FURP.ORG / PUBLIC DATA EXPLORER

ST MARYS HOSPITAL AND MEDICAL CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST MARYS HOSPITAL AND MEDICAL CENTER INC (EIN 84-0425720)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-16
IRS object ID
201203219349300535
Schema version
2011v1.3
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)
Timestamp2012-11-16T11:10:20-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BRUCE E BERNSTIEN & ASSOC PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110440 N CENTRAL EXPRESSWAY STE 1040AddressLine1
CityDALLASCity
StateTXState
ZIP Code75231ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840425720EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSPITAL & MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% FOREST BINDERInCareOfName
Name ControlSTMANameControl
Phone9702982273Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12635 N 7th StAddressLine1
CityGrand JunctionCity
StateCOState
ZIP Code81502ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFOREST BINDERName
TitleCFO/VP FINANCETitle
Date Signed2012-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRUCE E BERNSTIENName
Phone2147060840Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSP THE REGNL MED CTRBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer Personforest binderNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12635 N 7TH STAddressLine1
CityGRAND JUNCTIONCity
StateCOState
ZIP Code81502ZIPCode
FieldValueIRS element (for citing)
Gross Receipts387711148GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.stmarygj.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionWE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees2342TotalNbrEmployees
Total Nbr Volunteers631TotalNbrVolunteers
Total Gross UBI3362491TotalGrossUBI
Net Unrelated Business Txbl Income1198409NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3677454ContributionsGrantsPriorYear
Contributions Grants Current Year3502814ContributionsGrantsCurrentYear
Program Service Revenue Prior Year359933296ProgramServiceRevenuePriorYear
Program Service Revenue CY366833371ProgramServiceRevenueCY
Investment Income Prior Year5074085InvestmentIncomePriorYear
Investment Income Current Year1805906InvestmentIncomeCurrentYear
Other Revenue Prior Year12172883OtherRevenuePriorYear
Other Revenue Current Year13038393OtherRevenueCurrentYear
Total Revenue Prior Year380857718TotalRevenuePriorYear
Total Revenue Current Year385180484TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2455315GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2177258GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year145173976SalariesEtcPriorYear
Salaries Etc Current Year141167243SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year501149TotalFundrsngExpCurrentYear
Other Expense Prior Year206914170OtherExpensePriorYear
Other Expenses Current Year212261782OtherExpensesCurrentYear
Total Expenses Prior Year354543461TotalExpensesPriorYear
Total Expenses Current Year355606283TotalExpensesCurrentYear
Revenues Less Expenses Prior Year26314257RevenuesLessExpensesPriorYear
Revenues Less Expenses CY29574201RevenuesLessExpensesCY
Total Assets BOY497743813TotalAssetsBOY
Total Assets EOY511222492TotalAssetsEOY
Total Liabilities BOY69644115TotalLiabilitiesBOY
Total Liabilities EOY63783529TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY428099698NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY447438963NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense137914512Expense
Revenue180311313Revenue
DescriptionINPATIENT HEALTHCARE - ST. MARY'S HOSPITAL & MEDICAL CENTER, INC, DBA ST. MARY'S HOSPITAL THE REGIONAL MEDICAL CENTER IS A FULL-SERVICE HOSPITAL PROVIDING QUALITY HEALTHCARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS THE LARGEST HEALTHCARE FACILITY IN A 250-MILE RADIUS, ST. MARY'S PROVIDES MANY ADVANCED HEALTHCARE SERVICES NOT OFFERED BY ANY OTHER FACILITIES IN WESTERN COLORADO AND EASTERN UTAH, INCLUDING COMPREHENSIVE CARDIAC SERVICES, OPEN HEART SURGERY, COMPREHENSIVE CANCER CARE, A NEWBORN INTENSIVE CARE, AND LEVEL II TRAUMA SERVICES. ST. MARY'S IS LICENSED FOR 346 BEDS, 313 OF WHICH WERE STAFFED BY YEAR END 2011. 2011 ACUTE ADULT AND PEDIATRIC ADMISSIONS NUMBERED 12,187; 2,190 BIRTHS; SUB-ACUTE ADMISSIONS 309. MEDICARE REPRESENTS 41.6% OF THE PAYOR MIX; MEDICAID REPRESENTS 13.1% OF THE PAYOR MIX THE HOSPITAL PERFORMED 4,858 INPATIENT SURGERIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense63194503Expense
Revenue52782781Revenue
DescriptionOUTPATIENT HEALTHCARE - MOST OF ST. MARY'S OUTPATIENT HEALTHCARE SERVICES ARE DELIVERED IN CLINIC FACILITIES CONVENIENTLY LOCATED NEAR BUT SEPARATE FROM THE MAIN HOSPITAL CAMPUS. WITH THEIR OWN ENTRANCES AND PARKING LOTS, THESE FACILITIES KEEP PATIENTS OUT OF THE TRAFFIC AND ACTIVITY FLOW OF THE HOSPITAL BUT CLOSE TO THE MAJOR CONCENTRATION OF MEDICAL SERVICES AND PHYSICIAN OFFICES IN THE COUNTY. ST. MARY'S ADVANCED MEDICINE PAVILION HOUSES OUT-PATIENT MEDICAL AND RADIOLOGY CANCER CARE, IMAGING, BLOOD DONATION, AND LABORATORY SERVICES. ST. MARY'S LIFE CENTER CONTAINS REHABILITATION, WELLNESS, AND WEIGHT LOSS/MANAGEMENT SERVICES. A THIRD FREE-STANDING FACILITY HOUSES ST. MARY'S FAMILY MEDICINE RESIDENCY PROGRAM, WHICH TRAINS PHYSICIANS TO CARE FOR FAMILIES IN SMALL TOWNS AND RURAL AREAS; ST. MARY'S FAMILY MEDICINE CENTER, A MEDICAL CLINIC SPECIALIZING IN PRE-NATAL, OBSTETRICAL, PEDIATRIC, FAMILY, AND GERIATRIC CARE; AND ST. MARY'S WOUND CLINIC. ST. MARY'S 2011 OUTPATIENT SERVICES INCLUDED: 364,899 PATIENT VISITS (INCLUDING EMERGENCY ROOM VISITS), 70,064 CLINIC VISITS, AND 2,619 OUTPATIENT SURGERIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense21000549Expense
Revenue54154048Revenue
DescriptionEMERGENCY & TRAUMA SERVICES - ST. MARY'S OPERATES THE ONLY LEVEL II TRAUMA CENTER BETWEEN DENVER, CO AND SALT LAKE CITY, UT. WITH A 24-7 EMERGENCY DEPARTMENT STAFFED WITH EXPERIENCED EMERGENCY MEDICINE-TRAINED PHYSICIANS AND NURSES, TRAUMA AND NEUROSURGEONS ALWAYS AVAILABLE, AND AIR MEDICAL TRANSPORT SERVICES, ST. MARY'S CARES FOR SERIOUSLY ILL AND INJURED PATIENTS. THE TRANSPORT HELICOPTER ALSO ASSISTS IN RESCUE OR EVACUATION EFFORTS. DURING 2011 ST. MARY'S HELICOPTER MADE 370 TRANSPORT FLIGHTS. THE FIXED-WING AIRCRAFT FLEW 312 TRANSPORTS. OF ST. MARY'S 39,564 EMERGENCY DEPARTMENT VISITS DURING 2011, 6,226 PATIENTS WERE ADMITTED AND 33,338 WERE TREATED AS OUTPATIENTS.Description

Activity Other ActivityOther (12 entries)

ExpenseExpenseRevenueRevenueDescriptionDescriptionGrantsGrants
1594658447741562OUTPATIENT RADIOLOGY
1826763131048618REHABILITATION
1603494384532WELLNESS CENTER
6112214RESIDENCY PROGRAM
852432collaborative clinic
79233145735RESEARCH
2103319226339COMMUNITY BENEFIT PROGRAMS
137818580299BLOOD BANK
121721tumor registry
58144EDUCATION
2177258OTHER CHARITABLE CONTRIBUTIONS2177258
1279040JOINT VENTURE OUTPATIENT INCOME
FieldValueIRS element (for citing)
Total Of Other Program Service Exp49355169TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt2177258TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev80864269TotalOfOtherProgramServiceRev
Total Program Service Expense271464733TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096330NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2342NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFOREST BINDERNamePerson
Telephone Number9702442273TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12635 N 7TH STAddressLine1
CityGrand JunctionCity
StateCOState
ZIP Code81502ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeFormerFormer
Roy Cromer
Chair1.0XX000
Gregg Kampf
Vice Chair1.0XX000
Rob Bickley
Treasurer1.0XX000
Kristine Ruess
Secretary1.0XX000
Michael McBride
CEO/President54.0XX042183763997
Sister Catrina Ann Bones
Director1.0X000
Bruce Hill
Director1.0X000
Mark Luker
Director1.0X000
SISTER JEAN ANNE PANISKO
Director1.0X000
David James
Director1.0X000
Daniel M Roberts
Director1.0X000
Monique Serra
Director1.0X000
Sister Phyllis Stowell
Director1.0X000
LAUREL BARTHOLOMAY
Director1.0X000
Douglas Aden
Director1.0X000
Cherie Gorby
COO55.0X0560263308477
Forest Binder
CFO/VP Finance54.0X030142530246
John Beeson
Medical Director45.0040453634654X
Susan Hemley
Physician45.0741250019600X
John Lopez
Physician45.0734311019600X
Brian Witwer
Physician45.0725057019450X
James Narrod
Physician45.0708109019600X
