MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS (EIN 16-1523353)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201323189349302187
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T09:58:58-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161523353 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mount St Mary's Hospital of Niagara Falls | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MOUN | NameControl |
| Phone | 7162974800 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 Military Road | AddressLine1 |
| City | Lewiston | City |
| State | NY | State |
| ZIP Code | 140921997 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Judith A Maness | Name |
| Title | President/CEO | Title |
| Phone | 7162974800 | Phone |
| Date Signed | 2013-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew A Montgomery | Name |
| PTIN | P00492843 | PTIN |
| Phone | 5137847100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mount St Mary's Hospital & Health Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Judith A Maness | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 Military Road | AddressLine1 |
| City | Lewiston | City |
| State | NY | State |
| ZIP Code | 140921997 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 89250555 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.msmh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1907 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. In furtherance of our mission and in an effort to reduce the government's financial burden, Mount St. Mary's Hospital and Health Center provides essential heath care services to all persons without regard to ability to pay. Our Neighborhood Health Center, located in the poorest and most underserved Census Tract of the City of Niagara Falls, a full-service emergency room, numerous community education programs and screenings and more are evidence of our commitment to provide healthcare that leaves no one behind. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 963 | TotalNbrEmployees |
| Total Nbr Volunteers | 209 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1717541 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 738905 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 86185236 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 84725536 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 371577 | InvestmentIncomePriorYear |
| Investment Income Current Year | 531614 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3978123 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3254500 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 92252477 | TotalRevenuePriorYear |
| Total Revenue Current Year | 89250555 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 53705918 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 52617940 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 34071113 | OtherExpensePriorYear |
| Other Expenses Current Year | 34867962 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 87777031 | TotalExpensesPriorYear |
| Total Expenses Current Year | 87485902 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4475446 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1764653 | RevenuesLessExpensesCY |
| Total Assets BOY | 49786220 | TotalAssetsBOY |
| Total Assets EOY | 43490873 | TotalAssetsEOY |
| Total Liabilities BOY | 43361599 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 38971353 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6424621 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4519520 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The mission of Mount St. Mary's Hospital and Health Center, sponsored by Ascension Health, is: We are called to continue the healing ministry of Jesus by providing compassionate, person-centered care. We will respect the dignity of all, with special concern for those who are poor and vulnerable. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 28903182 | Expense |
| Revenue | 47265261 | Revenue |
| Description | Mount St. Mary's Hospital provides in-patient medical and surgical services to the community, including acute care, cardiac and medical intensive care, telemetry, maternity, pediatrics, palliative care, stroke care and inpatient alcohol & substance abuse rehab. During the calendar year ending December 31, 2012, our Hospital treated 5,727 inpatient adults and children in the community for a total of 30,474 patient days of service. A substantial portion of services are provided to the elderly and poor. During the calendar year ending December 31,2012, approximately 51% of the value of services rendered was to elderly patients under the Medicare program,and approximately 16% of the services were provided to patients who were deemed indigent under state, county, or Hospital guidelines. In the spirit of principles adopted by Ascension Health and our Mount St. Mary's Hospital Board of Trustees, Mount St. Mary's Hospital has taken proactive steps to address those issues that affect accessibility, financing, and delivery of healthcare to all persons, especially those who are uninsured, underinsured, and underserved. All services are designed to provide healing without harm to those we serve. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 24605079 | Expense |
| Revenue | 40236589 | Revenue |
| Description | Mount St. Mary's provides the following outpatient medical services to the community: cardiac services, emergency services, laboratory services, neurology services including EEG and EMG, orthopedic services, pain management, primary care clinic services, radiology services, rehabilitation services, surgical services, physical therapy, sleep studies, occupational therapy, speech therapy, wound care, ENT, urology, hyperbaric medicine, respiratory therapy and pulmonary function studies. Some of the services listed, such as the primary care clinic services, operate at a deficit but are supported and maintained in order to ensure that all services are available to meet community health care needs. During the calendar year ending December 31, 2012, our Hospital provided services to 144,678 outpatients, including 8,223 outpatient surgery patients, 22,814 emergency room visits, 65,221 referred ambulatory patients, and 48,420 clinic visits. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5418974 | Expense |
