Bon Secours Maria Manor Nursing Care Center: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Bon Secours Maria Manor Nursing Care Center (EIN 65-0061820)
Tax period
2010-09-01 to 2011-08-31
Filed
2012-07-10
IRS object ID
201221929349300242
Schema version
2010v3.4
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)
Timestamp2012-07-10T14:37:23-05:00Timestamp
Tax Period End Date2011-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11750 TYSONS BLVDAddressLine1
CityMCLEANCity
StateVAState
ZIP Code221024219ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN650061820EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Maria Manor Nursing Care CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone7275761025Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110300 Fourth Street NAddressLine1
CitySt PetersburgCity
StateFLState
ZIP Code337163814ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKaren ReichName
TitleCEOTitle
Phone7275761025Phone
Date Signed2012-07-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone7032511000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKaren ReichNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110300 Fourth Street NAddressLine1
CitySt PetersburgCity
StateFLState
ZIP Code337163814ZIPCode
FieldValueIRS element (for citing)
Gross Receipts22219661GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.bonsecoursstpete.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionNursing care to the elderlyActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees536TotalNbrEmployees
Total Nbr Volunteers30TotalNbrVolunteers
Total Gross UBI107875TotalGrossUBI
Net Unrelated Business Txbl Income-60450NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year154474ContributionsGrantsPriorYear
Contributions Grants Current Year326637ContributionsGrantsCurrentYear
Program Service Revenue Prior Year21421656ProgramServiceRevenuePriorYear
Program Service Revenue CY21700518ProgramServiceRevenueCY
Investment Income Prior Year-1879InvestmentIncomePriorYear
Investment Income Current Year-3295InvestmentIncomeCurrentYear
Other Revenue Prior Year588897OtherRevenuePriorYear
Other Revenue Current Year175039OtherRevenueCurrentYear
Total Revenue Prior Year22163148TotalRevenuePriorYear
Total Revenue Current Year22198899TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY83589GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12963873SalariesEtcPriorYear
Salaries Etc Current Year12462803SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9258325OtherExpensePriorYear
Other Expenses Current Year8990795OtherExpensesCurrentYear
Total Expenses Prior Year22222198TotalExpensesPriorYear
Total Expenses Current Year21537187TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-59050RevenuesLessExpensesPriorYear
Revenues Less Expenses CY661712RevenuesLessExpensesCY
Total Assets BOY8608335TotalAssetsBOY
Total Assets EOY9146237TotalAssetsEOY
Total Liabilities BOY13349336TotalLiabilitiesBOY
Total Liabilities EOY13741956TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-4741001NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-4595719NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense19479515Expense
Grants83589Grants
Revenue21700518Revenue
DescriptionBon Secours Maria Manor Nursing Care Center, Inc. is a freestanding, 274-resident nursing care center offering skilled and long-term nursing care for the Tampa Bay area as well as short-term rehabilitiation unit. The Center for Rehabilitation at Maria Manor is designated for those with short-term rehabilitation needs. This 32-bed, dedicated short-term unit mirrors the rehabilitation programs offered at many hospital and rehabilitation centers. For those with orthopedic injuries or surgeries, the CORE, or Center for Orthopedic Excellence, has been designed specifically for those rehabilitating from a fractured hip or hip or knee replacement surgery. Services at Maria Manor include, dental and podiatry services, physcial occupational and speech therapy, physician visits on site, interdisciplinary team approach to care, specialized end of life care programs, activities programming for each unit, mass or communion services offered daily, and pastoral care.Description
Total Program Service Expense19479515TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
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Report Other Assets1ReportOtherAssets
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Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
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Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
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Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109637NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees536NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Karen ReichBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7275761025TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110300 4th Street NorthAddressLine1
CitySt PetersburgCity
StateFLState
ZIP Code33716ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Karen Bigby MD
Board Member4.00X000
Teresa Bradley MD
Board Member (Jan-Aug)4.00X000
Regina Clifton
Board Member4.00X000
William R DiMarino
Board Member (Jan-Aug)4.00X000
Sr Frances McCabe
Board Member4.00X000
Terence McCarthy
Board Member4.00X000
Emily E Morgan
Board Member (Jan-Aug)4.00X000
Donna Potter
Board Member (Sept-Dec)4.00X000
Janice M Russell
Board Member4.00X000
Fr John Tapp
Board Member (Jan-Aug)4.00X000
John R Thomas
Board Member4.00X000
Lawrence Skip Hubbard
Board Member50.00X0474728118294
James Higgins
CEO BSSPHS (Sept-Mar)50.00X039147438676X
Brother Arthur Caliman
President50.00X000X
Joseph Mark Waterbury
Chairman6.00X000X
Harry B Jones
Secretary (Sept-Dec)6.00X000X
Robert Sherman
Secretary (Jan-Aug)6.00X000X
Karen Reich
EVP(Sept-Mar)/CEO(Mar-Aug)50.00X021843442262X
Kity Khundkar
CFO - BSSPHS50.00030278417400X
Vicki Ackerman
Administrator50.0017146108623X
Jennifer Craddock
Afternoon Supervisor50.0010037207266X
FieldValueIRS element (for citing)
Total Reportable Comp From Org271833TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1387420TotalReportableCompFrmRltdOrgs
Total Other Compensation232521TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Rehabcare Group
PO Box 502096St LouisMO631502096Rehab therapy1046911
Nurse Staffing
PO Box 4729Winter ParkFL327934729Contract labor233117
Arbor Temporary
PO Box 354526Palm CoastFL321354526Contract labor207901
Extended Care Respiratory Services
8452 118th Ave BLargoFL33773Respiratory therapy107061
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events2779FundraisingEvents
Related Organizations130000RelatedOrganizations
All Other Contributions193858AllOtherContributions
Total Contributions326637TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code621110BusinessCode
Total Revenue Column21700518TotalRevenueColumn
Related Or Exempt Function Income21700518RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue21700518TotalProgramServiceRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