Sara Pereira
Physician45.0708037019600X
JERRY SPICER
VP NURSING0.0019814115776X
ROBERT LADENBURGER
CEO PRESIDENT0.00108676184694X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3616764TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2972963TotalReportableCompFrmRltdOrgs
Total Other Compensation635694TotalOtherCompensation
Number Individuals GT100 K114NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Anesthesia Consultants of Western C
1120 Wellington Suite 206GRAND JUNCTIONCO81501anesthesia svcs4891334
Petroleum Helicopters Inc
2001 SE Evangeline ThruwayLAFAYETTELA70508Helicopter Service3182851
Aramark Corporation
4420 East 142 StGRAND VIEWMO64030Food Service Mgt2580754
fci mccarthy
2339 north 7th stGRAND JUNCTIONCO81502construction1645203
general surgeons of western co
1001 Wellington aveGRAND JUNCTIONCO81501physician svcs1519926
FieldValueIRS element (for citing)
Number Of Contractors GT100 K61NumberOfContractorsGT100K
Related Organizations1608800RelatedOrganizations
Government Grants1893791GovernmentGrants
All Other Contributions223AllOtherContributions
Total Contributions3502814TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INPATIENT REVENUE900099180311313180311313
OUTPATIENT REVENUE6214005278278152782781
OUTPATIENT RADIOLOGY6219904774156247741562
EMERGENCY SERVICES9000995415404854154048
REHABILITATION6214003104861831048618

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column795049TotalRevenueColumn
Related Or Exempt Function Income795049RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue366833371TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3078624TotalRevenueColumn
Related Or Exempt Function Income1279040RelatedOrExemptFunctionIncome
Exclusion$1,799,584ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1793819Real
Personal462984Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1063010Real
Personal31253Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real730809Real
Personal431731Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1162540TotalRevenueColumn
Unrelated Business Revenue442631UnrelatedBusinessRevenue
Exclusion$719,909ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1259458Securities
Other13260Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1259458Securities
Other-13260Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1272718TotalRevenueColumn
Exclusion-$1,272,718ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory242297GrossSalesOfInventory
Cost Of Goods Sold163683CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column78614TotalRevenueColumn
Unrelated Business Revenue291UnrelatedBusinessRevenue
Exclusion$78,323ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
REFERENCE LAB54138022045142204514
CAFETERIA SALES7222101454417$1,454,417
MANAGEMENT SERVICES541610633778514986$118,792

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column7504530TotalRevenueColumn
Unrelated Business Revenue200069UnrelatedBusinessRevenue
Exclusion$7,304,461ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue11797239TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column385180484TotalRevenueColumn
Related Or Exempt Function Income368112411RelatedOrExemptFunctionIncome
Unrelated Business Revenue3362491UnrelatedBusinessRevenue
Exclusion$10,202,768ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2122626Total
Program Services2122626ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total54632Total
Program Services54632ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1759965Total
Program Services563189ProgramServices
Management And General1196776ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total111376904Total
Program Services102024731ProgramServices
Management And General8958048ManagementAndGeneral
Fundraising394125Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6756345Total
Program Services5442598ProgramServices
Management And General1313747ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11916378Total
Program Services10558542ProgramServices
Management And General1275662ManagementAndGeneral
Fundraising82174Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9357651Total
Program Services8328726ProgramServices
Management And General1004075ManagementAndGeneral
Fundraising24850Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total5034651Total
Program Services4873680ProgramServices
Management And General160971ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total91053Total
Management And General91053ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total29800Total
Management And General29800ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total74580Total
Management And General74580ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total229163Total
Management And General229163ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total46350434Total
Program Services38695312ProgramServices
Management And General7655122ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total353108Total
Program Services9848ProgramServices
Management And General343260ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9292026Total
Program Services7186150ProgramServices
Management And General2105876ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total36980Total
Program Services36914ProgramServices
Management And General66ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3330738Total
Program Services2587171ProgramServices
Management And General743567ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total818910Total
Program Services786158ProgramServices
Management And General32752ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total345566Total
Program Services333133ProgramServices
Management And General12433ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1759533Total
Management And General1759533ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total31404326Total
Program Services27814383ProgramServices
Management And General3589943ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2916246Total
Management And General2916246ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES5938314159383141
BAD DEBTS2905971029059710
PROVIDER TAXES2022054520220545
MISCELLANEOUS1166673663799502874

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total364599Total
Management And General364599ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total355606283Total
Program Services271464733ProgramServices
Management And General83640401ManagementAndGeneral
Fundraising501149Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY869173BOY
EOY428235EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7231856BOY
EOY3670318EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY51108592BOY
EOY52155700EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7539706BOY
EOY6608501EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3756890BOY
EOY3886943EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis593946280LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec261886494LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY356007069BOY
EOY332059786EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY66524498BOY
EOY109947481EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2635159BOY
EOY2500646EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2070870BOY
EOY-35118EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY497743813BOY
EOY511222492EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY23824505BOY
EOY25851305EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY45819610BOY
EOY37932224EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY69644115BOY
EOY63783529EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY428099698BOY
EOY447438963EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY428099698BOY
EOY447438963EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY497743813BOY
EOY511222492EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses29574201ReconcilationRevenueExpenses
Reconcilation Other Changes-10234936ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$58,863GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$15,717OtherActivitiesAmount
Total Lobbying Expenditures IIB74580TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RURAL REFERRAL CENTERform 990, sch c, PART II-B, LINE 1F:$58,863 PAYMENT TO capstone lobbying group for promotion of health related legislation in colorado.