| Description | During the calendar year ending December 31, 2012, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $5,419,000, including $710,000 cost for charity care, $853,000 in programs for the poor, $577,000 in services to the general community, and $3,279,000 in unpaid cost of public programs. Community benefit programs or activities are those that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, Mount St. Mary's Hospital has made available the following programs to the community: physical fitness activities, community health programs, medical education, cancer screening programs, heart disease screening programs, support groups and educational classes, CPR and first aid classes, flu shot clinics, nutrition and weight loss management, and smoking cessation, among others. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 58927235 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 138 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 963 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stephen Franko | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7162982010 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 Military Road | AddressLine1 |
| City | Lewiston | City |
| State | NY | State |
| ZIP Code | 140921997 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Carmen A Granto | |||||||||
| Chairperson | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Robert J Travis | |||||||||
| Vice-Chair/Treasurer | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Mark J Gabriele | |||||||||
| Secretary | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Dena Armstrong | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Patrick J Berrigan | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| William Bradberry | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Lloyd W Brown MD | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Francis P DiCamillo | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Maria J Komen MD | |||||||||
| Trustee (End 11/12) | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Donald J Largo MD | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Joseph D McDonald | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Robert A Minicucci Sr | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Sister Kathleen Natwin DC | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Sister Marylin Perkins DC | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Sister Margaret Tuley DC | |||||||||
| Trustee (End 6/12) | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| Michael L Vitch | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Deborah J Winslow-Schaber | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Judith A Maness | |||||||||
| President/CEO | 40.00 | 4.40 | X | 759578 | 0 | 24659 | X | ||
| Michael F Ickowski | |||||||||
| VP Finance/CFO (End 4/12) | 40.00 | 2.00 | 137858 | 0 | 12754 | X | |||
| Gary Tucker | |||||||||
| Sr. VP/COO | 40.00 | 0.00 | 266111 | 0 | 24679 | X | |||
| Deborah Serafin | |||||||||
| VP Human Resources | 40.00 | 4.00 | 206143 | 0 | 12493 | X | |||
| Barbara Bucci | |||||||||
| VP Patient Care Services | 40.00 | 0.00 | 156648 | 0 | 22500 | X | |||
| Benjamin G Rueda MD | |||||||||
| Cardiologist | 40.00 | 0.00 | 447634 | 0 | 24982 | X | |||
| Arif S Syed MD | |||||||||
| Cardiologist | 40.00 | 0.00 | 371654 | 0 | 21791 | X | |||
| James M Wopperer MD | |||||||||
| Orthopedic Surgeon | 40.00 | 0.00 | 370893 | 0 | 23040 | X | |||
| Justin Miller MD | |||||||||
| Otolaryngologist | 40.00 | 0.00 | 329216 | 0 | 24037 | X | |||
| Marc J Veneziano MD | |||||||||
| Cardiologist | 40.00 | 0.00 | 324598 | 0 | 16231 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3370333 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 207166 | TotalOtherCompensation |
| Number Individuals GT100 K | 41 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| John W Danforth Company (Sch O) | |||||
| 300 Colvin Woods Parkway | Tonawanda | NY | 14150 | Construction Services | 1537069 |
| Trimedx LLC | |||||
| PO Box 636129 | Cincinnati | OH | 452636129 | Maintenance Services | 1254023 |
| Touchpoint Support Services | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Dietary/Environmental Services | 957723 |
| Catholic Health Systems | |||||
| 2157 Main Street | Buffalo | NY | 14214 | Lab Services | 781407 |
| Exigence Hospitalist Medical | |||||
| 1 John James Audubon Pkwy | Amherst | NY | 142281145 | Physician Services | 588419 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 17 | NumberOfContractorsGT100K |
| Related Organizations | 620154 | RelatedOrganizations |
| Government Grants | 115000 | GovernmentGrants |
| All Other Contributions | 3751 | AllOtherContributions |
| Total Contributions | 738905 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Inpatient Svcs | 621990 | 45765599 | 45765599 |
| Net Outpatient Svcs | 621990 | 38959937 | 38959937 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 84725536 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 531614 | TotalRevenueColumn |
| Exclusion | $531,614 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 102277 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 102277 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 102277 | TotalRevenueColumn |
| Exclusion | $102,277 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EHR Reimbursement | 900099 | 878023 | 878023 | |
| Phys. Incentive Pymts | 621110 | 849820 | 849820 | |
| Cafeteria | 722210 | 375909 | $375,909 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1048471 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1048471 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3152223 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 89250555 | TotalRevenueColumn |
| Related Or Exempt Function Income | 87501850 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,009,800 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1526338 | Total |
| Management And General | 1526338 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40403952 | Total |
| Program Services | 28595164 | ProgramServices |
| Management And General | 11808788 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125181 | Total |
| Program Services | 85369 | ProgramServices |
| Management And General | 39812 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7561625 | Total |
| Program Services | 5156788 | ProgramServices |
| Management And General | 2404837 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3000844 | Total |
| Program Services | 2046480 | ProgramServices |
| Management And General | 954364 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 432057 | Total |
| Management And General | 432057 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 123357 | Total |
| Management And General | 123357 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111768 | Total |
| Management And General | 111768 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429408 | Total |
| Program Services | 429408 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1159106 | Total |
| Program Services | 81083 | ProgramServices |
| Management And General | 1078023 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 992375 | Total |
| Program Services | 992375 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599729 | Total |