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Other3295Other

Gain Or Loss GainOrLoss

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Other-3295Other

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Total Revenue Column-3295TotalRevenueColumn
Exclusion-$3,295ExclusionAmount
FieldValueIRS element (for citing)
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Cntrbtns Rprtd Fundraising Events2779CntrbtnsRprtdFundraisingEvents
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Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column2779TotalRevenueColumn
Exclusion$2,779ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

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Management Fee900099107875107875
Beauty & Barber90009941004$41,004
Gift Shop90009911304$11,304

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column12077TotalRevenueColumn
Exclusion$12,077ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue172260TotalOtherRevenue

Total Revenue TotalRevenue

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Total Revenue Column22198899TotalRevenueColumn
Related Or Exempt Function Income21700518RelatedOrExemptFunctionIncome
Unrelated Business Revenue107875UnrelatedBusinessRevenue
Exclusion$63,869ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

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Total83589Total
Program Services83589ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

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Total169467Total
Program Services152520ProgramServices
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Other Salaries And Wages OtherSalariesAndWages

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Pension Plan Contributions PensionPlanContributions

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Management And General161275ManagementAndGeneral

Payroll Taxes PayrollTaxes

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Management And General81281ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

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Fees For Services Accounting FeesForServicesAccounting

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Management And General2507ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

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Fees For Services Other FeesForServicesOther

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Advertising Advertising

FieldValueIRS element (for citing)
Total16104Total
Program Services14494ProgramServices
Management And General1610ManagementAndGeneral

Office Expenses OfficeExpenses

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Total338703Total
Program Services304833ProgramServices
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Information Technology InformationTechnology

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Total57856Total
Program Services52070ProgramServices
Management And General5786ManagementAndGeneral

Occupancy Occupancy

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Management And General55952ManagementAndGeneral

Travel Travel

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Total53583Total
Program Services48225ProgramServices
Management And General5358ManagementAndGeneral

Conferences Meetings ConferencesMeetings

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Management And General47ManagementAndGeneral

Interest Interest

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Total543613Total
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Depreciation Depletion DepreciationDepletion

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Program Services486651ProgramServices
Management And General54072ManagementAndGeneral

Insurance Insurance

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Total463647Total
Program Services417282ProgramServices
Management And General46365ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

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Medical Suppies16981461528331169815
BSHSI Mgmt Allocation52368847131952369
Quality Assessment Fee37101933391737102
Bad Debt333285333285

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Total252210Total
Program Services226988ProgramServices
Management And General25222ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21537187Total
Program Services19479515ProgramServices
Management And General2057672ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

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BOY-85715BOY
EOY823743EOY

Accounts Receivable AccountsReceivable

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BOY2625815BOY
EOY1801465EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

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BOY82710BOY
EOY88574EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY26283BOY
EOY27425EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17788902LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12371366LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5289052BOY
EOY5417536EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY670190BOY
EOY987494EOY

Total Assets TotalAssets

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BOY8608335BOY
EOY9146237EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

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BOY904446BOY
EOY2008086EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
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Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12444890BOY
EOY11665483EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13349336BOY
EOY13741956EOY
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Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

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BOY-4754300BOY
EOY-4830238EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

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BOY0BOY
EOY234519EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY13299BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