LOBBYING PORTION OF MEMBERSHIP DUES REPORTED BY ASSOCIATIONSform 990, SCH C, PART II-B, line 1i:LOBBYING PORTION OF DUES REPORTED ON ASSOCIATION MEMBERSHIP INVOICES, $15,717. ST. MARY'S HOSPITAL HAS NO CONTROL OVER HOW THE FUNDS ARE SPENT OR DIRECTED.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6462683BeginningOfYearBalance
Contributions168214Contributions
Investment Earnings Or Losses50698InvestmentEarningsOrLosses
Other Expenditures261967OtherExpenditures
End Of Year Balance6419628EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5949382BeginningOfYearBalance
Contributions25481Contributions
Investment Earnings Or Losses771583InvestmentEarningsOrLosses
Other Expenditures283763OtherExpenditures
End Of Year Balance6462683EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4225092BeginningOfYearBalance
Contributions2619Contributions
Investment Earnings Or Losses1722549InvestmentEarningsOrLosses
Other Expenditures878OtherExpenditures
End Of Year Balance5949382EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6828227BeginningOfYearBalance
Contributions24377Contributions
Investment Earnings Or Losses-2535754InvestmentEarningsOrLosses
Other Expenditures91758OtherExpenditures
End Of Year Balance4225092EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.98000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.02000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis9904921OtherCostOrOtherBasis
Book Value9904921BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3971891003OtherCostOrOtherBasis
Depreciation142226952Depreciation
Book Value276504791BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis312960OtherCostOrOtherBasis
Depreciation305544Depreciation
Book Value9918BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis164642925OtherCostOrOtherBasis
Depreciation137463416Depreciation
Book Value35715582BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis21896471OtherCostOrOtherBasis
Depreciation13137762Depreciation
Book Value9924575BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings332059787TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (11 entries)

DescriptionDescriptionAmountAmount
ACCRUED PROPERTY TAXES$248,662
ACCRUED SALES TAXES$12,435
ACCRUED CONSTRUCTION CONTRACTS$317,507
OTHER DEFERRALS-$210,663
SR PROGRAMS - MEALS$27,908
REIMB SETTLEMENT DUE - MCARE$2,424,356
MINORITY INTEREST$0
STATE INCOME TAX$27,404
FEDERAL INCOME TAX-$39,396
CAPITAL STRUCTURE$35,065,288
ACCRUED EXPENSES & LIABILITIES$58,723
FieldValueIRS element (for citing)
Total Of Amounts37932224TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierEndowment FundsIdentifier
Return Referenceform 990, Sch D, Part V, Line 4:ReturnReference
ExplanationBOARD ENDOWMENT - QUASI ENDOWMENT USED FOR AREAS OF GREATEST NEED. BRUCE E. DIXSON PULMONARY REHABILITATION ENDOWMENT - ASSIST LOW INCOME PULMONARY PATIENTS CUMMINGS FAMILY ENDOWMENT - QUASI ENDOWMENT TO ASSIST LOW INCOME CANCER PATIENTS WORLEY FAMILY INFECTION CONTROL ENDOWMENT - INFECTION CONTROL education dr. lynn james pulmonary endowment fund - assist low income pulmonary patients ENDOWMENT FUNDS ARE HELD BY THE ST. MARY'S HOSPITAL FOUNDATION.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage46.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense23812366TotalCommunityBenefitExpense
Direct Offsetting Revenue6715551DirectOffsettingRevenue
Net Community Benefit Expense17096815NetCommunityBenefitExpense
Percent Of Total Expense0.05240PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense56106646TotalCommunityBenefitExpense
Direct Offsetting Revenue48560939DirectOffsettingRevenue
Net Community Benefit Expense7545707NetCommunityBenefitExpense
Percent Of Total Expense0.02310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense79919012TotalCommunityBenefitExpense
Direct Offsetting Revenue55276490DirectOffsettingRevenue
Net Community Benefit Expense24642522NetCommunityBenefitExpense
Percent Of Total Expense0.07550PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense7452036TotalCommunityBenefitExpense
Direct Offsetting Revenue161249DirectOffsettingRevenue
Net Community Benefit Expense7290787NetCommunityBenefitExpense
Percent Of Total Expense0.02230PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense681735TotalCommunityBenefitExpense
Net Community Benefit Expense681735NetCommunityBenefitExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense792331TotalCommunityBenefitExpense
Net Community Benefit Expense792331NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense2161165TotalCommunityBenefitExpense
Net Community Benefit Expense2161165NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense11087267TotalCommunityBenefitExpense
Direct Offsetting Revenue161249DirectOffsettingRevenue
Net Community Benefit Expense10926018NetCommunityBenefitExpense
Percent Of Total Expense0.03340PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense91006279TotalCommunityBenefitExpense
Direct Offsetting Revenue55437739DirectOffsettingRevenue
Net Community Benefit Expense35568540NetCommunityBenefitExpense
Percent Of Total Expense0.10890PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1602TotalCommunityBuildingExpense
Net Community Building Expense1602NetCommunityBuildingExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense1932061TotalCommunityBuildingExpense
Direct Offsetting Revenue226338DirectOffsettingRevenue
Net Community Building Expense1705723NetCommunityBuildingExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense4983TotalCommunityBuildingExpense
Net Community Building Expense4983NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense2812TotalCommunityBuildingExpense
Net Community Building Expense2812NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense250TotalCommunityBuildingExpense
Net Community Building Expense250NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1941708TotalCommunityBuildingExpense
Direct Offsetting Revenue226338DirectOffsettingRevenue
Net Community Building Expense1715370NetCommunityBuildingExpense
Percent Of Total Expense0.00520PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$12,542,171BadDebtExpenseAmount
Amount Attributable To877952AmountAttributableTo
Amount Reimbursed By Medicare87806001AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare101944765CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-14138764MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
PAVILION IMAGING
OUTPATIENT RADIOLOGY0.750000.25000
GRAND VALLEY SURG
OUTPATIENT SURGERY0.500000.50000
SAN JUAN CANCER CNT
OUPATIENT CANCER TREATMENT0.333300.33330
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSPITAL & MEDICAL Ctr INcBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12635 N 7TH STAddressLine1
CityGRAND JUNCTIONCity
StateCOState
ZIP Code81502ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSPITAL & MEDICAL Ctr INcBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent46.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Grand Valley Surgical Center LLC
710 WellingtonGrand JunctionCO81501outpatient surgery
San Juan Cancer Center LLC
600 SOUTH 5TH STREETMONTROSECO81401outpatient cancer treatment

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FEDERAL POVERTY GUIDELINESform 990, SCHE H, PART I, LINE 3C:N/A
COST TO CHARGE RATIOSCH H PART I, LINE 7:COST TO CHARGE RATIO. DERIVED FROM WORKSHEET 2 BAD DEBT EXPENSE SUBTRACTED BEFORE CALCULATING PERCENTAGES IN COLUMN (F) WAS $29,059,710.
BAD DEBT FOOTNOTEPART ii, LINE 4:COST-TO-CHARGE RATIO. DERIVED FROM WORKSHEET 2. THE HOSPITAL DOES NOT TAKE INTO ACCOUNT DISCOUNTS ON PATIENT ACCOUNTS WHEN DETERMINING BAD DEBT. PATIENT PAYMENTS ON ACCOUNTS WRITTEN OFF TO BAD DEBT DECREASE BAD DEBT EXPENSE.
MEDICAREform 990, sch h, PART III, section b, LINE 8:ST. MARY'S HOSPITAL DOES NOT CONSIDER THE UNREIMBURSED PORTION OF MEDICARE TO BE COMMUNITY BENEFIT. AS THE HOSPITAL IS ATTEMPTING TO MAKE MEDICARE COST EFFECTIVE, THE MEDICARE DEFICIENCIES ARE VIEWED AS MOSTLY INEFFICIENCIES IN OPERATIONS, NOT COMMUNITY BENEFIT. MEDICARE PART III, LINE 8, MEDICARE ALLOWABLE COSTS ARE DETERMINED BASED ON APPLICABLE MEDICARE RULES AND REGULATIONS. NONALLOWABLE EXPENSES ARE REMOVED VIA AN ADJUSTMENT, AS SHOWN ON WORKSHEET A-8 OF THE MEDICARE COST REPORT.
COLLECTIONSPART III, LINE 9B:AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. ST. MARY'S HOSPITAL & MEDICAL CENTER NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.