| Program Services | 599729 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2513397 | Total |
| Program Services | 2513397 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 399180 | Total |
| Program Services | 399180 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 11720122 | 10806504 | 913618 |
| Contracted Services | 7460263 | 1874494 | 5585769 |
| Equipment Rental | 3714561 | 1938873 | 1775688 |
| Professional Fees | 3689544 | 2714431 | 975113 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1523095 | Total |
| Program Services | 693960 | ProgramServices |
| Management And General | 829135 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87485902 | Total |
| Program Services | 58927235 | ProgramServices |
| Management And General | 28558667 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 590401 | BOY |
| EOY | 1398222 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10425711 | BOY |
| EOY | 8204403 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 142272 | BOY |
| EOY | 275027 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1648436 | BOY |
| EOY | 1646073 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 912648 | BOY |
| EOY | 600330 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 57540005 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 33038980 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20168483 | BOY |
| EOY | 24501025 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15898269 | BOY |
| EOY | 6865793 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49786220 | BOY |
| EOY | 43490873 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9049545 | BOY |
| EOY | 12145585 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34312054 | BOY |
| EOY | 26825768 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43361599 | BOY |
| EOY | 38971353 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1164376 | BOY |
| EOY | -359785 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5260245 | BOY |
| EOY | 4879305 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6424621 | BOY |
| EOY | 4519520 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49786220 | BOY |
| EOY | 43490873 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1764653 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -134630 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -3535124 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $95,452 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $16,316 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 111768 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Lobbying expenses represent the portion of dues paid to national and state associations that is specifically allocable to lobbying. In addition, expenses are paid to consultants for work on behalf of Mount St. Mary's Hospital of Niagara Falls. Mount St. Mary's Hospital of Niagara Falls does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or opposition to) any candidate for public office. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 377517 | OtherCostOrOtherBasis |
| Book Value | 377517 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25353851 | OtherCostOrOtherBasis |
| Depreciation | 16812747 | Depreciation |
| Book Value | 8541104 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19133774 | OtherCostOrOtherBasis |
| Depreciation | 12695791 | Depreciation |
| Book Value | 6437983 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12674863 | OtherCostOrOtherBasis |
| Depreciation | 3530442 | Depreciation |
| Book Value | 9144421 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24501025 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due from Affiliates | 367344 |
| Beneficial Interest in Net Assets of Foundation | 4464568 |
| Interest in Investments Held by Ascension Health Alliance | 1619144 |
| Assets Limited to Use | 414737 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6865793 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Third Party Liabilities | $2,286,686 |
| Self-Insurance Liability | $211,324 |
| Intercompany Debt with Ascension Health Alliance | $24,327,758 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 26825768 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1129406 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 418946 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 710460 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00810 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13083868 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9938193 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3145675 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03600 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 256404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 123036 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 133368 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14469678 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10480175 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3989503 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04560 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 852783 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 217584 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 635199 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 134737 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 134737 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1077642 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 572738 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 504904 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 843 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 843 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 153788 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 153788 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2219793 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 790322 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1429471 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01640 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16689471 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11270497 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5418974 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06200 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 904 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 904 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 3383 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3383 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 863 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 863 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 76644 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 76644 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 81794 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 81794 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,889,218 | BadDebtExpenseAmount |