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BOY-4741001BOY
EOY-4595719EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8608335BOY
EOY9146237EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses661712ReconcilationRevenueExpenses
Reconcilation Other Changes-516431ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21514CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3683CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2269CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year154474CurrentTaxYearMinus1Year
Current Tax Year326637CurrentTaxYear
Total508577Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19824086CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21349437CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22334259CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21421656CurrentTaxYearMinus1Year
Current Tax Year21700518CurrentTaxYear
Total106629956Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19845600CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21353120CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22336528CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21576130CurrentTaxYearMinus1Year
Current Tax Year22027155CurrentTaxYear
Total107138533Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
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Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37898CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18305CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1765CurrentTaxYearMinus2Years
Total57968Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year107875CurrentTaxYear
Total107875Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years18305CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1765CurrentTaxYearMinus2Years
Current Tax Year107875CurrentTaxYear
Total165843Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years273421CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years310005CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years375174CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year588897CurrentTaxYearMinus1Year
Current Tax Year84631CurrentTaxYear
Total1632128Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years20156919CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21681430CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22713467CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22165027CurrentTaxYearMinus1Year
Current Tax Year22219661CurrentTaxYear
Total108936504Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98350PublicSupportPercentage509
Prior Year Support Percentage0.98170PriorYearSupportPercentage
Investment Income Percentage0.00150InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00150PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSchedule A, Part IV, Supplemental Information: Part III, Section B, Line 12: Beauty&Barber, Gift Shop and Other.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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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)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$881OtherActivitiesAmount
Total Lobbying Expenditures IIB881TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i:ReturnReference
ExplanationThe filing organization paid dues to the Florida Association of Homes and Services for the Aging, Inc. (FAHSA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities was as follows: 5.3% ($881).Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Beginning Balance0BeginningBalance
Additions During Year68387AdditionsDuringYear
Ending Balance68387EndingBalance
Included On FS1IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1828977OtherCostOrOtherBasis
Book Value1828977BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2464997OtherCostOrOtherBasis
Depreciation1151300Depreciation
Book Value1313697BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4171256OtherCostOrOtherBasis
Depreciation3857281Depreciation
Book Value313975BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9323672OtherCostOrOtherBasis
Depreciation7362785Depreciation
Book Value1960887BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5417536TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Due from short term affiliates721926
Assets Held in Trust68387
Due from BSHSI197181
FieldValueIRS element (for citing)
Total Book Value Other Assets987494TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Due to BSHSI$10,716,524
Long term Pension Liability$150,000
FIN47- Asbestos$430,609
Third party liability$368,350
FieldValueIRS element (for citing)
Total Of Amounts11665483TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Bon Secours Maria Manor Nursing Care Center holds, safeguards, manages and accounts for the personal funds of residents who have authorized the facility in writing to manage any personal funds. Fund requests up to $25 are available for immediate distribution to residents. Written requests for greater than $25 are processed through the Accounts Payable Clerk. All excess custodial funds are held in interest bearing accounts separate from that of the organization.
Part X:Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48. FIN 48 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of FIN 48 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $89,500 and $98,300 of net operating loss carryforwards as of August 31, 2011 and 2010, respectively, which expire in varying periods through 2031 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2011 and 2010. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.Description of Uncertain Tax Positions Under FIN 48:

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Chihuly EventNameOfEvent1
Gross Receipts Event123025GrossReceiptsEvent1
Charitable Contributions Event12779CharitableContributionsEvent1
Gross Revenue Event120246GrossRevenueEvent1
Rent Facility Costs Event14196RentFacilityCostsEvent1
Food And Beverage Event18331FoodAndBeverageEvent1
Entertainment Event12110EntertainmentEvent1
Other Direct Expenses Event12830OtherDirectExpensesEvent1
Gross Receipts Total23025GrossReceiptsTotal
Charitable Contributions Total2779CharitableContributionsTotal
Gross Revenue Total Events20246GrossRevenueTotalEvents
Rent Facility Costs Total Events4196RentFacilityCostsTotalEvents
Food And Beverage Total Events8331FoodAndBeverageTotalEvents
Entertainment Total Events2110EntertainmentTotalEvents
Other Direct Expenses Total Events2830OtherDirectExpensesTotalEvents
Direct Expense Summary Events17467DirectExpenseSummaryEvents
Net Income Summary2779NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Friends of the Sunshine Center
330 5th St NStPetersburgFL33701161780444501(c)(3)100010000FMVExercise EquipmentSpecialized machine for seniors
DayStar Life Center Inc
226 6th StStPetersburgFL33713650523539501(c)(3)20000Funds for replacement Id's for homeless
St Petersburg Free Clinic Inc
863 3rd Ave NStPetersburgFL33701237208280501(c)(3)50000Equipment and materials to supply new dental clinic
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: The organization actively partners with all community groups which receive funding. Donees/grantees submit written reports regarding their expenditure of such funds.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 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
Lawrence Skip Hubbard
0365557010288006291096117022177059302200
James Higgins
0318905045156027413027333011343043015000
Karen Reich
0168833026614022987012420029842026069600
Kity Khundkar
025220902848402209101003016397032018400
Vicki Ackerman
135544035654026300086230180084000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 4bBon Secours Health System, Inc. and Frances Schervier Home and Hospital participate in a BSHSI sponsored executive retirement program that allows for deposits into additional retirements plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits are made into this plan.
Part IIIPart I, Line 3: Bon Secours Health System, Inc., a related organization of Bon Secours St. Petersburg Home Care Services, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation CommitteeSupplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2The Chairman of the Board, Mark Waterbury and another Board Member, Terence McCarthy, have a business relationship.
Form 990, Part VI, Section A, line 4The articles and bylaws were amended and restated in their entirety (effective 2/14/2011) to reflect current operational realities and governance best practices, and to reflect the transfer of sponsorship of the Bon Secours Health System from the Sisters of Bon Secours to Bon Secours Ministries.
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Maria Manor Nursing Care Center.
Form 990, Part VI, Section A, line 7aThe governing body of Bon Secours Maria Manor Nursing Care Center is appointed by its member Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Maria Manor Nursing Care Center, Inc. are reserved to its Members.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date of July 16, 2012. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed July 16, 2012.
The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).Form 990, Part VI, Section B, line 12c
The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS's rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section B, Line 15b - Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the positions of other officers or key employees of the organization were compared to similar position market data in comparably situated organizations taking into consideration geographic location and organization size where appropriate. During the review and approval of the compensation, documentation of the decision was recorded in human resources.Form 990, Part VI, Section B, line 15
Bon Secours Maria Manor Nursing Care Center provides any documents open to public inspection upon request.Form 990, Part VI, Section C, line 19
Hours worked are not tracked on an entity by entity basis. All officers' and directors' hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Voluntary Board Members are not compensated for their time. James Higgin's compensation is paid by Bon Secours Health System, Inc., a related organization. The calendar year 2010 compensation reported on Form 990, Part VII was reflective of his role as the CEO of both Bon Secours New York Health System, Inc. and Bon Secours St. Petersburg Health System. This role included direct management, monitoring and oversight of all related entities within both systems. As of March 2011, in FY11, Karen Reich (as described below), assumed the role of CEO at Bon Secours St. Petersburg Health System. Karen Reich's compensation is paid by Bon Secours Health System, Inc., a related organization. The calendar year 2010 compensation reported on Form 990, Part VII was reflective of her role as EVP and Administrator of Bon Secours Maria Manor Nursing Care Center and Bon Secours St. Petersburg Home Care Services, respectively. During FY11, starting in March of 2011, she transitioned into the role of CEO for Bon Secours St. Petersburg Health System. This role includes direct management, monitoring and oversight of all related entities within the system. Kity Khundkar's compensation is paid by Frances Schervier Home and Hospital, a related organization of Bon Secours Health System, Inc. During FYII, Ms. Khundkar continued to serve as the CFO of both Bon Secours New York Health System, Inc. and Bon Secours St. Petersburg Health System. The compensation she received was for her role as the CFO of both local systems which included direct financial management, monitoring and oversight of all related entities within the systems. Lawrence "Skip" Hubbard's compensation is from Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as a SVP and the Chief Information Officer of Bon Secours Health System, Inc. Brother Art Caliman does not receive payroll distributions as he has taken a vow of poverty.Form 990, Part VII:
Changes in Net Assets or Fund Balances:Transfers to Affiliates -503,132. Other changes in net assets 43,208. Amounts Reported as Rev in PY -57,000. Other misc 493. Total to Form 990, Part XI, Line 5: -516,431.Form 990, Part XI, line 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org - Management ServicesMD501(c)(3)11bBon Secours Inc0
Bon Secours St Petersburg Home Care Services
10300 Fourth Street NorthSt PetersburgFL33716134334363Home Care ServicesFL501(c)(3)9Bon Secours Maria Manor Nursing Care Center1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Place at St PetersburgBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110300 4th Street NorthAddressLine1
CitySt PetersburgCity
StateFLState
ZIP Code33716ZIPCode
FieldValueIRS element (for citing)
EIN593589729EIN
Primary ActivityAssisted Living/Senior CarePrimaryActivity
Legal Domicile StateFLLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours - Florida Integrated Services IncBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeType
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Bon Secours - Florida Integrated Services IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110300 4th Street NorthAddressLine1
CitySt PetersburgCity
StateFLState
ZIP Code33716ZIPCode
FieldValueIRS element (for citing)
EIN650779777EIN
Primary ActivityHolding Company/Assisted LivingPrimaryActivity
Legal Domicile StateFLLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Maria Manor Nursing Care CenterBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership0.80000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Bon Secours St Petersburg Home Health CareBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved1252098AmountInvolved
Method Of Amt DeterminationActual CostMethodOfAmtDetermination

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