NEEDS ASSESSMENTPART VI, QUESTION 2:AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. ST. MARY'S HOSPITAL & MEDICAL CENTER HAS REGULARLY PARTICIPATED IN NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THIS ASSESSMENT STUDIES A DEFINED COMMUNITY SERVED BY ST. MARY'S HOSPITAL & MEDICAL CENTER, AND IS DONE BY PARTNERING WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS AND ASSESSMENTS WITH THE ASSISTANCE OF OUTSIDE CONSULTANTS. WE ALSO CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. SURVEYS WERE ALSO CONDUCTED IN 1998 AND 2005. THE MOST RECENT SURVEY WAS CONDUCTED IN 2009 ANOTHER WILL BE CONDUCTED IN 2012. AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, ST. MARY'S TAKES STEPS TO DETERMINE WHERE THERE IS THE MOST NEED TO PROVIDE THE GREATEST GOOD. ST. MARY'S HOSPITAL & MEDICAL CENTER, IN CONJUNCTION WITH THESE OTHER ORGANIZATIONS, MARILLAC CLINIC, MESA COUNTY HEALTH DEPARTMENT, UNITED WAY OFF MESA COUNTY, ROCKY MOUNTAIN HEALTH PLANS, COLORADO WEST REGIONAL MENTAL HEALTH, MESA COUNTY SCHOOL DISTRICT 51, WESTERN COLORADO AREA HEALTH EDUCATION CENTER, WESTERN HEALTHCARE ALLIANCE, COUNSELING AND EDUCATION CENTER, MESA COUNTY METH TASK FORCE, COMPLETED THE 2009 SURVEY. THIS 2009 COMMUNITY HEALTH & QUALITY OF LIFE SURVEY, A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED LOCALLY SINCE 1994, IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS, PERCEPTIONS AND NEEDS OF RESIDENTS IN MESA COUNTY. SUBSEQUENTLY, THIS INFORMATION MAY BE USED TO FORMULATE STRATEGIES TO IMPROVE COMMUNITY HEALTH AND WELLNESS. A PRC COMMUNITY HEALTH & QUALITY OF LIFE SURVEY PROVIDES THE INFORMATION SO THAT COMMUNITIES MAY IDENTIFY ISSUES OF GREATEST CONCERN AND DECIDE TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. THIS COMMUNITY HEALTH & QUALITY OF LIFE SURVEY WILL SERVE AS A TOOL TOWARD REACHING THREE BASIC GOALS: 1. TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS NOT ONLY ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS, BUT ALSO ONE WHERE ITS RESIDENTS ENJOY A HIGH QUALITY OF LIFE. 2. TO REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT WILL BE POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH. 3. TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES WILL PROVE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS, AND ELEVATING THE QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM LACK OF PREVENTIVE CARE. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. IT IS VERY SIMILAR TO SURVEYS ADMINISTERED BY PRC IN MESA COUNTY IN 1994, 1997, 2001 AND 2005. THE STUDY AREA FOR THIS EFFORT IS DEFINED AS MESA COUNTY, COLORADO, SEGMENTED INTO THE TWO SUB-AREAS OF GRAND JUNCTION AND THE REMAINDER OF THE COUNTY. A PRECISE AND CAREFULLY EXECUTED METHODOLOGY IS CRITICAL IN ASSERTING THE VALIDITY OF THE RESULTS GATHERED IN THE 2009 PRC COMMUNITYHEALTH SURVEY. THUS, TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY WAS EMPLOYED. THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A RANDOM SAMPLE OF 1,000 INDIVIDUALS AGED 18 AND OLDER IN THE DEFINED COMMUNITIES. ONCE THE DATA WAS COLLECTED, THE SAMPLE WAS WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION AT THE ZIP CODE LEVEL SO THAT OUR ESTIMATES REFLECT THE AREA AS A WHOLE. POPULATION ESTIMATES WERE BASED ON CENSUS PROJECTIONS OF ADULTS AGED 18 AND OVER PROVIDED IN THE LATEST ESRI BIS DEMOGRAPHIC PORTFOLIO. A FULL TEXT OF THE NEEDS ASSESSMENT IS AVAILABLE AT HTTP://HEALTH .MESACOUNTY.US/ WE ALSO CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. ST. MARY'S UTILIZES THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY TO HELP PRIORITIZE THE ALLOCATION OF RESOURCES. THE ST. MARY'S BOARD, LEADERSHIP AND SERVICE MANAGERS WILL DEVELOP PROGRAMS, ALTER CURRENT OPERATIONS OR SPONSOR LOCAL EFFORTS TO RESPOND TO THE NEEDS IDENTIFIED IN THE SURVEY. IN ADDITION TO ST. MARY'S USE OF THE DATA, LOCAL AGENCIES AND ORGANIZATION WILL USE THE PUBLICLY AVAILABLE SURVEY RESULTS TO APPLY FOR GRANTS AND DEVELOP OR ADJUST CURRENT SERVICE TO BETTER MEET THE NEEDS OF THEIR CLIENTS.
COLLECTION PRACTICESPART VI, QUESTION 3:ST. MARY'S HOSPITAL & MEDICAL CENTER TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST. MARY'S HOSPITAL & MEDICAL CENTER HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WHEN POSSIBLE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE, WHEN POSSIBLE, MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY.
COMMUNITY INFORMATIONPART VI, QUESTION 4:ST. MARY'S IS THE LEADING PROVIDER OF COMMUNITY BENEFIT FOR RESIDENTS OF WESTERN COLORADO AND EASTERN UTAH. THE HOSPITAL IS LOCATED IN GRAND JUNCTION, CO THE LARGEST CITY BETWEEN SALT LAKE CITY, UTAH AND DENVER, COLORADO; THEREFORE, IT SERVES AS A REGIONAL HUB FOR SERVICES AND MEDICAL TECHNOLOGIES. MESA COUNTY LIES ON THE WESTERN BORDER OF COLORADO AND COVERS 3,309 SQUARE MILES. ACCORDING TO THE COLORADO STATE DEMOGRAPHY OFFICE THE ESTIMATED 2009 POPULATION OF MESA COUNTY WAS 144,452. MESA COUNTY HAS EXPERIENCED VERY HEALTHY POPULATION GROWTH RATES AND IS EXPECTING THIS TREND TO CONTINUE. HISTORICALLY, THE AREA HAS GROWN AT 2%, ANNUALLY, AND WAS RECENTLY PROJECTED TO CONTINUE TO GROW AT 2.3%, ANNUALLY, THROUGH 2013. THESE PROJECTIONS WERE PROVIDED PRIOR TO SOME OF THE ECONOMIC DOWNTURN. HOW THE RECESSIONARY INFLUENCES WILL AFFECT POPULATION GROWTH AND MOVEMENT WILL BE AN INDICATOR WE WILL INVESTIGATE EACH YEAR AS THE PROJECTIONS ARE MADE AVAILABLE. THE 'BABY-BOOMER' COHORT IS PROJECTED TO BE ONE OF THE FASTEST GROWING POPULATION SEGMENTS AND HISTORICALLY HAS BEEN PROVIDED THE MONIKER FOR BEING THE MOST SIGNIFICANT MARKET FORCE DRIVING DEMAND GROWTH AND CHANGES IN HOW CONSUMERS ENGAGE THE HEALTH CARE DELIVERY SYSTEM. ST. MARY'S WILL CONTINUE STRIVING TO PROVIDE HIGH QUALITY CARE OFFERING A FAVORABLE CONSUMER VALUE PROPOSITION TO MATCH THE COMMUNITY'S RISING EXPECTATIONS. IN CORRELATION WITH ST. MARY'S TREMENDOUS GROWTH IN BIRTHS, TODAY'S GENERATION Z (0-14) NOW REPRESENTS A SUBSTANTIALLY LARGE AND FAST GROWING AGE COHORT. POPULATION BY AGE 2008 2013 % GROWTH CAGR PRIMARY SERVICE AREA 0 TO 14 28,514 33,699 18.2% 3.4% 15 TO 44 59,595 66,061 10.8% 2.1% 45 TO 44 36,769 39,084 6.3% 1.2% 65 TO 74 10,559 12,318 16.7% 3.1% 75 TO 90+ 10,234 11,952 16.8% 3.2% TOTAL 145,671 163,114 12.0% 2.3% SECONDARY SERVICE AREA 0 TO 14 29,353 37,210 26.8% 4.9% 15 TO 44 54,501 69,192 27.0% 4.9% 45 TO 44 37,191 41,997 12.9% 2.5% 65 TO 74 9,398 12,404 32.0% 5.7% 75 TO 90+ 8,685 10,297 18.6% 3.5% TOTAL 139,128 171,100 23.0% 4.2% TERTIARY SERVICE AREA 0 TO 14 44,328 53,038 19.6% 3.7% 15 TO 44 101,855 14,891 12.8% 2.4% 45 TO 44 68,287 75,678 10.8% 2.1% 65 TO 74 12,626 18,778 48.7% 8.3% 75 TO 90+ 8,710 11,289 29.6% 5.3% TOTAL 235,806 273,674 16.1% 3.0% GRAND TOTAL 520,605 607,888 16.8% 3.1% 2007 HH INCOME PRIMARY SERVICE COLORADO STATE USA SEGMENT AREA <$15K 13.5% 9.6% 13.1% $15-25K 13.2% 9.0% 10.9% $25-50K 32.3% 26.1% 26.8% $50-75K 20.0% 20.8% 19.5% $75-100K 9.6% 13.4% 11.9% OVER $1OOK 11.3% 21.1% 17.9% 2007 RACE/ETHNICITY PRIMARY COLORADO USA SERVICE AREA STATE WHITE NON-HISPANIC 85.7% 71.1% 65.9% BLACK NON-HISPANIC 0.6% 3.7% 12.1% HISPANIC 11.2% 20.0% 14.9% ASIAN & PACIFIC NON-HISPANIC 0.6% 2.6% 4.4% ALL OTHERS 2.0% 2.7% 2.8% FOR ADDITIONAL COMMUNITY STATISTICAL INFORMATION INCLUDING UNINSURANCE RATES (18%), SPECIAL HEALTH RELATED ISSUES, COMMUNITY RISK FACTORS AND OTHER HEALTH RELATED INDICATORS PLEASE REFER TO THE MOST RECENT COMMUNITY HEALTH ASSESSMENT SURVEY AT HTTP://HEALTH .MESACOUNTY.US/ PROMOTION OF COMMUNITY HEALTH.