| Amount Attributable To | 145001 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 15528897 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 18201240 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2672343 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mount St Mary's Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 Military Road | AddressLine1 |
| City | Lewiston | City |
| State | NY | State |
| ZIP Code | 140921997 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.msmh.com | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mount St Mary's Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: A cost to charge ratio was used for costing various amounts in the table, using a calculation based on Worksheet 2. | ||
| Part I, Line 7g: A loss of $469,833 from the Neighborhood Health Center, a hospital-based clinic located in a low income, economically depressed and health shortage area of the City of Niagara Falls, is included in Part I, Line 7. It is located in a census tract which has the largest segment of people who are poor and underserved in Niagara County. | ||
| Part II: Among the Community Building activities the Hospital participates in are physicians recruitment and a Parish Nurse program. The physicians recruitment effort is designed to bring primary care and specialty physicians into the area for services that are underserved. The Parish Nurse Program is a partnership between the hospital and local religious congregations in the community. The goal of the program is to enhance the community's quality of life by helping to improve the health and spiritual well being of members of various congregations, through an integration of health care with the religious community. The Hospital incurred a total cost of $81,794 for these programs. | ||
| Part III, Line 4: The provision for doubtful accounts is based upon management's assessment of historical and expected net collections considering economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectable accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for uncollectable accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Hospital may place past due patient balances with collection agencies,subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Hospital's policies. The organization's share of bad debt expense in 2012 was $2,889,218 at charges. | ||
| Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association (CHA) guidelines for determinning community benefit. CHA community benefit guidelines suggest that Medicare shortfall is not treated as community benefit. In our calculations, the cost was determined by mutiplying total Medicare charges times the ratio of cost to charges. | ||
| Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance, certain collection practices do not apply. | ||
| Part V, Section B, Line 14g: Brochures describing the Financial Assistance Policy and a sign indicating where to call or go to talk to the Financial Counselor, are located at every entry point of the hospital, including all off campus locations. The brochure and application are also posted on the hospital's website. | Mount St. Mary's Hospital | |
| The following procedures are followed and are considered reasonable efforts for purposes of questions 15 & 16: The Hospital notifies each individual of the Financial Assistance Policy (FAP). This notification begins on the date care is provided and ends on the 120th day after the first billing statement is provided to the patient. Individuals are notified of the FAP as noted in the response to question 14. For individuals who submit an incomplete FAP application, the Hospital provides that individual with information relevant to assist them with completion of the application. For individuals who submit a complete application, the hospital makes and documents a determination as to whether that person was eligible under the facility's FAP. The Hospital determines eligibility based on one or more of the means tested programs indicated in question 12. | Part V, Section B, Line 15 & 16: | |
| Part VI, Line 2: The organization conducts a survey and also relies on a compliation of resources readily available. This includes information from the Healthcare Association of New York State, Niagara County Department of Health, the Niagara Falls Mayor's Health Task Force, and the Ascension Health Environmental Scan. By reviewing information on trends and needs from these sources, Mount St. Mary's also relies on input from its staff as it evaluates the patients that are being treated and any trends. Some of the community health needs indentified were childhood obesity, diabetes, and heart disease. Mount St. Mary's Hospital has developed programs to address these needs. | ||
| Part VI, Line 3: Patients are personally informed of the financial assistance and charity care policies at each inpatient and outpatient entry point of the Hospital by Patient Access Representatives, who also direct those individuals requiring further information to the Financial Assistance Counselors. Each entry point of the Hospital and all of its offsite locations have both signs and brochures explaining the Financial Assistance Policy in place. In addition, a summary brochure of the Financial Assistance Policy and application have been placed on the homepage of the Hospital's website. | ||
| Part VI, Line 4: Mount St. Mary's Primary Service Area includes the City of Niagara Falls (Zip Codes 14301, 14302, 14303, 14304 and 14305) a city of about 49,000 where 60% of the population is on some form of public assistance and the towns of Lewiston (14092, 14107, 14109, and 14132), Niagara (portions of 14304 and 14305), Wheatfield (portions of 14305 and 14120), Grand Island (14072), and Porter (14174) more suburban and rural areas with slightly higher income levels. Secondary Service Areas include the towns of Wilson (14172) a small agricultural community and Lockport (14094) a nearby city with similar characteristics to Niagara Falls. In general, the primary service area is described as Western Niagara County. | ||
| Part VI, Line 5: Other ways that the hospital furthers its exempt purpose by promoting the health of the community include free health screenings and health fairs as described further in our community benefit report in Schedule O. Also, a majority of the organization's governing body is comprised of persons who reside in the Hospital's primary service area who are not employees, contractors, nor family members therof. The organization extends medical staff priviledges to all qualified physicians in its community for many of its departments. The organization applies funding to improvements in patient care such as the expanded cardiology services, Womens Center for Breast Health, and the Center for Women. | ||
