing/PR0193171050332039950020253016346032005200
Maria Foti
Sr. VP Planning016555501134403353102019506744023736900
Bartholomew Rodrigues
Sr. VP Mission Integration0153335032085039147016226018379025917200
Dr Michael Galang
Chief Information Officer029513705906203891002039704998041850400
Nancy Sheehan
Sr. VP Legal Services, General Couns020629101606802708601989606473027581400
Richard j Ruh MD
Sr. VP Service Lines031190800049463017374015225039397000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 4bCertain Officers and Key employees participated in a supplemental nonqualified retirement plan per the terms and conditions of their employment arrangement. Joseph McDonald: Pension Gap: $26,000 CHE SERP: $150,012 Mark Sullivan: Pension Gap: $39,000 Michael Moley: Pension Gap: $20,697
Part I, Line 6The 2012 Incentive payments were dependent upon achieving the Catholic Health System Operating Income target for Catholic Health System participants or the Ministry Operating Income target for Ministry participants. Joseph McDonald - $436,814.82 Mark Sullivan - $253,093.07 James A. Dunlop, Jr. - $231,359.41 Nancy Sheehan - $16,068.24 Michael Moley - $145,164.42 John Stavros - $50,331.57 Maria Foti - 11,344.26 Bartholomew Rodrigues - $32,085.26 Dr. Michael Galang - $59,062.48 Peter Bergmann - $32,583.13 Nils Gunnerson - $12,426.51 Joyce Markiewicz - $57,471.86 Mike Osborne - $24,409.30

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
David Zapfel
Brother of BOD, Msgr. Robert Zapfel66713HR Employee of CHS0
Kathleen Zapfel
Sister-in-law of BOD, Mrgr. Robert Zapfel57335HR Employee of CHS0
Susan Gallagher-Stavros
Wife of Key Employee, John Stavros21753Nurse, McAuley Seton Home Care0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6CHS has three members: Ascension Health, Catholic Health East, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws.
Form 990, Part VI, Section A, line 7aAccording to the CHS Bylaws, each member is equally allowed to appoint up to three individuals to act as its representatives on the Corporate Member Board, and in undertaking any action in its capacity as a Member. The Corporate Member Board oversees the governance of the Catholic Health System.
Form 990, Part VI, Section A, line 7bEach member is entitled to one vote on each matter properly submitted at any membership meeting, and the members also have reserve powers which allow approval for certain business events and ratification of certain business transactions.
Form 990, Part VI, Section B, line 11Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6. Schedule J: Compensation Information 7. Schedule L: Transactions with Interested Persons 8. Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information
Form 990, Part VI, Section B, line 12cAll associates on the Merit program; all Physicians and Non Physician Practitioners as well as Physician groups who are independent contractors or employees of CHS; and all board members must complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner
Form 990, Part VI, Section B, line 15In 2012, the Catholic Health System utilized a Compensation Committee of the Board of Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO; COO; CFO; CEOs for each Ministry; and all Senior Vice Presidents. The Compensation Committee provides oversight to management decisions which are based on outlines approved by the committee, and performs a review of data. The outcome of these meetings is documented.
Form 990, Part VI, Section C, line 19We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws.
Form 990, Part XI, line 9:Minimum Pension Liability -27,931.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Catholic Health System
515 Abbott RoadBuffaloNY14220222565278Health Care Delivery SystemNY501 c 3Schedule A line 9N/A0
Mercy Hospital of Buffalo
565 Abbott RoadBuffaloNY14220160756336Acute Care HospitalNY501 c 3Schedule A line 30Catholic Health System Inc
Sisters of Charity Hospital
2157 Main StreetBuffaloNY14214160743187Acute Care HospitalNY501 c 3Schedule A line 30Catholic Health System Inc
Kenmore Mercy Hospital
2950 Elmwood AvenueKenmoreNY14217160762843Acute Care HospitalNY501 c 3Schedule A line 30Catholic Health System Inc
Nazareth Home of the Franciscan Sisters
291 North StreetBuffaloNY14201160813142Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Clare Manor
543 Locust StreetLockportNY14094160782647Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Elizabeth Home for the Aged
5539 BroadwayLancasterNY14086160743154Adult HomeNY501 c 3Schedule A line 90Catholic Health System Inc
St Francis Home of Williamsville
147 Reist StreetWilliamsvilleNY14221160743153Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Francis of Buffalo Inc
34 Benwood AvenueBuffaloNY14214161523535Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Joseph Manor
2211 West State StreetOleanNY14760160796400Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Luke Manor for the Chronically Ill
17 Wiard StreetBataviaNY14020160794811Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Mary's Manor
515 6th StreetNiagara FallsNY14301160924139Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
St Vincent Manor
319 Washington AvenueDunkirkNY14048160743167Adult HomeNY501 c 3Schedule A line 90Catholic Health System Inc
WNY Catholic Long Term Care Inc
6400 Powers RoadOrchard ParkNY14217161434368Skilled Nursing FacilityNY501 c 3Schedule A line 90Catholic Health System Inc
McAuley Seton Home Care
2875 Union Rd Suite 14CheektowagaNY14227161310062Home Care ProviderNY501 c 3Schedule A line 90Catholic Health System Inc
Catholic Health System Infusion Pharmacy
2875 Union Rd Suite 14CheektowagaNY14227200198518Home Care Infusion ServicesNY501 c 3Schedule A line 90Catholic Health System Inc
CHS Continuing Care Foundation
291 North StreetBuffaloNY14201200947831FoundationNY501 c 3Schedule A line 70Catholic Health System Inc
OLV Renaissance Corporation
291 North StreetBuffaloNY14201200167745Real Estate Holding CompanyNY501 c 3Schedule A line 90Catholic Health System Inc
CHS Program of All-Inclusive Care for the Elderly Inc
55 Melroy AvenueLackawannaNY14218261252884All-Inclusive Care for the ElderlyNY501 c 3Schedule A line 30Catholic Health System Inc
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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