PROMOTION OF COMMUNITY HEALTHPART VI, QUESTION 5:WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. OUR COMMUNITY BUILDING ACTIVITIES TOTALED $1,715,370 IN 2011 AND INCLUDED EFFORTS IN SIX DIFFERENT CATEGORIES REPORTED IN THE 990: ECONOMIC DEVELOPMENT; COMMUNITY SUPPORT; ENVIRONMENTAL IMPROVEMENTS; COALITION BUILDING; COMMUNITY HEALTH IMPROVEMENT ADVOCACY; AND WORKFORCE DEVELOPMENT. ST. MARY'S LARGEST AREA OF COMMUNITY BUILDING WAS IN THE AREA OF COMMUNITY SUPPORT FOR A TOTAL OF $1,705,723 OR 99.44%. DURING THIS YEAR OUR COMMUNITY SUPPORT ACTIVITIES INCLUDED ST. MARY'S SENIOR PROGRAMS - SENIOR COMPANION, FOSTER GRANDPARENT AND GRAY GOURMET FEDERALLY SUPPORTED PROGRAMS SPONSORED BY ST. MARY'S. ORIGINALLY SPONSORED BY MESA COUNTY, ST. MARY'S ASSUMED SPONSORSHIP AND SUPPORT OF THESE PROGRAMS DURING THE ECONOMIC DOWNTURN OF THE 1980'S WHEN THE COUNTY SUFFERED SEVERE BUDGET CONSTRAINTS FROM THE LOSS OF ENERGY-RELATED REVENUES. ST. MARY'S HAS CONTINUED TO SPONSOR AND SUPPORT THESE PROGRAMS BECAUSE OF THE UNIQUE SERVICES THEY PROVIDE TO THE SENIORS IN NEED IN MESA COUNTY. LIKE SENIOR COMPANION PROGRAMS ACROSS THE COUNTRY, ST. MARY'S SENIOR COMPANION PROGRAM HELPS OLDER ADULTS REMAIN HEALTHY, INDEPENDENT, AND IN THEIR OWN HOMES. THE NEED FOR THIS PROGRAM GROWS OUT OF THE PROBLEMS FACED BY SENIORS WHEN THEY OR THEIR PARTNER DEVELOPS MOBILITY ISSUES AND NEED HELP WITH EVERYDAY TASKS. VOLUNTEER COMPANIONS HELP SENIORS WITH DAILY ACTIVITIES, SUCH AS GROCERY SHOPPING, BILL PAYING, AND SIMPLE HOUSEHOLD TASKS. WITHOUT HELP OF SENIOR COMPANIONS, MANY OLDER ADULTS WOULD BE FORCED TO LEAVE THEIR HOMES FOR ASSISTED LIVING FACILITIES OR NURSING HOMES. MANY WOULD NEED TO RELY ON PUBLIC SUPPORT SUCH AS MEDICAID TO PAY FOR THESE SERVICES. BY PROVIDING LOW-COST, PERSONAL INTERACTION WITH AT-RISK SENIORS, THE PROGRAM HELPS ENSURE SENIORS ARE TAKING THEIR MEDICATION AND DOCTORS OR FAMILY ARE ALERTED TO ANY POTENTIAL HEALTH PROBLEMS. THE PROGRAM BENEFITS MORE THAN ST. MARY'S BECAUSE THE GOAL OF THE PROGRAM IS TO KEEP SENIORS LIVING INDEPENDENTLY OUTSIDE OF ASSISTED LIVING AND TO REDUCE THE RISK OF ILLNESS OR ACCIDENT THAT WOULD REQUIRE A HOSPITAL STAY. IN ADDITION TO MAJOR SUPPORT PROVIDED BY ST. MARY'S, THE COMMUNITY PROVIDES ADDITIONAL FINANCIAL SUPPORT THROUGH CONTRIBUTIONS TO ENHANCE THE SERVICES PROVIDED. FOSTER GRANDPARENT PROGRAM ST. MARY'S FOSTER GRANDPARENT PROGRAM PROVIDES TWO TYPES OF SUPPORT IN THE COMMUNITY: 1) ASSISTANCE FOR AT-RISK YOUTH, AND 2) SOURCE OF INCOME FOR LOW-INCOME SENIORS. QUALIFIED SENIOR VOLUNTEERS RECEIVE A TAX-FREE HOURLY STIPEND. PROVIDING INVALUABLE COMPANIONSHIP AND EDUCATIONAL SUPPORT FOR AT-RISK CHILDREN, THE PROGRAM WORKS IN COLLABORATION WITH A BROAD RANGE OF COMMUNITY AGENCIES INCLUDING: MESA COUNTY SCHOOL DISTRICT; DELTA COUNTY SCHOOL DISTRICT; MONTROSE COUNTY SCHOOL DISTRICT; ROCKY MOUNTAIN HEAD START, GRAND JUNCTION REGIONAL CENTER, MIGRANT HEAD START, HILLTOP'S SAFE HOUSE, KIDS OF THE KINGDOM, CHILD QUEST, KIDDIN' AROUND, LIL'MAVERICKS,GRAND MESA YOUTH SERVICES, AND COLLBRAN JOB CORPS. WITHOUT THE PROGRAM, MORE YOUTH WOULD LIKELY DROP OUT OF SCHOOL AND REQUIRE PUBLICLY SUPPORTED INTERVENTION, AND SENIORS WOULD RELY MORE HEAVILY ON PUBLICLY AND PRIVATELY SUPPORTED FINANCIAL ASSISTANCE PROGRAMS. THE PRIMARY BENEFICIARIES OF THIS PROGRAM ARE THE PARTICIPATING SENIORS AND STUDENTS AND COMMUNITY AND GOVERNMENT-SUPPORT PROGRAMS, AS THE BENEFITS ACHIEVED ARE OUTSIDE THE REALM OF ST. MARY'S HOSPITAL'S SERVICES. IN ADDITION TO MAJOR SUPPORT PROVIDED BY ST. MARY'S, THE COMMUNITY PROVIDES ADDITIONAL FINANCIAL SUPPORT THROUGH CONTRIBUTIONS TO ENHANCE THE SERVICES PROVIDED. ST. MARY'S GRAY GOURMET PROGRAM GOOD NUTRITION IS HEALTHY FOOD, GOOD COMPANY, AND AN ENJOYABLE DINING EXPERIENCE. GRAY GOURMET, A NUTRITIONAL MEAL PROGRAM FOR SENIORS SPONSORED BY ST. MARY'S HOSPITAL, DELIVERS ALL THREE. WITH DINING SITES, HOME-DELIVERED MEALS, AND OTHER NUTRITION-RELATED SERVICES, GRAY GOURMET IS DEDICATED TO THE GOOD HEALTH OF MESA COUNTY SENIORS. SENIORS CURRENTLY GET HOT, NUTRITIOUS MEALS IN FRIENDLY COMPANY AT EIGHT MEAL SITES; 108,051 MEALS WERE SERVED IN 2011. HOMEBOUND SENIORS 60 YEARS OF AGE AND OLDER CAN ARRANGE FOR HOME-DELIVERY SERVICE. WEEKEND, AND FROZEN MEALS ARE AVAILABLE DEPENDING ON THE SENIOR'S LOCATION. A GRAY GOURMET REGISTERED DIETITIAN ASSURES MEALS MEET RECOMMENDED DIETARY STANDARDS. THE DIETITIAN MAKES SURE MEALS MEET ANY DOCTOR-PRESCRIBED DIET RESTRICTIONS. AS A GRAY GOURMET PARTICIPANT, SENIORS WITH A DOCTOR'S PRESCRIPTION MAY ALSO BE ELIGIBLE TO RECEIVE MEDICAL NUTRITIONALS. ALL DIETARY COUNSELING IS FREE. WITHOUT THE NUTRITIONAL SUPPORT PROVIDED BY GRAY GOURMET, MORE SENIORS WOULD BE PLACED IN ASSISTED LIVING FACILITIES, RELYING ON PUBLIC SUPPORT SUCH AS MEDICAID TO PAY FOR THESE SERVICES. THIS PROGRAM HELPS SENIORS TO CONTINUE TO LIVE INDEPENDENTLY AND REDUCES THE RISK OF A HOSPITAL STAY BECAUSE OF POOR NUTRITION. ROSE HILL HOSPITALITY HOUSE ST. MARY'S ROSE HILL HOSPITALITY HOUSE PROVIDES SAFE, TEMPORARY HOUSING CLOSE TO THE HOSPITAL CAMPUS FOR THOSE WHO HAVE TRAVELED TO ST. MARY'S HOSPITAL & REGIONAL MEDICAL CENTER FROM OUTSIDE MESA COUNTY WHILE A LOVED ONE IS HOSPITALIZED AND PATIENTS WHO COME FOR LONG-TERM OUTPATIENT TREATMENT. THE ACCOMMODATIONS INCLUDE COMFORTABLE GUESTROOMS, FAMILY BEDROOMS, AND HANDICAPPED ACCESSIBLE ROOMS. ALL ROOMS HAVE PRIVATE BATHROOMS, QUEEN SIZE BEDS, TELEPHONE, AND TELEVISION. THE USE OF ROSE HILL HOSPITAL HOUSE ROOMS IS DETERMINED BY ESTABLISHING CRITERIA. THERE IS NO CHARGE, BUT DONATIONS ARE ACCEPTED. THE PROGRAM ALSO RECEIVES ADDITIONAL COMMUNITY SUPPORT TO ENHANCE THE SERVICES. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN ST. MARY'S HOSPITAL & MEDICAL CENTER HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS UNITED WAY CAMPAIGNS AND FOOD AND CLOTHING DRIVES. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. ST. MARY'S HOSPITAL OR ITS REPRESENTATIVES ARE MEMBERS OF THE CHAMBERS OF COMMERCE, ROTARY CLUB, AND CLUB 20. WE PROVIDE FINANCIAL SUPPORT FOR THE AMERICAN RED CROSS, MARCH OF DIMES, ALTRUSA, AMERICAN CANCER SOCIETY, GRAND JUNCTION ECONOMIC PARTNERSHIP AND THE DOWNTOWN DEVELOPMENT AUTHORITY, CATHOLIC OUTREACH, GRAND JUNCITON COMMUNITY HOMELESS SHELTER, HOSPICE AND PALLIATIVE CARE OF WESTERN COLORADO, HILLTOP COMMUNITY RESOURCES, MESA STATE COLLEGE, AND COLORADO REGIONAL WEST MENTAL HEALTH. WE PROVIDE FOCUSED SUPPORT FOR MARILLAC CLINIC, THE COMMUNITY'S HEALTH CLINIC FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER FACILITY FOR THEIR HEALTH NEEDS. MARILLAC CLINIC PROVIDES QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CLINIC IS COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, MEDICATION, OPTICAL, AND DENTAL ASSISTANCE. IN ADDITION TO FINANCIAL SUPPORT, ST. MARY'S HOSPITAlL ASSISTS THE CLINIC IN MANY OTHER WAYS INCLUDING STRATEGY AND OPERATIONS GUIDANCE, DONATING SUPPLIES, AND PROVIDING IT AND FINANCIAL SYSTEMS MANAGEMENT.
AFFILIATED HEALTH CARE SYSTEMPART VI, QUESTION 6:COMMUNITY BENEFITS PROVIDED IN 2011 THROUGHOUT SCLHS TOTALED $204.8 MILLION. AS PART OF SCLHS, WE PROMOTE THE SHARED MISSION THAT "WE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE."
STATE FILING OF COMMUNITY BENEFIT REPORTPART VI, QUESTION 7:Montana California and Kansas State filing is not required in Colorado
individuals eligibilityform 990, sch h, part v, line 19d:The Hospital uses a sliding scale for patients that are under 400% of the FPG. The greatest percentage charged to a qualifying patient is less than the lowest negotiated rate.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistanceAddress Line2AddressUS/AddressLine2
Colorado West Mental Health
858 Grand AveGrand JunctionCO81501840625890501(c)(3)450000OPERATIONAL SUPPORT
Marillac Clinic
2333 N 6th StGrand JunctionCO81501841085822501(C)(3)SUPPORT FOR OPERATIONS583382CostSupplies, services
Colorado Mesa University
1100 North AveGrand JunctionCO81051846037667501(C)(3)80500NURSING SCHOLARSHIPS
Hilltop Community Resources
1331 HermosaGrand JunctionCO81501742321009501(C)(3)55000prenatal education
Marillac Clinc
2333 N 6th StGrand JunctionCO81501131846366501(C)(3)400000OPERATIONAL SUPPORT
Hospice & Palliative Care of Western CO
3090b n 12th stGrand JunctionCO81506841207388501(C)(3)5150OPERATIONAL SUPPORT
American Cancer Society
2754 Compass DrGrand JunctionCO81506841316555501(c)(3)10000cancer prevention
Quality Health Network
2764 Compass DriveGrand JunctionCO81506201632384501(C)(3)400000HEALTH RECORD NETWORKINGSuite 203
Colorado Physicians Health
899 Logan StDenverCO80210742425019501(c)(3)10000PHYSICIAN HEALTHCARE
March of Dimes
634 Main StGrand JunctionCO81501131846366501(c)(3)12500prevention of childhood diseases
Western Healthcare Alliance
715 Horizon 485Grand JunctionCO81506841159443501(c)(3)6800NURSING SCHOLARSHIPS
Grand Junction Community Homeless Shelter
2853 North AvenueGrand JunctionCO81501981621600501(c)(3)linen svcs27631CostLaundry Services
GRAND VALLEY CATHOLIC OUTREACH
245 S 1ST STGRAND JUNCTIONCO81501200064007501(c)(3)12500assist needy
HOLY FAMILY CATHOLIC SCHOOL
786 26 1/2 RDGRAND JUNCTIONCO81506860297730501(c)(3)15100operations support
counseling & education center
2708 patterson rdgrand junctionCO81506742232416501(c)(3)11000education for elderly
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants14TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
ambulance services167571
pharmacueticals51726591TRANSP PAYMENT
transportation for indigents3106037Medicines & Supplies

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCESS FOR MONITORING GRANTS AND AWARDSIdentifier
Return ReferenceSCHEDULE I, PART 1, LINE 2:ReturnReference
ExplanationThe hospital has no mechanisms in place to monitor the use of grant funds.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Michael McBride
0378860022528020449048904015093048583400
Cherie Gorby
02763610415450242357029805201042508687400145948
Forest Binder
0234354031882035189019563010683033167100
John Beeson
0320947043646039943019600015054043919000
Susan Hemley
541540000199710019600000760850000
John Lopez
520384000213927019600000753911000
Brian Witwer
543693000181364019450000744507000
James Narrod
60704003091097978019600000727709000
Sara Pereira
4657870415840200666019600000727637000
JERRY SPICER
014836502425502552101163304143021391700
ROBERT LADENBURGER
0607673014461503344730738450108490117145500

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, SCHEDULE J, PART I, LINE 3:SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A & B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION.