| Part VI, Line 6: Mount St. Mary's Hospital of Niagara Falls d/b/a Mount St. Mary's Hospital and Health Center (the Hospital) is a member of Ascension Health. In December 2011, Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 21 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health Alliance, its subsidiaries, and Health Ministries are referred collectively from time to timehereafter as the System.Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province American Province.The Hospital, located in Lewiston, New York, is a nonprofit acute care hospital. The Hospital provides inpatient, outpatient, emergency care, and chemical dependency services for patients who reside primarily in the local geographic region. Admitting physicians are primarily practitioners in the local area. The Hospital is related to Ascension Health's other sponsored organizations through common control. The consolidated financial statements also include the financial results of Our Lady of Peace, Inc. (OLP) and Mount St. Mary's Child Care Center, Inc. (CCC), of which the Hospital is the sole corporate member. Unless indicated otherwise, the three entities are collectively referred to as the Hospital for purposes of these consolidated financial services.OLP is a not-for-profit organization established to operate a freestanding 250-bed skilled nursing facility. CCC is a not-for-profit organization that provides daytime child-care services primarily for employees of the Hospital. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Ascension Health Alliance directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:-Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.-Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.-Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the for persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with Acquired Immune Deficiency Syndrome.-Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty, including health promotion and education, health clinics and screenings.Discounts are provided to all uninsured patients in the acute care facility, including those with the means to pay. Discounts provided to these patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS). The amount of traditional charity care provided, determined on the basis of cost and reported in thousands, was approximately $738 and $826 for the years ended December 31, 2012 and 2011, respectively. The unpaid cost of public programs was approximately $3,118 and $4,109, the cost of other programs for persons living in poverty and other vulnerable persons was $857 and $1,134, and the cost of community benefit programs was $702 and $1,006 for years ended December 31, 2012 and 2011, respectively. | ||
| NY | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Judith A Maness | ||||||||||||||
| President/CEO | 318908 | 0 | 375582 | 0 | 65088 | 0 | 5000 | 0 | 19659 | 0 | 784237 | 0 | 0 | 0 |
| Michael F Ickowski | ||||||||||||||
| VP Finance/CFO (End 4/12) | 61630 | 0 | 0 | 0 | 76228 | 0 | 1448 | 0 | 11306 | 0 | 150612 | 0 | 0 | 0 |
| Gary Tucker | ||||||||||||||
| Sr. VP/COO | 219696 | 0 | 0 | 0 | 46415 | 0 | 4918 | 0 | 19761 | 0 | 290790 | 0 | 0 | 0 |
| Deborah Serafin | ||||||||||||||
| VP Human Resources | 165750 | 0 | 0 | 0 | 40393 | 0 | 3772 | 0 | 8721 | 0 | 218636 | 0 | 0 | 0 |
| Barbara Bucci | ||||||||||||||
| VP Patient Care Services | 129716 | 0 | 0 | 0 | 26932 | 0 | 2840 | 0 | 19660 | 0 | 179148 | 0 | 0 | 0 |
| Benjamin G Rueda MD | ||||||||||||||
| Cardiologist | 434894 | 0 | 0 | 0 | 12740 | 0 | 4375 | 0 | 20607 | 0 | 472616 | 0 | 0 | 0 |
| Arif S Syed MD | ||||||||||||||
| Cardiologist | 355869 | 0 | 0 | 0 | 15785 | 0 | 2124 | 0 | 19667 | 0 | 393445 | 0 | 0 | 0 |
| James M Wopperer MD | ||||||||||||||
| Orthopedic Surgeon | 326533 | 0 | 21860 | 0 | 22500 | 0 | 3378 | 0 | 19662 | 0 | 393933 | 0 | 0 | 0 |
| Justin Miller MD | ||||||||||||||
| Otolaryngologist | 279373 | 0 | 32865 | 0 | 16978 | 0 | 4375 | 0 | 19662 | 0 | 353253 | 0 | 0 | 0 |
| Marc J Veneziano MD | ||||||||||||||
| Cardiologist | 324598 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 16231 | 0 | 340829 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Part I, Line 4a: Severance Payments: Michael F. Ickowski - $51,326. Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. Amounts Paid: Judith A. Maness - $31,547 Michael F. Ickowski - 14,136 Gary Tucker - $22,718 Deborah Serafin - $17,893 Barbara Bucci - $13,932. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related Mount St. Mary's Hospital of Niagara Falls entity boards. | |
| Form 990, Part VI, Section A, line 6 | Mount St. Mary's Hospital has a single corporate member, Ascension Health. | |
| Form 990, Part VI, Section A, line 7a | Mount St. Mary's Hospital of Niagara Falls has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Mount St. Mary's Hospital of Niagara Falls. | |
| Form 990, Part VI, Section A, line 7b | Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain Officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to a designated committee of the Board, to review and answer any questions. Prior to filing the return, all Board Members are provided a copy the Form 990. | |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. | |
| Form 990, Part VI, Section B, line 15 | In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Board Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when her compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review of comparability data. In the review of the compensation, the other officers or key employees of the organization were compared to individuals at other hospitals in the area who hold the same title. | |
| Form 990, Part VI, Section C, line 19 | Mount St. Mary's Hospital will provide any documents open to public inspection upon request. | |
| Form 990, Part XI, line 9: | Pension Liability Adjustment -2,793,061. Transfer to Affiliates -767,343. Change in Interest in Foundation 30,869. Other -5,589. | Changes in Net Assets or Fund Balances: |
| Form 990, Part III, Line 4: | For the year ended December 31, 2012. This report illustrates the significant ongoing degree to which Mount St. Mary's Hospital and Health Center contributes to the positive health status of the communities we serve. As a member of Ascension Health, the nation's largest Catholic and non-profit health system, Mount St. Mary's continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it services. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Community Outreach Activities: Mount St. Mary's Hospital seeks to improve the physical, mental, social and spiritual health status of its surrounding community in addition to providing health care services to all individuals who require medical attention. Expanding Awareness, Health Education and Healthcare Promotion: Mount St. Mary's believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. Mount St. Mary's Hospital has invested to provide quality health education and materials to accomplish its goals. Mount St. Mary's has a positive impact on the surrounding neighborhoods as it contributes to civic and cultural programs, makes space available to support groups, community groups, and improves the overall healthcare environment. Through our "Health for All Seasons" educational programs, we reach out to the community with unique health education offerings. In 2012 these programs occurred throughout the year and covered a wide-array of topics from "Healthy Heart" to "Warning Signs of Stroke". To promote attendance and conduct the programs, Mount St. Mary's invests more than $25,000 on services and promotion. Throughout the year Mount St. Mary's conducts a series of community events including: - February: Heart Month - Free Community Lipid Panel Screening - Heart Month Education Events, free blood pressure screening, and more - May: Stroke Awareness Month - Stroke Awareness Day - Free Community Education events - June: Men's Health Month - Free Community PSA Prostate Screening in June - October: Breast Health Awareness Month - Free Community Mammogram Screening for the uninsured - Free Community Education events - November: Diabetes Awareness Month - Year Round: Staff at Mount St. Mary's attends numerous community health fairs and programs, offering screenings as requested for blood pressure and diabetes. Such events attended include those held at the Tuscarora Nation School, Niagara Falls Neighborhood Block Clubs, local businesses such as Dental Care Associates and ParMed Pharmaceuticals, the Head Start Program, among others. To address specific health issues and needs, Mount St. Mary's has launched targeted programs, and participates in others including: Niagara Falls Mayor's Task Group on Health: CEO participates in a community-based effort to have a demonstrated impact on health issues and awareness of individuals in the community. The area's largest private foundation has invested in the program that is working in a designated area of the city with a high amount of uninsured and underserved. The overall project goal: "Create a Healthier Niagara Falls by developing Sustainable Neighborhoods". Niagara County Community Health Assessment: Mount St. Mary's participates in a county led effort that involves other hospitals, in a community survey and identification of priority health needs which will be addressed with measureable results. HANCI/PACE Program: Mount St. Mary's Hospital and Our Lady of Peace have partnered with the Health Association of Niagara County (HANCI) to implement the "Program of All-Inclusive Care for the Elderly". This program, titled "Complete Senior Care" is designed to assist frail elderly persons to remain in their home and out of institutional care as long as possible. MSMH will support and staff the healthcare component with a clinic located in the center of the facility. This is a provider-based Medicare/Medicaid managed care program that follows with stated strategies for reforming healthcare in New York State advanced by the Governor. Pathways to Careers Program: The "Pathways to Careers" Program was initiated by Mount St. Mary's Hospital in collaboration with Niagara Catholic High School and Niagara University, as an adjunct to the hospital's HERO (Health Education Raises Opportunities) Program, to provide unique opportunities for high school students to plan for careers in health and health-related fields. The program was initiated in 2010 and continues each year starting with a "Career Fair" in the spring semester where several hospital departments provided exhibits on specific health careers which support acute care operations. Students are encouraged to visit each exhibit and pick up information about careers, certification and licensure requirements and local institutions of higher learning which offer courses of study in specific career programs. Students are also given the opportunity to sign up for an internship opportunity for the following September. Dr. Robert Greene, Chair of the Department of Biology at Niagara University is the Academic Moderator for the Program. This program was developed with an eye toward future recruitment as well as for the purpose of providing high school students with enriched educational options to assist them in the selection of college courses of study. The program is designed to move students along a chosen local, educational pathway to potential local employment while affording education and visibility for traditional and non-traditional health care occupations. On-Site Programs for Academic Nursing Education: In 2009, MSMH initiated a pilot program in collaboration with the Niagara University Department of Nursing, to provide two on-site baccalaureate nursing courses. The Program is designed to offer education to the nurses in a convenient and familiar environment and to encourage educational advancement to employed nurses. The Program opened with 8 nurses and 6 completed the program in December, 2009. Beginning in 2010, MSMH in collaboration with the Trocaire College Division of Nursing and Niagara-Orleans BOCES, piloted a unique LPN to RN program on the Hospital campus. The Program, designed with a "work as you learn" focus, is an evening program and features enhanced instruction in gerontological nursing. | Mount St. Mary's Hospital and Health Center Community Benefit Report: |
| HERO (Health Education Raises Opportunities) Health Literacy for Faith-Based Schools: The Health Education Raises Opportunities (HERO) Program, initiated by Mount St. Mary's Hospital and Health Center in 2009 focuses on improving health literacy for local school children. It is currently offered in different menu formats for students in Grades 3 12 in four schools with expansion to seven schools planned for the future. The Program brings experts in the health field into classrooms to teach children on important and current health issues. HERO's ultimate goal is to help students and their families to become better consumers of health care. HERO's Collaborative Partners include the following: - The Mental Health Association in Niagara County, Inc. - The Niagara County Health Department - Niagara University Department of Nursing - Niagara University Department of Biology - Catholic Charities of Western New York - The Buffalo Diocesan Catholic Schools - Fidelis Care New York - Catholic Academy of Niagara Falls - St. Peter's Roman Catholic School, Lewiston - St. Peter's Evangelical Lutheran School, Lockport - St. Peter's Lutheran School, Sanborn - The Niagara Charter School - St. Dominic Savio Middle School - DeSales Catholic School - Niagara Catholic High School - St. Mary's Hospital and Health Center, Departments of: Education and Staff Development, Mission Integration, Parish Nursing, Employee Health Services, Rehabilitation and Sports Medicine, and Community Relations. Childhood Weight Management Program: Childhood obesity is a health problem reaching epidemic proportions throughout the United States. Obesity in the young brings along with it, the stigma of being "different". Children who are obese are often challenged with poor self-esteem and the emotional trauma of taunting, bullying and other negative behaviors from other children. In addition, these children are at risk for other health problems as they grow, which may affect them in later life. Key to the success of any weight management program for children is parental support and encouragement. In an effort to address childhood obesity with a comprehensive, clinically sound, age-appropriate and results-oriented focus, the Hospital has developed a 16-week program comprised of 8 sessions for children, their parents and schools is being piloted beginning in February of 2011. Collaborative Partners include: - The Niagara County Health Department - The Mental Health Association in Niagara County, Inc. - MSMH - Department of Nutrition Services - Department of Education - Department of Rehabilitation and Sports Medicine Mount St. Mary's Hospital Student Affiliate Agreements: In 2009, the process for scheduling students for clinical rotations and internships with hospital departments was transitioned into a new, streamlined approach which reflects a more customer-friendly approach. To date, more than 50 institutions of higher learning, including three medical schools, have executed Student Affiliate Agreements on file. These facilities include not only local schools, but colleges and universities throughout the country. Community Service Education: The Department of Education and Staff Development provides instruction in the following areas for community health providers: - Basic Lifesaving Skills (BLS): Certification and Re-certification - Advanced Lifesaving Skills (ACLS): Certification and Re-certification The Department also coordinates and facilitates education for community health providers for the following: - Neonatal Lifesaving Skills (NALS): Re-certification - Pediatric Lifesaving Skills (PALS): Re-certification As an American Diabetes Association Certified Center, the Department of Education and Staff Development Certified Diabetes Educators provide individual counseling on Diabetes self-management for inpatients and outpatients. The Educator also provides instruction on Diabetes and Pre-Diabetes through group classes and serves as faculty support for local health providers on Diabetes education throughout Niagara County. In addition, as a Designated Stroke Center, Stroke Prevention Education is provided through focused programs both on the hospital campus, in local schools and throughout the community. Employee Health Services: Mount St. Mary's provides Medical Case Management to employees who are ill or injured in an effort to return them to full pay and benefits as soon as possible. We offer individual health coaching to each employee annually and on an as needed basis to improve the quality of life through health lifestyles and disease management. EAP referrals are made for employees (or employee's families) in crisis. Free onsite exercise classes, wellness seminars, recipes and self-guided fitness options are available to all employees, physicians' and volunteers. Catholic Health System of Buffalo - Home Care Service: Mount St. Mary's works in collaboration with Catholic Health of Buffalo to provide Home Health Care services to Niagara. In addition, the Mount St. Mary's Wound Care Center's Medical Director conducts training for home health care agency personnel. We are working with Buffalo CHS on an additional wide array of initiatives including eClinical Works, Catholic Medical Partners physician organization, laboratory system, and physician recruitment. New York State Designated Stroke Center: Application was approved in mid-2010 seeking a designation from the New York State Department of Health as a "Designated Stroke Center". MSMH works cooperatively with Catholic Health of Buffalo on components of this service. Echocardiography Accreditation: Accreditation received from the Intersocietal Commission for the Accreditation of Echocardiography (ICAEL). Chest Pain Center Designation: Accreditation Approved. Mandatory Concussion Training and Athletic Training: With the discussion growing on a local and national level regarding athletes and concussions, Mount St. Mary's Hospital is ahead of the curve in assessment and care. The ATCs at our Center for Sports Medicine and Physical Rehabilitation have been providing on-site coverage under contract at local high schools. During the past five years there has been a collaborative effort with local school systems and physicians to provide the student-athletes with the best possible care. Our Center provides a computer program to aid the ATC (Certified Athletic Trainer) with concussion assessment. Student athletes are assessed prior to the start of the season using the SAC (Standardized Assessment of Concussion) program. A summer conditioning program is also held for high schools. | ||
| Support of Niagara County Diabetes Coalition: The rate of diabetes in Niagara County is 11.9% with 10.6% in males and 13.2% in females. These statistics are higher than the NYS rates of 9.7% overall, 7.6% in males overall and 11.6% overall in females. An estimate of recent hospitalizations at MSM indicates that 1/6 of admissions were for diabetes. Only 1/3 of that population was referred for DSMT. To address these issues, cooperative strategies developed for all Niagara County hospitals: - Develop a protocol for patients with diabetes entering the hospital. Will include a physician check list that is placed on the front of the chart that will promote referring to class/counseling and A1C testing. - Query lab results for patients whose blood glucose levels are 125 and above for intervention. - Develop pre-diabetes education and offering for the community. - Develop community education lectures that emphasize good nutrition physical activity, mental health and lowering risks for chronic diseases. - Research funding opportunities to assist patients in receiving pre-diabetes and diabetes education. - Meet with insurance companies to discuss reimbursement of diabetes management services and education. - Develop a Niagara County resource guide to be available at all hospitals, clinics and physicians offices and home health care agencies. - Develop a tool to evaluate a 6 month outcome of patients health to include