Form 990, Schedule J, Part I, Line 4b:OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2011 WERE: ROBERT W. LADENBURGER-$116,293 FOREST C. BINDER-$9,439 JOHN C. BEESON-$13,583 IN ADDITION, VESTED AMOUNTS ARE PAYABLE UPON END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN, NOT PREVIOUSLY TAXED, FOR THIS TYPE OF PAYMENT IN 2011 WERE: CHERI L. GORBY-$145,948 JERRY SPICER-$21,028
Form 990, Schedule J, Part IITHE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND THREE CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. MARY'S HOSPITAL AND MEDICAL CENTER (ST. MARY'S) IN GRAND JUNCTION, COLORADO. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. ROBERT W. LADENBURGER IS EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. IN DENVER, COLORADO. HE IS A FORMER PRESIDENT & CHIEF EXECUTIVE OFFICER OF ST. MARY'S. THE COMPENSATION REFLECTED IS THAT OF MR. LADENBURGER'S POSITION AS AN SCLHS EXECUTIVE AND NOT AS A ST. MARY'S EXECUTIVE. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.
FORM 990, SCHEDULE J, PART I, LINE 4A:THE AMOUNTS PAID TO LISTED INDIVIDUALS FOR SEVERANCE IN 2011 WERE: CHERI L GORBY-$94,735

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WESTERN COLORADO LUNG CENTER
DRCTR,>5% WEST CO LUNG5680951FEES PAID TO CO WEST ER PHYSICfalse
COLORADO WEST EMERGENCY PHYSICIANS
DRCTR,>5% WST CO EMERG PH332123MED DIR FEES FEES TO PHY GROUPfalse
ROCKY MTN ORTHO ASSOC
DRCTR,>5% WMN HC OF W CO295245FEES TO PHYS GRPfalse
ROCKY MTN ORTHO ASSOC
DRCTR,>5% WEST CO LUNG19920FEES PAID FOR IMAGE STORAGEfalse
ROCKY MTN ORTHO ASSOC
DRCTR,>5% WST CO EMERG PH16068FEES PAID FOR ANSWERING SVCSfalse
WESTERN COLORADO LUNG CENTER
DRCTR,>5% WMN HC OF W CO5836FEES PAID FOR ANSWERING SVCSfalse
WESTERN COLORADO LUNG CENTER
DRCTR,>5% WMN HC OF W CO5640FEES PAID FOR IMAGE STORAGEfalse
COLORADO WEST EMERGENCY PHYSICIANS
DRCTR,>5% WMN HC OF W CO1683fees paid for cateringfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DELEGATE CONTROL OVER MANAGEMENT DUTIESFORM 990, PART VI SECTION A LINE 3ALTHOUGH THESE SERVICES MAY NOT ALL RISE TO THE LEVEL OF MANAGEMENT CONTROL AS DEFINED IN THE 990 INSTRUCTIONs, WE HAVE IN THE SPIRIT OF FULL TRANSPARENCY PROVIDED THE FOLLOWING DISCLOSURE. AS A MEMBER OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, THIS PROVIDER MAY HAVE INDIVIDUAL AND/OR SYSTEM CONTRACT(S) THAT HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES IN SOME OR ALL OF THE FOLLOWING AREAS: DIETARY AND FOOD SERVICE HOUSEKEEPING SUPPLY CHAIN REVENUE CYCLE SECURITY
BOARD MEMBERPART VI LINE 6THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE CORPORATE MEMBER OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. MARY'S HOSPITAL IN GRAND JUNCTION, COLORADO. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. THROUGHOUT THE YEAR MICHAEL MCBRIDE WAS PRESIDENT & CHIEF EXECUTIVE OFFICER AND FOREST C. BINDER was VICE PRESIDENT & CHIEF FINANCIAL OFFICER FOR ST. MARY'S HOSPITAL AND MEDICAL CENTER (ST. MARY'S). IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.
MEMBERSFORM 990 PART VI LINES 7A & 7BAS THE SOLE CORPORATE MEMBER THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM HAS THE AUTHORITY TO APPOINT BOARD MEMBERS. CERTAIN DECISIONS MADE BY THE COMMUNITY BOARD ARE SUBJECT TO APPROVAL BY THE CORPORATE MEMBER. THESE DECISIONS ARE PRIMARILY THOSE REGARDING DISSOLUTION.
BOARD REVIEW OF FORM 990FORM 990 PART VI LINE 11bPRIOR TO SUBMISSION OF THE 990, THE 990 IS REVIEWED EXTERNALLY BY bruce e. bernstien & associates, p.c. AND THE SYSTEM OFFICE. THE BOARD MEMBERS ARE THEN PRESENTED WITH COPIES OF THE FORM 990. AT A SUBSEQUENT BOARD MEETING, MEMBERS ARE ENCOURAGED TO ASK QUESTIONS REGARDING CLARIFICATION OR EXPRESS OPINIONS ON THE INFORMATION PROVIDED.
CONFLICT OF INTERESTFORM 990 PART VI SECTION B LINE 12cSENIOR LEADERSHIP OF ST. MARY'S HOSPITAL AND THE SISTERS OF CHARITY REGULARLY MONITOR AND REVIEW THE CONFLICT OF INTEREST STATEMENTS. WHEN CONFLICTS ARISE, BOARD MEMBERS WITH CONFLICTS RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON ACTIONS.
JOINT VENTURESPART VI SECTION B LINE 16bJOINT VENTURE ARRANGEMENTS ARE REVIEWED WITH INTERNAL AND EXTERNAL LEGAL COUNSEL AT THE LOCAL AND SYSTEM OFFICE LEVELS PRIOR TO ENTERING INTO THE AGREEMENTS.
PUBLIC INSPECTION OF DOCUMENTSPART VI SECTION C LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATIVE OFFICES OF ST. MARY'S HOSPITAL.
RECONCILIATION OF NET ASSETSFORM 990, PART XI, LINE 5:EQUITY TRANSFERS (TO)/FROM SCLHS (7,273,387) EQUITY TRANSFER (TO)/FROM FOUNDATION (1,775,120) UBI INCOME FROM JOINT VENTURE-ELIMINATED IN CONSOLIDATION (1,072,469) IMAGE STORAGE ADDBACK FOR CONSOLIDATED JOINT VENTURE (41,533) WOODEN HORSE GIFT SHOP (72,073) ROUNDING (354) TOTAL: (10,234,936)
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VII, COLUMN BNAME & TITLE HOURS PER WEEK ORGANIZATION MICHAEL MCBRIDE 1 ST. MARY'S HOSPITAL FOUNDATION PRESIDENT.CEO CHERIE GORBY 1 SAN JUAN CANCER CENTER, LLC CHIEF OPERATING OFFICER CHERIE GORBY 2 PAVILION IMAGING, LLC CHIEF OPERATING OFFICER FOREST BINDER 1 ST. MARY'S HOSPITAL FOUNDATION CHIEF FINANCIAL OFFICER
THE PROCESS FOR DETERMINING COMPENSATION:FORM 990, PART VI, LINE 15A & 15B:SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS.