repeat admissions, weight, quality of life, effectiveness of teaching and A1C level. - Press releases and TV appearances by hospital reps and LHD staff to update community on hospital collaboration. Financial Counselors: Mount St. Mary's has two full-time Financial Counselors positions to aid in identifying and assisting with charity care as well as facilitating the Medicaid enrollment process. The Financial Counselors are well-versed in our charity/financial assistance care policy which provides discounts from 0%-100%. Establishing a Full Continuum of Care in the Niagara Community: - Expansion of Mount St. Mary's Neighborhood Health Center: Mount St. Mary's Hospital invested more than $1.7 million from donations, public support and private grants to construct a new and expanded Mount St. Mary's Neighborhood Health Center. The new 6,500 square foot facility opened in April 2010. The facility doubles the current treatment space from 6 to 12 exam rooms. This primary care center includes adult and pediatric medicine and OB/GYN and serves as a medical home for the patients. It is located in the inner-city of Niagara Falls in the poorest census tract in the County. In addition, new low-income apartments for 250 families and other subsidized housing have been constructed in the surrounding neighborhood. The community served is predominantly minority (African-American) is of low income and minimally insured, if at all. If the clinic did not exist they would have no readily available health care options. The clinic currently operates at a financial loss, requiring an annual subsidy from MSMH in the hundreds of thousands of dollars. We remain committed to operating this clinic knowing its importance in the community, we have hired a full-time medical director to coordinate care and we continue to work to improve efficiency and services, facilitate enrollment in Medicaid plans as much as possible, and to minimize losses. It is anticipated that the new space will improve the productivity and the efficiency of the operations to reduce the losses associated with working in less than optimal conditions. We have already witnessed significant increases in patient visits. In addition, staff is looking to add new services to help in the treatment of chronic diseases such as diabetes and adding other specialists as needed. An on-site social worker helps patients of the NHC navigate the social service and governmental and non-government assistance system. A full time physician assistant (PA) was added in 2011 to provide additional capacity to see adults. Pediatrician coverage is being monitored to assure productivity as volumes have softened in this area as the population ages. Additional staffing in Obstetrics/Gynecology has also been added. - Heart and Soul Food Pantry: Mount St. Mary's Hospital continues to collaborate with the Heart and Soul Food Pantry located in Niagara Falls to provide referral navigation service and education services to those in need of health care and those who are uninsured and unable to obtain health care service. The Parish Nurse is presently on duty in the Heart and Soul location three days a week. She is actively working at Heart and Soul Soup Kitchen identifying health needs and referring to other social services agencies. Health referrals are made to Neighborhood Health Center as needed. Transportation to health services and Social Services is arranged and provided when necessary. Several local agencies have agreed to collaborate by offering services at Heart and Soul. We will continue to work with Heart and Soul and continue support for our Parish Nurse Program. - VanGo: Provides transportation services for patients (from all over the western part of Niagara County) to get to the hospital campus and to off-site services such as rehab and the Neighborhood Health Center. The charge is $1 each way unless patients cannot afford it. Volunteers drive the vans and scheduling is coordinated by hospital staff. As a rural county with an elderly population, the van provides reliable convenient service which fills a gaping hole in the public transportation system. The two mini-vans were purchased through the generous donation of a local businessman who also provides funds annually for the upkeep of the vans. - Women's Health Conference: One major event initiated by Mount St. Mary's that has become a significant community event is the annual "Women's Healthcare Conference" which now attracts more than 350 persons in a day-long program in downtown Niagara Falls. Community information support groups hosted by Mount St. Mary's each year cover Alzheimers, Breast Cancer, Diabetes, Fibromyalgia, Lupus, Parent Grief, Sleep Apnea, and Prostate Cancer. - Parish Nurse: The Mount St. Mary's Parish Nurse also provides a direct link between the Neighborhood Health Center and the nearby Heart and Soul food pantry. Regular screenings are held for the clients of the soup kitchen at Heart and Soul and those identified with health issues are referred to the Health Center. In addition, an on-staff social worker helps patients of the Neighborhood Health Center and others navigate important government and private programs. Summary In summary, Mount St. Mary's furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients unable to pay, and provide services to others. | ||
| Form 990, Part VII, Section B: | Amounts reported for John W. Danforth Company represents amounts paid for both services and materials. These amounts cannot be separated. | Explanation of Independent Contractor Amounts: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health | ||||||||||
| PO Box 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | Ascension Health Alliance | 0 |
| Our Lady of Peace Inc | ||||||||||
| 5285 Lewiston Road | Lewiston | NY | 140921997 | 161608735 | Nursing Home | NY | Section 501(c)(3) | Schedule A, Line 3 | Mount St Mary's Hospital of Niagara Falls | 1 |
| Mount St Mary's Hospital Child Care Center | ||||||||||
| 5310 Military Road | Lewiston | NY | 140921997 | 161523352 | Child Care Center | NY | Section 501(c)(3) | Schedule A, Line 9 | Mount St Mary's Hospital of Niagara Falls | 1 |
| Mount St Mary's Hospital Foundation | ||||||||||
| 5300 Military Road | Lewiston | NY | 140921997 | 161360884 | Foundation | NY | Section 501(c)(3) | Schedule A, Line 11a | Mount St Mary's Hospital of Niagara Falls | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Mount St Mary's Hospital Foundation | ||
| C | 620154 | Actual amount paid |
| Our Lady of Peace Inc | ||
| O | 421099 | Actual amount paid |
| Ascension Health | ||
| P | 5362348 | Actual amount paid |
| Our Lady of Peace Inc | ||
| Q | 2979762 | Actual amount paid |
| Ascension Health | ||
| R | 191772 | Actual amount paid |
| Our Lady of Peace Inc | ||
| A | 23778 | Actual amount paid |
Comments