STATEMENT OF CONTROLLED FOREIGN CORPORATIONST. MARY'S HOSPITAL & MEDICAL CENTER, INC., PARTICIPATION CORPORATION EIN: 84-0425720 FOR THE TAX YEAR ENDED DECEMBER 31, 2011 THIS STATEMENT IS BEING FILED PURSUANT TO TREAS. REG. 1.6038-2(J)(3). ST. MARY'S HOSPITAL & MEDICAL CENTER, INC.'S FILING REQUIREMENT FOR FORM 5471 FOR THE CONTROLLED FOREIGN CORPORATIONS LISTED BELOW HAS BEEN SATISFIED BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (FEIN:23-7379161). SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM HAS INCLUDED THE FORM 5471 WITH ITS FORM 990 WHICH WAS FILED ELECTRONICALLY. LEAVEN INSURANCE COMPANY, LTD. 98-0370522 23 LIMETREE BAY AVE., PO BOX 1051 GEORGETOWN, GRAND CAYMAN KY1-1102 CJ RIVERVIEW MULTI-SERIES FUND SPC, LTD. 510 THORNALL STREET, SUITE 220 EDISON, NJ 08837 JP MORGAN HEDGE FUND SPC-ACCESS MAR09 SEGREGATED 98-0680591 %INT'L FUND SVCS LTD, 78 SIR JOHN ROGERSON'S QUAY DUBLIN, IRELAND 2 EI JP MORGAN HEDGE FUND SPC-ACCESS JUN09 SEGREGATED 98-0680582 %INT'L FUND SVCS LTD, 78 SIR JOHN ROGERSON'S QUAY DUBLIN, IRELAND 2 EI

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SISTERS OF CHARITY LEAVENWORTH HLTH SYST
9801 RENNER BLVD STE 100LENEXAKS66219237379161SUPPORT MMBRSKS501(C)(3)11B-TYPE IINAfalse
CARITAS CLINICS INC
818 NORTH 7TH STREETLEAVENWORTHKS66048481009910CLINIC SVCSKS501(C)(3)3SCLHStrue
MARIAN CLINIC INC
1001 SW GARFIELDTOPEKAKS66604481046905CLINIC SVCSKS501(C)(3)3SCLHStrue
MARILLAC CLINIC INC
2333 N 6TH STREETGRAND JUNCTIONCO81501841085822CLINIC SVCSCO501(C)(3)3SCLHStrue
PROVIDENCE MEDICAL CENTER
8929 PARALLEL PARKWAYKANSAS CITYKS66112480784446HEALTHCAREKS501(C)(3)3SCLHStrue
ST JOHN HOSPITAL INC
3500 SOUTH FOURTH STREETLEAVENWORTHKS66048480543768HEALTHCAREKS501(C)(3)3PMCtrue
BETHANY COMMUNITY PLAZA INC
15 NORTH 12TH STREETKANSAS CITYKS66102481207407HEALTHCAREKS501(C)(3)3PMCtrue
PROVIDENCEST JOHN FOUNDATION INC
8929 PARALLEL PARKWAYKANSAS CITYKS66112480925688SUPPORT 501C3KS501(C)(3)7PMCtrue
ST FRANCIS HEALTH CENTER INC
1700 SW 7TH STREETTOPEKAKS66606480547719HEALTHCAREKS501(C)(3)3SCLHStrue
ST FRANCIS HEALTH CENTER FOUNDATION
1700 SW 7TH STREETTOPEKAKS66606481092520SUPPORT 501C3KS501(C)(3)11A-TYPE ISFHCtrue
ST MARYS HOSPITAL FOUNDATION
2635 N 7TH STREETGRAND JUNCTIONCO81502237001007SUPPORT 501C3CO501(C)(3)11A-TYPE ISMHMCtrue
SAINT JOSEPH HOSPITAL FOUNDATION
1835 FRANKLIN STREETDENVERCO80218840735096SUPPORT 501C3CO501(C)(3)11A-TYPE ISJHtrue
HOLY ROSARY HEALTHCARE
2600 WILSONMILES CITYMT59301810231792HEALTHCAREMT501(C)(3)3SCLHStrue
HOLY ROSARY HEALTHCARE FOUNDATION INC
2600 WILSONMILES CITYMT59301202270238SUPPORT 501C3MT501(C)(3)11A-TYPE IHRHCtrue
ST VINCENT HEALTHCARE
1233 NORTH 30THBILLINGSMT59101810232124HEALTHCAREMT501(C)(3)3SCLHStrue
ST VINCENT HEALTHCARE FOUNDATION
PO BOX 35200BILLINGSMT59107810468034SUPPORT 501C3MT501(C)(3)7SVHCtrue
NORTHWEST RESEARCH & EDUCATION INSTITUTE
315 NORTH 25TH STREETBILLINGSMT59101201343024COMM HLTH RESMT501(C)(3)9SVHCtrue
ST JAMES HEALTHCARE
400 SOUTH CLARK STREETBUTTEMT59701810231785HEALTHCAREMT501(C)(3)3SCLHStrue
ST JAMES HEALTHCARE FOUNDATION
400 SOUTH CLARK STREETBUTTEMT59701651202190SUPPORT 501C3MT501(C)(3)11A-TYPE ISJHCtrue
SAINT JOHNS HEALTH CENTER
2121 SANTA MONICA BLVDSANTA MONICACA90404951684082HEALTHCARECA501(C)(3)3SCLHStrue
JOHN WAYNE CANCER INSTITUTE
2000 SANTA MONICA BLVDSANTA MONICACA90404954291515CANCER R&DCA501(C)(3)4SJHHCtrue
SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN
2121 SANTA MONICA BLVDSANTA MONICACA90404956100079SUPPORT 501C3CA501(C)(3)11A-TYPE ISJHHCtrue
EXEMPLA INC FKA LUTHERAN HOSPITAL
2420 W 26TH AVE SUITE 100DDENVERCO80211841103606HEALTHCARECO501(C)(3)3SCLHStrue
EXEMPLA LUTHERAN MEDICAL CENTER FNDTN
2480 W 26TH AVESUITE 360BDENVERCO80211208846152SUPPORT 501C3CO501(C)(3)7EXEMPLA INCtrue
EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN
200 EXEMPLA CIRCLELAFAYETTECO80026841649162SUPPORT 501C3CO501(C)(3)7EXEMPLA INCtrue
LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST
2480 W 26TH AVESUITE 360BDENVERCO80211742571584INSURANCECO501(C)(3)11A-TYPE IEXEMPLA INCtrue
SAINT JOSEPH HOSPITAL
1835 FRANKLIN STREETDENVERCO80218840417134HEALTHCARECO501(C)(3)3SCLHStrue
MOUNT ST VINCENT HOME INC
4159 LOWELL BLVDDENVERCO80211840405260RES CARECO501(C)(3)11A-TYPE ISCLHStrue

Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
PAVILION IMAGING LL
750 WELLINGTONGRAND JUNCTIONCO81501030516198RADIOLOGYCOST MARY'S HOSPRELATED63638295281236false$0true0.75000
GRAND VALLEY SURGICAL CANTER LLC
710 WELLINGTONGRAND JUNCTIONCO81501841505075OP SURGERYCOST MARY'S HOSPRELATED7466721358075false$291true0.50000
SAN JUAN CANCER CENTER LLC
600 SOUTH 5TH STREETMONTROSECO81401202856331OP CANCERCOST MARY'S HOSPRELATED3546801612056false$0true0.33330
BILLINGS MRI CENTER LLC
1041 NORTH 29TH STREETBILLINGSMT59101810450943MRI-PET SCANMTN/A
LUTHERAN CAMPUS ASC LLC
3455 LUTHRN PKW SUITE 150WHEATRIDGECO800336028020749532OP SURGERYCON/A
COLORADO SURGICAL VENTURES LLC
30 S WACKER DR SUITE 2302CHICAGOIL60605208038915OP SURGERYCON/A
COLORADO SURGICAL HOSPITAL LLC
30 S WACKER DR SUITE 2302CHICAGOIL60605208038977OP SURGERYCON/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
CARITAS INC AND SUBSIDIARIES
9801 RENNER BOULEVARD SUITE 100LENEXAKS66219480941069OTHER MEDICALKSC CORP
LEAVEN INSURANCE COMPANY LTD
980370522INSURANCE23 LIME TREE BAY AVE PO BOX 1051GEORGETOWNGRAND CAYMANCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (26 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GRAND VALLEY SURGICAL CENTER LLC
a554389cost
Pavilion Imaging LLC
a2444947cost
MARILLAC CLINIC
b983382COST
ST MARY'S HOSPITAL FOUNDATION
b1442473COST
ST MARY'S HOSPITAL FOUNDATION
c1608800COST
grand valley surgical center llc
f5063cost
PAVILION IMAGING LLC
i2444947FMV
grand valley surgical center llc
i554389fmv
GRAND VALLEY SURGICAL CENTER LLC
k168637FMV
PAVILION IMAGING LLC
k2053505FMV
MARILLAC CLINIC
k583382COST
SAN JUAN CANCER CENTER LLC
k72000FMV
ST MARY'S HOSPITAL FOUNDATION
l1608800COST
st mary's hospital foundation
m83206cost
marillac clinic
m477990cost
GRAND VALLEY SURGICAL CENTER LLC
n2589257COST
PAVILION IMAGING LLC
n2887952COST
san juan cancer center llc
n366524COST
ST MARY'S HOSPITAL FOUNDATION
n1933052COST
ST MARY'S HOSPITAL FOUNDATION
p364686COST
pavillion imaging llc
p2098459cost
san juan cancer center llc
p319266cost
marillac clinic
p21113cost
GRAND VALLEY SURGICAL CENTER LLC
r800550CASH
PAVILION IMAGING LLC
r6787500CASH
SAN JUAN CANCER CENTER LLC
r364548CASH